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Radosta L. Behavior Changes Associated with Metabolic Disease of Dogs and Cats. Vet Clin North Am Small Anim Pract 2024; 54:17-28. [PMID: 37734960 DOI: 10.1016/j.cvsm.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Like many physical disorders, the clinical signs associated with metabolic diseases affecting thyroid, adrenal, and pancreatic function are reflective of nonspecific changes in behavior. Additionally, patients who have underlying disorders associated with fear, anxiety, stress, conflict, and/or panic may be under treatment with medications that alter basal thyroid, glucose, and cortisol levels. Through reinforcement and punishment of behaviors associated with clinical signs caused by organic or iatrogenic endocrine disease, behaviors can be perpetuated and become persistent patterns. Screening all patients presenting with a primary behavior complaint or those with behavioral clinical signs of endocrine diseases is essential. Alleviating stress immediately while working up or treating metabolic disease reduces suffering and may stave off the adoption of behavior patterns more permanently.
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Affiliation(s)
- Lisa Radosta
- Florida Veterinary Behavior Service, West Palm Beach, FL, USA.
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2
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Abend GC, de Azevedo SF, dos Santos AS, Cobucci GC, de Souza HJM. Feline congenital hypothyroidism: a case report. BRAZILIAN JOURNAL OF VETERINARY MEDICINE 2023; 45:e003423. [PMID: 38024778 PMCID: PMC10680995 DOI: 10.29374/2527-2179.bjvm003423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 09/20/2023] [Indexed: 12/01/2023] Open
Abstract
We report a two-month-old male cat weighing 630 grams with congenital hypothyroidism. The main complaints were difficulty defecating for more than three days and prostration. Physical examination revealed a broad, flat face, a short neck, enlarged submandibular lymph nodes, chemosis, mild bilateral mucopurulent ocular discharge, seborrheic coat, with gingival thickening around the upper and lower deciduous incisor teeth with partial eruption. The abdomen was distended due to constipation and right unilateral cryptorchidism. Based on this, feline congenital hypothyroidism was suspected. Hormonal tests (free T4 by equilibrium dialysis of 0.06 ng/dl, total T4 of 0.1 ng/ml and TSH of 4.7 ng/ml) confirmed this. Treatment was started with levothyroxine sodium (5-32.2 µg/kg/day). After 120 days of treatment, there was clinical stabilization. Then the patient underwent orchiectomy of the left and of the right ectopic testicles, and at 380 days of treatment, the thyroid scintigraphy showed intense uptake of the radiopharmaceutical by both thyroid lobes and a significant increase in volume. Clinical evaluation showed weight gain (2.6 kilograms during treatment), improvement in the shape of the skull, and a notable increase in body size. At 17 months of age, hormone values were within the reference limits after administration of levothyroxine sodium (32.2µg/kg/day).
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Affiliation(s)
| | - Stephanie Favato de Azevedo
- Veterinarian, Programa de Pós-Graduação em Clínica Médica de Felinos, Centro Universitário de Tecnologia de Curitiba (UNIFATEC-PR), Polo Equalis Sul, Curitiba, PR, Brazil.
| | - Arthur Saturiano dos Santos
- Undergraduate in Veterinary Medicine, Instituto de Veterinária (IV), Universidade Federal Rural do Rio de Janeiro (UFRRJ). Seropédica, RJ, Brazil.
| | - Gustavo Carvalho Cobucci
- Veterinarian, Autonomous, Centro de Diagnóstico por Imagem Avançada - Gamma Vet, Rio de Janeiro, RJ, Brazil.
