Hyperthyroidism in cats: what's causing this epidemic of thyroid disease and can we prevent it?

Organophosphate flame retardants and their metabolites in paired dog food and urine: Pet exposure through food consumption

Companion dogs are exposed to various chemicals. However, our understanding of the sources and pathways of chemical exposure in pets remains limited. In this study, we collected urine samples from 47 dogs and corresponding samples of the food they consumed to analyze the concentrations and dietary exposure to organophosphate flame retardants (OPFRs) and their metabolites (mOPFRs). Triphenyl phosphate (TPHP) and its metabolite, diphenyl phosphate (DHPH), were the predominant compounds detected in dog food and urine samples. The concentration of mOPFRs in urine decreased as body weight increased; however, neither sex nor age significantly influenced mOPFR levels in dog urine. The estimated daily intake of OPFRs (343 ng/kg bw/day) through food consumption (EDIfood) was comparable to the previously reported levels of polycyclic aromatic hydrocarbons (324 ng/kg bw/day) and higher than those of pesticides (214 ng/kg bw/day), parabens (120 ng/kg bw/day), and polychlorinated biphenyls (103 ng/kg bw/day). By calculating the ratio of EDIfood to the cumulative daily intake based on urinary mOPFR concentrations, it was found that dietary sources contributed to 66% of the total TPHP exposure in dogs. This finding was further supported by Spearman's correlation analysis between parent OPFR concentrations in dog food and mOPFR levels in urine (p < 0.01), indicating that dietary intake may be one of the most significant exposure pathways for OPFRs in dogs. To the best of our knowledge, this is the first study to investigate the levels of OPFR exposure in paired dog food and urine samples.

Prevalence of feline hyperthyroidism in a laboratory-based sample of 27,888 cats in Spain

OBJECTIVES

The objective of the study was to investigate the prevalence of hyperthyroidism in Spain, including its geographical distribution and prevalence across different age groups.

METHODS

A cross-sectional study was conducted. Samples submitted to a reference laboratory to evaluate serum total thyroxine concentration (TT4) during a 3-year period were evaluated (n = 27,888). A cat was considered hyperthyroid if the TT4 concentration was greater than 60.4 nmol/l (4.7 μg/dl). Hyperthyroid cats were classified based on their TT4 concentration at diagnosis as mildly (TT4 60.4-124.8 nmol/l [4.7-9.7 μg/dl]), moderately (TT4 124.8-249.68 nmol/l [9.7-19.4 μg/dl]) or severely (TT4 >249.6 nmol/l [>19.4 μg/dl]) hyperthyroid. The samples were also grouped by life stage, into young adults (1-6 years old), mature adults (7-10 years old) and seniors (>10 years old). The study included samples from 17 regions of Spain and geographical mapping was based on seven domains.

RESULTS

One thousand seven hundred and twenty-two out of 27,888 cats (6.2%, 95% confidence interval [CI] = 5.9-6.5) were classified as hyperthyroid. Within the hyperthyroid group, ages ranged from 2 to 25 years old, with a median of 14 years. Within the hyperthyroid population, 14/368 (3.8%), 27/368 (7.3%) and 327/368 (88.8%) were young adults, mature adults and seniors, respectively. The prevalence of hyperthyroidism in this laboratory-based sample in Spain was 2.7 (95% CI = 0.4-5.7) to 6.9% (95% CI = 6.4-7.4), depending on the geographical region. During the study period, 8.2% of cases that were initially non-hyperthyroid were later diagnosed with hyperthyroidism.

CONCLUSIONS AND RELEVANCE

Prevalence of hyperthyroidism in Spain is 6.2% (95% CI = 5.9-6.5) overall and 7.9% (95% CI = 7.2-8.8) in cats older than 10 years. The distribution of the disease is heterogeneous between different geographical regions. Further large-scale prospective studies are required to determine the risk factors in each region and understand the reasons for this variation.

Transcriptomic analysis reveals a critical role for activating Gsα mutations in spontaneous feline hyperthyroidism

Feline hyperthyroidism (FHT) is a debilitating disease affecting > 10% of elderly cats. It is generally characterised by chronic elevation of thyroid hormone in the absence of circulating TSH. Understanding of the molecular pathogenesis of FHT is currently limited. However, FHT shares clinical and histopathological similarities with human toxic multinodular goitre, which has been associated with activating mutations in TSH receptor (TSHR) and Gsα encoding genes. Using RNA-seq transcriptomic analysis of thyroid tissue from hyperthyroid and euthyroid cats, we identified differentially expressed genes and dysregulated pathways in FHT, many of which are downstream of TSHR. In addition, we detected missense variants in thyroid RNA-seq reads that alter the structure of both TSHR and Gsα. All FHT-associated mutations were absent in germline sequence from paired blood samples. Only a small number of hyperthyroid cats demonstrated TSHR variation, however all thyroids from advanced cases of FHT carried at least one missense variant affecting Gsα. The activating nature of the acquired Gsα mutations was demonstrated by increased cAMP production in vitro. These data indicate that constitutive activation of signalling downstream of TSHR is central to the TSH-independent production of thyroid hormone in FHT, offering a novel therapeutic target pathway in this common disease.

Changes in Erythrocytes in 88 Hyperthyroid Cats

BACKGROUND

There is only a limited number of studies that show alterations in erythrocytes in feline hyperthyroidism. Discrepancies between the findings of these studies may be caused by the presence of concurrent diseases and the use of various haematological analysers.

METHODS

This study analysed changes in red blood cells (RBCs) in 88 hyperthyroid cats without concurrent diseases, to identify associations between observed changes and to assess the influence of serum thyroxine (T4) concentration, cat age, and sex, on RBC changes.

RESULTS

Among the eighty-eight hyperthyroid cats, erythrocytosis was observed in twelve, anaemia in four, macrocytosis in two, and microcytosis in three. Three of the four cases of anaemia probably resulted from concurrent unrecognised disease. Interestingly, all cases of microcytosis were recognized in cats that had erythrocytosis. This study identified a moderate negative correlation between RBC count and mean corpuscular volume (MCV; r = -0.57, p < 0.001). Concluding, it appears that erythrocytosis may be a response to the development of microcytosis. The correlation between RBC count and MCV in hyperthyroid cats may result from the increased action of hepcidin and erythropoietin coupled with the decreased action of thyroid-stimulating hormone (TSH).

Serum metabolome analysis in hyperthyroid cats before and after radioactive iodine therapy

Hyperthyroidism is the most common feline endocrinopathy. In hyperthyroid humans, untargeted metabolomic analysis identified persistent metabolic derangements despite achieving a euthyroid state. Therefore, we sought to define the metabolome of hyperthyroid cats and identify ongoing metabolic changes after treatment. We prospectively compared privately-owned hyperthyroid cats (n = 7) admitted for radioactive iodine (I-131) treatment and euthyroid privately-owned control (CON) cats (n = 12). Serum samples were collected before (T0), 1-month (T1), and three months after (T3) I-131 therapy for untargeted metabolomic analysis by MS/MS. Hyperthyroid cats (T0) had a distinct metabolic signature with 277 significantly different metabolites than controls (70 increased, 207 decreased). After treatment, 66 (T1 vs. CON) and 64 (T3 vs. CON) metabolite differences persisted. Clustering and data reduction analysis revealed separate clustering of hyperthyroid (T0) and CON cats with intermediate phenotypes after treatment (T1 & T3). Mevalonate/mevalonolactone and creatine phosphate were candidate biomarkers with excellent discrimination between hyperthyroid and healthy cats. We found several metabolic derangements (e.g., decreased carnitine and α-tocopherol) do not entirely resolve after achieving a euthyroid state after treating hyperthyroid cats with I-131. Further investigation is warranted to determine diagnostic and therapeutic implications for candidate biomarkers and persistent metabolic abnormalities.

Behavior Changes Associated with Metabolic Disease of Dogs and Cats

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.

