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Peterson M.E.,Animal Endocrine Clinic | Peterson M.E.,Cornell University | Eirmann L.,Oradell Animal Hospital | Eirmann L.,Nestle
Veterinary Clinics of North America - Small Animal Practice | Year: 2014

When treating cats with endocrine disease, most veterinarians concentrate on medical or surgical treatments that can be used to manage or cure the disease. Dietary issues are frequently ignored or not properly addressed. However, nutritional support can play an integral role in the successful management of feline endocrine diseases. Furthermore, because most cats with endocrine disease are senior or geriatric, they may also have concurrent health conditions that warrant dietary intervention. This article discusses recommendations for nutritional support of the 2 most common endocrine problems of cats seen in clinical practice: hyperthyroidism and diabetes mellitus. © 2014 Elsevier Inc.


Peterson M.E.,Animal Endocrine Clinic
The Veterinary clinics of North America. Small animal practice | Year: 2014

When treating cats with endocrine disease, most veterinarians concentrate on medical or surgical treatments that can be used to manage or cure the disease. Dietary issues are frequently ignored or not properly addressed. However, nutritional support can play an integral role in the successful management of feline endocrine diseases. Furthermore, because most cats with endocrine disease are senior or geriatric, they may also have concurrent health conditions that warrant dietary intervention. This article discusses recommendations for nutritional support of the 2 most common endocrine problems of cats seen in clinical practice: hyperthyroidism and diabetes mellitus. Copyright © 2014 Elsevier Inc. All rights reserved.


Peterson M.E.,Animal Endocrine Clinic | Peterson M.E.,Cornell University
Journal of Endocrinology | Year: 2014

Since first discovered just 35 years ago, the incidence of spontaneous feline hyperthyroidism has increased dramatically to the extent that it is now one of the most common disorders seen in middle-aged to senior domestic cats. Hyperthyroid cat goiters contain single or multiple autonomously (i.e. TSH-independent) functioning and growing thyroid nodules. Thus, hyperthyroidismin cats is clinically and histologically similar to toxic nodular goiter in humans. The disease in cats is mechanistically different from Graves' disease, because neither the hyperfunction nor growth of these nodules depends on extrathyroidal circulating stimulators. The basic lesion appears to be an excessive intrinsic growth capacity of some thyroid cells, but iodine deficiency, other nutritional goitrogens, or environmental disruptorsmay play a role in the disease pathogenesis. Clinical features of feline toxic nodular goiter include one or more palpable thyroid nodules, together with signs of hyperthyroidism (e.g. weight loss despite an increased appetite). Diagnosis of feline hyperthyroidism is confirmed by finding the increased serum concentrations of thyroxine and triiodothyronine, undetectable serum TSH concentrations, or increased thyroid uptake of radioiodine. Thyroid scintigraphy demonstrates a heterogeneous pattern of increased radionuclide uptake, most commonly into both thyroid lobes. Treatment options for toxic nodular goiter in cats are similar to that used in humans and include surgical thyroidectomy, radioiodine, and antithyroid drugs. Most authorities agree that ablative therapy with radioiodine is the treatment of choice for most cats with toxic nodular goiter, because the animals are older, and the disease will never go into remission. © 2014 Society for Endocrinology.


Broome M.R.,Veterinary Medical Imaging | Peterson M.E.,Animal Endocrine Clinic | Kemppainen R.J.,Auburn University | Parker V.J.,The Ohio State University | Richter K.P.,Veterinary Specialty Hospital
Journal of the American Veterinary Medical Association | Year: 2015

Objective-To describe findings in dogs with exogenous thyrotoxicosis attributable to consumption of commercially available dog foods or treats containing high concentrations of thyroid hormone.Design-Retrospective and prospective case series.Animals-14 dogs.Procedures-Medical records were retrospectively searched to identify dogs with exogenous thyrotoxicosis attributable to dietary intake. One case was found, and subsequent cases were identified prospectively. Serum thyroid hormone concentrations were evaluated before and after feeding meat-based products suspected to contain excessive thyroid hormone was discontinued. Scintigraphy was performed to evaluate thyroid tissue in 13 of 14 dogs before and 1 of 13 dogs after discontinuation of suspect foods or treats. Seven samples of 5 commercially available products fed to 6 affected dogs were analyzed for thyroxine concentration; results were subjectively compared with findings for 10 other commercial foods and 6 beef muscle or liver samples.Results-Total serum thyroxine concentrations were high (median, 8.8 μg/dL; range, 4.65 to 17.4 μg/dL) in all dogs at initial evaluation; scintigraphy revealed subjectively decreased thyroid gland radionuclide in 13 of 13 dogs examined. At μ 4 weeks after feeding of suspect food or treats was discontinued, total thyroxine concentrations were within the reference range for all dogs and signs associated with thyrotoxicosis, if present, had resolved. Analy- sis of tested food or treat samples revealed a median thyroxine concentration for suspect products of 1.52 μg of thyroxine/g, whereas that of unrelated commercial foods was 0.38 μg of thyroxine/g.Conclusions and Clinical Relevance-Results indicated that thyrotoxicosis can occur secondary to consumption of meat-based products presumably contaminated by thyroid tissue, and can be reversed by identification and elimination of suspect products from the diet. © 2015, American Veterinary Medical Association. All rights reserved.


Peterson M.E.,Animal Endocrine Clinic | Peterson M.E.,Cornell University | Guterl J.N.,Animal Endocrine Clinic | Nichols R.,Animal Endocrine Clinic | Rishniw M.,Cornell University
Journal of Veterinary Internal Medicine | Year: 2015

Background: In humans, measurement of serum thyroid-stimulating hormone (TSH) concentration is commonly used as a first-line discriminatory test of thyroid function. Recent reports indicate that canine TSH (cTSH) assays can be used to measure feline TSH and results can help diagnose or exclude hyperthyroidism. Objectives: To investigate the usefulness of cTSH measurements as a diagnostic test for cats with hyperthyroidism. Animals: Nine hundred and seventeen cats with untreated hyperthyroidism, 32 euthyroid cats suspected of having hyperthyroidism, and 131 clinically normal cats. Methods: Prospective study. Cats referred to the Animal Endocrine Clinic for suspected hyperthyroidism were evaluated with serum T4, T3, free T4 (fT4), and TSH concentrations. Thyroid scintigraphy was used as the gold standard to confirm or exclude hyperthyroidism. Results: Median serum TSH concentration in the hyperthyroid cats (<0.03 ng/mL) was significantly (P < .001) lower than concentrations in clinically normal cats (0.05 ng/mL) or euthyroid cats with suspected thyroid disease (0.06 ng/mL). Only 18 (2.0%) hyperthyroid cats had measurable TSH concentrations (≥0.03 ng/mL), whereas 114 (69.9%) of the 163 euthyroid cats had detectable concentrations. Combining serum TSH with T4 or fT4 concentrations lowered the test sensitivity of TSH from 98.0 to 97.0%, but markedly increased overall test specificity (from 69.9 to 98.8%). Conclusions and Clinical Importance: Serum TSH concentrations are suppressed in 98% of hyperthyroid cats, but concentrations are measurable in a few cats with mild-to-moderate hyperthyroidism. Measurement of serum TSH represents a highly sensitive but poorly specific test for diagnosis of hyperthyroidism and is best measured in combination with T4 and fT4. © 2015 American College of Veterinary Internal Medicine.

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