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Small Animal Medicine > Endocrinology > Flashcards

Endocrinology Flashcards

1
Q

What is the function of the endocrine system?

A

Internal communication system utilizing chemicals called hormones

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2
Q

Explain how the negative feedback loop works in the endocrine system

A

Communication moves from endocrine organ to target tissues and back to endocrine organ

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3
Q

What are the endocrine organs and where are they located? (6)

A
  1. Pituitary gland - Brain
  2. Thyroid glands - Either side of trachea in the neck
  3. Parathyroid glands - “
  4. Adrenal glands - Next to kidneys
  5. Pancreas - Intersection of stomach & duodenum
  6. Ovary & Testes - Caudal to kidneys
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4
Q

Pituitary gland (or Hypophysis)
1. Function
2. Location
3. Role of anterior & posterior lobe

“Master Glands”

A
  1. Function
    - Gives directions to other endocrine glands
  2. Location
    - Ventromidline of the brain
  3. Roles:
    - Anterior: Adenohypophysis
    - Posterior: Neurohypophysis
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5
Q

Thyroid glands
1. Function
2. Hormone it produces

A
  1. Function
    - Production of T3 & T4 (thyroxine)
    + Iodine containing hormones
    + Adjusts metabolic rate
    - In response to TSH from P gland
    - Production of calcitonin
    + Decreases blood Ca level
    + Stores Ca in the bone
  2. Produces Thyroxine (T4) and Calcitonin
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6
Q

Hypothyroidism
1. Etiology
2. Clinical signs

A
  1. Function
    - Thyroid atrophy or thyroiditis
  2. Signs:
    - Weight gain on stable diet
    - Endocrine alopecia
    - Lethargy
    - Heat-seeking
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7
Q

T/F: Hypothyroidism is more common in cats than dogs

A

False! It is a common disease of dog, but uncommon in cats

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8
Q

Endocrine Alopecia
1. Clinical signs
2. Dx
3. Tx

A
  1. Signs
    - Bilateral symmetric flank alopecia
    - “Rat tail,” loss of volume in fur
    - Hyperpigmentation
    - Dry coat/excess shedding
  2. Dx: Blood eval
    - Tests of choice fT4 & TSH
    - Mult thyroid axis may need to be eval together
    - Thyroid eval tests: T4, fT4, TSH, & Thyroglobulin antibodies
  3. Tx
    - Thyroid replacement hormones for life
    - Monitor closely w/blood tests
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9
Q

T4 & clinical signs w/o thyroid panel might lead to misdiagnose Euthyroid sick in regards to endocrine alopecia

  • I’m not entirely sure what this means or what to do with it but it seems important
A
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10
Q

Euthyroid Sick is the body’s ___ response to sickness.
Lowering T4 in response to illness protects animals from ___ ___, ___ ___, & ____.
Animals sick with this should not be treated with ___ medication.

A
  1. Normal response to sickness
  2. Muscle wasting, weight loss, & hypertension
  3. Thyroid medication
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11
Q

T/F: If the primary problem that is causing euthyroid sickness gets resolved, the thyroid will return to normal

A

True!

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12
Q

Hyperthyroidism
1. Etiology
2. Clinical signs

A
  1. Etiology
    - Functional thyroid adenoma tumor
  2. Signs
    - Weight loss with excellent appetite (polyphagia)
    - Vocalizing/behavior change
    - Tachycardia
    - Thyroid nodule
    - Vomiting/diarrhea
    - Hypertension
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13
Q

Hyperthyroidism
1. Dx
2. Therapy

A
  1. Dx
    - Elevated T4
    - Thyroid nodule
    - Thyroid scintigraphy
  2. Therapy
    - Sx
    + Curative, although tend to not be good Sx candidates
    - Methimazole
    + Monitor liver & bone marrow
    - Radioactive Iodine
    + Curative
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14
Q

Pancreas
Endocrine vs Exocrine

A

Exocrine:
- Digestive enzymes
Endocrine:
- Insulin: Lowers blood sugar by moving sugar into cells
- Glucagon: Raises blood gluc by activating liver gluconeogenesis

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15
Q

Diabetes Mellitus defined

A

Inadequate secretion or utilization of insulin resulting in a disorder of carbohydrate metabolism

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16
Q

Diabetes Mellitus
1. Clinical signs (9)
2. Pathology

A
  1. Signs
    - Polydipsia/polyuria, polyphagia, weight loss, lethargy, weakness, unkempt, plantigrade stance, sudden cataracts, obtunded
  2. Pathology
    - Persistent hyperglycemia
    - Glucosuria (increased gluc in urine)
17
Q

Diabetes Mellitus in Dogs
1. Predisposing factors (4)
2. Breeds at risk (4)
3. Type I or II?

A
  1. Predisposition
    - Genetics
    - Pancreatitis
    - Endocrine disease
    - Obesity
  2. Breeds
    - Poodles
    - Schnauzers
    - Keeshonds
    - Dachshunds
  3. Type I
18
Q

Type I diabetes vs Type II diabetes

A

Type I
- Absolute lack of insulin production
Type II
- Relative decrease of insulin (tissues are less sensitive)

19
Q

Diabetes Mellitus in Cats
1. Predisposing factors (3)
2. Obesity relationship w/diabetes (1)
3. Type I or II?

