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JVIM 2018-2023 > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

How is baseline GH associated with hypothyroidism compared to NTI?

A

Increased in hypothyroidism compared to NTI

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2
Q

What does GH do when TRH is administered to a dog with hypothyroidism and a dog with NTI

A

increases in hypothyroid dogs and not NTI dogs

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3
Q

How does TSH change after administration of TRH in dogs with hypothyroidism and dogs with NTI dogs

A

TSH does not increase after TRH in hypothyroid dogs
TSH increases in NTI dogs

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4
Q

what is the difference in efficacy between enteric coated micropellets and non coated pancreatic enzyme supplementation?

A

no difference in formulations

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5
Q

How is IGF-1 different 2-4 weeks after starting inuslin?

A

higher after starting insulin (300 vs 670)

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6
Q

what can be used to predict diabetic remission in cats?

A

Increase in IGF-1
increased TC and IGFBP-3 in cats who went into remission

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7
Q

How are retinol, 25OHD, and alpha-tocopherol impacted by EPI? How are levels impacted by enzyme supplementation?

A

retinol and alpha-tocopherol lower in dogs with EPI
If weight loss, lower 25ODH
Remain low in the face of enzyme supplementation

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8
Q

How does adjusting i-131 dose based on thyroid:salivary gland size ratio impact outcome compared to fixed dosing?

A

no difference in outcome
variable dose: 61% euthyroid, 30% hypothyroid, 9% persistently hyperthyroid
fixed dose: 58%, 26%, and 16%

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9
Q

What is the most common form of spontaneous hypothyroidism in cats?

A

Goitrous hypothyroidism associated with thyroid hyperplasia

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10
Q
A
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11
Q

how does treating hypothyroidism impact azotemia in cats with spontanous hypothyroidism?

A

High serum creatinine normalized

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12
Q

Prognosis of cats hospitalized with acute pancreatitis (aka how many survived to discharge)

A

77.7% survived to discharge

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13
Q

Negative prognostic indicators for pancreatitis

A

longer to evaluation, pleural effusion, lethargy, hypoglycemia, ionized hypocalcemia, azotemia, parenteral nutrition and persistent anorexia in hospital

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14
Q

How many cats hospitalized with acute pancreatitis had ultrasonographic changes?

A

85%, majority (81.3%) pancreatomegaly

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15
Q

Difference between low dose and high dose cosyntropin?

A

no difference between 1 ug/kg compared to 5 ug/kg

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16
Q

How does TSH administration impact dose of radioactive iodine?

A

does not lower i-131 dose, even at high TSH doses

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17
Q

Sensitivity of post stimulation cortisol of 24.8 to diagnose HAC (all cause)? Does basal cortisol change test interpretation?

A

All cause HAC: Sn 86% and sp 94%
Basal cortisol is redundant

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18
Q

Sensitivity of post stimulation cortisol of 24.8 to diagnose PDH?

A

100% sp, 81% sn

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19
Q

How do serotonin and prolactin concentrations differ at 6 weeks and 6 months post thyroid hormone supplementation?

A

no difference in either hormone

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20
Q

How does C-BARQ change with levothyroxine supplementation in hypothyroid dogs?

A

Increased in C-BARQ scores at 6 weeks, no change at 6 months

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21
Q

How many dogs (all dogs and dex-resistant) have concurrent pituitary and adrenal lesions?

A

5% pituitary and adrenal lesions in all dogs
10% pituitary and adrenal lesions in dex-resistant dogs

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22
Q

What is heterogenous contrast enhancement on CT of the pancreas associated with?

A

longer hosplization, more likely to have PVT, higher SpecCPL

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23
Q

what are risk factors for short term death in dogs with pancreatitis?

A

Presence of SIRS, coagulation disorders, increased creatinine, ionized hypocalcemia

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24
Q

After bilateral thyroidectomy, how many cats were hypothyroid and how many cats had recurrent hypothyroidism?

A

49% hypothyroid
22% persistent hyperthyroidism

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25
Q

Of all euthyroid and hypothyroid cats post bilateral thyroidectomy, how many remained hypothyroid, euthyroid, and developed recurrent hyperthyroidism?

