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10- sa- abdominal, oral and rectal disease > Weight gain and hypothyroidism > Flashcards

Weight gain and hypothyroidism Flashcards

1
Q

List 3 non-pathological reasons for weight gain

A

over feeding
reduced exercise
predispositions = age, neutering, breed, owner

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2
Q

List 2 diseases that cause higher caloric demand

A

acromegaly
insulinoma

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3
Q

List a systemic disease with normal caloric demand which cause weight gain

A

hyperadrenocorticism

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4
Q

What disease causes normal appetite but decreased metabolic rate

A

hypothyroidism

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5
Q

what is acromegaly associated with in cats

A

usually associated with functional pituitary adenoma
mostly males middle age/older

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6
Q

what is acromegaly associated with in dogs

A

usually unneutered females
due to elevated progesterone levels in the luteal phase OR exogenous progesterone admin (iatrogenic)

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7
Q

what is the clinical signs of acromegaly

A

weight gain
cutaneous thickening
macroglossia- enlarged tongue
increased dental spacing
signs associated with diabetes- PU/PD, polyphagia

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8
Q

why do animals with acromegaly get diabetes mellitus

A

due to insulin resistance-

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9
Q

Describe how to diagnose acromegaly

A

clinical signs
elevated serum GH and IGF-1 (growth hormone)- can get false neg if early insulin therapy

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10
Q

Describe how to treat acromegaly

A

GOLD STANDARD
Surgery - dogs spay and take mammary strip
Cat- hypophysectomy but expensive

Radiotherapy
drugs such e.g. somatostatin analogues, dopaminergic agonist

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11
Q

what are insulinomas

A

Functional neuroendocrine tumour of pancreas - B cells
produce excessive insulin

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12
Q

List the clinical signs of insulinoma

A

increased appetite and weight gain
Weakness, ataxia, collapse, seizures- particularly after exercising/ fasting OR feeding

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13
Q

describe how to diagnose insulinomas

A

Demonstrate hypoglycaemia (BG <3mmol/l) while clinical signs, which resolve with glucose admin
exclude other causes of hypoglycaemia

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14
Q

what % of insulinomas are visible on ultrasound

A

50-75%

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15
Q

what is the treatment of choice for insulinoma

A

excisional biopsy- care is metastatic, but this will help with clinical signs

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16
Q

describe dietary management of insulinomas

A

multiple small meals high in protein, fat and complex carbs

17
Q

describe medical management of insulinomas

A

Diet management
preds- insulin antagonist

More expensive options:
octreotide- inhibits insulin synthesis and secretion
Diazoxide - stimulates gluconeogenesis

18
Q

Describe the staging of insulinomas

A

Stage I: Only pancreas affected
Stage II: Regional lymph node metastasis
Stage III: Distant metastasis

19
Q

What is the prognosis of insulinomas

A

Stage I- with surgical excision >2 years
Stage II or III- approx. 6 months regardless of treatment.

20
Q

List 2 causes of primary hypothyroidism

A

Idiopathic thyroid gland atrophy OR
Immune-mediated lymphocytic thyroiditis

21
Q

what is the most common cause of hypothyroidism in dogs

A

> 95% primary causes

22
Q

describe signalment of hypothyroidism in dogs

A

Middle age- older
Mostly large breed

23
Q

describe the signalment of hypothyroidism in cats

A

Usually older cats following treatment for HyperT4
Often little/ no signs but can worsen renal dx - often silent

24
Q

Describe the clinical signs of hypothyroidism

A

very variable - easy to attribute to normal aging
increased weight gain without increased appetite
dull
heat seeking behaviour
increased shedding- dry skin
tragic facial expression

25
Q

List the clinical signs of congenital hypothyroidism

A

Disproportionate dwarfism
goitre
retained puppy coat
poor appetite
delayed dental eruption

26
Q

How do we definitively diagnose hypothyroidism

A

compatible signs +

low Total T4/ Free T4
and
NORMAL-HIGH TSH

27
Q

what is seen with T4 with sick euthyroid

A

low total T4/ free T4

LOW/NORMAL TSH

28
Q

Describe how to treat hypothyroidism

A

levothyroxine- synthetic T4
lifelong treatment

29
Q

Which test(s) would you chose to confirm a diagnosis of hypothyroidism in a dog with compatible clinical signs?
ACTH stimulation test
FreeT4 and Total T4
TSH and total T4
Bile acid stimulation test
Basal cortisol

A

TSH and total T4

30
Q

What is sick euthyroid

A

systemic illness causes a low T3/T4 level that can appear like hypothyroidism

10- sa- abdominal, oral and rectal disease (19 decks)

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