Podcast
Questions and Answers
What is one of the potential causes of hypoglycemia in dogs?
What is one of the potential causes of hypoglycemia in dogs?
- Hyperadrenocorticism
- Obesity
- Cushing's disease
- Congenital enzyme deficiency (correct)
Which clinical sign is associated with growth hormone (GH) deficiency in dogs?
Which clinical sign is associated with growth hormone (GH) deficiency in dogs?
- Retention of primary hairs
- Coughing with exercise
- Increased aggressiveness
- Lack of growth despite normal body proportions (correct)
What laboratory finding would indicate hypoglycemia in a dog?
What laboratory finding would indicate hypoglycemia in a dog?
- Blood glucose above 60 mg/dL
- Increased liver enzymes
- Normal insulin level
- Inappropriately high insulin level with low glucose (correct)
Which of the following can be a result of suboptimal cortisol levels in dogs?
Which of the following can be a result of suboptimal cortisol levels in dogs?
What is a common consequence of insulinoma in dogs?
What is a common consequence of insulinoma in dogs?
Which condition typically does NOT lead to hypoglycemia in dogs?
Which condition typically does NOT lead to hypoglycemia in dogs?
What is an appropriate protocol before testing a dog for insulin levels?
What is an appropriate protocol before testing a dog for insulin levels?
What is one of the treatment protocols for hypoglycemia in dogs?
What is one of the treatment protocols for hypoglycemia in dogs?
What serum sodium concentration indicates normal levels in a patient with potential hyperaldosteronism?
What serum sodium concentration indicates normal levels in a patient with potential hyperaldosteronism?
What is typically observed in clinical signs related to primary hyperaldosteronism?
What is typically observed in clinical signs related to primary hyperaldosteronism?
Which condition is indicated by a serum potassium level of 5.4 mEq/L in the context discussed?
Which condition is indicated by a serum potassium level of 5.4 mEq/L in the context discussed?
What role does ionized calcium (iCa) play in the context of calcium metabolism?
What role does ionized calcium (iCa) play in the context of calcium metabolism?
What is the primary reason for measuring serum ionized calcium in patients suspected of having calcium metabolic disorders?
What is the primary reason for measuring serum ionized calcium in patients suspected of having calcium metabolic disorders?
In cases of systemic hypertension related to sodium and fluid retention, which of the following is a possible cause?
In cases of systemic hypertension related to sodium and fluid retention, which of the following is a possible cause?
Which of the following diagnoses is least likely to present with normal blood urea nitrogen (BUN) levels?
Which of the following diagnoses is least likely to present with normal blood urea nitrogen (BUN) levels?
What physiological changes occur in patients with elevated phosphorus levels affecting calcitriol production?
What physiological changes occur in patients with elevated phosphorus levels affecting calcitriol production?
What is a common post-surgery complication related to pancreatic conditions?
What is a common post-surgery complication related to pancreatic conditions?
Which hormone's concentration is typically low in young individuals experiencing deficiencies related to growth?
Which hormone's concentration is typically low in young individuals experiencing deficiencies related to growth?
What dietary recommendations should be followed to manage insulin-related conditions?
What dietary recommendations should be followed to manage insulin-related conditions?
What is a significant characteristic of acromegaly in cats?
What is a significant characteristic of acromegaly in cats?
Which treatment option is known for effectively decreasing insulin release from pancreatic beta cells?
Which treatment option is known for effectively decreasing insulin release from pancreatic beta cells?
What is the prognosis for patients diagnosed with acromegaly?
What is the prognosis for patients diagnosed with acromegaly?
How soon can skin and hair responses be expected after injections of Growth Hormone (GH)?
How soon can skin and hair responses be expected after injections of Growth Hormone (GH)?
What happens to patients regarding insulin synthesis when octreotide is administered?
What happens to patients regarding insulin synthesis when octreotide is administered?
What is a potential consequence of oversuppression of cortisol production?
What is a potential consequence of oversuppression of cortisol production?
Which treatment option is the most successful for adrenal tumors?
Which treatment option is the most successful for adrenal tumors?
What is the primary method for monitoring the effectiveness of Trilostane treatment?
What is the primary method for monitoring the effectiveness of Trilostane treatment?
Which of the following describes a common side effect associated with Ketoconazole?
Which of the following describes a common side effect associated with Ketoconazole?
In the context of hypoadrenocorticism, which statement is true regarding its pathogenesis?
In the context of hypoadrenocorticism, which statement is true regarding its pathogenesis?
Which of the following treatments has not shown effective long-term results for managing hyperadrenocorticism?
Which of the following treatments has not shown effective long-term results for managing hyperadrenocorticism?
What type of hormone production does Trilostane inhibit?
What type of hormone production does Trilostane inhibit?
Which type of supplementation may be necessary after a bilateral adrenalectomy for pituitary-dependent hyperadrenocorticism (PDH)?
Which type of supplementation may be necessary after a bilateral adrenalectomy for pituitary-dependent hyperadrenocorticism (PDH)?
What is a potential reason that animals with poorly controlled diabetes mellitus (DM) may appear thin?
What is a potential reason that animals with poorly controlled diabetes mellitus (DM) may appear thin?
How does insulin resistance in acromegaly affect existing diabetes mellitus?
How does insulin resistance in acromegaly affect existing diabetes mellitus?
Which diagnostic measure is used to assess the concentration of growth hormone in suspected acromegaly cases?
Which diagnostic measure is used to assess the concentration of growth hormone in suspected acromegaly cases?
What is characteristic of urine when assessing for nephrogenic diabetes insipidus (DI) in affected animals?
What is characteristic of urine when assessing for nephrogenic diabetes insipidus (DI) in affected animals?
What does hypernatremia with hyposthenuria typically suggest in an animal's diagnosis?
What does hypernatremia with hyposthenuria typically suggest in an animal's diagnosis?
What does the modified water deprivation test assess in relation to urine specific gravity (USG)?
What does the modified water deprivation test assess in relation to urine specific gravity (USG)?
In cases of central diabetes insipidus (CDI), how does absolute vasopressin deficiency manifest?
In cases of central diabetes insipidus (CDI), how does absolute vasopressin deficiency manifest?
What is a consideration when performing a modified water deprivation test?
What is a consideration when performing a modified water deprivation test?
What is the preferred insulin type for initial therapy in cats with hyperglycemia?
What is the preferred insulin type for initial therapy in cats with hyperglycemia?
In managing hyperglycemia, what is the typical initial insulin dosage recommended?
In managing hyperglycemia, what is the typical initial insulin dosage recommended?
Which cause is not typically associated with hyperglycemia in cats?
Which cause is not typically associated with hyperglycemia in cats?
What should be measured to assess the efficacy of the initial insulin therapy after administration?
What should be measured to assess the efficacy of the initial insulin therapy after administration?
Why is beef origin insulin generally avoided in therapy?
Why is beef origin insulin generally avoided in therapy?
What characteristic is NOT associated with subclinical thyroiditis?
What characteristic is NOT associated with subclinical thyroiditis?
Which statement best describes the condition of subclinical hypothyroidism?
Which statement best describes the condition of subclinical hypothyroidism?
In clinical hypothyroidism, what is a significant laboratory finding?
In clinical hypothyroidism, what is a significant laboratory finding?
Which statement accurately describes the role of parathyroid hormone (PTH) in calcium metabolism?
Which statement accurately describes the role of parathyroid hormone (PTH) in calcium metabolism?
What could indicate an excessive T4 supplement dose in a patient?
What could indicate an excessive T4 supplement dose in a patient?
What is the mechanism of action for bisphosphonates in treating hypercalcemia?
What is the mechanism of action for bisphosphonates in treating hypercalcemia?
When considering the treatment of primary hyperparathyroidism, what is the underlying cause of elevated ionized calcium?
When considering the treatment of primary hyperparathyroidism, what is the underlying cause of elevated ionized calcium?
When should thyroid supplements be stopped to accurately test for hypothyroidism?
When should thyroid supplements be stopped to accurately test for hypothyroidism?
Which factor does NOT influence the absorption of T4 supplements?
Which factor does NOT influence the absorption of T4 supplements?
What role does synthesized calcitriol play in calcium metabolism?
What role does synthesized calcitriol play in calcium metabolism?
What effect does the retention of calcium by the kidneys have on serum calcium levels?
What effect does the retention of calcium by the kidneys have on serum calcium levels?
Which is a characteristic finding in the diagnosis of subclinical hypothyroidism?
Which is a characteristic finding in the diagnosis of subclinical hypothyroidism?
Which of these is a common result of decreased bone resorption due to changes in calcium metabolism?
Which of these is a common result of decreased bone resorption due to changes in calcium metabolism?
Which breed is mentioned as having normally lower concentrations of thyroid hormones?