DISEASE PROCESSES IDENTIFIED IN CAPTIVE ARABIAN SAND CATS (FELIS MARGARITA HARRISONI)

The objective of this retrospective study is to identify common and significant causes of mortality and disease processes in the Arabian sand cat (Felis margarita harrisoni) captive population at Al Ain Zoo (Abu Dhabi, United Arab Emirates). Complete postmortem records of 25 Arabian sand cats, dead between 2009 and 2022, were reviewed retrospectively. A complete postmortem examination was done in all cases, and information was recorded in the Al Ain Zoo database and files. Out of 25 animals dead, 11 were adults (4-12 yr) and 12 were classified as geriatric animals (>12 yr), with only two neonatal (0-4 mon) deaths and no recorded deaths in juveniles (4 mon to 4 yr). Interestingly, but also expected because of the age range, 24% of the cases had concurrent pathologies at the time of death. As expected in adult and geriatric felines, more than half of the cases (60%) developed nephropathies that were either one of the most important contributors or the main cause of death of the animal. Different neoplastic lesions were described in four cases and reported for the first time in this subspecies: benign peripheral nerve sheath tumor, hepatobiliary carcinoma, and two different thyroid neoplasia. A vasculoproliferative disorder of the liver, peliosis hepatis, was described in one of the cases. Additionally, in at least four cases, hyperthyroidism was strongly suspected in connection with thyroid neoplasia and hyperplasia, clinical signs, and other observed postmortem lesions. Traumatic causes of death also were reported in six cases, including the only two neonates recorded dead. This information will contribute to Arabian sand cat improved veterinary care by identifying common pathologies in this species, potentially allowing earlier diagnosis and, ultimately, improving their management and husbandry in the captive breeding populations.

Radioiodine treatment in hyperthyroid cats: insights into the characteristics of owners and their cats, and owner motivation and perceptions

OBJECTIVES

Radioiodine (131I) therapy is the most appropriate treatment option for many hyperthyroid cats, as it is minimally invasive and often curative. Nevertheless, 131I treatment is not always pursued by owners. Hence, it is important to obtain more insight into owner satisfaction during and after 131I treatment, and their decision-making process. In this study, we describe the characteristics of owners and their hyperthyroid cats referred for 131I therapy, and determine owners' motivation and how they experienced the 131I treatment of their cat.

METHODS

A survey was sent to owners whose cats underwent 131I therapy (n = 1071) between 2010 and 2017 at Ghent University. The survey contained 35 questions with tick-box or free-text answer options concerning family situation, pet insurance, previous therapy, comorbidities, motivation for 131I therapy and owner perception of this treatment.

RESULTS

In total, 438 owners completed 94% or more of the questionnaire. Over half of the cats (55%) had received previous medical, dietary or surgical treatment. Motivations for changing the initial therapy to 131I therapy included difficulties in administering medication (31%), insufficient improvement in clinical signs (23%), side effects (16%) and following the referring veterinarian's advice (16%). Almost a fifth of owners (18%) were not informed about the existence of 131I therapy by their veterinarian and found information on 131I treatment online or through friends. Hospitalising their cat was very distressing for 17% of owners. Most owners (92%) were satisfied with the treatment. Reasons for dissatisfaction were insufficient communication, iatrogenic hypothyroidism, persistent hyperthyroidism and comorbidities post-treatment.

CONCLUSIONS AND RELEVANCE

Our study stresses the importance of communication regarding the possible outcome of 131I treatment, the importance of managing underlying comorbidities before treatment and anticipating the stress of owners during their cat's hospitalisation period. The results of this study could help in improving client communication when advising on 131I treatment.

Endocrine-Disrupting Chemicals and Their Effects in Pet Dogs and Cats: An Overview

Over the past few decades, several pollutants classified as environmental endocrine-disrupting chemicals (EDCs) have become a matter of significant public health concern. Companion animals play a major role in human society, and pet ownership is substantially increasing worldwide. These intimate human-pet relationships imply sharing much of the same environment, thus including exposure to similar levels of EDCs in daily routine. Here, we review the current knowledge on the sources and routes of exposure to EDCs in domestic indoor and outdoor environments and discuss whether endocrine disruption is a health concern in pets. We summarize the phenomenon of endocrine disruption, providing examples of EDCs with a known impact on dog and cat health. Then, we propose an overview of the literature on the adverse effects of EDCs in domestic pets, with a special focus on the health of reproductive and thyroid systems. Finally, we explore the potential role of companion animals as unintentional sentinels of environmental exposure to EDCs and the implications for public health risk assessment in a "shared risk" scenario. Overall, this review supports the need for an integrated approach considering humans, animals, and the environment as a whole for a comprehensive assessment of the impact of EDCs on human and animal health.

No evidence of pulmonary hypertension revealed in an echographic evaluation of right-sided hemodynamics in hyperthyroid cats

OBJECTIVES

Hyperthyroidism is a common endocrinopathy affecting middle-aged to elderly cats, with multisystemic repercussions. Hyperthyroid humans show decreased lung compliance and increased cardiac output with subsequent left heart failure leading to pulmonary capillary congestion. Prognosis worsens with the development of increased pulmonary vascular pressures (ie, pulmonary hypertension [PH]) in hyperthyroid humans. The effect of excess thyroid hormone concentration on pulmonary arterial hemodynamics is unknown in cats. Assessing pulmonary vascular pressures in veterinary medicine relies heavily on echocardiographic measurements performed at the level of the heart and pulmonary trunk. This study investigated right-sided cardiac and pulmonary arterial hemodynamics in hyperthyroid cats using echocardiography.

METHODS

Echocardiographic examinations of hyperthyroid cats identified through a bi-institutional database search were reviewed for the determination of systolic pulmonary arterial pressure (PAP) and 20 other metrics. Values were compared with those of a healthy cat group using non-parametric statistical analyses.

RESULTS

Systolic PAP could not be determined in 23/26 hyperthyroid and 13/14 healthy cats owing to unmeasurable tricuspid regurgitation flow velocity. Hyperthyroid cats were roughly twice as old (P <0.001) and had 2-4-fold higher respiratory rates (P <0.001) than healthy cats. Hyperthyroid cats showed an increase in acceleration time-to-ejection time ratio of pulmonary flow (1.4-fold, P = 0.001), pulmonary artery velocity time integral (1.2-1.6-fold, P = 0.001), maximal pulmonary velocity (1.3-1.7-fold, P = 0.002), stroke volume (1.5-fold, P = 0.001) and cardiac output (1.6-fold, P <0.001) vs healthy cats. None of the other echocardiographic metrics reached statistical significance.

CONCLUSIONS AND RELEVANCE

Systolic PAP estimation proved unsuitable as a sole measurement for the assessment of PH in hyperthyroid cats owing to the frequent inability to interrogate tricuspid regurgitant flow velocity. Hyperthyroid cats have altered echocardiographic measures of pulmonary hemodynamics dissimilar to those reported in hyperthyroid humans. Differential effects of thyrotoxic cardiomyopathy on ventricular systolic function may underlie species differences.

Health impact assessment of pet cats caused by organohalogen contaminants by serum metabolomics and thyroid hormone analysis

Companion animals are in close contact with the human surroundings, and there is growing concern about the effects of harmful substances on the health of pet cats. In this study, we investigated the potential health effects of organohalogen compounds (OHCs) on thyroid hormone (TH) homeostasis and metabolomics in Japanese pet cats. There was a significant negative correlation between concentrations of several contaminants, such as polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), hydroxylated PCBs (OH-PCBs), hydroxylated PBDEs (OH-PBDEs), and THs in cat serum samples. These results suggested that exposure to OHCs causes a decrease in serum TH levels in pet cats. In this metabolomics study, each exposure level of parent compounds (PCBs and PBDEs) and their hydroxylated compounds (OH-PCBs and OH-PBDEs) were associated with their own unique primary metabolic pathways, suggesting that parent and phenolic compounds exhibit different mechanisms of action and biological effects. PCBs were associated with many metabolic pathways, including glutathione and purine metabolism, and the effects were replicated in in-vivo cat PCB administration studies. These results demonstrated that OHC exposure causes chronic oxidative stress in pet cats. PBDEs were positively associated with alanine, aspartate, and glutamate metabolism. Due to the chronic exposure of cats to mixtures of these contaminants, the combination of their respective metabolic pathways may have a synergistic effect.

Radioactive iodine dose and survival in cats with hyperthyroidism (2015-2020)

OBJECTIVES

Radioactive iodine (131I) is the preferred treatment for feline hyperthyroidism but neither the optimal 131I dose nor consistent predictors of post-treatment azotaemia have been determined. The aims of the study were to evaluate the relationships between: (1) 131I dose and survival; and (2) pretreatment and post-treatment serum creatinine concentration.

METHODS

Medical records of hyperthyroid cats treated with 131I at a single referral hospital were reviewed. Information regarding signalment, body weight, pretreatment and post-treatment serum total thyroxine concentration (TT4), serum creatinine concentration, 131I dose and survival were determined. Multivariable Cox proportional hazards analysis was used to identify variables associated with survival. Multivariable linear regression analysis was used to identify variables associated with post-treatment serum creatinine concentration.

