Endocrine Diseases

Question 1

Hypothyroidism

Answer 1

thyroid gland dysfunction

Thyroid function will not return 🡪 daily life-long medication

Question 2

Hypothyroidism commonly in

Answer 2

dogs
▪ Seen in cats treated for hyperthyroidism

Question 3

Hypothyroidism acquired

Answer 3

hypothalamus or pituitary dysfunction

Question 4

Hypothyroidism clinical signs

Answer 4

▪ Weight gain w/ no diet change
▪ Bilaterally symmetric alopecia; “rat tail”
▪ Cold intolerance
▪ Recurrent skin infections
▪ Reproduction problems

Question 5

Hypothyroidism dx

Answer 5

▪ Thyroid ultrasound
▪ Thyroid biopsy

Question 6

Hypothyroidism tx

Answer 6

Life-long supplementation w/ thyroid replacement
hormone
▪ Reevaluate 4-8 weeks after the start of therapy to evaluate levels

Question 7

Hyperthyroidism

Answer 7

▪ Result of a functional thyroid adenoma (>70%) or thyroid carcinoma (1-2%)

Question 8

Hyperthyroidism common in

Answer 8

cats ▪ Rare in dogs (neoplasia)

Question 9

Hyperthyroidism clinical signs

Answer 9

▪ Middle-aged 🡪 older cat
▪ Polyphagia, V, weight loss
▪ Tachycardia +/- murmur, ↑ systolic BP
▪ Palpable enlarged thyroid
▪ Aggressive behavior, hyperactivity
▪ Blindness w/ retinal detachment

Question 10

Hyperthyroidism dx

Answer 10

▪ Palpation
▪ ↑ Thyroid hormone levels
▪ CBC/chem – r/o other organ system failures
▪ Nuclear scintigraphy – 1-2 glands

Question 11

Hyperthyroidism tx

Answer 11

Surgery – curative, preserve parathyroid
▪ Radioactive Iodine-131
▪ Antithyroid drug therapy

Question 12

Antithyroid drug therapy

Answer 12

inhibit the synthesis of thyroid hormone by disrupting the incorporation of iodine

Question 13

Diabetes Mellitus

Answer 13

Β-cells in pancreas stop producing insulin in adequate amounts or the cells in specific body tissues become resistant to action of insulin

Question 14

Diabetes Mellitus occurs

Answer 14

Insulin facilitates the entry of glucose into the cell 🡪 glycolysis

Question 15

Diabetes Mellitus type 1

Answer 15

100% of dogs, 50% of cats 🡪 insulin therapy
Insulin dependent

Question 16

Diabetes Mellitus type 2

Answer 16

Noninsulin dependent 50% of cats

Question 17

Insulin

Answer 17

▪ Protein molecule: damaged by heat, rough
handling, chemicals
▪ Refrigerate, mix gently, use new syringe (Vetsulin)

Question 18

Diabetes Mellitus types

Answer 18

Nonketotic diabetes
Ketotic diabetes

Question 19

Diabetes Mellitus Nonketonic diabetes signs

Answer 19

▪ PU/PD, dehydration
▪ Weight loss (especially in cats)
▪ Polyphagia
▪ Sudden cataract formation

Question 20

Diabetes Mellitus signs

Answer 20

▪ All of the above +
▪ Depression, weakness
▪ Tachypnea
▪ Vomiting

PU/PD, dehydration
▪ Weight loss (especially in cats)
▪ Polyphagia
▪ Sudden cataract formation

▪ Odor of acetone on breath

Question 21

Diabetes Mellitus dx

Answer 21

Evaluate clinical signs
Urine glycosuria
CBC/chem: r/o other concurrent disease
BG curve

Question 22

Diabetes Mellitus types of tx

Answer 22

Dietary
Insulin therapy
Excercise regulation

Question 23

Diabetes Mellitus dietary tx

Answer 23

High fiber w/ complex carbs

Question 24

Diabetes Mellitus insulin therapy tx

Answer 24

Human or animal based
▪ Intermediate or long-acting
▪ SID or BID
▪ Monitor clinical signs, BG levels, and BG curves to adjust insulin levels as therapy progresses

Question 25

Diabetes Mellitus excercise regulation tx

Answer 25

Normalize routines (diet and exercise)
▪ Excessive exercise may warrant a decrease in insulin for the day

Question 26

Primary hypoadrenocorticism

Answer 26

Atrophy of the adrenal cortex 🡪 decreased production of glucocorticoids and mineralocorticoids

Question 27

Secondary hypoadrenocorticism

Answer 27

Lack of adrenocorticotropic hormone (ACTH) – less common

Question 28

hypoadrenocorticism causes

Answer 28

Trauma, fungal infection, neoplasm, and hereditary tendencies

Question 29

Hypoadrenocorticism clinical signs

Answer 29

▪ Depression, lethargy, weakness, anorexia, weight loss
▪ V/D
▪ PU/PD
▪ Symptoms frequently wax and wane over time

Question 30

Hypoadrenocorticism dx serum chem

Answer 30

Serum chemistry
▪ Low Na:K ratio
▪ ↑ BUN, creatinine, Ca, K
▪ ↓glucose and albumin, Na

Question 31

Hypoadrenocorticism dx Adrenocorticotropic Hormone Stimulation test (ACTH stim)

Answer 31

Low resting cortisol [ ], which remains essentially unchanged after administration of ACTH
▪ Definitive diagnosis

Question 32

Hypoadrenocorticism tx acute

Answer 32

Fluid replacement w/ normal saline
▪ Drug therapy: replace and balance steroid levels

Question 33

Hypoadrenocorticism chronic tx

Answer 33

Oral steroid replacement therapy – daily
▪ DOCP injection every 25-30 days
▪ Monitor for clinical signs of crisis
▪ Periodic bloodwork: electrolytes, BUN, creatinine

Question 34

Hyperadrenocorticism

Answer 34

Any disease state that results in hypersecretion of cortisol

Question 35

Hyperadrenocorticism leads to

Answer 35

Pituitary lesion (excess ACTH)
▪ Abnormal pituitary cells secrete excessive amounts of ACTH 🡪 adrenal gland hyperplasia 🡪 oversecretion of cortisol

Adrenal tumor (excess cortisol)

Question 36

Hyperadrenocorticism common in

Answer 36

dogs <20 kg

Question 37

Hyperadrenocorticism clinical signs

Answer 37

Dogs >6 years old
▪ PU/PD
▪ Polyphagia, abdominal enlargement, obesity
▪ Excessive panting
▪ Muscle weakness, lethargy, lameness
▪ Bilateral symmetrical alopecia, pruritis, pyoderma

Question 38

Hyperadrenocorticism dx serum chem

Answer 38

▪ ↑ ALP, ALT, cholesterol, glucose
▪ ↓BUN
▪ Lipemia

Urine cortisol:creatinine ratio ↑
▪ ACTH stimulation test

Question 39

Hyperadrenocorticism dx Dexamethasone suppression test

Answer 39

Low dose
▪ PHD: no change in cortisol [ ] 8 hrs post
injection (remains high)
▪ Adrenal tumor: no change in cortisol

Question 40

Tx Hyperadrenocorticism

Answer 40

▪ ▪
Surgical removal of one or both adrenal glands
Medical management
▪ Drug therapy to decrease adrenal gland function (trilostane/mitotane)
▪ Life-long