A
  1. Predisposition
    - Pancreatitis
    - Certain meds
    - OBESITY!!!
  2. Obesity & diabetes
    - 35% of cats are obese and 60% will become diabetic
  3. Type II
20
Q

Diabetes Mellitus
1. Tx
2. Diet Therapy
3. Insulin Therapy goals

A
  1. Tx
    - Oral hypoglycemics (not an option for dogs)
    + Generally don’t work well in vet med :(
  2. Diet Therapy
    - High fiber vs high protein
    - Dogs do best w/high fiber (low fat)
    - Cats do best w/high protein & others on high fiber
  3. Insulin Therapy goals
    - Maintain blood gluc 100-300 mg/dL
    - Maintain ideal BCS
    - Resolution of neuropathies
    - Gen well being of Px & O
21
Q

Should glucose be kept on the higher or lower side with diabetes while the patient is being treated at home with insulin?

A

We air on the side fo caution and allow the glucose on the high side to prevent the patient from going into a coma at home with the O.
Doing this is okay as Px shorter lifespan & unable to communicate. Keeps O a bit happier.

22
Q

Insulin Overdose
1. Causes
2. Consequences
3. Tx

A
  1. Causes
    - Too much insulin administered
    - Px isn’t eating or is vomiting
    - Px getting increased exercise
    - Px needs change
  2. Consequences: Hypoglycemia
    - Weakness
    - Disorientation
    - Seizures
    - Coma
  3. Tx
    - Feed Px if able to swallow
    - Syrup on gums (ex Karo)
    - IV gluc support until normalizes
23
Q

Diabetes Mellitus exercise goals (4)

A
  1. Correct obesity
  2. Decrease insulin requirements
  3. Improve muscle tone
  4. Should be consistent and done daily as to not create variation in insulin needs
24
Q

Diabetic Ketoacidosis
1. What is it?
2. Common signs (3)
3. Additional signs (6)

A
  1. A serious complication of diabetes which is fatal is untreated.
    - This occurs if Px isnt Tx w/insulin!!
  2. Common signs
    - Dehydration
    - Hyperglycemia
    - Electrolyte derangements
  3. Additional
    - Lethargy
    - Vomiting
    - Weakness
    - Kussmaul breathing
    - Stupor
    - Hyperosmolar coma
25
Q

What is insulinoma?

A

It is a functional tumor of pancreatic B cells leading to excess secretion of insulin & chronic, severe hypoglycemia

26
Q

Insulinoma
1. Clinical signs
2. Tx

A
  1. Signs
    - Weakness
    - Collapse
    - Disorientation
    - Seizures
  2. Tx
    - Sx removal or medical support
    - These are normally malignant tumors
27
Q

Function of adrenal medulla (3)

A
  1. Epinephrine & norepinephrine
  2. Signal from sympathetic nervous system
  3. “Fight or flight” magnification
28
Q

Function of adrenal cortex (3)

A
  1. Secretes Corticosteroids (cortisol)
    - Will do this as emergency to inflamm & stress
  2. ACTH signal from P gland
    - Pro: Anti-inflamm, chronic stress
    - Con: Lower immune system function
  3. Secretes Mineralocorticoids
    - Aldosterone: Conserves Na+ & water in kidney to maintain blood pressure
    + Signaled by renin release by kidney as part of a hormone cascade
29
Q

Hypoadrenocorticism
1. Etiology
2. Clinical signs

A
  1. Etiology
    - Insufficient production of glucocorticoids
    - “ of mineralocorticoids
  2. Signs
    - Intermittent vomiting/diarrhea
    - Weakness
    - PD/PU
    - Bradycardia
    - Endocrine coat pattern
30
Q

Hypoadrenocorticism
1. Possible blood changes
2. ACTH Stimulation test

A
  1. Possible blood changes
    - Non regenerative anemia
    - Low gluc
    - Low Na+ and high K
    - Low WBC count
  2. ACTH Stimulation test
    - Test of choice!
    - BD, ACTH administered, repeat BD & eval for cortisol, sex hormones, & aldosterone
31
Q

Hypoadrenocorticism therapy
1. If severe acute:
2. If chronic:

A
  1. Acute
    - IV fluids
    - Electrolyte correction
    - Glucocorticoids
  2. Chronic
    - Mineralcorticoid replacement
    - Glucocorticoid replacement
32
Q

Hyperadrenocorticism
1. Etiology
2. Clinical signs

A
  1. Etiology
    - Excess cortisol in the body!!
    - Pituitary tumor
    - Adrenal tumor
    - Iatrogenic
  2. Clinical signs
    - PD/PU (USG <1.015)
    - Panting
    - Abdominal fat
    - Hair coat changes
    - Elevated AP
33
Q

Hyperadrenocorticism
1. Secondary problems
2. Therapy

A
  1. Secondary problems
    - Hypertension
    - Chronic infections
    - Pancreatitis
    - Diabetes mellitus
    - Heart failure
    - Cruciate ligament rupture
  2. Therapy
    - Sx removal of adrenal tumor if present
    - Medical:
    + Chemo to shrink hyperplasia of adrenals
    + Chemical interference w/excess steroid production
34
Q

T/F: In regards to hyperadrenocorticism, Low dose Dexamethasone Suppression test (LDDS) is the most sensitive test for Cushing’s disease

A

True! Although, a false positive may occur if Px is ill with another disease

Small Animal Medicine (18 decks)

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