A

17% remained hypothyroid
83% euthyroid
44% developed recurrent hyperthyroidism

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26
Q

In cats with hyperthyroidism, what is higher, SDMA or creatinine?

A

SDMA increases more relative to creatinine

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27
Q

In cats with hyperthyroidism, how does SDMA and creatinine correlate with GFR?

A

GFR and SDMA have low correlation and is not significant, creatinine has moderate correlation with GFR and is significant

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28
Q

In a cat with elevated SDMA prior to i-131 treatment, would you expect this cat to become azotemic following treatment?

A

no, all cats with elevated SDMA prior to i-131 were not azotemia following treatment

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29
Q

What ultrasonographic abnormalities of the gastric wall may be associated with pancreatitis?

A

Loss of wall layering
Intermediate hyperechoic echogenicity of thick submucosal layer
Focal thickening adjacent to diseased pancreas

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30
Q

What starting dose of DOCP is sufficient?

A

1.5 mg/kg, 28-30 day interval

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31
Q

how is age associated with DOCP dose?

A

younger dogs need higher DOCP dosing, none needed 2.2 mg/kg

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32
Q

What is the median dose of DOCP needed?

A

1.1 mg/kg

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33
Q

How does insulin lispro differ when compared to regular insulin when managing cats with DKA?

A

median time to glucose <250 is faster with lispro compared to regular insulin
0.09 u/kg/hr lispro safe and effective

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34
Q

OR of having CKD in diabetic cats?

A

4.47

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35
Q

What breeds of dogs in the USA are at risk for diabetes?

A

Samoyed
Miniature schnauzer
Miniature poodle
Pug
Toy poodle
Australian terrier breed

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36
Q

What is the heritability of DM in american eskimo dogs? What is the most of inheritance?

A

0.62 (high heritability, low precision)
Polygenic, no evidence of single gene/large effect

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37
Q

What ECG changes are expect in a dog with hypothyroidism? How does treating dogs with hypothyroidism affect these changes?

A

Hypothyroid: Bradycardia, decreased P and R wave amplitude
Treatment: improved HR, p wave amplitude, fractional shortening, decreased LV end diastolic volume, normalized systolic diameter

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38
Q

What parameters can be used to predict ionized calcium from total calcium? Sensitivity and specificity of model for hypercalcemia?

A

tCa, chloride, albumin, cholesterol, creatinine, BUN, body condition score, GGT, age, and potassium
Sn 30.4% Sp 99.8%

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39
Q

How are melatonin, serotonin, and dopamine different in dogs with SARDS vs PDH?

A

no difference

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40
Q

What urine marker is increased in dogs with PDH compared to SARDS

A

Urine MT6s: creatinine ratio
[Urine 6-sulfatoxymelatonin (MT6s) concentrations represent accumulated amounts of systemic melatonin over several hours and are therefore less affected by fluctuations in circulating concentrations]

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41
Q

How does trilostane impact QoL based on survery?

A

Dogs had better QoL, questions related to owner impact more important than patient demeanor

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42
Q

In non-hyperphosphatemic dogs, what tCa concentration can be used to predict hypercalcemia and what is the PPV, and sn?

A

12.0 cut off
PPV 93%
Sn 52%

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43
Q

Prevalence of ionized hypercalcemia is more in hyperphosphatemic or non-hyperphosphatemic?

A

non-hyperphosphatemic
also had lower prevalence of ionized-hypocalcemia

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44
Q

What factors affect CGM accuracy in dogs with DKA?

A

NO effect of metabolic variables, BSC, and time wearing sensor
analytic accuracy not achieved, however clinical accuracy 100% and 99.6%

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45
Q

How does idexx TT4 compared with immulite TT4

A

Dogs: lower levels good agreement, higher levels impact idexx sampling
Immulite underestimates TT4
Cat: no effect on clinical decision until TT4 over 10

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46
Q

How do diabetic cat erythrocytes compare to control cats?

A

higher membrane carbonyls
lower cytoplasmic TBAR and thiols. No change in treatment and remission

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47
Q

what is the significance of diabetic erythrocyte change in cats?