RESULTS

One hundred and ninety-eight (79 male, 119 female) cats were treated for hyperthyroidism with 131I (median dose 138 MBq; interquartile range 92-168). Median survival time was 1153 days (range 16-1871). Post-treatment serum creatinine (P <0.001) and age (P = 0.049) were significantly associated with survival. Every 10 µmol/l increase in post-treatment serum creatinine concentration and every year increase in age was associated with a 1.07-fold (confidence interval [CI] 1.04-1.11) and 1.17-fold (CI 1.00-1.37) increase in the daily hazard of death, respectively. Pretreatment serum creatinine concentration was directly, and post-treatment serum TT4 concentration was inversely, associated with post-treatment serum creatinine concentration. Every 1 μmol/l increase in pretreatment serum creatinine concentration was associated with an increase in post-treatment serum creatinine concentration of 0.7 μmol/l (SE 0.17; P <0.001). Conversely, every 1 nmol/l decrease in post-treatment serum TT4 concentration was associated with a 1.2 μmol/l (SE 0.61; P <0.001) increase in post-treatment serum creatinine concentration.

CONCLUSIONS AND RELEVANCE

Post-treatment serum TT4 concentration was associated with post-treatment azotaemia, which was associated with survival. Although 131I dose was not directly associated with survival, dosing strategies that minimise post-treatment hypothyroidism and azotaemia could improve patient survival.

Hyperthyroid cats and their kidneys: a literature review

Hyperthyroidism and chronic kidney disease (CKD) are common diseases of geriatric cats, and often occur concurrently. Thus, a thorough understanding of the influence of thyroid function on renal function is of significant value for all feline practitioners. Among other effects, hyperthyroidism causes protein catabolism and increases renal blood flow and glomerular filtration rate (GFR). These effects render traditional renal markers insensitive for the detection of CKD in cats with uncontrolled hyperthyroidism. Furthermore, the development of iatrogenic hypothyroidism with over treatment of hyperthyroidism can be detrimental to renal function and may negatively affect long-term survival. This review discusses important diagnostic considerations of feline hyperthyroidism, as well as key treatment modalities, with an emphasis on the use of radioiodine and the importance of post treatment monitoring of thyroid and renal parameters. In Australia, a common curative treatment for cats with benign hyperthyroidism (i.e. thyroid hyperplasia or adenoma) is a fixed dose of orally administered radioiodine, regardless of the serum total thyroxine concentration at the time of diagnosis. This review discusses the long term outcomes of this standard of care in comparison with current, relevant research literature from around the world. Finally, this review explores the use of symmetric dimethylarginine (SDMA) in assessing renal function before and after treatment in hyperthyroid cats. SDMA correlates well with GFR and creatinine in non-hyperthyroid cats, but our understanding of its performance in hyperthyroid cats remains in its infancy.

Feline Comorbidities: Balancing hyperthyroidism and concurrent chronic kidney disease

PRACTICAL RELEVANCE

Both hyperthyroidism and chronic kidney disease (CKD) are common long-term conditions in older cats, which might be diagnosed concurrently or develop at different times. Hyperthyroidism may mask the presence of CKD, and vice versa, by various mechanisms that are described in this review. Hyperthyroidism treatment options should be carefully considered when CKD has also been diagnosed.

CLINICAL CHALLENGES

Although it can be difficult to diagnose hyperthyroidism and CKD simultaneously, given that one condition may mask the other, it is important to consider the presence of both diseases when examining an older cat presenting with vomiting, weight loss, polyuria/ polydipsia, anorexia or sarcopenia. The concurrent presence of hyperthyroidism and CKD requires careful monitoring of glomerular filtration rate biomarkers, and adequate and prompt support of kidney function when normal thyroid function is re-established. Iatrogenic hypothyroidism is a recognised complication of all of the treatment options for hyperthyroidism, and increases the risk of azotaemia. Therapy with levothyroxine is recommended for cats that are hypothyroid and azotaemic.

EVIDENCE BASE

The information in this review draws on current literature and guidelines related to the pathophysiology, diagnosis and treatment recommendations for feline hyperthyroidism and CKD.

Evaluation of potential thiamazole exposure of owners of orally treated hyperthyroid cats

OBJECTIVES

The objective of this study was to evaluate the presence of traces of thiamazole in the urine of owners of hyperthyroid cats treated with antithyroid drugs.

METHODS

Urine was collected from 24 owners of hyperthyroid cats, five human patients treated with thiamazole and five healthy humans without any contact with antithyroid drugs. All owners of hyperthyroid cats were asked to fill out a questionnaire. Urine of hyperthyroid cats was collected by spontaneous micturition. All urine samples were stored at -20°C until analysis by ultra-high-performance liquid chromatography coupled to high-resolution quadrupole Orbitrap mass spectrometry.

RESULTS

These owners were assessed to have a lot of contact with their cat. Adherence to antithyroid medication handling guidelines was rather poor. High concentrations of thiamazole were detected in all feline samples (median concentration 2818 ng/ml; range 104-15,127) and in the urine of all human patients treated with thiamazole (median concentration 4153 ng/ml; range 1826-5009). No thiamazole was detected in the urine of owners of hyperthyroid cats (limit of detection 3.88 ng/ml; limit of quantification 11.75 ng/ml).

CONCLUSIONS AND RELEVANCE

The results regarding the potential exposure of owners of hyperthyroid cats to antithyroid drugs are reassuring. Nevertheless, prudence is still warranted when administering antithyroid drugs. Whether these results can be extrapolated to the use of transdermal application requires further investigation.

Estimating short and longer-term exposure of domestic cats to dietary iodine fluctuation

Hyperthyroidism is a common endocrinopathy of domestic felines. In humans, toxic nodular goitre is pathophysiologically similar to feline hyperthyroidism and can be caused by chronically low or fluctuating dietary iodine intake. The aetiopathogenesis of feline hyperthyroidism is not known, but chronically low or fluctuating dietary iodine intake is likely common. This study assessed habitual iodine intake in domestic cats by: (1) conducting a dietary survey involving 361 owners of 549 cats, (2) analysing iodine content of 119 cat feeds, 38 urine and 64 hair samples and (3) assessing variation in iodine content of eight cat feeds over 4–6 different batches. Owners varied their cats feed regularly, usually on a day-to-day basis and often between wet and dry feeds with differing flavours. The majority (78%; 93 of 119) feeds for cats were within the guideline range for iodine. Of the 22% (n = 26 feeds) that were not compliant, the majority (n = 23) were below the nutritional minimum value with most (n = 16) being dry kibble. Iodine content of feeds did not vary considerably between types of feed or feed packaging, but variation between different batches of the same feed was 14–31%. Hence, urine iodine in cats also varied markedly. Cats being treated for hyperthyroidism had lower hair iodine. In conclusion, a survey assessing how domestic cats are fed, together with an analysis of commercial cat feeds suggests that domestic cats are likely to experience chronically low or fluctuating dietary iodine intake. The latter is supported by wide variation in urine iodine content.

Utility of a canine TSH assay for diagnosis and monitoring of feline hyperthyroidism

OBJECTIVE

This retrospective study was initiated to evaluate the utility of TSH measurements using a common canine TSH assay to diagnose and monitor feline hyperthyroidism after radioiodine or thyreostatic drug treatment.

MATERIAL AND METHODS

The electronic database of the University of Veterinary Medicine Vienna was searched for combined TSH and T4 measurements. 217 pairs of TSH and T4 from 136 cats with possible hyperthyroidism were assigned to group A (untreated; n = 24) and B (treated; n = 193). Measurements in group B were then subcategorized according to T4 concentrations (reference range 15-50 nmol/L): group B1 = elevated T4 (n = 46), group B2 = normal T4 (n = 84) and group B3 = decreased T4 (n = 63). Group B2 was further divided into cats with low normal (group B2a; n = 35), medium normal (group B2b; n = 29) and high normal (group B2c; n = 20) T4 concentrations.

RESULTS

TSH was detectable in 4 (17 %) of the 24 untreated cats (group A) and did not return to normal despite seemingly successful therapy in two. Increased TSH concentrations were observed in 3.6 % of the treated cats in group B2 and 2.9 %, 6.9 %, and 0 % in subgroups B2a, B2b and B2c, respectively. Forty-four percent of the treated cats with a decreased T4 (group B3) had an increased TSH concentration. TSH correlated with treatment length (r = 0.358, p = 0.004) and was significantly higher in cats treated for more than 3 months (p = 0.008).

