CBLs 1 & 2

Question 1

what is a stress (cortisol) leukogram in dogs

Answer 1

neutrophilia
lymphopenia
monocytosis
eosinopenia

Question 2

Addison’s disease: Na and K levels

Answer 2

hyperkalemia
hyponatremia

Question 3

Addison’s disease: glucose levels

Answer 3

hypoglycemia

Question 4

Addison’s disease: cholesterol

Answer 4

hypocholesterolemia

Question 5

Addison’s disease: CBC findings

Answer 5

NNN anemia
normal leukogram despite being sick (no stress leukogram bc no cortisol)

Question 6

Addison’s disease: heart rate/rhythma

Answer 6

bradyarrhythmic

Question 7

what tests are done to diagnose Addison’s disease

Answer 7

• ACTH stimulation test (good rule-out test)
• resting cortisol (good rule-in test)

Question 8

what is the best liver function test

Answer 8

bile acids

Question 9

Addison’s disease: cortisol concentration

Answer 9

low (<2)

Question 10

Addison’s disease: aldosterone concentration

Answer 10

typical Addisons: low
atypical Addisons: normal

Question 11

Addison’s disease: vasopressin concentration

Answer 11

high
(stimulated by dehydration)

Question 12

Addison’s disease: insulin concentration

Answer 12

low
(hypoglycemic)

Question 13

Addison’s disease: T4 concentration

Answer 13

low to normal
(possible euthyroid sick syndrome - mediated by more than just cortisol)

Question 14

Addison’s disease: ACTH concentration

Answer 14

high

Question 15

typical addisons

Answer 15

cortisol & aldosterone deficiency
- low aldosterone –> electrolyte imbalances (hyperkalemia, hyponatremia)
- low cortisol –> GI signs, leukogram changes, anemia, hypoglycemia, hypoalbuminemia, hypocholesterolemia

Question 16

atypical addison’s

Answer 16

cortisol deficiency only
- normal aldosterone –> no electrolyte imbalances
- low cortisol (same signs as above)

Question 17

how do you treat Addison’s disease

Answer 17

• fluids (bolus + CRI)
• 5% dextrose (bolus + CRI)
• exogenous cortisol
• percorten (exogenous aldosterone)

Question 18

common causes of PU/PD

Answer 18

1. diabetes mellitus
2. hyperthyroidism
3. renal disease
4. hypercalcemia (hyperparathyroidism)
5. Cushing’s
6. diabetes insipidus (central)
7. pyometra/pyelonephritis
8. iatrogenic
9. Addison’s
10. hepatic insufficiency
11. renal glucosuria
12. hypokalemia

Question 19

what are the mechanisms for the development of PU/PD (6 total)

Answer 19

1. central DI
2. primary nephrogenic DI
3. secondary nephrogenic DI
4. osmotic diuresis
5. psychogenic
6. multifactorial

Question 20

how does central DI cause PU/PD

Answer 20

lack of ADH production in pituitary –> reduced water reabsorption in kidneys

Question 21

how does primary nephrogenic DI cause PU/PD

Answer 21

congenital defect of ADH receptor –> reduced water reabsorption in kidneys

Question 22

how does secondary nephrogenic DI cause PU/PD

Answer 22

• blocking of ADH release from pituitary
• blocking of ADH V2 receptors in collecting ducts

ex. Cushing’s, hypercalcemia, glucocorticoids, hypokalemia, bacterial endotoxins

Question 23

how does osmotic diuresis cause PU/PD

Answer 23

something pulls water into the renal tubules

ex. diabetes mellitus, renal glucosuria, renal disease, post-obstructive diuresis, drugs

Question 24

how does psychogenic mechanisms cause PU/PD

Answer 24

young, anxious dogs

Question 25

how do multifactorial mechanisms cause PU/PD

Answer 25

ex. hyperthyroidism - high RBF/GFR - psychogenic - downregulation of AQP

Question 26

Hyperthyroidism: heart rate/murmurs

Answer 26

systolic murmur tachycardia often leads to HCM in cats

Question 27

Hyperthyroidism: liver enzymes

Answer 27

reactive hepatopathy (elevated ALT)

Question 28

what tests are used to diagnose hyperthyroidism

Answer 28

total T4 (free T4 and TSH less common) other options: nuclear scintigraphy, cervical ultrasound, check PE for thyroid slip, fundic exam for hypertension signs

Question 29

Hyperthyroidism: TSH levels

Answer 29

low (should be 0)

Question 30

Hyperthyroidism: free T4 levels

Answer 30

high

Question 31

Hyperthyroidism: total T4 levels

Answer 31

high

Question 32

Hyperthyroidism: TGAA levels

Answer 32

normal (undetectable)

Question 33

Hyperthyroidism: PTH levels

Answer 33

normal (calcium levels should be normal)

Question 34

T3 suppression test

Answer 34

administering exogenous T3 then measuring T3, total T4, and TSH

Question 35

T3 suppression test in a euthyroid cat

Answer 35

expect DECREASE in total T4 and TSH - exogenous T3 will suppress TSH and the production of T4

Question 36

T3 suppression test in a hyperthyroid cat

Answer 36

expect NO CHANGE in total T4 and TSH - loss of negative feedback on T4 due to primary hyperthyroid; administering T3 will not suppress T4 production - TSH is already suppressed from excess T4, will still be low

Question 37

reversible treatments for hyperthyroid

Answer 37

methimazole limited iodine diet

Question 38

irreversible treatments for hyperthyroid

Answer 38

radioactive iodine (gold standard) thyroidectomy (less common in cats)