A

DM is associated with increased protein oxidation and reduced antioxidant defences

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48
Q

What is the complication rate of adrenal FNAs? what were they?

A

8% (4/50). 3 hemorrhage, 1 death from ARDS
No hypertensive crises

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49
Q

What is the strength of correlation between specCPL and AUS findings of pancreatitis?

A

AUS is weakly correlated with specCPL

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50
Q

What pancreatic ultrasonographic changes are correlated with clinical diagnosis of pancreatitis?

A

pancreatic size, echogenicity, mesenteric echogenicity (moderate correlation)

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51
Q

Sensitivity and specificity of ultrasound for pancreatitis when one pancreatic change required vs three changes?

A

One change: sn 89%, sp 43%
Three changes: sn 43%, sp 92%

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52
Q

How many dogs with clinical pancreatitis had hypertriglycemia and hypercholesterolemia?
What is the OR for each for pancreatitis compared to normal dogs?

A

18% hypertriglyceridemia (OR 2.6)
24% hypercholesterolemia (OR 16)

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53
Q

How do lipoprotein profiles differ in dogs with pancreatitis compared to healthy dogs?

A

Pancreatitis: higher LDL, lower TG rich lipoproteins and HDL compared to healthy

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54
Q

When compared to histopathology, what is the sn of specCPL in dogs with moderate or severe AP?

A

90%

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55
Q

What percent of dogs with pancreatic neoplasia have elevated specCPL?

A

83%

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56
Q

MST of dogs with insulinoma post op? How does this vary with stage?

A

MST 372 days,
Stage I: 652 days
Stage II or III: 320 days

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57
Q

How many dogs have post-operative hyperglycemia after surgical management of insulinoma?

A

33% post-op hyperglycemia
19% total population persistent DM
No risk factors identified

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58
Q

How does pancreatitis influence ADMA (asymmetric dimethylarginine)?

A

Higher in acute pancreatitis and associated with mortality

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59
Q

What pancreatic lipase diagnostic has the highest repeatability and which one the lowest?

A

Spec cPL highest
Vcheck lower repeatability

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60
Q

How does in house pancreatic lipase different from Spec cPL assay?

A

In house assays are lower

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61
Q

Is there a difference in subclinical bacteriuria in cats with hyperthyroidism vs euthyroidism?

A

no difference (4.3% vs 4.6%)
female increased risk (OR 6.9)

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62
Q

what is the prevalence of hypoadrenocorticism in dogs with chronic GI disease per JVIM 2020 (Hauck)

A

4%

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63
Q

Is a fPL more likely to be falsely positive or falsely negative?

A

Positive indicates pancreatitis is probable
Negative test cannot rule out pancreatitis

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64
Q

How long does it take for trilostane to suppress cortisol and how long does this last?

A

1 hour, lasts 8 hours

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65
Q

what markers are not helpful to determine dose of trilostane?

A

USG, UCCR, and ACTHst

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66
Q

What percent of dogs with pancreatitis associated EHBO survived? what proportion of survivors survived with medical management alone?

A

79% survived, 94% survived with medical management alone
no difference in outcome for median bile duct dilation

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67
Q

In dogs with acute pancreatitis, how many days to see peak of hyperbilirubinemia, how many days to see decline of hyperbilirubinemia?

A

8 days peak
15 days to see decline

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68
Q

Mortality rate of pancreatitis per JVIM 2020 (Kuzi)

A

19%

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69
Q

Inflammatory markers of pancreatitis

A

CRP, IL-6, TNF-alpha increased
Antithrombin lower

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70
Q

What treatment can be considered for dogs with MPS-I?

A

Pentosan polyphosphate

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71
Q

What mutation is seen in Golden Retrievers with MPS-I

A

Homozygous deletion of 287 bp resulting in full deletion of exon 10 of the IDUA gene

72
Q

How does non-critical illness impact TT4 after TSH stimulation test in RAI and euthyroid cats?

A

no impact of non-critical illness

73
Q

What diagnostic tests can be used to assess for iatrogenic hypothyroidism in RIA treated cats?