Which breed is mentioned as having normally lower concentrations of thyroid hormones?
What potential consequences arise from the over-secretion of parathyroid hormone due to a parathyroid tumor?
What potential consequences arise from the over-secretion of parathyroid hormone due to a parathyroid tumor?
How does vitamin D influence calcium metabolism similarly to parathyroid hormone?
How does vitamin D influence calcium metabolism similarly to parathyroid hormone?
Which clinical sign is a common indication of deficiencies in calcium, vitamin D, or excessive phosphate intake in young animals?
Which clinical sign is a common indication of deficiencies in calcium, vitamin D, or excessive phosphate intake in young animals?
What condition results from a progressive reduction in renal tubule cells affecting calcium retention?
What condition results from a progressive reduction in renal tubule cells affecting calcium retention?
Which of the following biochemical findings is associated with a diagnosis of diabetes mellitus in dogs?
Which of the following biochemical findings is associated with a diagnosis of diabetes mellitus in dogs?
What is an expected physiological consequence of decreased calcitriol levels in the body?
What is an expected physiological consequence of decreased calcitriol levels in the body?
In diabetic dogs, which of the following must be observed for a diagnosis of diabetic ketoacidosis (DKA)?
In diabetic dogs, which of the following must be observed for a diagnosis of diabetic ketoacidosis (DKA)?
What clinical sign commonly associated with diabetes mellitus can also lead to dehydration and muscle wasting?
What clinical sign commonly associated with diabetes mellitus can also lead to dehydration and muscle wasting?
Which process is directly implicated in the development of neurologic signs during chronic renal failure (CRF)?
Which process is directly implicated in the development of neurologic signs during chronic renal failure (CRF)?
What is the threshold for blood glucose concentration that usually triggers clinical signs of diabetes mellitus in dogs?
What is the threshold for blood glucose concentration that usually triggers clinical signs of diabetes mellitus in dogs?
What is the recommended dosage of oral calcium for Siamese cats?
What is the recommended dosage of oral calcium for Siamese cats?
Which treatment for hypocalcemia has the fastest onset of action?
Which treatment for hypocalcemia has the fastest onset of action?
What potential condition can occur with the treatment of hypocalcemia?
What potential condition can occur with the treatment of hypocalcemia?
What is the least effective form of vitamin D for correcting hypocalcemia?
What is the least effective form of vitamin D for correcting hypocalcemia?
Which of the following is NOT a cause of hypocalcemia?
Which of the following is NOT a cause of hypocalcemia?
What is the most prevalent clinical condition causing hypoparathyroidism?
What is the most prevalent clinical condition causing hypoparathyroidism?
In the context of magnesium depletion, what is a common consequence?
In the context of magnesium depletion, what is a common consequence?
What clinical condition is prevalent in lactating bitches or queens during the first three weeks postpartum?
What clinical condition is prevalent in lactating bitches or queens during the first three weeks postpartum?
Which type of insulin is classified as long-acting?
Which type of insulin is classified as long-acting?
What should be monitored to assess the effectiveness of diabetes mellitus treatment?
What should be monitored to assess the effectiveness of diabetes mellitus treatment?
Which insulin type is typically used in place of poor absorption in diabetic dogs?
Which insulin type is typically used in place of poor absorption in diabetic dogs?
During which situation should glucose curves be performed?
During which situation should glucose curves be performed?
Which insulin type is classified as intermediate-acting?
Which insulin type is classified as intermediate-acting?
What is the typical duration of action for glargine insulin in cats?
What is the typical duration of action for glargine insulin in cats?
What is the initial recommended dosage range for insulin therapy in cats?
What is the initial recommended dosage range for insulin therapy in cats?
What insulin types are preferred for use in cats?
What insulin types are preferred for use in cats?
After starting insulin therapy, when should glucose concentrations be measured?
After starting insulin therapy, when should glucose concentrations be measured?
What might be necessary regarding the insulin dose after two weeks in cats using glargine?
What might be necessary regarding the insulin dose after two weeks in cats using glargine?
Which factor is not associated with conditions leading to hyperglycemia in cats?
Which factor is not associated with conditions leading to hyperglycemia in cats?
What is a common effect of glucocorticosteroids on diabetic cats?
What is a common effect of glucocorticosteroids on diabetic cats?
Which is a characteristic of insulin therapy in cats with diabetes mellitus?
Which is a characteristic of insulin therapy in cats with diabetes mellitus?
What is the primary cause of death in severe diabetic ketoacidosis (DKA)?
What is the primary cause of death in severe diabetic ketoacidosis (DKA)?
Which condition is most commonly associated with insulin resistance in cats?
Which condition is most commonly associated with insulin resistance in cats?
In cases of insulinoma, which is a common characteristic regarding the age of affected dogs?
In cases of insulinoma, which is a common characteristic regarding the age of affected dogs?
What does fructosamine reflect in dogs with diabetes mellitus?
What does fructosamine reflect in dogs with diabetes mellitus?
Which is an unlikely clinical sign associated with hypoglycemia in dogs?
Which is an unlikely clinical sign associated with hypoglycemia in dogs?
What is a known effect of the Somogyi phenomenon in diabetic patients?
What is a known effect of the Somogyi phenomenon in diabetic patients?
Which of the following statements accurately describes a common predisposition in insulinoma cases?
Which of the following statements accurately describes a common predisposition in insulinoma cases?
What is the expected course of action regarding insulin dose adjustment after recording glucose levels?
What is the expected course of action regarding insulin dose adjustment after recording glucose levels?
Why is the high-dose dexamethasone suppression test not recommended for diagnosing HAC?
Why is the high-dose dexamethasone suppression test not recommended for diagnosing HAC?
What indicates a low concentration of endogenous ACTH in adrenal tumors?
What indicates a low concentration of endogenous ACTH in adrenal tumors?
What clinical sign is typically seen in dogs with PDH?
What clinical sign is typically seen in dogs with PDH?
How might abdominal ultrasound findings differ between adrenal tumors and PDH?
How might abdominal ultrasound findings differ between adrenal tumors and PDH?
What is a common clinical pathology finding associated with hyperadrenocorticism?
What is a common clinical pathology finding associated with hyperadrenocorticism?
Which of the following is a major concern when handling samples for endogenous ACTH measurement?
Which of the following is a major concern when handling samples for endogenous ACTH measurement?
Which breed of dog is at increased risk for developing adrenal tumors?
Which breed of dog is at increased risk for developing adrenal tumors?
What is a characteristic of clinical signs seen in hyperadrenocorticism?
What is a characteristic of clinical signs seen in hyperadrenocorticism?
What is a potential reason for insufficient insulin efficacy in a diabetic dog?
What is a potential reason for insufficient insulin efficacy in a diabetic dog?
Which condition is likely to cause an increase in blood glucose levels in unregulated diabetic dogs?
Which condition is likely to cause an increase in blood glucose levels in unregulated diabetic dogs?
What is the recommended frequency of insulin administration for optimal management in diabetic dogs?
What is the recommended frequency of insulin administration for optimal management in diabetic dogs?
Which of the following is NOT a common cause of insulin antagonism in dogs?
Which of the following is NOT a common cause of insulin antagonism in dogs?
What is a consequence of insulin-induced hyperglycemia in diabetic dogs?
What is a consequence of insulin-induced hyperglycemia in diabetic dogs?
During serial blood glucose monitoring, what should be observed to adjust insulin dosing?
During serial blood glucose monitoring, what should be observed to adjust insulin dosing?
What is an indication that a diabetic dog may require a dosage change in insulin therapy?
What is an indication that a diabetic dog may require a dosage change in insulin therapy?
Which of the following is a distinguishing factor for selecting insulin regimens in unregulated diabetic dogs?
Which of the following is a distinguishing factor for selecting insulin regimens in unregulated diabetic dogs?
What can result from improper insulin storage in diabetic dogs?
What can result from improper insulin storage in diabetic dogs?
What is commonly monitored to assess the adequacy of insulin therapy in dogs?
What is commonly monitored to assess the adequacy of insulin therapy in dogs?
What is the initial insulin dosing protocol recommended for diabetic cats?
What is the initial insulin dosing protocol recommended for diabetic cats?
Which insulin type is generally avoided due to its potential to induce antibody formation?
Which insulin type is generally avoided due to its potential to induce antibody formation?
Which condition is specifically associated with renal disease as a cause of hyperglycemia?
Which condition is specifically associated with renal disease as a cause of hyperglycemia?
What physiological contribution is most significant in cases of stress-induced hyperglycemia in cats?
What physiological contribution is most significant in cases of stress-induced hyperglycemia in cats?
What glucose measurement protocol is crucial for assessing the effectiveness of initial insulin therapy?
What glucose measurement protocol is crucial for assessing the effectiveness of initial insulin therapy?
