Examination of the endocrine organs

Question 1

What are the main endocrine organs

Answer 1

Pituitary gland 
Thyroid gland- only palpable therefore the only one that can be examined directly 
Parathyroid gland 
Adrenal gland 
Pancreas
Ovaries/Testis

Question 2

Typical/suggestive findings of inappropriate hormone function

Answer 2

In the history
Abnormalities of another organ system (similar to haemaotpoietic in this case)
Lab parameters

Question 3

Steps of diagnostic approach

Answer 3

Signalment 
History
Physical exam
Routine labs of blood and urine 
Hormone assays 
Diagnostic imaging

Question 4

Signalment: dog

Answer 4

Hypothyroidism
DM
Cushing’s
Addison’s

Question 5

Signalment cat

Answer 5

Hyperthyroidism

DM

Question 6

Signalment- age

Answer 6

Juvenile- congenital
Young adult- Addison’s
Adult- hypothyroidism
Older- Cushing’s, DM, Hyperthyroidism

Question 7

History

Answer 7

Appetite 
PU/PD- almost always shown
Activity
Other organ system signs 
Previous med

Question 8

Appetite

Answer 8

Polyphagia- hyperthyroidism, DM, Cushing’s

Inappetance- Addison’s

Question 9

Other organ systems

Answer 9

Vomitting, diarrhoea
Neurological- hypoglycaemia, hypothyroid Ca
Skin- hypothyroidism and Cushing’s

Question 10

Previous medication

Answer 10

NB!!
Can mimic or induce disease
GC’s- similar to Cushing’s
Trimethoprim sulphonamide- hypothyroidism

Question 11

Lab exams

Answer 11

Blood and urine

Question 12

Haematology

Answer 12

Biochem- glucose, ALKP, lipids, Na, K, Ca

Hormonal assays

Question 13

Urinalysis

Answer 13

SG, glucose, ketone bodies
Secondary UTI’s
UCCR= urine creatinine cortisol ratio

Question 14

Goal of carrying out the lab exams

Answer 14

Find the consequences of the hormonal disease e.g hyperglycaemia with DM
Find concurrent diseases e.g DM with pancreatitis
Exclude or diagnose other diseases with similar symptoms

Question 15

Hormone assays

Answer 15

Blood or urine
Hypofunction- stimulation tests
Hyperfunction- suppression tests

Question 16

Diagnostic imaging

Answer 16

To determine the size and structure of the endocrine gland
US
Radiographs
CT/ MRI

Question 17

US

Answer 17

Cervical: thyroid and parathyroid gland
Abdomen: adrenal glands and pancreas

Question 18

Radiographs

Answer 18

Secondary changes are indications
Urolithiasis
Hepatomegaly

*can’t figure out the endocrine disorders that would cause these

Question 19

CT/ MRI

Answer 19

Skull- pituitary gland
Cervical- thyroid gland
Abdomen- pancreas and adrenals

Question 20

Diseases of the Pituitary gland

Answer 20

DI (decrease in ADH)
Hyposomatotropism
Hypersomatotropism
Central hypercortisolism- Cushing’s (it would be secondary in this case?)- ACTH producing tumour

Question 21

Hyposomatotropism

Answer 21

Usually juvenile and congenital e.g in german shepheds
Proportional dwarfism
Puppy coat maintained

Question 22

Hypersomatotropism/ Acromegaly

Answer 22

Elderly cats and dogs caused by tumour causing an overproduction of the hormone
PU/PD weight gain
Enlarged head, paws, abdominal organs
Widening interdigital spaces

Question 23

Diseases of the thyroid gland

Answer 23

Hypothyroidism
Congenital hypothyroidism
Hyperthyroidism

Question 24

Hypothyroidism

Answer 24

Decrease of T3 and T4
Obesity
Alopecia symmetrical
Hyperpigmentation
Thickened skin with mucin deposits 
Bradycard
Hypotherm

T4 and TSH measurement
For diagnosis- also need to conduct TSH stim test

Question 25

Congenital hypothyroidism

Answer 25

Congenital in male british short hair cats from 8 weeks Disproportional dwarfism Lethargy Inappetence Dehydration Constipation! Characteristic as very rare in kittens usually

Question 26

Hyperthyroidism

Answer 26

``` Increase of T3 and T4 PU/PD Weight loss Unkept hair coat Masseter muscle atrophy- triangle-shaped head Nervousness and aggression Tachycard Increased metab Palpable thyroid gland Diagnose with T4 measurement ```

Question 27

Diseases of the adrenal gland

Answer 27

Addison's Cushing's Pheochromocytoma Primary hyperaldosteronism

Question 28

Addison's

Answer 28

``` Decrease of aldosterone and cortisol Signs are very unspecific- inappetance/ anorexia Vomitting/ diarrhoea PU/PD Addison's crisis- hypovolemic shock, prolonged CRT Increase K, decrease Na ``` Diagnose with ACTH stimulation test

Question 29

Cushing's syndrome

Answer 29

``` Increase cortisol (not so much aldosterone) More typical symptoms! PU/PD Polyphagia Enlarged urinary bladder Abdominal enlargement- pot belly Muscle atrophy Alopecia Comedons Increase of SIAP ``` Diagnose: LDDST- low dose dexamethasone suppression test Dynamic hormone testing is necessary- just cortisol is not enough

Question 30

Pheochromocytoma

Answer 30

Tumour of adrenal medulla producing adrenaline and noradrenaline

Question 31

Disease of the pancreas

Answer 31

DM Cataracts more likely in dogs Plantigrade more common in cats