Midterm--Ferrets, GH, Thyroid, Ca Flashcards
Adrenal disease in ferrets is associated with overproduction of?
Sex hormones
*cortisol is normal
Which adrenal gland in ferrets is most commonly affected? Is that good or bad?
Left
Good–easier to access with sx
the most common clinical sign associated with ferret adrenal disease
symmetric, progressive alopecia
Two options for treating adrenal disease in ferrets?
Surgical removal
GnRH agonist
A 5yr old male ferret presents for progressive ataxia in his hind end; owner also reports he’s been difficult to rouse from sleep and is drooling a lot…how would you diagnose this? (2 ways)
1) document presence of hypoglycemia when signs are present
2) measure insulin after a fast (high insulin with low glucose= diagnostic)
Best treatment option for insulinomas in ferrets?
surgery with nodule removal
GH deficiency affects all cells of the pituitary except?
ACTH cells (adrenals will be normal)
What hormone can you measure to diagnose GH deficiency
Insulin-like growth factor (IGF)
Growth hormone excess in dogs:
1) primary sex affected
2) _______ induced
3) source of the excess GH
Females
PROGESTERONE induced
excess GH is from mammary gland!!
How does GH excess in cats differ from dogs?
In cats, it’s due to a GH-secreting pituitary tumor
GH excess in cats:
1) a common clinical sign
2) how to dx
1) insulin-resistant DM (cat requires >15u/day)
2) measure IGF
Majority of canine hypothyroidism is caused by?
Idiopathic atrophy (95%)
T/F: Dogs with neurological signs secondary to hypothyroidism are easy to diagnose due to concurrently present “classical” clinical signs.
FALSE
**these dogs usually LACK the common clinical signs
Most common labwork finding with K-9 hypothyroid?
Elevated cholesterol (due to decreased clearance)
The main value of testing total T4?
to RULE OUT hypothyroidism
If T4 is in normal range–hypothyroid is very unlikely
*measure using SERUM
Why don’t we typically measure T3?
Often normal in hypothyroid dogs
The BEST test we currently have to diagnose hypo-t?
Free T4 by dialysis
If TGAA is positive but the dog isn’t hypo-t, what does this mean?
Could mean the dog is AT RISK for developing the disease
Name the 3 Ca regulators and describe their net effects
1) Calcitonin–LOWERS Ca
2) PTH–RAISES Ca; gets rid of PO4 (hyperCa, low/low normal P)
3) Vitamin D–Raises Ca; saves PO4; (hyperCa/hyperP)
Activation of vitamin D requires? What is the active form of Vit D called?
Requires PTH for activation
Calcitriol
If Ca x P is > ____, the animals is at risk for?
> 70;
dystrophic mineralization
Concerning hypercalcemia:
1) most common clinical sign (dogs vs. cats)
2) first organ to be affected by mineralization
3) why do we see urinary signs
1) PU/PD (dog); vomiting (cats)
2) kidney
3) excessive loss of Ca in urine leads to stone formation
Why is it important to test a fasted sample when checking for hyperCa?
because there is post-prandial hyperCa
What are the 3 forms of Ca? Which is active?
ionized (active)
protein-bound
complexes
What are your pathologic differentials for hyperCa?
GOSH DARNIT
granulomatous dz osteolytic dz supurious (lab error) hyperPTH D toxicosis (vit D) addison's renal failure neoplasia idiopathic (CATS ONLY) temperature
How does granulomatous disease lead to hyperCa?
macrophages convert cholecalciferol to calcitriol–>vit D toxicosis
2 ways neoplasia can lead to hyperCa?
secreting PTHrP
osteolytic disease
Most common causes for hyperCa in:
1) dogs
2) cats
1) neoplasia
2) idiopathic hyperCa
3 neoplasias assoc. w/ hyperCa in dogs
lymphoma (#1)
apocrine gland of anal sac adenocarcinoma
multiple myeloma
4 reasons to treat hyperCa directly
1) diagnosis is unknown and Ca x P >70
2) hyperCa is severe (>14)
3) clinical signs are present
4) idiopathic
4 treatments used for hyperCa
Fluids (first!!)
Diuretics
Glucocorticoids
Bisphosphates
Which type of diuretics should be avoided and why?
Thiazides–increase Ca reabsorption in tubules
*Best choice is furosemide
How do glucocorticoids help with hyperCa?
decrease GI Ca absorption
increase renal excretion of Ca
Concerning hyperPTH:
1) which dog breed is genetically predisposed
2) what is typical age of onset
1) Keeshonds
2) >7yr
intense facial pruritus, leg cramping, and tremors are associated with?
HYPOCa
Pathologic differentials for HypoCa?
HAMPER HELP
HypoPTH acute pancreatitis measuring EDTA PLE Eclampsia Renal failure
Hypoalbuminemia
ethylene glycol
lab error
phosphate enema (cats)
when diagnosing hypoparathyroidism, what are you REQUIRED to check?
What is one additional thing that is important to check?
ALWAYS check serum PTH levels
check Mg levels too—Low Mg can cause hypoPTH (fixable)
When supplementing Ca, which form is preferred for:
1) emergency treatment
2) long-term supplementation
1) Ca gluconate (can go IV)
2) Ca carbonate (highest Ca concentration/pill)
Why should you avoid OTC vitamin D supplements?
they contain cholecalciferol which needs to be activated
HypoPTH patients are unable to activate vitamin D into calcitriol so it must be provided in already activated form