What clinical sign is most commonly associated with decreased potassium in animals?
What clinical sign is most commonly associated with decreased potassium in animals?
Which metabolic condition is indicated by a serum potassium level at or above 5.4 mEq/L?
Which metabolic condition is indicated by a serum potassium level at or above 5.4 mEq/L?
What is the primary function of thyroid-releasing hormone (TRH)?
What is the primary function of thyroid-releasing hormone (TRH)?
Which thyroid hormone is considered the active form?
Which thyroid hormone is considered the active form?
Which condition is least likely to cause fluid retention related to primary hyperaldosteronism?
Which condition is least likely to cause fluid retention related to primary hyperaldosteronism?
In the context of calcium metabolism, what is the physiological role of ionized calcium (iCa)?
In the context of calcium metabolism, what is the physiological role of ionized calcium (iCa)?
What do thyroglobulin autoantibodies (TgAA) indicate in dogs?
What do thyroglobulin autoantibodies (TgAA) indicate in dogs?
What is the effect of T3 autoantibodies (T3AA) on thyroid measurements?
What is the effect of T3 autoantibodies (T3AA) on thyroid measurements?
Which statement best describes the relationship between elevated phosphorus levels and calcitriol production?
Which statement best describes the relationship between elevated phosphorus levels and calcitriol production?
What is the significance of measuring serum total calcium (tCa) in diagnosing calcium metabolic disorders?
What is the significance of measuring serum total calcium (tCa) in diagnosing calcium metabolic disorders?
Why is the T3 suppression test utilized?
Why is the T3 suppression test utilized?
What is measured in the 'pre' sample of the T3 suppression test?
What is measured in the 'pre' sample of the T3 suppression test?
Which of the following best describes one of the common clinical signs in older animals diagnosed with primary hyperaldosteronism?
Which of the following best describes one of the common clinical signs in older animals diagnosed with primary hyperaldosteronism?
Which hormone's elevated levels promote negative feedback on TSH production?
Which hormone's elevated levels promote negative feedback on TSH production?
What is the typical cause of elevated creatine kinase levels in cases related to decreased potassium?
What is the typical cause of elevated creatine kinase levels in cases related to decreased potassium?
What does the presence of T4 autoantibodies (T4AA) suggest in dogs?
What does the presence of T4 autoantibodies (T4AA) suggest in dogs?
What is the primary effect of elevated PTHrP in the plasma?
What is the primary effect of elevated PTHrP in the plasma?
Which statement best describes parathyroid-independent hypocalcemia?
Which statement best describes parathyroid-independent hypocalcemia?
What is a significant diagnostic challenge when evaluating for malignancy related to PTHrP?
What is a significant diagnostic challenge when evaluating for malignancy related to PTHrP?
What is the recommended initial treatment approach for cases of hypercalcemia where other treatments have not worked?
What is the recommended initial treatment approach for cases of hypercalcemia where other treatments have not worked?
What underlying condition is primarily associated with the clinical signs of hypocalcemia?
What underlying condition is primarily associated with the clinical signs of hypocalcemia?
Which of the following is a common feature of parathyroid-independent hypercalcemia?
Which of the following is a common feature of parathyroid-independent hypercalcemia?
In the context of hypoadrenocorticism, what effect does treating underlying conditions like hypovolemia have on hypercalcemia?
In the context of hypoadrenocorticism, what effect does treating underlying conditions like hypovolemia have on hypercalcemia?
What is an important consideration when diagnosing causes of calcium imbalance, particularly in cases of malignancy-related hypercalcemia?
What is an important consideration when diagnosing causes of calcium imbalance, particularly in cases of malignancy-related hypercalcemia?
Which disorder is most commonly associated with renal secondary hyperparathyroidism?
Which disorder is most commonly associated with renal secondary hyperparathyroidism?
What is a common biochemical finding in humoral hypercalcemia of malignancy?
What is a common biochemical finding in humoral hypercalcemia of malignancy?
Which parathyroid hormone level would you expect in a case of primary hyperparathyroidism?
Which parathyroid hormone level would you expect in a case of primary hyperparathyroidism?
In nutritional secondary hyperparathyroidism, what happens to the serum phosphorus level?
In nutritional secondary hyperparathyroidism, what happens to the serum phosphorus level?
What is the typical response of serum calcium levels in a case of idiopathic hypercalcemia in cats?
What is the typical response of serum calcium levels in a case of idiopathic hypercalcemia in cats?
What laboratory finding would indicate hypervitaminosis D?
What laboratory finding would indicate hypervitaminosis D?
What is a distinctive feature of cholecalciferol toxicity in terms of biochemical markers?
What is a distinctive feature of cholecalciferol toxicity in terms of biochemical markers?
In dehydration, which serum parameter is likely to be altered?
In dehydration, which serum parameter is likely to be altered?
What is the expected laboratory finding in a case of hyperthyroidism in cats?
What is the expected laboratory finding in a case of hyperthyroidism in cats?
What physiological condition is associated with aluminum exposure and renal failure?
What physiological condition is associated with aluminum exposure and renal failure?
What type of insulin is categorized as short-acting?
What type of insulin is categorized as short-acting?
Which monitoring procedure is recommended when hypoglycemia is suspected during initial treatment regulation?
Which monitoring procedure is recommended when hypoglycemia is suspected during initial treatment regulation?
What is a type of long-acting insulin listed in the provided content?
What is a type of long-acting insulin listed in the provided content?
Which type of insulin treatment is known for its poor absorption?
Which type of insulin treatment is known for its poor absorption?
What clinical signs should be monitored to assess the effectiveness of insulin treatment?
What clinical signs should be monitored to assess the effectiveness of insulin treatment?
Which hormone is primarily responsible for increasing calcium levels in the blood?
Which hormone is primarily responsible for increasing calcium levels in the blood?
What is the primary effect of synthesized calcitriol on calcium metabolism?
What is the primary effect of synthesized calcitriol on calcium metabolism?
Which treatment option acts specifically as an inhibitor of bone resorption in hypercalcemia management?
Which treatment option acts specifically as an inhibitor of bone resorption in hypercalcemia management?
In primary hyperparathyroidism, what process causes elevated ionized calcium levels?
In primary hyperparathyroidism, what process causes elevated ionized calcium levels?
Which mechanism is NOT a direct action of parathyroid hormone (PTH)?
Which mechanism is NOT a direct action of parathyroid hormone (PTH)?
What is a common characteristic of disorders associated with excessive bone resorption?
What is a common characteristic of disorders associated with excessive bone resorption?
What role does vitamin D play in calcium metabolism?
What role does vitamin D play in calcium metabolism?
Which drug is known to facilitate the correction of dehydration in hypercalcemic patients?
Which drug is known to facilitate the correction of dehydration in hypercalcemic patients?
What is the recommended glucose concentration maintenance range for diabetic dogs?
What is the recommended glucose concentration maintenance range for diabetic dogs?
What does the glucose nadir indicate in the context of insulin therapy?
What does the glucose nadir indicate in the context of insulin therapy?
What clinical sign is typically observed in dogs and cats with diabetic ketoacidosis (DKA)?
What clinical sign is typically observed in dogs and cats with diabetic ketoacidosis (DKA)?
How long can it take for clinical signs of diabetic ketoacidosis to develop after initial onset?
How long can it take for clinical signs of diabetic ketoacidosis to develop after initial onset?
What is the definition of glucose differential in diabetic monitoring?
What is the definition of glucose differential in diabetic monitoring?
What condition may lead to diabetic ketoacidosis in pets receiving inadequate insulin?
What condition may lead to diabetic ketoacidosis in pets receiving inadequate insulin?
When should blood glucose concentration be measured in relation to insulin administration?
When should blood glucose concentration be measured in relation to insulin administration?
What is the target range for glucose nadir in diabetic dogs?
What is the target range for glucose nadir in diabetic dogs?
What is the preferred type of insulin for initial therapy in cats with diabetes mellitus?
What is the preferred type of insulin for initial therapy in cats with diabetes mellitus?
What dosage range is typically recommended to start insulin therapy in cats?
What dosage range is typically recommended to start insulin therapy in cats?
How long does glargine insulin typically last in cats?
How long does glargine insulin typically last in cats?
What is important to monitor after the initial administration of insulin therapy in cats?
What is important to monitor after the initial administration of insulin therapy in cats?
What is a potential adjustment that may be needed after 2 weeks of insulin therapy in cats?
What is a potential adjustment that may be needed after 2 weeks of insulin therapy in cats?
Which of the following is NOT a common drug that may influence insulin therapy in cats?
Which of the following is NOT a common drug that may influence insulin therapy in cats?
What is a notable characteristic of the effects of using glargine in insulin therapy for cats?
What is a notable characteristic of the effects of using glargine in insulin therapy for cats?