CONCLUSION

TSH was detectable in a significant number of untreated hyperthyroid cats and thus this parameter should not be used to definitively rule out feline hyperthyroidism. Furthermore, the very low prevalence of increased TSH concentrations in treated hyperthyroid cats with a normal T4 and cost benefit calculations do not support the routine measurement of TSH in these cats. The fact that TSH correlated with time since treatment start and 56 % of the cats with a decreased T4 had TSH concentrations within the reference limits, suggests delayed recovery of the pituitary thyrotrophs which might explain the low prevalence of subclinical hypothyroidism in the present study.

CLINICAL RELEVANCE

TSH measurement in cats with suspected or treated hyperthyroidism using a canine assay lacks diagnostic sensitivity and can only complement therapeutic decision-making.

Protective Effect of Natural Antioxidant Compounds on Methimazole Induced Oxidative Stress in a Feline Kidney Epithelial Cell Line (CRFK)

The treatment of choice for feline hyperthyroidism is the administration of the antithyroid drug methimazole. Both the endocrinopathy and the drug adverse reactions (e.g., hepatotoxicosis, gastrointestinal disorders, and renal injury) are partly due to oxidative stress and redox unbalance. This study investigated the free radical production and the impairment of the antioxidant barrier induced by methimazole in an in vitro model of feline renal epithelium. The protective effects of quercetin and resveratrol were also explored. CRFK cells were incubated with a methimazole concentration equivalent to the maximum plasma levels in orally treated cats (4 µM), in the presence or absence of either one of the two selected antioxidants at different time-points (up to 72 h). Cell viability, ROS production, GSH levels, and mRNA expression of antioxidant enzymes (i.e., CAT, SOD, GPx, and GST) were assessed. Methimazole impaired cell viability and increased ROS levels in a time-dependent manner. Similarly, GSH content and CAT, SOD, and GPx3 expression were higher compared with control cells. Such effects were significantly counteracted by quercetin. These results provide new insights about the mechanisms underlying the methimazole-related side effects frequently observed in hyperthyroid cats. They also support the use of quercetin in the management of feline hyperthyroidism.

Management of Feline Hyperthyroidism and the Need to Prevent Oxidative Stress: What Can We Learn from Human Research?

Feline hyperthyroidism is a clinical syndrome related to an excessive production of thyroid hormones, and it is considered as a spontaneous animal model for human thyrotoxicosis. Many shared features between the feline and the human disease have been identified so far, including pathogenesis, clinical signs, and treatment options. Although methimazole is considered the first-choice drug in both species, several side effects have been described. Furthermore, methimazole could interfere with the oxidative status, already perturbated by the disease. It has been reported in humans that dietary management, mainly through antioxidant supplementation, could mitigate this oxidative burden. The purpose of the review is to describe current therapeutic options in the course of feline hyperthyroidism and to summarize the state of the art relationship between dietary antioxidants administration and the reduction of methimazole side-effects in humans to support the use of this approach also in cats.

2021 AAFP Feline Senior Care Guidelines

The '2021 AAFP Feline Senior Care Guidelines' are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat's care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of 'budgets of care', which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.

Pathological and Immunohistochemical Characterization of Thyroid Neoplasms in Cats

There are few pathological and immunohistochemical descriptions of thyroid neoplasms in cats. We investigated neoplasms of the thyroid in 31 cats (average age 15.6 years) in Southern Brazil. Most (96.8%) of these cases were classified as follicular adenomas and were predominantly unilateral and multinodular. Histologically, macrofollicular adenomas were the most common type observed. Carcinomas represented 3.2% of the investigated tumours. By immunohistochemical labelling, thyroglobulin was expressed more commonly than paired box gene 8 or thyroid transcription factor 1 in the follicular adenomas. One carcinoma was immunopositive for thyroglobulin, pancytokeratin, chromogranin A and synaptophysin, suggestive of a calcitonin-negative neuroendocrine carcinoma.

Serum concentration of bisphenol A in elderly cats and its association with clinicopathological findings

OBJECTIVES

Bisphenol A (BPA) has been mentioned as a possible factor contributing to feline hyperthyroidism. Nevertheless, there are no previous studies reporting on the concentration of BPA in feline serum and its association with thyroid function. The objectives of this study were to measure serum BPA concentration in cats aged ⩾7 years, considered as healthy by their owners, and to compare the results with clinicopathological findings.

METHODS

Sixty-nine cats aged ⩾7 years considered as healthy by their owners were enrolled in the study. The concentration of BPA in feline serum was measured using liquid chromatography-tandem mass spectrometry. In all cats, signalment, living environment, diet history, and the results of haematological and biochemical analysis, including thyroxine levels, were available.

RESULTS

The mean serum BPA concentration in feline serum was 1.06 ± 0.908 ng/ml. Significant correlation was found between BPA concentration and haemoglobin (r = 0.3397; P = 0.0043), haematocrit (r = 0.3245; P = 0.0065) and the number of red blood cells (r = 0.2916; P = 0.0151), concentration of total protein (r = 0.2383; P = 0.0486), concentration of calcium (r = 0.3915; P = 0.0009) and level of bilirubin (r = 0.3848; P = 0.0011). No other significant correlations were found. Significant differences (P <0.01) were found between mature (1.28 ± 0.994 ng/ml) and geriatric cats (0.420 ± 0.240 ng/ml), between strictly indoor cats (1.27 ± 0.992 ng/ml) and cats with outdoor access (0.660 ± 0.529 ng/ml), and between cats fed canned food (1.23 ± 0.935 ng/ml) and cats fed non-canned food (0.774 ± 0.795 ng/ml).

CONCLUSIONS AND RELEVANCE

Measurable serum BPA levels were found in all examined samples. The age of the cats was revealed as a significant factor affecting BPA concentration and mature cats had the highest levels. A significantly higher concentration of BPA was found in cats living strictly indoors and in cats fed canned food. No association was found between BPA and thyroid function. Further studies are needed that focus on hyperthyroid cats for better evaluation of this relationship.

Hyperthyroidism in Cats: Considering the Impact of Treatment Modality on Quality of Life for Cats and Their Owners

In cats, hyperthyroidism can be treated in 4 ways: medical management with methimazole or carbimazole, nutritional management (low-iodine diet), surgical thyroidectomy, and radioactive iodine (¹³¹I). Each form of treatment has advantages and disadvantages that should be considered when formulating a treatment plan for the individual hyperthyroid cat. Medical and nutritional managements are considered "reversible" or palliative treatments, whereas surgical thyroidectomy and ¹³¹I are "permanent" or curative treatments. The author discusses how each treatment modality could be the optimal choice for a specific cat-owner combination and reviews the advantages and disadvantages of each treatment option.

Short-term biological variation of serum thyroid hormones concentrations in clinically healthy cats

Thyroid disease is common in cats, but little is known about the biologic variability of serum thyroid hormone concentrations and its impact on diagnostic utility in either healthy cats or cats with thyroid disease. The purpose of this study was to determine the biological variation, index of individuality, and reference change values for thyroid hormones and thyroid-stimulating hormone (TSH) in clinically healthy cats. Serum samples for analysis of total thyroxine (T₄), triiodothyronine (T₃), free T₄ by dialysis, and TSH were obtained weekly for 6 wk from 10 healthy cats, then frozen until single-batch analyzed. Data were evaluated for outliers, and we determined the CV within individual cats (CV_I) and between individual cats (CV_G) for each hormone and the variation between duplicates or analytical variation (CV_A). The index of individuality and reference change values for each hormone were then calculated. Serum concentrations of total T₄, free T₄, T₃, and TSH all showed greater variation between cats (CV_G) than within cats (CV_I). Total and free T₄ had an intermediate index of individuality (1.1 and 1.2, respectively), suggesting that these hormones would be best evaluated by a combination of their population-based reference intervals and reference change values. Serum TSH concentrations had high index of individuality (1.8), suggesting this hormone would be best evaluated with reference change values rather than the population-based reference interval. Total T₃ also had a high calculated index of individuality (1.8); however, T₃ had high ratio of analytical variation (CV_A) to within cat variation (CV_I), so RCV could not be accurately calculated. This study demonstrates that clinically normal cats show considerable interindividual biological variation in serum thyroid hormone and TSH concentrations, whereas the intraindividual variability in hormone concentrations is much narrower. This suggests that for all serum thyroid hormones, but especially serum TSH and T₃ concentrations, comparing individual cat's hormone results to a population-based reference interval may be misleading, especially in those with early or subclinical thyroid disease. Clinicians might improve the diagnosis of feline thyroid disease by establishing baseline concentrations of T₄, free T₄, T₃, and TSH for individual cats (ideally when healthy) and applying reference change values to subsequent measurements.