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Pankowski F, Bartyzel BJ, Paśko S, Moroz A, Mickiewicz M, Szaluś-Jordanow O, Bonecka J. CT appearance and measurements of the normal thyroid gland in goats. BMC Vet Res 2021; 17:337. [PMID: 34696796 PMCID: PMC8547050 DOI: 10.1186/s12917-021-03047-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 10/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Goats are increasingly being kept as companion animals, thus their owners expect advanced medical care, including modern diagnostic imaging. Computed tomography (CT) is now widely used in veterinary medicine, in both clinical practice and for scientific purposes. So far, the CT appearance of various body parts has been described in goats, but reports on thyroid gland CT are still lacking. The thyroid gland in goats may become enlarged due to dietary, genetic or neoplastic disorders. CT examination, as in other animals and humans, could aid in the diagnosis of thyroid diseases in goats and could be used for research purposes. The aim of the study was to present the CT characteristics of the normal caprine thyroid gland, in particular its dimensions, volume and density. Results Fifty-seven goats were included in the study. None of the animals had clinical, CT, post-mortem or histopathologic abnormalities in the thyroid gland. CT features of the thyroid gland were determined, such as dimensions, volume, density, location and shape. The presence of the thyroid isthmus and ectopic thyroid tissue was also assessed. The gland was visible in every animal as two homogenous, highly attenuating, well-circumscribed lobes located in the most cranial part of the trachea. The mean dimensions of the thyroid lobe were 30.3 × 12.7 × 6.7 mm, the mean density was 80.9 Hounsfield Units (HU) and the mean volume was 1.32 cm3 or 1.39 cm3, depending on the method used. Also, the internal parathyroid glands were visible in some animals. Conclusions For the first time, the normal CT appearance of the thyroid gland has been presented. CT clearly shows the thyroid gland in goats and therefore can be used in clinical practice and for research. The results of the current study may serve as a radiological guideline for practitioners and may be the basis for further CT studies on normal and diseased caprine thyroid glands. Supplementary Information The online version contains supplementary material available at 10.1186/s12917-021-03047-w.
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Affiliation(s)
- Filip Pankowski
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland.
| | - Bartłomiej Jan Bartyzel
- Department of Morphological Sciences, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Sławomir Paśko
- Virtual Reality Techniques Division, Institute of Micromechanics and Photonics, Faculty of Mechatronics, Warsaw University of Technology, Warsaw, Poland
| | - Agata Moroz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Marcin Mickiewicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Olga Szaluś-Jordanow
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Joanna Bonecka
- Department of Small Animal Diseases with Clinic, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
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Brame B, Cain C. Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors. J Feline Med Surg 2021; 23:433-446. [PMID: 33896249 PMCID: PMC10741284 DOI: 10.1177/1098612x211007072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE Chronic otitis can be one of the most frustrating diseases to manage for a small animal practitioner. While it occurs less commonly in the cat than the dog, it is no less challenging. The purpose of this review is to discuss the common and uncommon causes of chronic otitis in the cat within the clinical framework used for diagnosis and treatment. The focus is on diseases that affect the ear canal, rather than those restricted to the pinnae. CLINICAL CHALLENGES Otitis is multifactorial, which complicates management. A common clinical mistake is to focus solely on treating the infection present. Only by addressing all factors will a clinician successfully control chronic otitis. For the purposes of this review, the authors have adopted the established model of separating primary, predisposing and perpetuating causes of otitis. Primary factors are those that directly cause otitis (inflammation); predisposing factors are those that put the patient at risk for development of otitis; and perpetuating factors are those that result in ongoing clinical signs of otitis or that prevent clinical resolution. AUDIENCE This review is aimed at veterinarians who treat cats and particularly those with an interest in feline dermatology and otology. EQUIPMENT While many practitioners rely on a hand-held otoscope, a video-otoscope can be very helpful for the diagnosis and treatment of chronic otitis. EVIDENCE BASE This review presents up-to-date information regarding the diagnosis and treatment of chronic otitis in cats, with emphasis on the most recent peer-reviewed literature.
