Endocrine Disease

Question 1

What is hyperadrenocorticism

Answer 1

Cushing disease
Caused by excessive cortisol production

Question 2

What is cortisol

Answer 2

Natural body steroid
Produced by the adrenal gland

Question 3

What is the majority if cases for HAC

Answer 3

Pituitary dependent

Question 4

What are other disease forms of HAC

Answer 4

Adrenal dependent and iatrogenic which is caused by medications or prolonged steroids

Question 5

What is pituitary dependent HAC

Answer 5

Caused by benign pituitary tumor that is common in middle aged or older dogs
Usually affects small breeds
Bilateral adrenal gland enlargement

Question 6

What is adrenal dependent HAC caused by and what is it

Answer 6

Caused by adrenal tumor
Unilateral adrenal gland enlargement
Usually affects medium and large breeds

Question 7

What are clinical signs of hyperadrenocortism

Answer 7

Polyuria, polydipsia, polyphagia (most important)
Also pendulous abdomen and panting or alopecia

Question 8

How can you diagnose HAC

Answer 8

Bloodwork where you see increased ALP and increase platelets
Urinalysis with low urine concentrations
Ultrasound where you may see bilateral or unilateral enlarged adrenal glands

Question 9

What is the confirmatory test of HAC

Answer 9

Low dose dexamethasone suppression test (LDDST)
This is diagnostic of choice
Can sometimes differentiate between adrenal and pituitary HAC

Question 10

What is an ACTH stimulation test in regards to HAC

Answer 10

Doesn’t differentiate between pituitary and adrenal HAC
ONLY tests to identify iatrogenic Cushing disease

Question 11

Treatment of HAC

Answer 11

Lifelong management
Pituitary dependent treatments use trilostane or mitotane
Adrenal dependent you can treat with an adrenalectomy

Question 12

What is hypoadrenocorticism

Answer 12

Addisons disease
Caused by adrenocortical insufficiency
Most common in young or middle aged female dogs

Question 13

Clinical signs of hypoadrenocorticism

Answer 13

Weakness, lethargy, anorexia, vomiting, worse in stressful situations
Can present with acute signs in life threatening scenarios

Question 14

How can you diagnose hypoadrenocorticism

Answer 14

Screening bloodwork where you see anemia, absence of stress leukogram, hyponatremia and hypernatremia

Question 15

What is the confirmatory test for hypoadrenocorticism

Answer 15

ACTH stimulation test
Low serum cortisol concentration
Definitive diagnostic test

Question 16

Treatment for hypoadrenocorticism

Answer 16

If critical use iv fluids and injectable glucocorticoids
Chronic life management with glucocorticoid and mineralocorticoid supplementation

Question 17

What is hypothyroidism

Answer 17

Decreased thyroid hormone from thyroid gland commonly due to atrophy of thyroid glands
Seen in Middle Ages dogs and typically uncommon and over diagnosed
Usually affects any breeds

Question 18

What are the clinical signs of hypothyroidism

Answer 18

Unexpected weight gain, lethargic, mental dullness, exercise intolerance, cold intolerance, rat tail appearance

Question 19

How do you diagnose hypothyroidism

Answer 19

Low total T4 and low free T4 (Should always be confirmed with both of these)
Increased thyroid stimulating hormone

Question 20

What is Euthyroid sick syndrome

Answer 20

Thyroid hormone is low in patients with another systemic illness
Just because TT4 is low doesn’t mean hypothyroid

Question 21

How do you treat hypothyroidism

Answer 21

Lifelong
Goal is to treat serum T4 levels to normal range
Levothyroxine which is a T4 supplement

Question 22

What is diabetes mellitus

Answer 22

Caused by decrease production of insulin by pancreatic beta cells and or decreased insulin utilization by peripheral tissue
Affects older dogs and cats, especially obese cats

Question 23

What are signs of diabetes

Answer 23

Polydipsia, Polyuria, polyphagia, weight loss, blindness from cataracts, plantigrade stance

Question 24

How do you diagnose diabetes

Answer 24

Bloodwork where you see hyperglycemia and urinalysis where you see glucosuria

Question 25

How can you treat diabetes

Answer 25

Life long treatment Insulin therapy (vetsulin for dogs and glargine in cats) High protein low carb diets

Question 26

Who will not develop cataracts because of diabetes and why

Answer 26

Cats Won’t because they lack aldose reducatse which is an enzyme responsible for diabetic cataract formation

Question 27

Who can recover from diabetes dogs or cats?

Answer 27

Cats Dogs are considered type 1

Question 28

What is hyperthyroidism

Answer 28

Continued excessive segregation of thyroid hormone Caused by benign thyroid neoplasia or hyperplasia involving one or both thyroid lobes Usually seen in older cats

Question 29

Clinical signs of hyperthyroidism

Answer 29

Weight loss despite normal or increased appetite Polyphagia Vomiting or diarrhea Hyperactive or nervousness

Question 30

How can you diagnose hyperthyroidism

Answer 30

Increased alt on bloodwork Increased total T4

Question 31

How do you treat hyperthyroidism

Answer 31

Methimazole which suppresses thyroid hormone stimulation Il31 therapy which is a radiation treatment that renders all hyper functional thyroid tissue nonfunctional

Question 32

What is acromegaly

Answer 32

Results from chronic exposure to GH hormone from adenoma of pituitary gland Causes overgrowth of connective tissue, bone, or internal organs Leads to insulin resistant diabetes Uncommon in cats

Question 33

Clinical signs for acromegaly

Answer 33

Polyuria, polydipsia, polyphagia, weight gain, lameness, enlargement of lower jaw

Question 34

How can you diagnose acromegaly

Answer 34

Hyperglycemia in bloodwork or mild ALT and ALP elevations Radiographs where you see oropharyngeal tissue and degenerative joint disease of multiple joints

Question 35

Treatment for acromegaly

Answer 35

Insulin dose adjustment to maintain glycemic control if diabetic No consistently effective treatment Radiation therapy of pituitary tumor