(C) feline and canine endocrine disorders

what are cat blood glucose normal (range)

2.6 - 8.4 mmol/L

what is the renal thershold in cats

14 mmol/L

what is the renal threshold in dogs

10 mmol/L

what are dog blood glucose normal (range)

3.5 - 6.1 mmol/L

define renal threshold

value above this indicates there should also be (thing) present in the urine.

what causes diabetes mellitus (4)

1. Pancreatic Damage

2. Insulin Resistance

3. Corticosteroids

4. progesterones

what is diabetes mellitus (2)

1. Decreased insulin production and excretion by pancreatic islet cells

OR

2. Body cells become resistant to the insulin

Decreased insulin = — intracellular glucose = — glucose production = — serum glucose levels

decreased, increased, increased

define hyperglycemia

glucose exceeds renal threshold and results in glucosuria

what breeds are susceptible to diabetes (9)

1. Keeshond

2. puli

3. miniature pinscher

4. cairn terrier

5. miniature schnauzer

6. poodle

7. cocker spaniel

8. beagles

9. dachshund

what is this stance called

plantigrade stance

clinical signs of diabetes mellitus (12)

1. plantigrade stance

2. PU/PD

3. Polyphagia

4. decreased appetite

5. Weight loss

6. muscle wasting

7. Unkempt hair coat

8. increased susceptibility to infection

9. Weakness

10. Dehydration

11. Cataract formation

12. Diabetic Ketoacidosis

define Polyphagia

extreme, insatiable hunger or an excessive desire to eat that does not go away even after you finish a meal

what does DKA stand for

Diabetic Ketoacidosis

DKA causes what clinical signs? (7)

1. Dehydration

2. vomiting

3. hypovolemia

4. electrolyte abnormalities

5. anorexia

6. weakness

7. azotemia

Diabetic Ketoacidosis Must be treated with insulin to decrease — production

ketone

how to diagnose diabetes mellitus (12)

1. History

2. PU/PD

3. Weight loss

4. changes to appetite

5. Hyperglycemia

6. Glucosuria

7. +/- Ketones in urine

8. +/- azotemia

9. liver elevations in chem

10. T4 (cats)

11. Fructosamine → cats

12. A1C

how to treat diabetes mellitus (5)

1. Insulin Therapy

2. Once regulated, patient needs regular monitoring

3. diet

4. Prevent and manage obesity

5. exercise

in diabetes mellitus what 2 comon foods should always be avoided

1. semi moist foods

2. sugary snacks

what diet should dogs have to help treat diabetes mellitus (4)

1. more energy/calories should come from fat

2. Fiber helps to slow digestion

3. Increased protein to reduce gluconeogenesis

4. Maintain appropriate BCS

what diet should cats have to help treat diabetes mellitus (2)

1. low carbohydrate

2. high protein

what are the treatment goals of diabetes mellitus (5)

1. Control clinical signs

2. Maintain healthy body weight

3. maintain hydration

4. Manage concurrent diseases

5. Prevent hypoglycemia and other complications

6. Educate owners about ongoing care

how to prevent diabetes mellitus (3)

1. weight control

2. Careful not to feed foods that contribute to obesity

3. Feeding the same foods that can contribute to obesity

client education regarding diabetes mellitus should include (6)

1. How to give injections

2. Storage and handling of insulin - no shaking!

3. Diet & exercise

4. Home monitoring

5. Complications

6. Signs of insulin overdose:

what are the signs of an insulin overdose (7)

1. Hypoglycemia

2. Weakness

3. Incoordination

4. Restlessness

5. Seizures

6. Coma

7. Death

what is an insulinoma

Tumours of the β cells of the pancreas that secrete insulin unchecked by the normal negative feedback loop

what breeds are susceptible to insulinoma (5 dogs + 1 cat)

1. Standard Poodle

2. GSD

3. Irish Setter

4. Boxer

5. Fox Terrier

6. Siamese in cats

clinical signs of insulinoma (7)

1. Seizures

2. Weakness

3. collapse

4. Ataxia

5. Bizarre behaviour

6. Depression

7. lethargy

clinical signs can seem worse in insulinoma from (3)

1. exercise

2. fasting

3. excitement

how to diagnose insulinoma (3)