In the context of insulin therapy for cats, what is the significance of measuring glucose concentration at certain intervals?
In the context of insulin therapy for cats, what is the significance of measuring glucose concentration at certain intervals?
What indicates a potential case of hyperadrenocorticism (HAC) in post-dexamethasone cortisol measurements?
What indicates a potential case of hyperadrenocorticism (HAC) in post-dexamethasone cortisol measurements?
Which of the following best describes occult hyperthyroidism?
Which of the following best describes occult hyperthyroidism?
What consequence can arise from surgical treatment of hyperthyroidism?
What consequence can arise from surgical treatment of hyperthyroidism?
Which laboratory finding may indicate pituitary-dependent hyperadrenocorticism (PDH) after dexamethasone suppression testing?
Which laboratory finding may indicate pituitary-dependent hyperadrenocorticism (PDH) after dexamethasone suppression testing?
What is a key factor in the testing for occult hyperthyroidism?
What is a key factor in the testing for occult hyperthyroidism?
Which treatment is not utilized for managing hyperthyroidism?
Which treatment is not utilized for managing hyperthyroidism?
Which of the following conditions may result in normal thyroid hormone concentrations despite underlying hyperthyroidism?
Which of the following conditions may result in normal thyroid hormone concentrations despite underlying hyperthyroidism?
What indicates a false-positive result in cortisol concentration testing?
What indicates a false-positive result in cortisol concentration testing?
What is the preferred insulin type commonly recommended for cats with diabetes mellitus?
What is the preferred insulin type commonly recommended for cats with diabetes mellitus?
Which insulin dosing protocol is typically initiated in cats undergoing treatment?
Which insulin dosing protocol is typically initiated in cats undergoing treatment?
How long does Glargine insulin typically last in cats?
How long does Glargine insulin typically last in cats?
What is a critical consideration regarding her insulin dose after two weeks of therapy?
What is a critical consideration regarding her insulin dose after two weeks of therapy?
What is the preferred method for monitoring glucose levels post-insulin administration?
What is the preferred method for monitoring glucose levels post-insulin administration?
Why might cats require high doses of insulin initially?
Why might cats require high doses of insulin initially?
Which type of insulin is preferred for initial treatment in cats due to its action?
Which type of insulin is preferred for initial treatment in cats due to its action?
What insulin concentration should be aimed for when measuring glucose levels after treatment?
What insulin concentration should be aimed for when measuring glucose levels after treatment?
What is a potential affected factor that could lead to a high nadir in unregulated diabetic dogs?
What is a potential affected factor that could lead to a high nadir in unregulated diabetic dogs?
Which condition is least likely to affect insulin metabolism in an unregulated diabetic dog?
Which condition is least likely to affect insulin metabolism in an unregulated diabetic dog?
What is the recommended adjustment to insulin therapy if blood glucose levels are consistently too high?
What is the recommended adjustment to insulin therapy if blood glucose levels are consistently too high?
What is the typical insulin dosage recommended for managing unregulated diabetic patients?
What is the typical insulin dosage recommended for managing unregulated diabetic patients?
Which of the following is NOT considered an error in diabetes management for dogs?
Which of the following is NOT considered an error in diabetes management for dogs?
What is a potential consequence of exogenous steroids in diabetic dogs?
What is a potential consequence of exogenous steroids in diabetic dogs?
What is the method of monitoring that aids in adjusting insulin therapy for diabetic dogs?
What is the method of monitoring that aids in adjusting insulin therapy for diabetic dogs?
Which factor can complicate the insulin therapy for an unregulated diabetic dog?
Which factor can complicate the insulin therapy for an unregulated diabetic dog?
Which type of insulin administration schedule is recommended for diabetic dogs?
Which type of insulin administration schedule is recommended for diabetic dogs?
What is one of the signs indicating an unregulated diabetic state in dogs?
What is one of the signs indicating an unregulated diabetic state in dogs?
What indicates primary hyperaldosteronism in a patient?
What indicates primary hyperaldosteronism in a patient?
What effect does hypercalcemia have on the kidneys?
What effect does hypercalcemia have on the kidneys?
Which condition is commonly associated with nephrotoxicity caused by hypercalcemia?
Which condition is commonly associated with nephrotoxicity caused by hypercalcemia?
What clinical sign is most commonly observed in cats with hypercalcemia?
What clinical sign is most commonly observed in cats with hypercalcemia?
What laboratory finding would indicate a parathyroid tumor?
What laboratory finding would indicate a parathyroid tumor?
Which statement is true regarding the effects of hypokalemia on aldosterone concentrations?
Which statement is true regarding the effects of hypokalemia on aldosterone concentrations?
Which treatment is appropriate for correcting hypokalemia in a patient with hyperaldosteronism?
Which treatment is appropriate for correcting hypokalemia in a patient with hyperaldosteronism?
What mechanism explains why parathyroid hormone (PTH) production is not suppressed by high levels of ionized calcium in the context of a parathyroid tumor?
What mechanism explains why parathyroid hormone (PTH) production is not suppressed by high levels of ionized calcium in the context of a parathyroid tumor?
What is the primary role of thyroid-releasing hormone (TRH) in the endocrine system?
What is the primary role of thyroid-releasing hormone (TRH) in the endocrine system?
Which of the following statements regarding thyroglobulin autoantibodies (TgAA) is incorrect?
Which of the following statements regarding thyroglobulin autoantibodies (TgAA) is incorrect?
What is the potential impact of T3 autoantibodies (T3AA) on laboratory tests?
What is the potential impact of T3 autoantibodies (T3AA) on laboratory tests?
In the context of the T3 suppression test, what is the purpose of administering T3 supplements?
In the context of the T3 suppression test, what is the purpose of administering T3 supplements?
Which hormone is primarily measured in diagnosing hyperthyroidism in cats using the T3 suppression test?
Which hormone is primarily measured in diagnosing hyperthyroidism in cats using the T3 suppression test?
What is the typical form of thyroid hormones measured in most laboratory tests?
What is the typical form of thyroid hormones measured in most laboratory tests?
What does an increase in released thyroid hormones imply in terms of feedback control?
What does an increase in released thyroid hormones imply in terms of feedback control?
What does the presence of T4 autoantibodies (T4AA) indicate in affected dogs?
What does the presence of T4 autoantibodies (T4AA) indicate in affected dogs?
In the management of diabetes insipidus, what is the expected effect of administering desmopressin (dDAVP) in animals with central DI?
In the management of diabetes insipidus, what is the expected effect of administering desmopressin (dDAVP) in animals with central DI?
What is the main reason why animals with nephrogenic diabetes insipidus (NDI) fail to concentrate urine effectively when dehydrated?
What is the main reason why animals with nephrogenic diabetes insipidus (NDI) fail to concentrate urine effectively when dehydrated?
Which treatment option is considered unnecessary for animals with secondary diabetes insipidus as long as there is a constant water supply?
Which treatment option is considered unnecessary for animals with secondary diabetes insipidus as long as there is a constant water supply?
How does the pathogenesis of primary diabetes insipidus differ from secondary diabetes insipidus?
How does the pathogenesis of primary diabetes insipidus differ from secondary diabetes insipidus?
What is the typical long-term prognosis for animals diagnosed with conditions related to pituitary tumors, such as insulin resistance and chronic renal failure?
What is the typical long-term prognosis for animals diagnosed with conditions related to pituitary tumors, such as insulin resistance and chronic renal failure?
What is a significant consequence of chronic renal failure in cats that may arise from underlying endocrine disorders?
What is a significant consequence of chronic renal failure in cats that may arise from underlying endocrine disorders?
Which of the following statements regarding the administration of dDAVP is true in the context of veterinary medicine?
Which of the following statements regarding the administration of dDAVP is true in the context of veterinary medicine?
What is the primary mechanism through which gastrinomas cause endocrine-related issues in animals?
What is the primary mechanism through which gastrinomas cause endocrine-related issues in animals?
Which of the following may contribute to hypoglycemia in dogs?
Which of the following may contribute to hypoglycemia in dogs?
What is a clinical sign that could indicate growth hormone (GH) deficiency in dogs?
What is a clinical sign that could indicate growth hormone (GH) deficiency in dogs?
Which physiological condition should be evaluated for its possibility of causing hypoglycemia?
Which physiological condition should be evaluated for its possibility of causing hypoglycemia?
Which statement best describes the procedure needed before assessing insulin levels in dogs?
Which statement best describes the procedure needed before assessing insulin levels in dogs?
In the context of insulinoma diagnosis, which laboratory finding would be consistent?
In the context of insulinoma diagnosis, which laboratory finding would be consistent?
What is a potential outcome of a nonpancreatic tumor related to hypoglycemia?
What is a potential outcome of a nonpancreatic tumor related to hypoglycemia?