A retrospective evaluation of the relationship between symmetric dimethylarginine, creatinine and body weight in hyperthyroid cats

Hyperthyroidism in cats can mask changes in renal function, including chronic kidney disease (CKD), because of hyperfiltration and muscle loss. Symmetric dimethylarginine (SDMA) has been shown to increase earlier than creatinine in cats with renal dysfunction, and, unlike creatinine, SDMA is not impacted by lean muscle mass. The aim of this study was to describe the relationship between SDMA, creatinine, body weight and TT4 over time during treatment of hyperthyroidism. Cats were retrospectively identified from the US IDEXX Reference Laboratories database where TT4, SDMA and creatinine were measured on the same cat at multiple time points. A hyperthyroid treated group was identified (TT4 ≤ 4.7 μg/dL and decreased by a minimum of 2.5 μg/dL) that had body weight and laboratory results available from more than one visit, and was used to evaluate body weight, creatinine, SDMA and TT4 pre-treatment and at 1–30, 31–60, 61–90, 91–120 days post-treatment. Creatinine significantly decreased with increasing concentrations of TT4 (Spearman’s ρ = -0.37, P < 0.001), whereas SDMA did not. Body weight, SDMA and creatinine concentrations significantly increased during the immediate 1–30 day post-treatment period (P < 0.012, P < 0.001, P < 0.001, respectively). During treatment creatinine continued to increase as cats gained weight. In contrast, SDMA remained stable during treatment and was comparable to age-matched control cats. Therefore, SDMA may be a more reliable biomarker of renal function than creatinine in hyperthyroid cats before and during treatment.

Biomonitoring of exposure to bisphenols, benzophenones, triclosan, and triclocarban in pet dogs and cats

Similar to humans, pet animals are exposed to environmental contaminants through multiple sources and pathways. Although a few studies have demonstrated exposure of cats and dogs to environmental chemicals, little is known about exposure to bisphenols, benzophenone UV filters, and antibacterial agents. In this study, we measured three bisphenols, three benzophenone-type UV filters, triclosan (TCS), and triclocarban (TCC) in dog (n = 50) and cat urine (n = 50) collected from New York State, USA. Among bisphenols, BPS was found at the highest concentrations (mean ± SD: 3.2 ± 8.5 ng/mL in dogs and 8.85 ± 30.0 ng/mL in cats) with detection frequencies of 96% in dogs and 78% in cats. Among benzophenones, BP-3 (oxybenzone) was the dominant compound in pet urine, followed by BP-1 and BP-8. TCS was found at concentrations higher than those of TCC in both cat and dog urine. There were no significant differences in bisphenol concentrations between sexes or age groups, both in dogs and cats. The calculated hazard quotients (HQ) suggested that the current exposure levels of BPS and BP-3 in pets were 2-5 orders of magnitude below the tentative threshold values available for humans.

Coagulation parameters in hyperthyroid cats before and after radioiodine treatment compared with healthy controls

OBJECTIVES

The aim of the study was to describe the coagulatory state of hyperthyroid cats before and after successful radioiodine therapy (RIT) compared with healthy age-matched controls, using classical coagulation parameters and thromboelastogram (TEG) as a global assessment method. The differences in coagulation activity after RIT, depending on the thyroid hormone (normal vs low total thyroxine [T4]) state, were also evaluated.

METHODS

Fifteen hyperthyroid cats and 10 healthy age-matched controls were recruited. Hyperthyroid cats that remained hyperthyroid 14 days after RIT were excluded. Haematology, biochemistry, T4, prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen and TEG were assessed in control cats and hyperthyroid cats before and 7 and 14 days after RIT. Two weeks after successful RIT, further comparisons were made between cats with normal T4 vs those with low T4.

RESULTS

Fourteen days after successful RIT, 7/15 cats had normal T4 and 8/15 had low T4. Thrombocytosis was noted in 6/15 cats after treatment. Fibrinogen was significantly higher (P <0.001) and PT shorter (P <0.01) in the hyperthyroid cats compared with the healthy controls and these changes persisted after RIT. Persistent increases in fibrinogen, PT, TEG maximal amplitude and TEG clot rigidity, reflecting clot stability, after RIT primarily occurred in the cats with normal T4. TEG-K (time until preset amplitude of 20 mm is reached) and alpha (α) angle reflected impaired fibrin cross-linking ability prior to RIT, which significantly increased after therapy (P <0.05).

CONCLUSIONS AND RELEVANCE

Based on some of the coagulation parameters, cats with hyperthyroidism showed hypercoagulable tendencies, which were mildly increased after RIT, possibly due to transient radiation-induced thyroiditis.

Effects of PCB exposure on serum thyroid hormone levels in dogs and cats

Polychlorinated biphenyls (PCBs) and their hydroxylated metabolites (OH-PCBs) might disrupt thyroid function. However, there is no clear evidence of PCB exposure disrupting thyroid hormone (TH) homeostasis in dogs and cats. The present study conducted in vivo experiments to evaluate the effects of a mixture of 12 PCB congeners (CB18, 28, 70, 77, 99, 101, 118, 138, 153, 180, 187 and 202, each congener 0.5 mg/kg BW, i.p. administration) on serum TH levels in male dogs (Canis lupus familiaris) and male cats (Felis silvestris catus). In PCB-exposed dogs, the time courses of higher-chlorinated PCBs and L-thyroxine (T4)-like OH-PCBs (4-OH-CB107 and 4-OH-CB202) concentrations were unchanged or tended to increase, whereas those of lower-chlorinated PCBs and OH-PCBs tended to decrease after 24 h. In PCB-exposed cats, concentrations of PCBs increased until 6 h and then remained unchanged. The levels of lower-chlorinated OH-PCBs including 4'-OH-CB18 increased until 96 h and then decreased. In PCB-exposed dogs, free T4 concentrations were higher than those in the control group at 48 and 96 h after PCB administration and positively correlated with the levels of T4-like OH-PCBs, suggesting competitive binding of T4 and T4-like OH-PCBs to a TH transporter, transthyretin. Serum levels of total T4 and total 3,3',5-triiodo-L-thyronine (T3) in PCB-exposed dogs were lower than in the control group at 24 and 48 h and negatively correlated with PCB concentrations, implying that PCB exposure enhanced TH excretion by increasing TH uptake and TH conjugation enzyme activities in the dog liver. In contrast, no obvious changes in TH levels were observed in PCB-exposed cats. This could be explained by the lower levels of T4-like OH-PCBs and lower hepatic conjugation enzyme activities in cats compared with dogs. Different effects on serum TH levels in PCB-exposed dogs and cats are likely to be attributable to species-specific PCB and TH metabolism.

Are persistent organic pollutants important in the etiology of feline hyperthyroidism? A review

Feline hyperthyroidism is a rather new disease, first reported from the North American east coast in 1979. The prevalence is increasing, especially in older cats, and hyperthyroidism is now reported worldwide as the most common feline endocrinopathy. Several studies have been performed trying to identify important etiological factors such as exposure to persistent organic pollutants, and especially brominated flame retardants, have been suggested to be of importance for the development of the disease. Recent studies have shown higher concentrations of these contaminants in serum of hyperthyroid cats in comparison to cats with normal thyroid status. However, other still unknown factors are most probably of importance for the development of this disease.

Silicone Pet Tags Associate Tris(1,3-dichloro-2-isopropyl) Phosphate Exposures with Feline Hyperthyroidism

Feline hyperthyroidism is the most commonly diagnosed endocrine-related disease among senior and geriatric housecats, but the causes remain unknown. Exposure to endocrine-disrupting compounds with thyroid targets, such as flame retardants (FRs), may contribute to disease development. Silicone passive sampling devices, or pet tags, quantitatively assessed the bioavailable FR exposures of 78 cats (≥7 y) in New York and Oregon using gas chromatography-mass spectrometry. Pet tags were analyzed for 36 polybrominated diphenyl ethers, six organophosphate esters (OPEs), and two alternative brominated FRs. In nonhyperthyroid cats, serum free thyroxine (fT4), total T4 (TT4), total triiodothyronine, and thyroid-stimulating hormone concentrations were compared with FR concentrations. Tris(1,3-dichloro-2-isopropyl) phosphate (TDCIPP) concentrations were higher in hyperthyroid pet tags in comparison to nonhyperthyroid pet tags (adjusted odds ratio, p < 0.07; Mantel-Cox, p < 0.02). Higher TDCIPP concentrations were associated with air freshener use in comparison to no use (p < 0.01), residences built since 2005 compared to those pre-1989 (p < 0.002), and cats preferring to spend time on upholstered furniture in comparison to no preference (p < 0.05). Higher TDCIPP concentrations were associated with higher fT4 and TT4 concentrations (p < 0.05). This study provides proof-of-concept data for the use of silicone pet tags with companion animals and further indicates that bioavailable TDCIPP exposures are associated with feline hyperthyroidism.