A

fT4 and TSH (canine assay)

74
Q

What thyroid function tests are associated with decreased survival in cats with NTI?

A

Cats who died had lower T4 and TSH and T3
No difference in fT4

75
Q

How is glycemic variability implicated in diabetic remission?

A

cats with lower GV are more likely to achieve remission

76
Q

What medication can be used to decrease glycemic variability?

A

GLP-1 agonist (exenatide)

77
Q

In what percent of dogs was a nadir detected using a CGM vs alpha track?

A

79% CGM, 41% alpha track
CGM allows for more accurate identification of nadir and hypoglycemic episodes

78
Q

What variables are used in a model to accurately predict hypercortisolism in dogs?

A

sex, age, breed, polydipsia, vomiting, potbelly/hepatomegaly, alopecia, pruritus, alkaline phosphatase, and urine specific gravity.

79
Q

What percent of dogs with increased lipase have pancreatitis?

A

32%

80
Q

What are predictors to develop high lipase?

A

hemodialysis, increased bilirubin, increased creatinine, decreased HCT

81
Q

What disease processes is are associated with high lipase?

A

renal disease, endocrine disease, immune mediated disease, and upper airway obstruction

82
Q

What is hyperlipasemia associated with prognostically?

A

longer hospitalization and higher mortality

83
Q

How does prednisone impact DGGR (1,2-O-dilauryl-rac-glycero glutaric acid-(6’-methylresorufin))

A

increase over a period of 7 days but does not increase over RR

84
Q

How many dogs with PDH need antihypertensive therapy?

A

60%
BP is not associated with disease control

85
Q

In cats with hypophysectomy, how many died post ops and how many were alive at 4 week?

A

85.3% alive
15% post op deaths

86
Q

What marker can be used to predict DM remission in cats undergoing hypophysectomy?

A

4 week post-op IGF-1 lower in cats achieving Dm remission

87
Q

How is diabetes control impacted post hypophysectomy? (Fenn 2021)

A

71% of surviving cats went into diabetic remission, 12% recurrence after median of 248 days

88
Q

What % of cats undergoing hypophysectomy had improved control of DM?

A

95% of surviving cats

89
Q

MST of cats undergoing hypophysectomy? (Fenn 2021)

A

853 days (just over 2 years)

90
Q

How is diabetes control impacted post hypophysectomy? (von Bokhorts 2021)

A

92% diabetic remission
IGF 1 normalized in 23/24 cats

91
Q

MST of cats undergoing hypophysectomy? (von Bokhorts 2021)

A

1347 days (just under 4 years)

92
Q

In diabetic dogs with CGM, what time periods was associated with higher BGs?

A

1-6am

93
Q

What insulin pens are the most accurate when delivering low doses of insulin?

A

JuniorSTAR and Vetpen 0.5-8U
especially if dose is 0.5 or 1U

94
Q

how does dose accuracy compared with insulin pens vs syringes?

A

pens underestimate, syringes over estimate
Degree of which syringes over estimate is more than pens underestimate

95
Q

What markers of calcium homeostasis are higher in dogs with hypercortisolism? What values are lower?

A

Higher: phosphorus, Fractional excretion of calcium, serum, serum PTH
Lower: 25OHD, FGF23
Suggests urine loss of calcium

96
Q

How does IGF-1 differ in healthy cats with weight gain/loss?

A

no correlation with body weight in cats

97
Q

When is a CGM least accurate in diabetic cats?

A

during periods of rapid BG change
Lag between IG and BG

98
Q

In cats with TT4 over 40 nmol/L (3.1 ug/dL) at time of discharge after treatment with i-131, how many became euththyroid?

A

40%

99
Q

what cut off of TT4 at time of discharge can be used to predict candidates for immediate retreatment with i-131

A

> 150 nmol/L (11.65 ug/dL)

100
Q

How many cats who failed RAI treatment were treated successfully again with RAI?

A

86%

101
Q

what is the variation in activity of RAI before administration?

A

88.4-103.3% of prescribed dose

102
Q

What is the variation compared to prescribed dose of RAI after administration?