In cases of severe hypoglycemia, which clinical pathology finding may be observed?
In cases of severe hypoglycemia, which clinical pathology finding may be observed?
Which factor can lead to the inhibition of insulin release when blood glucose is below the normal threshold?
Which factor can lead to the inhibition of insulin release when blood glucose is below the normal threshold?
What percentage of thyroid carcinomas in dogs are likely to be associated with hyperthyroidism?
What percentage of thyroid carcinomas in dogs are likely to be associated with hyperthyroidism?
Which statement regarding the ACTH response test is accurate?
Which statement regarding the ACTH response test is accurate?
Which treatment is recommended post-surgery for dogs diagnosed with thyroid carcinoma?
Which treatment is recommended post-surgery for dogs diagnosed with thyroid carcinoma?
What disadvantage is associated with the ACTH response test for diagnosing HAC?
What disadvantage is associated with the ACTH response test for diagnosing HAC?
Which of the following is NOT a clinical sign associated with hyperthyroidism in dogs?
Which of the following is NOT a clinical sign associated with hyperthyroidism in dogs?
When assessing the urinary cortisol-to-creatinine ratio (UCCR), which statement is correct?
When assessing the urinary cortisol-to-creatinine ratio (UCCR), which statement is correct?
Which zone of the adrenal cortex primarily secretes mineralocorticoids?
Which zone of the adrenal cortex primarily secretes mineralocorticoids?
In the context of iatrogenic hyperadrenocorticism (HAC), which of the following tests is preferred?
In the context of iatrogenic hyperadrenocorticism (HAC), which of the following tests is preferred?
What is the typical clinical feature associated with decreased potassium levels?
What is the typical clinical feature associated with decreased potassium levels?
Which hormone's production decreases with increased ionized calcium levels?
Which hormone's production decreases with increased ionized calcium levels?
What is the most reliable method to assess calcium metabolic disorders?
What is the most reliable method to assess calcium metabolic disorders?
What is a common clinical sign observed in patients with primary hyperaldosteronism?
What is a common clinical sign observed in patients with primary hyperaldosteronism?
What is the recommended duration of action for Glargine insulin in cats?
What is the recommended duration of action for Glargine insulin in cats?
Which insulin type is preferred for managing feline diabetes?
Which insulin type is preferred for managing feline diabetes?
Which laboratory finding is least likely associated with hypokalemia?
Which laboratory finding is least likely associated with hypokalemia?
Which electrolyte abnormality can lead to systemic hypertension due to sodium and fluid retention?
Which electrolyte abnormality can lead to systemic hypertension due to sodium and fluid retention?
What initial insulin dosage is commonly recommended for cats diagnosed with hyperglycemia?
What initial insulin dosage is commonly recommended for cats diagnosed with hyperglycemia?
What laboratory result would most likely indicate a calcium metabolic disorder?
What laboratory result would most likely indicate a calcium metabolic disorder?
What is one potential adjustment required after two weeks of insulin therapy in cats?
What is one potential adjustment required after two weeks of insulin therapy in cats?
What adjustment should NOT be made when interpreting serum calcium and albumin levels?
What adjustment should NOT be made when interpreting serum calcium and albumin levels?
When monitoring the initial insulin therapy's efficacy in cats, when should glucose concentration be measured?
When monitoring the initial insulin therapy's efficacy in cats, when should glucose concentration be measured?
Which hormone is NOT mentioned as a factor influencing feline hyperglycemia?
Which hormone is NOT mentioned as a factor influencing feline hyperglycemia?
What is the primary concern with administering beef origin insulin to cats?
What is the primary concern with administering beef origin insulin to cats?
Which condition is linked to the use of dextrose-containing fluids in cats?
Which condition is linked to the use of dextrose-containing fluids in cats?
What is the expected urine specific gravity (USG) in animals with nephrogenic diabetes insipidus (DI)?
What is the expected urine specific gravity (USG) in animals with nephrogenic diabetes insipidus (DI)?
Which finding would raise suspicion for diabetes insipidus (DI) in an animal presenting with hypernatremia?
Which finding would raise suspicion for diabetes insipidus (DI) in an animal presenting with hypernatremia?
What is a characteristic of absolute vasopressin deficiency in central diabetes insipidus (CDI)?
What is a characteristic of absolute vasopressin deficiency in central diabetes insipidus (CDI)?
Which diagnostic measure is essential to differentiate between absolute and partial CDI?
Which diagnostic measure is essential to differentiate between absolute and partial CDI?
In diagnosing acromegaly in a diabetic cat, what is a potential complication to be cautious about?
In diagnosing acromegaly in a diabetic cat, what is a potential complication to be cautious about?
What is a significant indicator of insulin-resistant diabetes mellitus in the presence of acromegaly?
What is a significant indicator of insulin-resistant diabetes mellitus in the presence of acromegaly?
What is the expected duration of recurrence following radiation therapy for pituitary mass in acromegaly treatment?
What is the expected duration of recurrence following radiation therapy for pituitary mass in acromegaly treatment?
Which condition could complicate the diagnosis of diabetes insipidus?
Which condition could complicate the diagnosis of diabetes insipidus?
What is a less common cause of acromegaly in dogs compared to other species?
What is a less common cause of acromegaly in dogs compared to other species?
Which breed is primarily associated with congenital growth hormone deficiency?
Which breed is primarily associated with congenital growth hormone deficiency?
Which clinical signs are indicative of acromegaly in dogs?
Which clinical signs are indicative of acromegaly in dogs?
What is the significance of insulin ineffectiveness in diagnosing acromegaly?
What is the significance of insulin ineffectiveness in diagnosing acromegaly?
Which of the following clinical signs is considered late in the progression of acromegaly?
Which of the following clinical signs is considered late in the progression of acromegaly?
What is a common characteristic of acromegaly that might be observed during a physical examination?
What is a common characteristic of acromegaly that might be observed during a physical examination?
Which clinical abnormalities might be associated with a deficiency of pituitary hormones in affected dogs?
Which clinical abnormalities might be associated with a deficiency of pituitary hormones in affected dogs?
In which age group is acromegaly most frequently observed in cats?
In which age group is acromegaly most frequently observed in cats?
What is a function of thyroid-releasing hormone (TRH) in normal thyroid function?
What is a function of thyroid-releasing hormone (TRH) in normal thyroid function?
What is the role of thyroglobulin autoantibodies (TgAA) in dogs?
What is the role of thyroglobulin autoantibodies (TgAA) in dogs?
What is the primary objective of calcitriol therapy in the context of glucose metabolism disorders?
What is the primary objective of calcitriol therapy in the context of glucose metabolism disorders?
How do T3 and T4 autoantibodies (T3AA and T4AA) affect thyroid testing in dogs?
How do T3 and T4 autoantibodies (T3AA and T4AA) affect thyroid testing in dogs?
Which statement accurately describes the characteristics of insulin-dependent diabetes mellitus (IDDM) in dogs?
Which statement accurately describes the characteristics of insulin-dependent diabetes mellitus (IDDM) in dogs?
What does a T3 suppression test primarily diagnose?
What does a T3 suppression test primarily diagnose?
What type of information does free T4 (FT4) provide concerning thyroid function?
What type of information does free T4 (FT4) provide concerning thyroid function?
In cats diagnosed with non-insulin-dependent diabetes mellitus (NIDDM), which of the following is true regarding insulin concentration?
In cats diagnosed with non-insulin-dependent diabetes mellitus (NIDDM), which of the following is true regarding insulin concentration?
What is a key consideration when managing the dietary therapy for dogs with diabetes mellitus?
What is a key consideration when managing the dietary therapy for dogs with diabetes mellitus?
What might a high level of thyroglobulin autoantibodies indicate in a canine patient?
What might a high level of thyroglobulin autoantibodies indicate in a canine patient?
Which thyroid hormone includes both free and protein-bound forms?
Which thyroid hormone includes both free and protein-bound forms?
What is the recommended use of oral hypoglycemic drugs in cats?
What is the recommended use of oral hypoglycemic drugs in cats?
In the context of thyroid function tests, which statement about T4AA is accurate?
In the context of thyroid function tests, which statement about T4AA is accurate?
Which effect does severe hyperglycemia have on stressed cats?
Which effect does severe hyperglycemia have on stressed cats?
What is the goal of therapy in managing diabetes mellitus?
What is the goal of therapy in managing diabetes mellitus?
When using glipizide for managing non-insulin-dependent diabetes in cats, what should be monitored?
When using glipizide for managing non-insulin-dependent diabetes in cats, what should be monitored?
Which of the following describes a potential clinical sign associated with excessive vitamin D intake?
Which of the following describes a potential clinical sign associated with excessive vitamin D intake?
What biochemical change is typically observed in primary hypoparathyroidism?