Neuropathology of Spontaneous Hypertensive Encephalopathy in Cats

Pathologic features of 12 cats with naturally acquired systemic hypertension and concomitant hypertensive encephalopathy were analyzed. All cats demonstrated acute onset of signs localized to the forebrain and/or brainstem, including stupor, coma, and seizures. All cats had systemic hypertension, ranging from 160 to 300 mm Hg. Gross lesions were identified in 4 of 12 cases, including caudal herniation of the cerebrum and cerebellum, sometimes with compression of the rostral colliculus and medulla. Histologically, all cases featured bilaterally symmetrical edema of the cerebral white matter. Associated vascular lesions, especially arteriolar hyalinosis, were also observed. Concurrent lesions were chronic tubulointerstitial nephritis (11/12 cases), adenomatous hyperplasia of the thyroid gland (4 cases), hypertensive choroidal arteriopathy (6 cases), and left ventricular hypertrophy (5 cases). This study demonstrates that the typical histologic manifestation of spontaneous hypertensive encephalopathy in cats is bilaterally symmetrical edema of the subcortical cerebral white matter.

Redox unbalance in the hyperthyroid cat: a comparison with healthy and non-thyroidal diseased cats

Background

Feline hyperthyroidism, the most common endocrinopathy in older cats, provides a spontaneous model for human thyrotoxicosis. Human thyrotoxicosis is associated with redox unbalance, which may result in organ damage. The redox status of hyperthyroid cats is largely unknown. The aims of the present study were to compare the redox status of cats with hyperthyroidism with that of healthy cats and cats with chronic non-thyroidal illness.

Results

Forty cats with untreated hyperthyroidism (group H), 45 chronically ill cats with non-thyroidal illness (group I), and 39 healthy cats (group C) were recruited for this observational cross-sectional study. All cats were screened for redox status markers. Determinable reactive oxygen metabolites (d-ROMs) were used as oxidative stress markers. Antioxidant status was determined using the OXY-Adsorbent test to quantify the plasma barrier to oxidation. The Oxidative Stress index (OSi) was calculated as the ratio of d-ROMs and OXY-Adsorbent test values. Data were compared by ANOVA with Tukey’s multiple comparisons post-hoc test. The dROMs of group H (193 ± 47 CarrU) were significantly higher (p &lt; 0.001) than those of the healthy cats (103 ± 17 CarrU). The OXY-Adsorbent test results in group H (265 ± 68 μmol HClO/ml) were significantly lower than those in healthy cats (390 ± 83 μmol HClO/ml; p &lt; 0.01) and chronically ill cats (306 ± 45 μmol HClO/ml, p &lt; 0.05). Moreover, the Osi value in group H (0.8 ± 0.2 CarrU/μmol HClO/ml) was significantly higher (p &lt; 0.001) than that of the healthy cats (0.3 ± 0.1 CarrU/μmol HClO/ml).

Conclusions

As described in humans with hyperthyroidism, feline hyperthyroidism is associated with redox unbalance. Free radical production is increased in hyperthyroid cats and their antioxidant depletion seems to be more severe than in cats with non-thyroidal illnesses. Our results support the rationale for a clinical trial investigating the potential positive effects of antioxidant supplementation to cats with hyperthyroidism.

Electronic supplementary material

The online version of this article (10.1186/s12917-019-1896-7) contains supplementary material, which is available to authorized users.

Widespread occurrence of glyphosate in urine from pet dogs and cats in New York State, USA

Glyphosate is one of the most widely used herbicides in the United States, which has led to its ubiquitous occurrence in food and water and regular detection in human urine at concentrations of 1-10 μg/L. Data pertaining to health risks arising from the ingestion of glyphosate are limited and are the subject of much debate, which demands the need for more exposure information for this herbicide. Very little is known about glyphosate exposure in pets. In this study, we determined concentrations of glyphosate (Glyp) and its derivatives, methyl glyphosate (Me-Glyp) and aminomethylphosphonic acid (AMPA), in urine collected from 30 dogs and 30 cats from New York State, USA. Glyp was the most predominant compound found in pet urine followed by AMPA and Me-Glyp. The mean urinary concentration of ∑Glyp (sum of Glyp + Me-Glyp + AMPA) in cats (mean: 33.8 ± 46.7 ng/mL) was 2-fold higher than that in dogs (mean: 16.8 ± 24.4 ng/mL). Cumulative daily intakes (CDI) of Glyp in dogs and cats estimated from the urinary concentrations were, on average, 0.57 and 1.37 μg/kg bw/d, respectively. The exposure doses were two to four orders of magnitude below the current acceptable daily intake (ADI) suggested by several international health organizations for humans.

Inhibitory effect of Bisphenol A on in vitro feline uterine contractions

Bisphenol A (BPA) is an environmental pollutant used as a plasticizer in the manufacture of many plastic products, such as packaging, containers, and water and beverage bottles. There are deleterious effects of BPA on metabolic, endocrine, nervous, and reproductive systems. This is the first study in which there was investigation of the in vitro effect of BPA on the spontaneous contractions of the cat uterus. The tubal uterine segments (1 cm) collected from queens in estrus were suspended in an isolated organ bath. Following tissue stabilization, spontaneous contractions were recorded for 10 min to constitute the control group. The effects of the solvent (alcohol) and BPA at different concentrations (1, 10, and 100 μM) on uterine contractions were subsequently evaluated at 10 min intervals in terms of frequency and mean amplitude variables. The ethanol vehicle did not alter the uterine contractions compared to the control group. All concentrations of BPA used in the study resulted in a reduction (P < 0.05) in amplitude of uterine contractions in a dose-dependent manner, while only the largest dose of BPA decreased the frequency of contractions (P < 0.05). In reproductive physiology, regular uterine contractions facilitate successful fertilization, migration, implantation, and maintenance of pregnancy, as well as fetus expulsion. The results of this study indicate BPA has an inhibitory effect on spontaneous contractions of the cat uterus. It is proposed that this suppressive effect of BPA on uterine contractions might lead to queen infertility.

Expected total thyroxine (TT4) concentrations and outlier values in 531,765 cats in the United States (2014-2015)

Background

Levels exceeding the standard reference interval (RI) for total thyroxine (TT4) concentrations are diagnostic for hyperthyroidism, however some hyperthyroid cats have TT4 values within the RI. Determining outlier TT4 concentrations should aid practitioners in identification of hyperthyroidism. The objective of this study was to determine the expected distribution of TT4 concentration using a large population of cats (531,765) of unknown health status to identify unexpected TT4 concentrations (outlier), and determine whether this concentration changes with age.

Methodology/Principle findings

This study is a population-based, retrospective study evaluating an electronic database of laboratory results to identify unique TT4 measurement between January 2014 and July 2015. An expected distribution of TT4 concentrations was determined using a large population of cats (531,765) of unknown health status, and this in turn was used to identify unexpected TT4 concentrations (outlier) and determine whether this concentration changes with age. All cats between the age of 1 and 9 years (n = 141,294) had the same expected distribution of TT4 concentration (0.5–3.5ug/dL), and cats with a TT4 value >3.5ug/dL were determined to be unexpected outliers. There was a steep and progressive rise in both the total number and percentage of statistical outliers in the feline population as a function of age. The greatest acceleration in the percentage of outliers occurred between the age of 7 and 14 years, which was up to 4.6 times the rate seen between the age of 3 and 7 years.

Conclusions

TT4 concentrations >3.5ug/dL represent outliers from the expected distribution of TT4 concentration. Furthermore, age has a strong influence on the proportion of cats. These findings suggest that patients with TT4 concentrations >3.5ug/dL should be more closely evaluated for hyperthyroidism, particularly between the ages of 7 and 14 years. This finding may aid clinicians in earlier identification of hyperthyroidism in at-risk patients.