A

79.1%-100.2%

103
Q

What percentage of cats with CGMs had sensor failure and what was median time of sensor activity?

A

80%
7 days
Good agreement of BGs and IGs

104
Q

how is TLI associated with DM?

A

No associated with TLI in dogs with diabetes

105
Q

What does of DOCP is shown to be equivalent to 2.2 mg/kg? (JVIM, Vincent 2021)

A

1.1 mg/kg q30 days

106
Q

What percentage of Korean compounded trilostane packets had acceptable strength of trilostane?

A

40.9%

107
Q

How many dogs given fenofibrate had reduction in triglycerides? What else did fenofibrate reduce?

A

100%, 90% had decrease in cholesterol
ALP also was decreased

108
Q

Reported adverse effects of fenofibrate

A

quieter demeanor and firm stools in 1 dog

(note in JFMS cats number 1 side effect = diarrhea)

109
Q

When transitioning cats from glargine to ultra long acting once a week insulin, what changed? what adverse effects were noted?

A

no change in body weight, clinical signs, fructosamine, and mean IG concentration (aka equivalent to glargine at controlling DM)
No adverse reactions

110
Q

What insulins are associated with lower day to day variability?

A

Degludec and Toujeo compared to vetsulin

111
Q

what percent of subclinical and overt hypothyroid cats developed azotemia in Pederson 2021?

A

71.9% overt
39.6 subclinical

112
Q

What dosing scheme was proposed in Pederson 2021? What was the median dose?

A

80% of composite dose from T4/T3, thyroid volume, TcTU uptake
1.9 mCi

113
Q

In cats with hyperaldosteronism, what other hormones are increased?

A

Progesterone and corticosterone
32% of cats with aldosterone >3000 had progesterone over 10

114
Q

How is cortisol correlated with hyperaldosteronism?

A

Lower in cats with aldo over 3000, higher with aldo under 500

115
Q

Are cats with aldosterone and progesterone secreting adrenal tumors more likely to have bilateral or unilateral tumor?

A

100% of cats had unilateral tumors with contralateral adrenal atrophy

116
Q

Percentage of cats with aldosterone and progesterone secreting tumors who have DM? What was the remission rate of these cats?

A

100% had DM, 3 cats had high corticosterone
Remission in 3/10 cats with surgery, none with medical management

117
Q

How many cats with aldosterone and progesterone secreting adrenal tumors developed hypoadrenocorticism following adrenalectomy?

A

3/4 (75%)

118
Q

Prognosis following surgery for aldosterone and progesterone secreting adrenal tumors vs medical management

A

Surgery: 2/4 >1 year
Medical management: 2/4 >1 year

119
Q

What markers can be considered for detecting under control vs well control of hypercortisolism in context of clinical picture?

A

Haptoglobin (increase is associated with poor control), less degree ALT and GGT

120
Q

are CGMs reliable for hypoglyemia?

A

no, for BGs less than 100, only 39.1% of CGM readings were within 15 mg/dL of reference BG

121
Q

What hemostatic changes are expected in hyperthyroid cats? Are they more hypercoagulable?

A

Higher fibrinogen, higher AT activity, and vWF:Ag concentration (may suggest endothelial dysfunction) however NOT more likely to be hypercoagulable
Hemostatic changes resolved after i-131

122
Q

What percent of cats with EPI had pancreatitis with little to no ultrasonographic changes?

A

39%

123
Q

Most common clinical sign of EPI in cats? Most common concurrent disease?

A

weight loss (15/22 cats, 68%)
CE is most common concurrent disease

124
Q

Ultrasonographic findings in cats with EPI?

A

Thin pancreatic parenchyma, pancreatic duct dilation or diffuse SI dilatation with echogenic contents

125
Q

Is there a difference in orally administered I 123 compared to SC I 123 in euthyroid cats?

A

No difference in administration route on paired % thyroidal RAIU

126
Q

What is a more reliable indication of chronic stress in cats, hair cortisol or nail cortisol?