What biochemical change is typically observed in primary hypoparathyroidism?
Which condition is associated with lymphoplasmacytic destruction of the parathyroid glands?
Which condition is associated with lymphoplasmacytic destruction of the parathyroid glands?
Which of the following is a typical finding in serum biochemistry for patients experiencing pseudohypoparathyroidism?
Which of the following is a typical finding in serum biochemistry for patients experiencing pseudohypoparathyroidism?
What is a likely description of the parathyroid hormone (PTH) level in cases of acute sepsis related to hypocalcemia?
What is a likely description of the parathyroid hormone (PTH) level in cases of acute sepsis related to hypocalcemia?
Which of the following describes the effect of ingested plants containing vitamin D metabolites?
Which of the following describes the effect of ingested plants containing vitamin D metabolites?
Which consequence is associated with the ingestion of anti-psoriasis creams that contain vitamin D metabolites?
Which consequence is associated with the ingestion of anti-psoriasis creams that contain vitamin D metabolites?
How can the presence of acromegaly complicate the management of diabetes mellitus (DM) in animals?
How can the presence of acromegaly complicate the management of diabetes mellitus (DM) in animals?
What laboratory finding may indicate diabetic insipidus (DI) in an animal with hypernatremia?
What laboratory finding may indicate diabetic insipidus (DI) in an animal with hypernatremia?
What clinical sign is likely observed in animals with poorly controlled diabetes mellitus?
What clinical sign is likely observed in animals with poorly controlled diabetes mellitus?
Which statement accurately describes one of the challenges in diagnosing acromegaly in diabetic cats?
Which statement accurately describes one of the challenges in diagnosing acromegaly in diabetic cats?
What is the significance of documenting a pituitary mass in cats suspected of having acromegaly?
What is the significance of documenting a pituitary mass in cats suspected of having acromegaly?
What is a crucial factor to consider before performing the modified water deprivation test?
What is a crucial factor to consider before performing the modified water deprivation test?
Which of the following best describes the outcome of absolute vasopressin deficiency in central diabetes insipidus?
Which of the following best describes the outcome of absolute vasopressin deficiency in central diabetes insipidus?
Why should caution be applied when interpreting elevated IGF-1 levels in diabetic cats?
Why should caution be applied when interpreting elevated IGF-1 levels in diabetic cats?
Flashcards are hidden until you start studying
Study Notes
Hyperadrenocorticism (HAC)
- HAC is a condition characterized by excessive cortisol production by the adrenal glands.
- HAC can occur in dogs and cats.
- Signs of HAC include increased thirst and urination, increased appetite, weight gain, muscle wasting, and thinning of the skin.
- HAC can be diagnosed with blood tests and imaging.
- Treatment for HAC includes medications and surgery.
Treatment of HAC
- Mitotane is a drug that inhibits the production of cortisol.
- Mitotane is typically given in three phases: induction, maintenance, and monitoring.
- It can be used to treat HAC, including the pituitary dependent form (PDH).
- It is commonly used in dogs with HAC.
- Trilostane is another drug that inhibits the production of cortisol.
- Trilostane is typically given daily.
- Ketoconazole is a drug that can be used to treat HAC.
- Ketoconazole is typically used in cases where other treatments have failed.
- Surgery is also an option for treating HAC.
- Adrenalectomy is the most successful treatment method for HAC.
- Unilateral adrenalectomy is performed if there is an adrenal tumor.
- Bilateral adrenalectomy is performed if the HAC is caused by PDH.
- Hypophysectomy is an option for treating PDH.
- Medical therapy is less successful than surgery or other treatments.
Hypoadrenocorticism
- This condition is also known as Addison's disease.
- Primary hypoadrenocorticism is characterized by a deficiency of both glucocorticoid and mineralocorticoid.
- Idiopathic adrenocortical atrophy is the most common cause of primary hypoadrenocorticism.
Hypercalcemia
- Hypercalcemia is characterized by high levels of calcium in the blood.
- It can be caused by several factors including:
- Parathyroid gland disease
- Certain tumors
- Dietary deficiencies
- Kidney disease
- Increased bone breakdown
- Hypercalcemia can lead to several health problems, including:
- Kidney stones
- Bone loss
- Weakness
- Confusion
- Loss of appetite
- Increased thirst
- Increased urination
Pituitary Dwarfism
- This condition is characterized by a deficiency of growth hormone.
- Pituitary dwarfism is usually autosomal recessive.
- It is most common in German shepherd dogs and Carnelian bear dogs.
- Signs of pituitary dwarfism include:
- Short stature
- Delayed bone growth
- Delayed tooth eruption
- Delayed sexual development
- Thin skin with hair loss
- Mental dullness.
Diabetes Insipidus (DI)
- DI is a condition that causes the body to produce too much urine.
- This is caused by a deficiency of antidiuretic hormone (ADH) which helps the kidneys to reabsorb water.
- Signs of DI include:
- Increased thirst
- Increased urination
- Dehydration
- The urine will be dilute, with a specific gravity less than 1.008.
Acromegaly
- Acromegaly is characterized by an excess of growth hormone.
- It is usually caused by a pituitary tumor.
- Signs of acromegaly include:
- Enlarged extremities
- Thickened skin
- Muscle weakness
- Enlarged organs
- It can lead to:
- Diabetes mellitus
- High blood pressure
- Heart disease
- Sleep apnea
- Joint pain
- Vision problems
Lymphocytic Thyroiditis
- Subclinical thyroiditis has normal thyroid hormone and TSH concentrations, focal inflammatory infiltrates of lymphocytes and no clinical signs.
- Subclinical hypothyroidism has elevated TSH, normal or borderline low thyroid hormone concentrations, extensive lymphocytic inflammatory infiltrates with follicular cell hypertrophy.
- Clinical Hypothyroidism has low thyroid hormone concentrations, elevated TSH, extensive diffuse lymphocytic inflammatory infiltrates.
Hypothyroidism
- Hypothyroidism can be caused by medications, breed predispositions and inherited diseases.
Hypercalcemia
- Primary hyperparathyroidism is most common in dogs and is treated with calcium and vitamin D supplementation.
- Puerperal tetany (eclampsia) occurs in the first 3 weeks postpartum in lactating bitches.
Diabetic Ketoacidosis
- Hypoglycemia can be caused by diets deficient in calcium and vitamin D.
- Clinical signs include bone pain, lameness, limb deformities, fractures.
- More common in young, growing animals.
- Diabetic ketoacidosis (DKA) is a common complication of diabetes mellitus.
- Clinical signs include polyuria, polydipsia, polyphagia, weight loss, blindness.
- Treatment includes insulin therapy, volume expansion and correction of dehydration.
Hypocalcemia
- Hypocalcemia - can be caused by Magnesium depletion, albumin ↓, atrophy of parathyroid gland, trauma, hypoparathyroidism, hypoproteinemia, hypomagnesmia, infarction of the parathyroid gland, nutritional deficiencies, gastrointestinal disease and drugs.
- Symptoms include tetany, muscle tremors, seizures.
- Treatment includes calcium supplementation and correction of the underlying cause.
Canine Hypoadrenocorticism (HAC)
- HAC is also known as Addison's disease.
- It is caused by the inadequate production of glucocorticoids and mineralocorticoids by the adrenal cortex.
- This results in deficiencies in cortisol and aldosterone.
Diagnosis
- Diagnosis relies on clinical presentation and laboratory tests.
- A combination of clinical signs, bloodwork, and urine analysis is used to confirm the diagnosis.
- High-dose dexamethasone suppression test shouldn't be used for diagnosis.
- Endogenous ACTH measurement is used, with very low concentrations indicating adrenal tumors.
- Abdominal ultrasound can reveal an enlarged and irregular adrenal gland with an adrenal tumor.
Clinical Signs of HAC
- Polyuria and polydipsia (increased urination and thirst)
- Polyphagia (increased hunger)
- Abdominal distension (pot-bellied appearance)
- Muscle wasting and weakness
- Lethargy and poor exercise tolerance
- Skin thinning, decreased elasticity, calcinosis cutis, and hyperpigmentation.
- Symmetrical alopecia (hair loss)
- Persistent anestrus or testicular atrophy
Clinical Pathology Findings
- Nonspecific findings include:
- Stress leukogram (neutrophilia, lymphopenia, eosinopenia, monocytosis)
- Hyperglycemia with or without glucosuria
- Hypercholesterolemia and hypertriglyceridemia
- Increased corticosteroid-induced ALP (ciALP), ALT, and bile acids
HAC: Canine Predisposition
- HAC is more common in certain breeds, including:
- Poodles (miniature and standard)
- Portuguese water dogs
- Bearded collies
- Rottweilers
- Irish setters
- Labrador retrievers
- American cocker spaniels
- Terriers (Yorkshire terrier, Parson Russell terrier, Staffordshire bull terrier)
- Large breeds weighing more than 20 kg.