One-year study evaluating efficacy of an iodine-restricted diet for the treatment of moderate-to-severe hyperthyroidism in cats

PURPOSE

This study sought to determine the efficacy of a therapeutic iodine-restricted diet during a 12 -month interval in cats with moderately to severely increased total thyroxine (TT4) concentrations.

PATIENTS AND METHODS

Eight hyperthyroid cats with serum creatinine <2.0 mg/dL and TT4 >6.0 µg/dL (reference interval 1.5-4.0 µg/dL) were enrolled. Each cat underwent an initial physical examination, complete blood count, serum chemistry panel, thyroid profile, thyroid scintigraphy, and echocardiogram. Physical examination and all blood samplings were repeated at 1, 2, 3, 6, and 12 months after enrollment. Clients were instructed to feed only the therapeutic iodine-restricted diet throughout the entire study.

RESULTS

Median TT4 was 8.4 (range 6.2-24.0) µg/dL at study onset. Thyroid scintigraphy was abnormal in all cats, confirming hyperthyroidism. Six out of eight cats had normal serum TT4 after 4 weeks of feeding the therapeutic diet. The two cats that did not achieve normalization of TT4 at 4 weeks had the highest initial TT4 concentrations. Three cats were withdrawn from the study due to emergence of chronic kidney disease.

CONCLUSION

An iodine-restricted diet was able to control moderate-to-severe hyperthyroidism in most (six out of eight) of the cats by 4 weeks. Cats with highest baseline TT4 took substantially longer before TT4 concentrations normalized, if at all.

Clinicopathological features and comorbidities of cats with mild, moderate or severe hyperthyroidism: a radioiodine referral population

OBJECTIVES

This study sought to explore the clinicopathological features and comorbidities of cats with mild, moderate and severe hyperthyroidism in a radioiodine referral population.

METHODS

Medical records were reviewed, along with results of serum biochemistry, urinalysis, systolic blood pressure and diagnostic imaging performed at the time of radioiodine referral. Cats were grouped by total thyroxine (TT4) levels as mildly (TT4 60.1-124.9 nmol/l), moderately (TT4 125-250 nmol/l) or severely (TT4 >250 nmol/l) hyperthyroid at the time of diagnosis and referral.

RESULTS

Thirty percent (42/140) of the cats were <10 years old at diagnosis. In 24.3% (34/140), hyperthyroidism was diagnosed incidentally. The time between diagnosis and referral for radioiodine was significantly longer in cats with severe hyperthyroidism at the time of referral ( P = 0.004). An increase in severity group between the time of diagnosis and referral occurred in 38.6% (54/140) of cats. At referral, 54.3% (25/46) of cats with mild, 66.7% (42/63) with moderate and 80.6% (25/31) with severe hyperthyroidism were unstable despite ongoing medical or dietary management. The prevalence of cardiac abnormalities was significantly increased in cats with severe hyperthyroidism ( P = 0.014) compared with those with mild or moderate hyperthyroidism. There was no significant difference in the likelihood of renal disease ( P = 0.708) or hypertension ( P = 0.328) between the groups.

CONCLUSIONS AND RELEVANCE

Incidental diagnosis of hyperthyroidism occurs commonly, potentially owing to increased disease screening. Cats with severe hyperthyroidism at referral were more likely to be chronically hyperthyroid with a history of poor stabilisation. This subset of patients was significantly more likely to have cardiac abnormalities. Thyrotoxic cardiomyopathy may ultimately affect patient suitability for curative treatments (radioiodine or thyroidectomy) owing to higher anaesthetic risks and potential for decompensation into congestive heart failure with the stress of travel and hospitalisation. Curative therapy should be considered before the development of severe hyperthyroidism.

Per- and polyfluoroalkyl substances in Northern California cats: Temporal comparison and a possible link to cat hyperthyroidism

The indoor environment and dietary intake are considered to be major human exposure pathways to per- and polyfluoroalkyl substances (PFASs). Cats have similar exposures to humans by sharing their residential environments, although they have different diet, body sizes, and indoor activities. In the present study, we report PFAS levels in the serum of 2 groups of Northern California cats (>10 yr old) collected during 2 time periods: 2008 to 2010 (n = 21) and 2012 to 2013 (n = 22). Levels of ∑PFAS (geometric mean) were lower in the second period (geometric mean = 8.10 ng/mL) than the first time period (geometric mean = 15.8 ng/mL), although PFAS profiles remained similar. We also analyzed PFAS levels in human serum collected in the same time period (2008-2010) and geographic area, and compared the profiles and ∑PFAS levels (15.8 vs 14.3 ng/mL for cat and human, respectively). Long chain perfluorinated carboxylic acids, especially perfluorononanoic acid and perfluoroundecanoic acid, were significantly higher in cat serum than in humans. Furthermore, serum from hyperthyroid cats in the second time period showed higher ∑PFAS level (9.50 ng/mL) compared to nonhyperthyroid cats (7.24 ng/mL), and it is the perfluorooctanoic acid levels that were statistically significantly higher in hyperthyroid cats' serum (p < 0.05). This result may indicate a possible link between PFAS levels and cat hyperthyroid, warranting a larger study for further investigation. Environ Toxicol Chem 2018;37:2523-2529. © 2018 SETAC.

Companion animals in comparative oncology: One Medicine in action

Comparative oncology is poised to have a far-reaching impact on both animals and human beings with cancer. The field is gaining momentum and has repeatedly proven its utility in various aspects of oncology, including study of the genetics, development, progression, immunology and therapy of cancer. Companion animals provide many advantages over both traditional rodent models and human beings for studying cancer biology and accelerating the development of novel anti-cancer therapies. In this review, several examples of the ability of companion animals with spontaneous cancers to fill a unique niche in the field of oncology are discussed. In addition, potential caveats of the use of companion animals in research are reviewed, as well as ethical considerations and efforts to standardize veterinary clinical trials.

AAFP Feline Anesthesia Guidelines

AIM

The overarching purpose of the AAFP Anesthesia Guidelines (hereafter referred to as the 'Guidelines') is to make anesthesia and sedation safer for the feline patient. Scope and accessibility: It is noteworthy that these are the first exclusively feline anesthesia guidelines authored by an expert panel, making them particularly useful as an extensively referenced, practical resource for veterinary practice teams. Because much of the key content is presented in tabular or visual format, the Guidelines have a high level of accessibility and convenience that invites regular usage. While the recommendations in the Guidelines focus primarily on client-owned cats, the content is also applicable to community-sourced animals with an unknown medical history.

Trade-offs of Personal Versus More Proxy Exposure Measures in Environmental Epidemiology

The technological ability to make personal measurements of toxicant exposures is growing rapidly. While this can decrease measurement error and therefore help reduce attenuation of effect estimates, we argue that as measures of exposure or dose become more personal, threats to validity of study findings can increase in ways that more proxy measures may avoid. We use directed acyclic graphs (DAGs) to describe conditions where confounding is introduced by use of more personal measures of exposure and avoided via more proxy measures of personal exposure or target tissue dose. As exposure or dose estimates are more removed from the individual, they become less susceptible to biases from confounding by personal factors that can often be hard to control, such as personal behaviors. Similarly, more proxy exposure estimates are less susceptible to reverse causation. We provide examples from the literature where adjustment for personal factors in analyses that use more proxy exposure estimates have little effect on study results. In conclusion, increased personalized exposure assessment has important advantages for measurement accuracy, but it can increase the possibility of biases from personal factors and reverse causation compared with more proxy exposure estimates. Understanding the relation between more and less proxy exposures, and variables that could introduce confounding are critical components to study design.

Parabens and Their Metabolites in Pet Food and Urine from New York State, United States

The exposure of pets, such as dogs and cats, to a wide range of chemicals present in the indoor environment and the concomitant increase in noninfectious diseases in these companion animals are a concern. Nevertheless, little is known about the sources and pathways of exposure to chemicals in pets. In this study, we determined the concentrations of parabens in commercially available cat and dog foods as well as in urine samples from these pets collected from the Albany area of the state of New York in the United States. Parabens, especially methyl paraben (MeP), and their metabolites were found in all pet food and urine samples. The mean concentrations of total parabens (i.e., sum of parabens and their metabolites) in dog ( n = 23) and cat ( n = 35) food were 1350 and 1550 ng/g fresh wt, respectively. Dry food contained higher concentrations of parabens and their metabolites than did wet food, and cat food contained higher concentrations of target chemicals than did dog food. The mean concentrations of total parabens found in dog ( n = 30) and cat ( n = 30) urine were 7230 and 1040 ng/mL, respectively. In both pet food and urine, MeP (among parabens) and 4-hydroxy benzoic acid (4-HB) (among metabolites) were the dominant compounds. The metabolites of parabens accounted for ∼99% (∼99.1% in food and ∼98.9% in urine) of the total concentrations in both food and urine. The profiles of parabens and their metabolites in the urine of dogs and cats varied. In addition to diet, other sources of paraben exposures were found for dogs, whereas, for cats, the majority of exposures was identified as related to diet.