A

Nail cortisol, hair cortisol is too varaible

127
Q

Sensitivity and specificity of endogenous ACTH to differentiate between PDH and and AT

A

sn 90.62%, sp 87.5%

128
Q

Sensitivity and specificity of post CRH stimulation ACTH to differentiate between PDH and and AT

A

Sn 100%, sp 66.67%

129
Q

How is CRHT impacted by adrenal tumor size or pituitary tumor size?

A

no correlation

130
Q

Incidence of hyponatremia and hypernatremia in dogs post hypophysectomy? Incidence of hyperkalemia? How long did sodium take to normalize?

A

46.5% hypernatremia
6.3% hyponatremia
No instances of hyperkalemia
24-48 hours, does not influence post op outcome

131
Q

Risk factors associated with persistent DI in dogs post hypophysectomy

A

longer surgery times, enlarged pituitary glands

132
Q

In Pederson 2021, how many cats remained hyperthyroid and how many cats developed hypothyroidism post I-131?

A

5-10% cats hyperthyroid, 20-50% developed hypothyroidism

133
Q

Risk factors for developing hypothyroidism post I-131

A

older (OR 1.1), female (OR 2.04), detectable TSH (4.19), bilateral thyroid nodules (1.57), homogenous distributions of Tc99m uptake, higher I131 uptake, milder severity score

134
Q

Risk factors for persistent hyperthyroidism post I-131

A

younger (OR 0.81), higher severity score, lower I-131 uptake

135
Q

What disease processes are cavitary effusions rich in VLDL and LDL associated with?

A

CKD, acquired PSS, PLE
Lower in protein

136
Q

What can be measured in cavitary effusion that might suggest pancreatitis?

A

Transudate rich in triglycerides

137
Q

What disease processes are cavitary effusions rich in dense lipoproteins associated with?

A

heart disease, caudal vena cava syndrome, intracavitary neoplasia
protein higher

138
Q

What metabolites are associated with pancreatitis in cats (when fPLI is used to diagnose pancreatitis)

A

Selected sphingolipids (2 cerebrosides (HexCer(d18:1/24:0) and HexCer(d18:1/24:1)) and 1 sphingomyelin (SM C18:0)

139
Q

What cut off of UCCR can be used to diagnose hypoadrenocorticism with what sn and sp?

A

<1.4
100% sn
97.3% sp

140
Q

How does serum calprotectin change in schnauzers treated for idiopathic hyperlipidemia with ULFD?

A

increased calprotectin after resolution of hypertriglyceridemia
Lower in dogs with untreated disease
clinical implication unknown

141
Q

How is hyperlipidemia associated with insulin resistance in miniature schnauzers?

A

Insulin concentrations are higher in miniature schnauzers with hyperlipidemia, insulin decreases after treatment with ULFD

142
Q

How does ultra long acting insulin compare to intermediate acting insulin in dogs treated for 8 week? what were adverse effects?

A

No change in body weight, clinical signs, fructosamine concentration, or mean interstitial glucose concentrations
No adverse events

143
Q

What clinical features/biochemical features are diagnostic for congenital hypothyroidism in cats?

A

Disproportionate dwarfism, high TSH, low to low normal TT4

144
Q

What mutation may be associated with congenital hypothyroidism in cats?

A

recessive c.430G>A (p.(Gly144Arg)) thyroid peroxidase variant

145
Q

What percent of cats with persistent ionized hypercalcemia were azotemic?

A

75%

146
Q

What is a potential adverse effect of alendronate when treating hypercalcemia in cat?

A

Severe hypophosphatemia

147
Q

What is the effect of alendronate on hypercalcemia in cats?

A

shorter time to reach 15% decrease in ionized calcium concentration, though not significant after adjustment for age and initial iCa

148
Q

How does I-131 affect muscle mass?

A

restores muscle mass in >85% of cats
2/3 of cats with hyperthyroidism have abnormally low muscle mass

149
Q

How many false positives were there in Addison’s machine learning

A

4/12 false positive (clinically acceptable)
No false negatives

150
Q

What variable can be used to predict glucocorticoid-deficient hypoadrenocorticism?