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Affiliation(s)
- Bailey Brame
- Department of Clinical Sciences and Advanced
Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce
Street, Philadelphia, PA 19104, USA
| | - Christine Cain
- Department of Clinical Sciences and Advanced
Medicine, University of Pennsylvania, School of Veterinary Medicine, 3900 Spruce
Street, Philadelphia, PA 19104, USA
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Hermans M, Burger NC, Kromhout K, Bhatti SFM, Cornelis I. Clinical and diagnostic findings in a dog and a cat with congenital hypothyroidism. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Michelle Hermans
- Small Animal DepartmentUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
| | | | - Kaatje Kromhout
- Veterinary Medical Imaging and Small Animal OrthopaedicsUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
| | - Sofie F M Bhatti
- Small Animal DepartmentUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
| | - Ine Cornelis
- Small Animal DepartmentUniversiteit Gent Faculteit DiergeneeskundeMerelbekeBelgium
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Iturriaga MP, Cocio JA, Barrs VR. Cluster of cases of congenital feline goitrous hypothyroidism in a single hospital. J Small Anim Pract 2020; 61:696-703. [PMID: 32974927 DOI: 10.1111/jsap.13231] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To describe the clinicopathological findings and outcomes of cases of feline congenital hypothyroidism diagnosed in a single veterinary hospital in Santiago, Chile. MATERIALS AND METHODS Medical records were searched for cases of congenital hypothyroidism over an 18-month period. Inclusion criteria were a diagnosis of congenital hypothyroidism based on consistent historical and clinical findings, a low or low-normal serum total T4 and elevated serum canine TSH (cTSH). RESULTS Six unrelated cats ranging in age from 4 to 19 months met the inclusion criteria. The most common historical signs were small stature and lethargy. All cats had disproportionate dwarfism, delayed tooth eruption, retained deciduous teeth, bilateral palpable goitres and low rectal temperatures. Other findings were bradycardia, obesity, poor hair coat and focal alopecia on the ventral aspects of the elbows and hocks. In all cases, cTSH was markedly elevated. Sequential changes noted after the initiation of therapy included normal T4 after 6 weeks, improved hair coat and increased physical activity by 8 weeks, normal cTSH by 10 weeks and normal physical appearance and dentition after 4 months. Goitres shrank markedly but remained palpable. Hypothyroidism was well managed clinically in all cases 2 years after diagnosis except for one cat that died of unrelated causes. CLINICAL SIGNIFICANCE This is the first report to describe a cluster of congenital hypothyroidism cases in non-related cats that were presented over a short period of time. Growth defects resolve with treatment, even in cats diagnosed after puberty. Larger, prospective multi-centre studies are warranted to determine the incidence of congenital hypothyroidism in cats.
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Affiliation(s)
- M P Iturriaga
- Escuela de Medicina Veterinaria, Facultad de Medicina Veterinaria y Agronomía, Universidad de Las Américas, Manuel Montt 948, Providencia, Santiago, 7500975, Chile
| | - J A Cocio
- Hospital Clínico Veterinario Universidad de Chile, Francisco Bilbao 2854, Providencia, Santiago, 7510828, Chile
| | - V R Barrs
- Jockey Club College of Veterinary Medicine and Life Sciences, Department of Veterinary Clinical Sciences, City University of Hong Kong, 31 To Yuen St, Kowloon Tong, Hong Kong, SAR China
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Peterson ME, Carothers MA, Gamble DA, Rishniw M. Spontaneous primary hypothyroidism in 7 adult cats. J Vet Intern Med 2018; 32:1864-1873. [PMID: 30294940 PMCID: PMC6271337 DOI: 10.1111/jvim.15239] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/10/2018] [Accepted: 05/15/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Naturally occurring hypothyroidism in adult cats is rare, with only 4 cases reported. OBJECTIVES To describe the historical, clinical, laboratory, and scintigraphic features of adult cats with spontaneous hypothyroidism. ANIMALS Seven adult cats referred for suspected hypothyroidism. METHODS Prospective case series. We collected data on cats' signalment, clinical signs, results of physical examination, routine laboratory and thyroid hormone testing, and thyroid imaging (thyroid scintigraphy or ultrasound). We subsequently treated cats with levothyroxine and evaluated their response to treatment. RESULTS Cats ranged from 3.5 to 11 years, with no apparent breed predilection; 6/7 cats were male. Only 2/7 cats were initially tested because of signs of hypothyroidism (hair-coat changes, lethargy, obesity); others were tested for routine thyroid monitoring or palpable thyroid nodules. Four were azotemic (serum creatinine, 2.2-3.4 mg/dL). Six of the cats had low serum thyroxine (T4 ) and free T4 (fT4 ) concentrations, whereas all 7 cats had high thyroid-stimulating hormone (TSH) concentrations. In 6/7 cats, thyroid scintigraphy revealed bilateral goiter with intense radionuclide uptake; imaging showed no visible thyroid tissue in the other. After levothyroxine treatment, serum concentrations of T4 and fT4 increased and TSH fell; high serum creatinine normalized in azotemic cats; and repeat imaging showed reduction in goiter size. CONCLUSIONS AND CLINICAL IMPORTANCE Primary hypothyroidism develops in adult cats, with a higher prevalence than previously thought. Most cats appear to develop a goitrous form of hypothyroidism associated with thyroid hyperplasia, whereas thyroid atrophy appears to be less common. With levothyroxine replacement, clinical and laboratory abnormalities improve or resolve.
