DL: Endocrine 4 Cases Flashcards
is 2+ protein in reasonably concentrated urine worrying?
No can be normal
Causes of malutilisation
- DM
- Neoplasia
- LIver dz
- CHF
- Hyperthyroidism
3 broad causes of hepatomegaly
- infiltration
- accumulation
- congestion
Why may DM cause an azotaemia?
Produces a catabolic state -> ^ urea and creatininte
Neutrophilia in the abscnce of a stress leucogram indicates what?
- focus of inflame/infection somewhere
What can cause ^ urine pH ?
- UTI (urease producing bacteria -> ammonia NH3 collects H= -> alkalination)
- ^ veg content diet
Empirical tx or diagnostics for a suspected UTI?
urine culture
tx amoxyclav
What endocrine causes of wt loss despite ^ appetite and CV changes are possible?
- hypersomatotropism (expect concurrent DM, r/o with UA)
- hyperthyroidism
What does azotaemia with appropriately concentrated USG tell you?
Pre-renal azotaemia
How does phosphate change in diabetic cats?
decreases
-> haemolysis (cuase or effect? not sure look up)
If unsure whether apparent hyperglycaemia is d/t stress or DM, how can this be differentiated?
> fructosamine poss to r/o immediate stress at time of sample (pooled average of 10-14d)
- BUT if stress hyperglycaemia more chronic d/t stress of chronic disease then this will not differentiate and stress still poss cause
When can IGF-1 levels not be used to test for acromegaly?
- on admittance of an uncontrolled diabetic
- liver has no insulin to make IGF1
- need to give insulin 1st for a few days then retest when insulin in system
What IGF1 levels indicate hyperosmatotrophism?
> 90 (32-90 normal)
How can hyperthyroidism be dx?
Serum T4 conc (20-45)
What can falsely increase the TSP/ TPP count?
Lipaemic serum
What can cause a relative insulin deficiency in the dog?
- pancreatitis
> not typical type 1 DM seen commonly in the dog - if not improved in few days try insulin but give time for pancreas to recover first
What may cause bilirubin to be present in the urine?
- pancreatitis
> bile duct runs through pancreas to get to SI
What does a significantly increased amylase suggest? (>2-3x upper limit) What finding would support this finding?
Exocrine pancreatic disease
- PANCREATITIS -> fasting lipaemia
Why may liver enzymes be raised with pancreatitis?
2* dmagae to liver
Will you expect to see an inflammatory profile with pancreatitis?
YES and left shift likely
What tests could you perform to further clarify suspicions of pancreatitis?
> cPLI (canine pancreatic lipase immunoreactivity)
- SNAP test (^ risk false +, yes/no)
rads/ultrasound for structural change
- spec tet (lab IDEX numerical, 25% false -ves)
Tx for pancreatitis?
- fluids, pain relief
- Nil per os until stops vomming
- v dietary fat
- antiemetic (ensure tx nausea as well as emesis: maropitant potensh not very good, ondansetron better)
Describe the typical presentation of DM with acute ketoacodiosis
- 3d V+ and inappetance
- rapidly progressive lethargy, V+, anorexia
- months hx PD, ravenous apetitie with wt loss
- hepatomegaly
Will all DM animals become ketotic?
NO severe insulin deficiency needed for this
