Midterm--Ferrets, GH, Thyroid, Ca

Question 1

Adrenal disease in ferrets is associated with overproduction of?

Answer 1

Sex hormones

*cortisol is normal

Question 2

Which adrenal gland in ferrets is most commonly affected? Is that good or bad?

Answer 2

Left

Good–easier to access with sx

Question 3

the most common clinical sign associated with ferret adrenal disease

Answer 3

symmetric, progressive alopecia

Question 4

Two options for treating adrenal disease in ferrets?

Answer 4

Surgical removal

GnRH agonist

Question 5

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)

Answer 5

1) document presence of hypoglycemia when signs are present

2) measure insulin after a fast (high insulin with low glucose= diagnostic)

Question 6

Best treatment option for insulinomas in ferrets?

Answer 6

surgery with nodule removal

Question 7

GH deficiency affects all cells of the pituitary except?

Answer 7

ACTH cells (adrenals will be normal)

Question 8

What hormone can you measure to diagnose GH deficiency

Answer 8

Insulin-like growth factor (IGF)

Question 9

Growth hormone excess in dogs:

1) primary sex affected
2) _______ induced
3) source of the excess GH

Answer 9

Females

PROGESTERONE induced

excess GH is from mammary gland!!

Question 10

How does GH excess in cats differ from dogs?

Answer 10

In cats, it’s due to a GH-secreting pituitary tumor

Question 11

GH excess in cats:

1) a common clinical sign
2) how to dx

Answer 11

1) insulin-resistant DM (cat requires >15u/day)

2) measure IGF

Question 12

Majority of canine hypothyroidism is caused by?

Answer 12

Idiopathic atrophy (95%)

Question 13

T/F: Dogs with neurological signs secondary to hypothyroidism are easy to diagnose due to concurrently present “classical” clinical signs.

Answer 13

FALSE

**these dogs usually LACK the common clinical signs

Question 14

Most common labwork finding with K-9 hypothyroid?

Answer 14

Elevated cholesterol (due to decreased clearance)

Question 15

The main value of testing total T4?

Answer 15

to RULE OUT hypothyroidism

If T4 is in normal range–hypothyroid is very unlikely

*measure using SERUM

Question 16

Why don’t we typically measure T3?

Answer 16

Often normal in hypothyroid dogs

Question 17

The BEST test we currently have to diagnose hypo-t?

Answer 17

Free T4 by dialysis

Question 18

If TGAA is positive but the dog isn’t hypo-t, what does this mean?

Answer 18

Could mean the dog is AT RISK for developing the disease

Question 19

Name the 3 Ca regulators and describe their net effects

Answer 19

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)

Question 20

Activation of vitamin D requires? What is the active form of Vit D called?

Answer 20

Requires PTH for activation

Calcitriol

Question 21

If Ca x P is > ____, the animals is at risk for?

Answer 21

> 70;

dystrophic mineralization

Question 22

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

Answer 22

1) PU/PD (dog); vomiting (cats)
2) kidney
3) excessive loss of Ca in urine leads to stone formation

Question 23

Why is it important to test a fasted sample when checking for hyperCa?

Answer 23

because there is post-prandial hyperCa

Question 24

What are the 3 forms of Ca? Which is active?

Answer 24

ionized (active)
protein-bound
complexes

Question 25

What are your pathologic differentials for hyperCa?

Answer 25

GOSH DARNIT

granulomatous dz
osteolytic dz
supurious (lab error)
hyperPTH
D toxicosis (vit D)
addison's
renal failure
neoplasia
idiopathic (CATS ONLY)
temperature

Question 26

How does granulomatous disease lead to hyperCa?

Answer 26

macrophages convert cholecalciferol to calcitriol–>vit D toxicosis

Question 27

2 ways neoplasia can lead to hyperCa?

Answer 27

secreting PTHrP

osteolytic disease

Question 28

Most common causes for hyperCa in:

1) dogs
2) cats

Answer 28

1) neoplasia

2) idiopathic hyperCa

Question 29

3 neoplasias assoc. w/ hyperCa in dogs

Answer 29

lymphoma (#1)
apocrine gland of anal sac adenocarcinoma
multiple myeloma

Question 30

4 reasons to treat hyperCa directly

Answer 30

1) diagnosis is unknown and Ca x P >70
2) hyperCa is severe (>14)
3) clinical signs are present
4) idiopathic

Question 31

4 treatments used for hyperCa

Answer 31

Fluids (first!!)
Diuretics
Glucocorticoids
Bisphosphates

Question 32

Which type of diuretics should be avoided and why?

Answer 32

Thiazides–increase Ca reabsorption in tubules

*Best choice is furosemide

Question 33

How do glucocorticoids help with hyperCa?

Answer 33

decrease GI Ca absorption

increase renal excretion of Ca

Question 34

Concerning hyperPTH:

1) which dog breed is genetically predisposed
2) what is typical age of onset

Answer 34

1) Keeshonds

2) >7yr

Question 35

intense facial pruritus, leg cramping, and tremors are associated with?

Answer 35

HYPOCa

Question 36

Pathologic differentials for HypoCa?

Answer 36

HAMPER HELP

HypoPTH
acute pancreatitis
measuring EDTA
PLE
Eclampsia
Renal failure

Hypoalbuminemia
ethylene glycol
lab error
phosphate enema (cats)

Question 37

when diagnosing hypoparathyroidism, what are you REQUIRED to check?

What is one additional thing that is important to check?

Answer 37

ALWAYS check serum PTH levels

check Mg levels too—Low Mg can cause hypoPTH (fixable)

Question 38

When supplementing Ca, which form is preferred for:

1) emergency treatment
2) long-term supplementation

Answer 38

1) Ca gluconate (can go IV)

2) Ca carbonate (highest Ca concentration/pill)

Question 39

Why should you avoid OTC vitamin D supplements?

Answer 39

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