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Affiliation(s)
- Mark E. Peterson
- Animal Endocrine ClinicNew York
- College of Veterinary MedicineCornell UniversityIthacaNew York
| | | | | | - Mark Rishniw
- College of Veterinary MedicineCornell UniversityIthacaNew York
- Veterinary Information NetworkDavisCalifornia
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Wormhoudt TL, Boss MK, Lunn K, Griffin L, Leary D, Dowers K, Rao S, LaRue SM. Stereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly. J Vet Intern Med 2018; 32:1383-1391. [PMID: 29782043 PMCID: PMC6060317 DOI: 10.1111/jvim.15212] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 02/21/2018] [Accepted: 04/19/2018] [Indexed: 12/11/2022] Open
Abstract
Background Conventional fractionated radiotherapy has been shown to be partially effective for management of pituitary tumors in cats that cause acromegaly and diabetes mellitus (DM), but, the efficacy and safety of stereotactic radiation therapy (SRT) as a treatment for acromegalic cats has not been described. Hypothesis Stereotactic radiation therapy is an effective and safe treatment for controlling acromegaly associated with pituitary adenomas in cats. Additionally, SRT‐treated acromegalic cats with DM will experience a decrease in insulin requirements after radiation therapy. Animals Fifty‐three client‐owned cats referred to Colorado State University for SRT to treat pituitary tumors causing poorly controlled DM secondary to acromegaly. Methods Retrospective study of cats treated for acromegaly with SRT between 2008 and 2016 at Colorado State University. Diagnosis of acromegaly was based on history, physical examination, laboratory results, and cross‐sectional imaging of the pituitary. Signalment, radiation protocol, insulin requirements over time, adverse effects, and survival were recorded. Results Median survival time was 1072 days. Of the 41 cats for which insulin dosage information was available, 95% (39/41) experienced a decrease in required insulin dose, with 32% (13/41) achieving diabetic remission. Remission was permanent in 62% (8/13) and temporary in 38% (5/13) cats. Median duration to lowest insulin dose was 9.5 months. Of the treated cats, 14% developed hypothyroidism and required supplementation after SRT. Conclusions Stereotactic radiation therapy is safe and effective for treating cats with acromegaly. Cats treated with SRT have improved survival time and control of their DM when compared to previously reported patients treated with non‐SRT.
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Affiliation(s)
- Tiffany L Wormhoudt
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Mary-Keara Boss
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Katharine Lunn
- Department of Clinical Sciences, North Carolina State University Veterinary Hospital, Raleigh, North Carolina
| | - Lynn Griffin
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Del Leary
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
| | - Kristy Dowers
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Sangeeta Rao
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado
| | - Susan M LaRue
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado
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Bree L, Gallagher BA, Shiel RE, Mooney CT. Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area. Ir Vet J 2018; 71:2. [PMID: 29372047 PMCID: PMC5769238 DOI: 10.1186/s13620-017-0113-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 12/21/2017] [Indexed: 11/10/2022] Open
Abstract
Background Hyperthyroidism is common in older cats. Prevalence varies geographically, but is anecdotally considered low in Ireland. The aim of this study was to document prevalence of hyperthyroidism in older cats in the greater Dublin area of Ireland and to assess environmental and clinical associations for development and identification of the disease. Methods Primary-care veterinary practices were requested to select cats aged 10 years or older where blood sampling was being performed for health screening or clinical investigations. Surplus serum/plasma samples were submitted to University College Dublin Diagnostic Endocrine Laboratory for total thyroxine (T4) measurement. Cats were classified as hyperthyroid, equivocal or euthyroid based on a total T4 concentration (reference interval, 15-60 nmol/L), of >60 nmol/L, 30-60 nmol/L or <30 nmol/L, respectively. Simultaneous free T4 or repeat (after 4-6 weeks) total T4 measurement was recommended in all equivocal cases. Animals receiving treatment for hyperthyroidism were excluded. A questionnaire completed by the client and veterinarian detailing historical and physical information was also required. Associations between categorical variables were analysed by Chi-square or Fisher's exact test and odds ratio (OR) calculated. A P value of <0.05 was considered statistically significant. Results Samples were submitted from 507 cats including 107 (21.1%) hyperthyroid, 54 (10.6%) equivocal and 346 (68.2%) euthyroid. The presence of goitre (P < 0.0001), tachypnoea (P = 0.0378), tachycardia (P = 0.002), polyphagia (P = 0.0003) and weight loss (P < 0.0001) were significantly associated with hyperthyroidism. Cats with goitre were more likely to be diagnosed as hyperthyroid [OR 2.85, (95% CI 1.75-4.62] compared to those without. However, goitre was only palpated in 40 of 102 (39.2%) hyperthyroid cats. Increasing age was the only significant (P < 0.002) risk factor for development of hyperthyroidism. A relationship between hyperthyroidism and sex, breed, lifestyle, parasite control, vaccination status or feeding habits was not identified. Conclusions Hyperthyroidism is not uncommon in Irish cats. Age was the only significant risk factor for its development. The high proportion of hyperthyroid cats without palpable goitre (> 60%) may reflect failure to detect goitre and account for the perceived low prevalence of this condition in Ireland.