A

No single variable can predict glucocorticoid-deficient hypoadrenocorticism

151
Q

What percent of diabetic cats achieved remission in a recent large retrospective? what is associated with remission?

A

29% received remission
Commercially avaiable low carb wet diet that was higher in fat

152
Q

How is oxidative stress associated with acute pancreatitis?

A

increased markers of oxidative stress in dogs with AP, not associated with outcome

153
Q

What is hypercalcemia in cats most commonly associated with?

A

AKI 13%
Malignancy 10.1%
Idiopathic 10.1%
CKD/diet associated 8.4%

154
Q

What percent of cats could no cause of hypercalcemia be determined?

A

47.1%

155
Q

What percentage of cats hypercalcemia had urolithiasis with AKI, iatrogenic, CKD/renal diet associated/idiopathic?

A

83.3% AKI
72.7% iatrogenic
61.1% CKD/diet
50% idiopathic

156
Q

What are miR-216a and miR-375 associated with?

A

positive association with CRP

157
Q

what miRNA may serve as a biomarker for acute pancreatitis?

A

miR-375

158
Q

What is the prevalence of systemic hypertension of dogs with HAC (Jose 2020)

A

> 150 82%, >180 46%

159
Q

Sn and Sp of platelet count of at least 438,000 to predict systemic hypertension in a dog with HAC?

A

100% sp
61.1% sn

160
Q

What biochemical changes would you expect to see in a hypertensive dog with HAC?

A

Platelets over 438,000
Lower potassium levels (3.1-5.4)
UPC over 0.5

161
Q

How does concurrent diabetes mellitus impact risk for SH in dogs with HAC?

A

lower risk

162
Q

What breed of cat is predisposed to hypoadrenocorticism?

A

British short hair

163
Q

What is the median dose of DOCP and prednisolone in cats with hypoadrenocorticism?

A

2.2 mg/kg q28d (1.3-3.0 mg/kg)
Pred 0.3 mg/kg/day (0.08-0.5 mg/kg/day)

164
Q

How long does it take for lipase activity to decrease in dogs with acute pancreatitis?

A

2 days

165
Q

What may be an early marker of AP on ultrasound in dogs?

A

mesenteric echogenicity
Correlated with lipase and PLI, ultrasonographic diagnosis of AP did not correlate

166
Q

TT4, fT4, and TSH in cats with spontaneous hypothyroidism

A

low fT4 and TT4
High TSH

167
Q

How long should you wait after anesthesia or surgery to test thyroid function?

A

14 days

168
Q

How long after discontinuing a sulfonamide before testing thyroid function?

A

4 weeks, in some cases may need 12 to 22 weeks for clinical hypothyroidism to resolve

169
Q

How do sulfonamides impact thyroid function?

A

Inhibit thyroid peroxidase
will see low TT4, fT4, and increased TSH

170
Q

Which NSAID has the biggest impact on thyroid function? How long should you wait after stopping an NSAID to test thyroid function?

A

Aspirin
Wait 7-14 days

171
Q

How does phenobarbital impact thyroid function?

A

Acclerates clearance of T4 via peripheral deiodination to T4 and subsequent hepatobiliary clearance and fecal excretion
Will see decreased TT4, fT4, TSH will be increased or unchanged. TT3 is unchanged
Takes 1 month to see changes

172
Q

How long should you wait to test thyroid function after stopping phenobarbital?

A

6 weeks

173
Q

How long should you wait after stopping steroids before testing thyroid function?

A

1 week

174
Q

How does both anti-inflammatory and immunosuppressive steroids impact thyroid function?

A

anti-inflammatory: after 3-5 weeks inhibits iodothyronine deiodinases. decreases TT3 only

immunosuppressive: Decrease in TT4, TT3, and fT4, no change in TSH

Topical also will decrease TT4 and TT3

175
Q

How does clomipramine impact thyroid function? (tricyclic antidepressant)

A

Decreases TT4, fT4, and rT3 though not below reference range
MOA:
1. Inhibits thyroid hormone synthesis
2. enhances 5′-deiodinase activity
3. Interferes with the HPT axis

176
Q
A

JVIM 2018-2023 (9 decks)

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