Examination of the endocrine organs Flashcards
What are the main endocrine organs
Pituitary gland Thyroid gland- only palpable therefore the only one that can be examined directly Parathyroid gland Adrenal gland Pancreas Ovaries/Testis
Typical/suggestive findings of inappropriate hormone function
In the history
Abnormalities of another organ system (similar to haemaotpoietic in this case)
Lab parameters
Steps of diagnostic approach
Signalment History Physical exam Routine labs of blood and urine Hormone assays Diagnostic imaging
Signalment: dog
Hypothyroidism
DM
Cushing’s
Addison’s
Signalment cat
Hyperthyroidism
DM
Signalment- age
Juvenile- congenital
Young adult- Addison’s
Adult- hypothyroidism
Older- Cushing’s, DM, Hyperthyroidism
History
Appetite PU/PD- almost always shown Activity Other organ system signs Previous med
Appetite
Polyphagia- hyperthyroidism, DM, Cushing’s
Inappetance- Addison’s
Other organ systems
Vomitting, diarrhoea
Neurological- hypoglycaemia, hypothyroid Ca
Skin- hypothyroidism and Cushing’s
Previous medication
NB!!
Can mimic or induce disease
GC’s- similar to Cushing’s
Trimethoprim sulphonamide- hypothyroidism
Lab exams
Blood and urine
Haematology
Biochem- glucose, ALKP, lipids, Na, K, Ca
Hormonal assays
Urinalysis
SG, glucose, ketone bodies
Secondary UTI’s
UCCR= urine creatinine cortisol ratio
Goal of carrying out the lab exams
Find the consequences of the hormonal disease e.g hyperglycaemia with DM
Find concurrent diseases e.g DM with pancreatitis
Exclude or diagnose other diseases with similar symptoms
Hormone assays
Blood or urine
Hypofunction- stimulation tests
Hyperfunction- suppression tests
Diagnostic imaging
To determine the size and structure of the endocrine gland
US
Radiographs
CT/ MRI
US
Cervical: thyroid and parathyroid gland
Abdomen: adrenal glands and pancreas
Radiographs
Secondary changes are indications
Urolithiasis
Hepatomegaly
*can’t figure out the endocrine disorders that would cause these
CT/ MRI
Skull- pituitary gland
Cervical- thyroid gland
Abdomen- pancreas and adrenals
Diseases of the Pituitary gland
DI (decrease in ADH)
Hyposomatotropism
Hypersomatotropism
Central hypercortisolism- Cushing’s (it would be secondary in this case?)- ACTH producing tumour
Hyposomatotropism
Usually juvenile and congenital e.g in german shepheds
Proportional dwarfism
Puppy coat maintained
Hypersomatotropism/ Acromegaly
Elderly cats and dogs caused by tumour causing an overproduction of the hormone
PU/PD weight gain
Enlarged head, paws, abdominal organs
Widening interdigital spaces
Diseases of the thyroid gland
Hypothyroidism
Congenital hypothyroidism
Hyperthyroidism
Hypothyroidism
Decrease of T3 and T4 Obesity Alopecia symmetrical Hyperpigmentation Thickened skin with mucin deposits Bradycard Hypotherm
T4 and TSH measurement
For diagnosis- also need to conduct TSH stim test
Congenital hypothyroidism
Congenital in male british short hair cats from 8 weeks
Disproportional dwarfism
Lethargy
Inappetence
Dehydration
Constipation! Characteristic as very rare in kittens usually
Hyperthyroidism
Increase of T3 and T4 PU/PD Weight loss Unkept hair coat Masseter muscle atrophy- triangle-shaped head Nervousness and aggression Tachycard Increased metab Palpable thyroid gland Diagnose with T4 measurement
Diseases of the adrenal gland
Addison’s
Cushing’s
Pheochromocytoma
Primary hyperaldosteronism
Addison’s
Decrease of aldosterone and cortisol Signs are very unspecific- inappetance/ anorexia Vomitting/ diarrhoea PU/PD Addison's crisis- hypovolemic shock, prolonged CRT Increase K, decrease Na
Diagnose with ACTH stimulation test
Cushing’s syndrome
Increase cortisol (not so much aldosterone) More typical symptoms! PU/PD Polyphagia Enlarged urinary bladder Abdominal enlargement- pot belly Muscle atrophy Alopecia Comedons Increase of SIAP
Diagnose: LDDST- low dose dexamethasone suppression test
Dynamic hormone testing is necessary- just cortisol is not enough
Pheochromocytoma
Tumour of adrenal medulla producing adrenaline and noradrenaline
Disease of the pancreas
DM
Cataracts more likely in dogs
Plantigrade more common in cats