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Affiliation(s)
- Laura Bree
- 1Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Barbara A Gallagher
- Present Address: Chestergates Veterinary Specialists, Telford Court Chestergates Roads Chester, Cheshire, CH1 6LT UK
| | - Robert E Shiel
- 1Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Carmel T Mooney
- 1Section of Small Animal Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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Peterson ME, Nichols R, Rishniw M. Serum thyroxine and thyroid-stimulating hormone concentration in hyperthyroid cats that develop azotaemia after radioiodine therapy. J Small Anim Pract 2017; 58:519-530. [DOI: 10.1111/jsap.12695] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 03/10/2017] [Accepted: 04/14/2017] [Indexed: 02/01/2023]
Affiliation(s)
- M. E. Peterson
- Animal Endocrine Clinic; New York NY 10025 USA
- Department of Clinical Sciences, College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
| | - R. Nichols
- Animal Endocrine Clinic; New York NY 10025 USA
- Antech Diagnostics; Lake Success NY 11042 USA
| | - M. Rishniw
- Department of Clinical Sciences, College of Veterinary Medicine; Cornell University; Ithaca NY 14853 USA
- Veterinary Information Network; Davis CA 95615 USA
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Peterson ME. Primary goitrous hypothyroidism in a young adult domestic longhair cat: diagnosis and treatment monitoring. JFMS Open Rep 2015; 1:2055116915615153. [PMID: 28491394 PMCID: PMC5362015 DOI: 10.1177/2055116915615153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2015] [Indexed: 11/17/2022] Open
Abstract
Case summary Primary goitrous hypothyroidism was diagnosed in a 12-month-old cat examined because of small stature, mental dullness, severe lethargy, generalized weakness and gait abnormalities. Radiographs of the long bones and spine revealed delayed epiphyseal ossification and epiphyseal dysgenesis. Diagnosis of primary hypothyroidism was confirmed by low serum concentrations of total and free thyroxine (T4) with high thyroid-stimulating hormone (TSH) concentrations. Thyroid scintigraphy revealed severe enlargement of both thyroid lobes, as evidenced by a seven-fold increase in calculated thyroid volume above the reference interval. In addition, this bilateral goiter had an extremely high radionuclide uptake, about 10-fold higher than the normal feline thyroid gland. Treatment with twice-daily levothyroxine (L-T4), administered on an empty stomach, resulted in increased alertness, playfulness, strength and improvement in gait, as well as an increase in body length and weight. L-T4 replacement also led to normalization of serum thyroid hormone and TSH concentrations, and complete resolution of goiter. Relevance and novel information Spontaneous hypothyroidism is rarely reported in cats, with congenital hypothyroidism in kittens diagnosed most frequently. Despite the fact that this cat was a young adult, it likely had a form of congenital hypothyroidism caused by dyshormonogenesis (defect in thyroid hormone synthesis) that led to compensatory development of goiter. In hypothyroid cats, treatment with L-T4 is best given twice daily on an empty stomach to ensure adequate absorption. Normalization of serum TSH and shrinkage of goiter, as well as improvement in clinical signs, is the goal of treatment for cats with goitrous hypothyroidism.
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Affiliation(s)
- Mark E Peterson
- Animal Endocrine Clinic, New York, NY, USA.,College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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