1. Ultrasound to detect mass

2. Whipple’s triad

3. plasma insulin concentrations

define Whipple’s triad

a classic three-part clinical diagnostic framework used to confirm true, clinically significant hypoglycemia (low blood sugar)

how to treat insulinoma (5)

1. surgery

2. Karo syrup to be given during periods of acute hypoglycemia crisis at home

3. fed more frequent meals

4. limit exercise

5. prescribed medications that will inhibit the production of insulin

what is the exocrine function of the pancreas

Produce digestive enzymes that are released into the duodenum

what is the endocrine function of the pancreas

produce hormones

what do beta cells in the pancreas produce

insulin

what do alpha cells in the pancreas produce

glucagon

what does insulin do

lowers blood glucose by helping glucose enter cells

what does glucagon do

increases glucose in the blood

what causes hyperthyroidism (3)

1. a benign tumor

2. enlargement of the thyroid gland

3. rarely by thyroid carcinoma

what age range does hyperthyroidism affect cats (super general) (range)

middle to old

clinical signs of hyperthyroidism (13)

1. PU/PD

2. Weight loss

3. Polyphagia

4. Tachycardia

5. +/- heart murmur

6. Palpable thyroid nodule

7. Change in behaviour

8. unkempt fur

9. Anorexia

10. Hypertension

11. Retinal detachment

12. retinal bleeding

13. Kidney disease

how to diagnose hyperthyroidism (3)

1. very elevated T4

2. Elevation in liver enzymes

3. Ultrasound to assess heart

how to medically treat hyperthyroidism (5)

1. Oral medication

2. transdermal medication

3. methimazole

4. Usually twice daily therapy

5. Recheck T4 level in 3 to 4 weeks after initial diagnosis, then every 3-6 months for continued monitoring

how to surgically treat hyperthyroidism (1)

Requires complete removal of thyroid tumor

what are Potential complications in surgical treatment for hyperthyroidism (3)

1. Ectopic thyroid tissue

2. Damage to parathyroid gland

3. High risk general anesthesia patients

how to treat hyperthyroidism with radiation (1)

A subcutaneous injection of I131

what diet can treaet hyperthyroidism

y/d diet

what causes Primary hypothyroidism (2)

1. Immune mediated thyroiditis

2. Idiopathic thyroid atrophy

define Immune mediated thyroiditis

immune system attacks normal thyroid tissue

Immune mediated thyroiditis aka

lymphocytic thyroiditis

define Idiopathic thyroid atrophy

thyroid tissue is replaced with fat tissue, poorly understood

what causes hypothyroidism (3)

1. Primary hypothyroidism

2. Congenital hypothyroidism

3. Cancer of the thyroid gland

what dog breeds are prone to hypothyroidism (6)

1. Cocker spaniel

2. dobermans

3. golden retrievers

4. Irish setters

5. dachshunds

6. schnauzers

clinical signs of hypothyroidism (19)

1. Weight gain

2. decrease food intake

3. Lethargy

4. Cold intolerance

5. Poor hair coat

6. Scaly

7. +/- greasy

8. ± smelly

9. increased risk of ear

10. increased risk of skin infections

11. Alopecia

12. Dark pigmentation to the skin

13. Rat tail

14. High blood cholesterol

15. KCS

16. Bradycardic

17. Mental dullness

18. Reproductive abnormalities

19. infertility

how to diagnose hypothyroidism (7)

1. Bradycardic

2. Mental dullness

3. Reproductive abnormalities

4. infertility

5. Mild non-regenerative anemia

6. Hypercholesterolemia

7. mild elevations in liver enzymes

how to treat hypothyroidism (3)

1. Oral synthetic T4

2. Begin with BID therapy

3. Check levels every 6 months to see if adjustment is needed

What is the main reason for a lot of the clinical signs we see in our hyperthyroid cats like weight loss, hypertension, retinal detachment, and heart disease?

a. decreased metabolic rate

b. Increased metabolic rate

b. Increased metabolic rate

I131 works by:

a. Causing uptake of the iodine by thyroid tissue and preserving healthy tissue

b. causing uptake of the iodine by thyroid tissue and destroying only abnormal tissue

b. causing uptake of the iodine by thyroid tissue and destroying only abnormal tissue