Canine Diabetes Mellitus (DM)
- DM occurs when the pancreas doesn't produce enough insulin (Type 1) or when the body doesn't respond properly to insulin (Type 2).
- This leads to a lack of glucose uptake by cells, resulting in hyperglycemia.
Treatment of DM
- Insulin therapy is essential in managing DM.
- Short-acting, intermediate-acting, and long-acting insulins are available.
- Insulin should be administered twice daily with Lente or PZI preferred.
- Glargine insulin lasts 12 to 16 hours and takes several days for maximum effect.
- Initial insulin doses are typically 1 to 3 units per cat twice daily.
Canine Insulinoma
- Insulinoma is a rare tumor of the pancreatic beta cells, resulting in excessive insulin production and hypoglycemia.
- The incidence is higher in middle-aged to older dogs, with a higher predisposition in medium to large breeds.
- Clinical signs may be episodic and worsen after eating, excitement, or exercise.
- Symptoms include lethargy, weakness, ataxia, dementia, seizures, coma, death, and weight gain.
Thyroid Function
- The hypothalamus secretes thyroid-releasing hormone (TRH) which stimulates the pituitary gland to release thyroid-stimulating hormone (TSH).
- TSH stimulates the thyroid gland to release thyroid hormones, which include total T4 (thyroxine), total T3 (tri-iodothyronine), free T4 (FT4), and free T3 (FT3) which is the active thyroid hormone.
- Thyroid hormone production is regulated by negative feedback, where the thyroid hormones inhibit the production of TRH and TSH.
Thyroid Function Tests
- Total T4 is a test that measures the total amount of thyroxine in the blood.
- Total T3 is a test that measures the total amount of tri-iodothyronine in the blood.
- Free T4 is a test that measures the amount of thyroxine that is not bound to protein.
- Free T3 is a test that measures the amount of tri-iodothyronine that is not bound to protein.
- Thyroglobulin autoantibodies (TgAA) are present in dogs with lymphocytic thyroiditis.
- TgAA can be detected before the development of hypothyroidism.
- TgAA indicate active inflammation but do not provide information about thyroid function.
- T3AA and T4AA are present in some dogs with lymphocytic thyroiditis.
- T3AA interfere with the measurement of T3 and FT3.
- T4AA interfere with the measurement of T4 and FT4, but not FT4d.
T3 Suppression Test
- The T3 suppression test is used to diagnose hyperthyroidism in cats.
- A "pre" sample is taken for measuring T4, T3, FT4, and FT3.
- A T3 supplement is given every 8 hours for 6 to 7 treatments.
- A "post" sample is collected 2 to 4 hours after the last T3 supplement.
Calcium Metabolism
- Serum total calcium (tCa) is the sum of serum ionized calcium (iCa), complexed calcium (cCa), and protein-bound calcium (pCa).
- Ionized calcium is the most important biologically active calcium fraction.
- tCa does not accurately predict iCa.
- iCa concentration should be measured when a calcium metabolic disorder is suspected.
- Formulas that adjust tCa to protein or albumin do not improve the prediction of iCa status.
Hypercalcemia
- Hypercalcemia can be caused by parathyroid-dependent (primary hyperparathyroidism) or parathyroid-independent mechanisms.
- Parathyroid-dependent hypercalcemia is caused by excessive secretion of parathyroid hormone (PTH) which causes an increase in calcium reabsorption from the bones and decrease in calcium excretion by the kidneys.
- Parathyroid-independent hypercalcemia can be caused by humoral hypercalcemia of malignancy, local osteolytic lesions, hypervitaminosis D, hypoadrenocorticism, hypercitaminosis A, idiopathic hypercalcemia, dehydration, aluminum exposure, hyperthyroidism or raisin/grape toxicity.
Parathyroid Hormone-Related Protein (PTHrP)
- PTHrP is similar in structure to PTH.
- PTHrP causes bone resorption and renal calcium conservation.
- Hypercalcemia caused by PTHrP is associated with malignancy.
Hypocalcemia
- Hypocalcemia can be caused by parathyroid-dependent (primary hypoparathyroidism) or parathyroid-independent mechanisms.
- Parathyroid-dependent hypocalcemia is caused by destruction of the parathyroid glands.
- Parathyroid-independent hypocalcemia occurs when the demand for iCa exceeds the supply or mobilization.
Diabetes Mellitus
- Diabetes mellitus is caused by a deficiency of insulin or a lack of responsiveness to insulin.
- Insulin deficiency leads to hyperglycemia.
- Glucocorticoids are a common cause of hyperglycemia.
- Insulin therapy is the treatment for diabetes mellitus.
- Insulin for veterinary use should be of human or porcine origin since bovine insulin may induce antibody formation.
- The initial insulin dose is 0.5 unit/kg twice daily.
- Glucose concentrations should be measured 4 to 7 hours after the initial insulin dose.
Hyperthyroidism
- Significantly elevated thyroid hormones can be seen in fasting hyperlipidemia, hypercholesterolemia, and many cases of hyperthyroidism.
- Occult hyperthyroidism may present with normal or slightly increased thyroid hormone levels.
- It may be necessary to perform a T3 suppression test to demonstrate a loss of negative feedback in occult hyperthyroidism.
- Treatment for hyperthyroidism includes surgical thyroidectomy, radioactive iodine therapy, and chronic methimazole therapy.
- Complications of treatment include transient or permanent hypoparathyroidism post-surgery, recurrence of hyperthyroidism, reduced glomerular filtration rate (GFR), renal failure, and cardiac arrhythmias.
Hyperadrenocorticism
- Causes: pituitary-dependent hyperadrenocorticism (PDH) or an adrenal tumor.
- Diagnosis: Low-dose dexamethasone suppression test (LDDST) is performed by measuring cortisol levels.
- Interpreting Results:
- Cortisol concentration greater than 30 to 40 nmol/L suggests HAC.
- Suppression of cortisol concentration greater than 50% of baseline (but still greater than 30 to 40 nmol/L) at 3 to 6 hours post or 8 hours post dexamethasone suggests PDH.
- Suppression of cortisol concentration less than 50% of baseline (but still greater than 30-40 nmol/L) could indicate either PDH or an adrenal tumor.
- A normal LDDST makes HAC unlikely.
- False-positive results are seen especially in patients with other illnesses, such as diabetes mellitus.
Hypercalcemia
- Causes:
- Primary hyperparathyroidism
- Postprandial (dogs), pancreatitis, pheochromocytoma (dogs), progesterone, parenteral nutrition
- Exocrine pancreatic insufficiency, eating
- Diabetes mellitus, diestrus (dog), drugs (glucocorticosteroids, progesterone, megestrol acetate, thiazide diuretics), dextrose-containing fluids
- Treatment:
- Remove the underlying cause
- Volume expansion (correct dehydration)
- Furosemide
- Glucocorticoids
- Bisphosphonates
- Calcitonin
Primary Hyperparathyroidism
- Parathyroid tumor secretes PTH, which causes ionized calcium to elevate.
- More common in dogs than cats.
- In cats: can be caused by insulin, Lente, or PZI (human or beef origin), glargine.
Diabetes Mellitus
- Types of insulin:
- Short-acting: regular, semi-lente
- Intermediate-acting: NPH or isophane, Lente
- Long-acting: Ultralente, PZI, glargine
- Insulin therapy:
- In cats, 1 to 3 units/cat twice daily initially.
- Dose may need to be decreased after 2 weeks, especially if using glargine.
- Measure glucose concentration 4 and 6-7 hours after initial insulin.
- Monitoring treatment:
- Monitor clinical signs such as appetite, water consumption, urination, activity, and general well-being.
- Perform glucose curves during initial regulation, when hypoglycemia is suspected, and in poorly controlled DM.
- Hypoglycemia:
- Signs include ataxia, weakness, lethargy, seizures.
- Treat with glucose administration (food, sugar water, or IV dextrose).
Diabetic Ketoacidosis (DKA)
- Occurs most commonly in dogs and cats with previously undiagnosed DM.
- May occur in patients receiving inadequate insulin and a concurrent infection, inflammation, or insulin-resistant disorder.
- Clinical signs may develop over time.
- Once ketoacidosis develops, severe illness occurs within 7 days.
- Clinical signs include dehydration, decreased appetite, lethargy, and vomiting.
Thyroid Disorders
- Normal thyroid function is regulated by a feedback loop between the hypothalamus, pituitary, and thyroid glands.
- Hypothalamus secretes thyroid-releasing hormone (TRH), which stimulates the release of thyroid-stimulating hormone (TSH) from the pituitary gland.
- TSH stimulates the release of thyroid hormones from the thyroid glands.