Comparison of health parameters in normal cats fed a limited iodine prescription food vs a conventional diet

Objectives The objective was to compare the effect on thyroid function in healthy, adult cats fed a limited-iodine food or conventional diet for 24 months. Methods Cats in the limited-iodine group (n = 14) were fed a commercial, dry food containing 0.2 ppm iodine on a dry-matter basis (DMB). Cats in the conventional diet group (n = 12) were fed an identical diet except that the iodine content was 3.2 ppm on a DMB. Both groups were maintained on their respective diets for 24 months. The median age of the cats at baseline was 3.2 years (interquartile range 2.4-4.3). Diagnostic samples were obtained for measurement of serum biochemistry parameters, thyroid hormone concentrations, complete blood count and urinalysis, and thyroid ultrasound examination was performed at baseline, 6, 12, 18 and 24 months. Results Median serum concentrations of free and total thyroxine and thyroid-stimulating hormone were within respective reference intervals for both test groups at all sampling intervals. Median urine iodine concentrations in the limited-iodine group declined significantly ( P = 0.0001) from baseline and were significantly different than conventional diet ( P ⩽0.0007). Ultrasound examination revealed no significant change in median thyroid height in the limited-iodine group at any time point. Conclusions and relevance Normal serum thyroid hormone concentrations and results of urinalysis and routine biochemical testing confirmed that the limited-iodine food was safely fed for 2 years to healthy, adult cats. Ultrasound examination showing that cats on limited-iodine did not develop a change in thyroid gland height was a further indication of the absence of iatrogenic hypothyroidism in the limited iodine diet group. These results support the lack of obvious side effects associated with feeding a limited-iodine diet for 2 years to healthy, adult cats, a situation that may occur in multi-cat households where healthy cats have access to a limited-iodine diet being used to manage cats with feline hyperthyroidism.

Prevalence and risk factors for hyperthyroidism in Irish cats from the greater Dublin area

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.

Prävalenz und Risikofaktoren der felinen Hyperthyreose in einer Klinik population in Süddeutschland

Ziel: Die feline Hyperthyreose ist eine häufige Endokrinopathie bei älte ren Katzen. In früheren Studien wurden unausgewogene Ernährung, Schilddrüsen-Disruptoren, hohes Alter sowie fehlende Reinrassigkeit als Risikofaktoren diskutiert, ein endgültiger Auslöser bleibt jedoch unbekannt. Die Ziele dieser prospektiven Studie waren a) die Berech nung der Klinikprävalenz in einer Katzenpopulation in Süddeutschland, b) die Feststellung, wie häufig die Diagnose nach dem klini schem Verdacht bestätigt wurde und c) die Auswertung mutmaßlicher in- und extrinsischer Risikofaktoren anhand des Signalements der Katzen und eines Fragebogens. Methoden: Gesamt-Thyroxin (T4) wurde im Serum von 495 Katzen ≥ 8 Jahre gemessen und die Prävalenz mit einem 95%-Konfidenzintervall (95%-KI) berechnet. Abhängigkeiten zwischen Signalement und Hyperthyreose wurden durch den Student-T-Test, Chi-Square-Test und den Mann-Whitney U-Test analysiert. Das Signifikanzniveau lag bei 0,05. Zur Ermittlung extrinsischer Risikofaktoren diente ein logistisches Regressionsmodell. Ergebnisse: Bei 61 Katzen wurde eine Hyperthyreose diagnostiziert, was eine Prävalenz von 12,3% ergibt (95%-KI: 9,7–15,5). Ältere (p < 0,001) weibliche Katzen (p = 0,019; Odds Ratio 1,9) waren signifikant häufiger betroffen. Hauskatzen (Europäisch Kurz- und Langhaarkatzen) erkrankten häufiger als Rassekatzen (p = 0,016). Bei 164 Katzen wurde die Verdachtsdiagnose Hyperthyreose gestellt und in 20,1% (33/164) der Fälle verifiziert. In 2,4% (12/495) der Fälle war die erhöhte T4-Konzentration ein Zufallsbefund. Hyperthyreote Katzen wurden häufiger mit Nassfutter aus Aluminiumschalen (p < 0,013) gefüttert als nichthyperthyreote Katzen. Schlussfolgerung und klinische Re levanz: Ältere, weibliche Hauskatzen sind prädisponiert, an einer Schilddrüsenüberfunktion zu erkranken. Die Diagnose lässt sich häufig nach initialem klinischem Verdacht stellen, woraus in der Studienpopulation eine Prävalenz von 12,3% resultierte. Rückstände aus Aluminiumschalen oder das Nassfutter selbst scheinen eine Rolle in der Ätiopathogenese zu spielen.

Effects of dietary selenium and moisture on the physical activity and thyroid axis of cats

Consumption of canned cat food is considered a risk factor for the development of feline hyperthyroidism. Because selenium and water are substantially higher in canned diets compared to dry diets, objectives of this study were to determine whether increased dietary selenium or water alters the function of the hypothalamic-pituitary-thyroid axis and leads to an increase in activity level. Employing a 28-day latin square design with a 14-day washout, six lean, neutered male domestic shorthair cats were fed (i) commercially available adult dry feline diet containing 0.8 ppm selenium (control), (ii) control diet with added sodium selenite to achieve a dietary selenium concentration of 1.125 ppm (selenium treatment) and (iii) the control diet with additional water to achieve a moisture content of 75% wt/wt (water treatment). Water consumption was determined using deuterium oxide washout. Actical activity monitors were placed on each cat's collar to allow quantification of the activity of each cat. Circulating serum T3 and T4 was measured on days 0, 14, and 28. On day 28, a thyrotropin-releasing hormone (TRH) stimulation test was conducted to determine treatment effects on serum concentrations of thyroid hormones. There was a significant increase in daily water consumption with dietary water treatment (192 ml ± 7.85 SEM) compared to the control (120 ml ± 20.4) and selenium (116 ml ± 14.6) treatments. Both water and selenium treatments were associated with greater (p < .05) activity over that of the control treatment by 20.5% and 11% respectively. Serum TT3 AUC concentrations (0-4 hr) of TRH stimulation tests were greater (p < .05) by 16% with water compared to control treatments. The results of this study indicate that dietary water content may alter the function of the thyroid axis and that this effect is associated with an increase in physical activity.

Management and monitoring of hyperthyroid cats: a survey of Australian veterinarians

Objectives This study sought to evaluate how Australian veterinarians approach management and monitoring of feline hyperthyroidism and compare these results with a similar survey recently performed in the UK. Methods An invitation to complete an online survey was sent to veterinarians in all states and territories of Australia. The survey comprised questions relating to management of hyperthyroidism, use of antithyroid drugs vs radioiodine treatment vs surgical thyroidectomy, in addition to demographic information for respondents. Results A total of 546 clinicians completed the survey. The most commonly preferred treatments for long-term management of feline hyperthyroidism were antithyroid medications (305/546; 56%) and radioiodine (210/546; 38%), with substantially more respondents selecting radioiodine when cost was removed as a consideration (425/546; 78%). However, most respondents had treated or referred few cases for radioiodine (median 2). Most veterinarians (500/546; 92%) used antithyroid medications either long term or prior to definitive treatment of hyperthyroidism. For medical management, 45% (244/546) of veterinarians used twice-daily carbimazole. Half of respondents (274/546) aimed to maintain the total thyroxine concentration anywhere within the laboratory reference interval in hyperthyroid cats without chronic kidney disease. Blood pressure monitoring was uncommon. Surgical thyroidectomy was rarely performed. Conclusions and relevance Radioiodine was more frequently preferred by Australian veterinarians compared with those in the UK, likely associated with greater availability, reduced cost and shorter hospitalisation times in this jurisdiction, although antithyroid medications were the most frequently used treatment modality. Barriers remain to its utilisation, however, including perceived cost, misconceptions with regard to expected success rate and accessibility. Recent changes to recommendations on the management and monitoring of hyperthyroid cats do not appear to have been widely adopted by veterinarians at this time.