Hypothyroidism usually affects

a. dogs

b. cats

a. dogs

Which of the following is not a clinical sign of hypothyroidism?

a. rat tail

b. weight gain

c. weight loss

d. alopecia

c. weight loss

For diagnosis of an animal with hypothyroidism their blood sample usually looks like

a. low T4, low TSH

b. high T4, low TSH

c. high T4, high TSH

d. low T4, high TSH

d. low T4, high TSH

Hyperadrenocorticism aka

Cushing’s disease

what causes Cushing’s disease (3)

1. Pituitary tumor

2. Adrenal tumor

3. iatrogenic from excess or prolonged steroid administration

non-dermatological related clinical signs of cushings disease (8)

1. PU/PD

2. Polyphagia

3. Pot belly

4. Obesity

5. Panting

6. Muscle weakness

7. lethargy

8. lameness

dermatology related clinical signs of cushings disease (8)

1. Alopecia

2. Seborrhea sicca

3. Pruritus

4. pyoderma

5. Comedones on the ventral abdomen

6. Comedones on the caudo-dorsal back

7. Thin skin that lacks elasticity and tone, very fragile

8. Abnormal gonadal function

how to diagnose cushings disease (10)

1. increased ALP

2. increased ALT

3. increased cholesterol

4. increased blood glucose

5. Decreased BUN.

6. Lipemia

7. Evaluate cortisol levels

8. LDDST

9. HDDST

10. ACTH stimulation Test

how to treat adrenal cushings disease (2)

1. medical

2. surgical

what is the goal of cushings disease treatment

resolution of clinical signs

how to treat pituitary cushings disease

medical

how to treat cushings disease (non-specific) (4)

1. Mitotane

2. Ketaconazole

3. Selegiline

4. Trilostane

Hypoadrenocorticism aka

addison’s disease

addison’s disease is a decreased production of (2)

1. Cortisol

2. Aldosterone

cortisol is known as the — hormone

stress

Aldosterone is known as the — hormone

mineralocorticoid

what causes addisons disease (2)

1. Immune mediated disease

2. Iatrogenic

define Immune mediated addisons disease

The body attacks the adrenal glands

define iatrogenic addisons disease (2)

1. due to sudden withdrawal of steroid treatment

2. overdose of mitotane when treating hyperadrenocorticism

clinical signs of addisons disease (10)

1. GI signs

2. PU/PD

3. Weakness

4. lethargy

5. depression

6. Bradycardia

7. Waxing and waning of clinical signs

8. Dehydration

9. Collapse

10. Acute Addisonian Crisis

define Acute Addisonian Crisis (2ish)

Deficiency in both mineralocorticoids and glucocorticoids

clinical signs of acute addisonian crisis (5)

1. Hypovolemic

2. hypotensive

3. shock

4. electrolyte imbalances

5. acidotic

define Moribund

approaching death

how to diagnose addisons disease (9)

1. Non regenerative anemia

2. lymphocytosis

3. Elevated potassium

4. decrease sodium

5. Azotemia

6. Hypercalcemia

7. Hypoglycemia

8. decreased albumin

9. Acidosis

10. ACTH stimulation test

in a ACTH stimulation test : If no rise in blood cortisol after ACTH injection = —

hypoadrenocorticism

how to treat addisons disease (6)

1. Mineralocorticoid replacement

2. Glucocorticoid replacement

3. Addisonian crisis treatment

4. IV fluids

5. Steroids

6. +/- Bicarbonate

Adrenal cortex produces: — hormones

steroids

Adrenal medulla produces: — and —

epinephrine, norepinephrine

Adrenal cortex is stimulated by — hormone

Adrenocorticotropic

ACTH stands for

Adrenocorticotropic hormone

Adrenocorticotropic hormone is released by the — — —

anterior pituitary gland

Cushing’s disease can be caused by all of the following except for:

a. pituitary tumour

b. adrenal tumour

c. immune mediated

d. iatrogenic from excess or prolonged steroid use

c. immune mediated

Addison’s disease is caused by

a. decreased production of cortisol

b. increased production of cortisol

c. decreased production of aldosterone

d. A and C

d. A and C

Which electrolyte must be controlled during an Addisonian crisis that can cause heart arrhythmias and a slow heart rate?

a. potassium

b. sodium

c. chloride

d. glucose

a. potassium