endocrine - session 16/18 Flashcards
how long is NPH active for
intermediate acting
how long is Lente active for
intermediate acting
how long is PZI active for
long
how long is glargine and detamir active for
long acting
what are the preferred insulins in dogs
NPH & Lente
what are the preferred insulin in cats?
PZI & Glargine
Which drug inhibits the formation of functional T3 and T4 and what disease is it used to treat?
Methimazole
Hyperthyroidism
Describe the species predilections for DM
Dog, type 1, insulin dependent
cat, type 2, remission may occur
Which drug is a teratogen and has been associated with hypersensitivity reactions that can lead to dermatitis, vasculitis, and blood-cell dyscrasias?
Methimazole
What is an adverse effect of methimazole?
Teratogen
Which of the following insulin preparations can be administered IV to affect a rapid response under emergency conditions (e.g., a DKA patient)?
Regular crystalline insulin
You are caring for a cat that has been taking another drug for a prior condition unrelated to its new diagnosis today of diabetes mellitus. Which of the following concurrent drugs would you be most concerned about in terms of complicating treatment of his new diagnosis?
glucocorticoids because the can increase insulin resistance and cause hyperglycemia
Which drug COMMONLY causes adrenocortical cell death?
Mitotane
Mitotane MOA
cytotoxic, causes cell death
What frequency of dosing has been shown to BEST control clinical signs in dogs with hyperadrenocorticism?
every 12 hours
What drugs can be used to treat hyperadrenocorticism?
Mitotane and trilostane
When do you tell the owner to stop administering mitotane during the induction phase?
when they start showing signs of dec appetite
What medication should be dispensed to patients taking mitotane in case they develop severe adverse effects?
prednisone can counter the adverse effects caused by rapidly declining cortisol levels
Which of the following antifungal drugs inhibits glucocorticoid and androgen synthesis and can be used to treat hyperadrenocorticism?
ketoconazole
What medication is most commonly used to treat hyperadrenocorticism in cats?
trilostane
What is the treatment of choice for large pituitary tumors?
radiation therapy
Trilostane or mitotane may help reduce systemic signs from hyperadrenocorticism but will not help the neurologic signs caused from the tumor
If a dog with a functional adrenal tumor is not a surgical candidate, what is the treatment of choice?
trilostane
What is the preffered treatment for a dog with a functional adrenal tumor?
Surgery
What is the best way to monitor adrenocortical reserve in a patient being treated for hyperadrenocorticism?
ACTH stim
A 14YO MN mixed breed dog has been PU/PD, polyphagic, and panting excessively. Blood work showed a severely elevated ALP and a mildly elevated ALT. A urinalysis showed a USG of 1.004 and was otherwise unremarkable. A low dose dexamethasone suppression test was performed and is consistent with pituitary dependent hyperadrenocorticism. His blood pressure was 140mmHg. What is recommended at this time?
medical therapy should be started to control clinical signs and better QOL
A 14YO CAT has been PU/PD, polyphagic, and panting excessively. Blood work showed a severely elevated ALP and a mildly elevated ALT. A urinalysis showed a USG of 1.004 and was otherwise unremarkable. A low dose dexamethasone suppression test was performed and is consistent with pituitary dependent hyperadrenocorticism. His blood pressure was 140mmHg. What is the recommendation at this time?
Medical therapy should be started immediately in cats.
If the client were concerned about having to give medication daily, what would be the best medication to use?
Mitotane - twice a week after induction
Trilostane is SID or BID
The client is extremely concerned about adverse effects when treating hyperadrenocorticism. What medication do you recommend starting?
Trilostane has less effects then mitotane and is more effective then ketoconazole
When would ketoconazole be recommended to treat hyperadrenocorticism?
its not
After starting therapy for cushings, when do you recommend rechecking the patient?
patient should be rechecked 10-14 days after starting therapy and an ACTHST, chemistry panel and electrolytes should be performed at this time. If a patient is ever showing signs of hypoadrenocorticism, the trilostane should be stopped and an ACTHST and chemistry with electrolytes should be evaluated
recheck if signs of GI upset or lethargy
What is the treatment of choice for functional adrenal dependent hyperadrenocorticsim in dogs?
Surgery
Which of the following describes the best nutritional recommendation for diabetic cats?
Feed a diet that is high in protein and restricted in carbohydrates, ad lib or multiple small meals each day.
What are the best nutritional recommendation for diabetic dogs?
The diet should optimize body condition and minimize postprandial hyperglycemia and this may vary based on the individual dog.
When might a spot glucose reading be helpful?
To ensure a patient isnt hypoglycemic
What are commonly used insulins in dogs?
Lente and NPH