- Thyroid hormones exert negative feedback on the hypothalamus and pituitary glands to decrease TSH production.
- Thyroid hormones include:
- Total T4 (thyroxine, tetra-iodothyronine): includes free and protein-bound T4
- Total T3 (tri-iodothyronine): includes free and protein-bound T3
- Free T4 (FT4)
- Free T3 (FT3): the active thyroid hormone
- Tests used in diagnosis of thyroid disease include:
- Total T4 measurement: This is a common test for thyroid disorders.
- T3 Suppression Test: Used in the diagnosis of hyperthyroidism in cats. A pre-sample is taken for T4, T3, FT4, and FT3 measurement. T3 supplement (25 ug) is given every 8 hours for six or seven treatments. A post-sample is collected 2 to 4 hours after the last dose.
- Thyroglobulin autoantibodies (TgAA): Used in dogs only as a marker for lymphocytic thyroiditis. TgAA can be detected before the development of hypothyroidism and indicate active inflammation. However, it does not provide information on thyroid function.
- T3AA and T4AA: Present in some dogs with lymphocytic thyroiditis. T3AA interferes with the measurement of T3 and FT3, while T4AA interferes with T4 and FT4 measurement (some methods) but does not interfere with FT4d.
Other Endocrine Disorders
-
Diabetes Insipidus (DI): A disorder characterized by excessive thirst and urination due to a deficiency in vasopressin or an inability of the kidneys to respond to vasopressin.
- Primary DI (Central DI [CDI]):
- Defective synthesis or secretion of vasopressin by the hypothalamus
- May be idiopathic or due to head trauma, neoplasia, or hypothalamic or pituitary malformations
- Secondary DI (Nephrogenic DI [NDI]):
- Renal tubules are unable to respond to vasopressin
- Primary DI (Central DI [CDI]):
-
Treatment for DI:
- CDI: dDAVP (synthetic vasopressin) is administered in the conjunctival sac once or twice daily or parenterally
- NDI: No treatment is really necessary as long as there is a constant water supply
-
Hypercalcemia: A condition of elevated calcium levels in the blood.
- Causes:
- Parathyroid tumor: Excess PTH secretion causes hypercalcemia. The increase in ionized calcium does not suppress PTH production by the tumor.
- Parathyroid-independent: Ionized calcium concentration increases in serum. Negative feedback causes suppression of PTH production.
- Clinical signs:
- Dogs: Polyuria and polydipsia are most common.
- Cats: Anorexia is the most common sign.
- Other clinical signs include: depression, weakness, vomiting, and diarrhea
- Causes:
-
Gastrinoma: A tumor that secretes gastrin, leading to increased gastric acid production and potential complications.
- Etiology:
- Pancreatic tumor secreting primarily gastrin.
- Etiology:
Adrenal Function
- Adrenal cortex has three zones: Zona glomerulosa, Zona fasciculata, Zona reticularis
- Zona glomerulosa secretes primarily mineralocorticoids
- Zona fasciculata secretes primarily glucocorticosteroids
- Rare case: Primary hyperaldosteronism in cats
- Primary hyperaldosteronism is more common in older animals
Clinical Signs of Adrenal Function
- Decreased potassium levels
- Weakness, lethargy, depression, polyuria, polydipsia
- Reluctance to move, poor muscle tone, apparent muscle pain
- Systemic hypertension as a result of sodium and fluid retention
Diagnosis of Adrenal Function
- Hypokalemia: Potassium often below 3.0 mmol/L
- Elevated creatine kinase
- Blood urea nitrogen (BUN) typically normal
Hypercalcemia
- Mechanisms of hypercalcemia
- Parathyroid-dependent (primary hyperparathyroidism)
- Congenital enzyme deficiency (glycogen storage disease)
- Hunting dog hypoglycemia
- Hepatic disease (liver failure, vascular shunts)
- Sepsis
- Polycythemia
- Nonpancreatic tumors (hepatic carcinoma, leiomyosarcoma)
- Growth hormone (GH) deficiency
- Hypoadrenocorticism
- Insulinoma
- Administration of insulin or drugs
- Toxins
Diagnosis of Hypoglycemia
- Hypoglycemia with an inappropriately high insulin level
- Fast the animal before testing
- Blood glucose below 60 mg/dL (3.3 mmol/L) should inhibit insulin release
- Insulin therapy:
- Artifact (serum left on clot)
- Strenuous exercise
- Prolonged inappetence
Acromegaly
- Elevated concentration of IGF-1 accompanied by appropriate clinical signs
- IGF-1 production parallels GH production
- Elevated concentrations of IGF-1 also occur in association with diabetes mellitus
- Presence of acromegaly may result in insulin-resistant diabetes mellitus
- Documentation of pituitary mass in cats by computed tomography or magnetic resonance imaging
- Radiation therapy of the pituitary mass has limited availability, and acromegaly often recurs 6 to 18 months later
Diabetes Insipidus (DI)
- Polyuria and polydipsia are the most common clinical signs
- Acquired NDI:
- Hypoadrenocorticism
- Hypercalcemia
- Hyperthyroidism
- Diabetes mellitus
- Acromegaly
- Urine is usually hyposthenuric
- Hypernatremia with hyposthenuria raises suspicion for DI
- Differentiating absolute and partial CDI:
- Absolute vasopressin deficiency causes persistent hyposthenuria and severe diuresis even if dehydrated
- In partial CDI, animals can increase USG into isosthenuric range but typically not above 1.015
- Modified water deprivation test:
- Assesses the effects of water deprivation and dehydration on USG
- Do not perform if the animal is dehydrated
Thyroid Function Tests
- Total T4 is a measurement that includes both free T4 and protein-bound T4.
- Total T3 is a measurement that includes both free T3 and protein-bound T3.
- Free T4 is a measurement of the active form of T4.
- Free T3 is a measurement of the active form of T3.
- Thyroglobulin autoantibodies (TgAA) can be detected in dogs before the development of hypothyroidism, indicating active inflammation.
- T3AA and T4AA are present in some dogs with lymphocytic thyroiditis.
- T3AA interferes with the measurement of T3 and FT3
- T4AA can interfere with the measurement of T4 and FT4.
Disorders of Calcium Metabolism
- Hypocalcemia can occur due to various disorders including primary hypoparathyroidism, pseudohypoparathyroidism, sepsis/critical care, ethylene glycol toxicity, paraneoplastic syndrome, phosphate enema, eclampsia, and hypoalbuminemia.
- Primary hypoparathyroidism occurs when the parathyroid glands are unable to secrete adequate amounts of parathyroid hormone due to lympho-plasmacytic destruction of the glands.
- Calcitriol therapy can be used to treat hypoparathyroidism by decreasing the production of PTH and bone resorption, but serum phosphorus must be controlled for maximum effectiveness.
Diabetes Mellitus (DM)
- Most dogs with DM have insulin-dependent DM (IDDM) with decreased serum insulin concentration and no increase in insulin after glucose administration.
- Non-insulin-dependent DM (NIDDM) is very uncommon in dogs.
- Many cats have NIDDM which may become permanently insulin-dependent.
- The goal of DM therapy is to eliminate clinical signs, prevent complications, and prevent hypoglycemia.
- Treatment includes dietary therapy, exercise, and oral hypoglycemic drugs.
- Oral hypoglycemic drugs are only indicated for NIDDM in cats.
- Glipizide is a commonly used oral hypoglycemic drug for cats at a dose of 2.5 mg twice daily with food.
- If hyperglycemia persists or recurs, switching to insulin therapy may be necessary.
Disorders of Growth Hormone
- Growth hormone (GH) deficiency can occur due to congenital deficiency of GH or a congenital cystic distention or persistence of the craniopharyngeal duct (Rathke’s pouch).
- GH deficiencies are more commonly seen in German Shepherds, Weimaraners, Spitz, and Carnelian Bear Dogs.
- Acromegaly is usually considered only when insulin is ineffective at controlling hyperglycemia.
- The presence of acromegaly may result in insulin-resistant DM or poor control of existing diabetes.
- Acromegaly is more common in male cats and usually older cats.
- Clinical signs of acromegaly include polyuria, polydipsia, weight gain, increased size, enlargement of head, extremities, feet, abdomen, heart, and viscera.
Central Diabetes Insipidus (CDI)
- Central Diabetes Insipidus (CDI) occurs when the pituitary gland does not secrete adequate amounts of antidiuretic hormone (ADH).
- CDI is a rare condition.
- Clinical Signs of CDI include polyuria, polydipsia, neurologic signs, and weight loss.
- Diagnosis of CDI requires ruling out other causes of polyuria and polydipsia.
- The urine of animals with CDI is typically hyposthenuric.
- A modified water deprivation test can be used to assess the effect of water deprivation on USG and differentiate between absolute and partial CDI.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
