For this month’s webinar, I chose “Common challenges and practical solutions in feline hyperthyroidism: Diagnosis” by Sarah M. A. Caney, because I have always found endocrinology cases quite challenging, especially in cats. 

This talk aims to define which cats are most at risk of developing the disease, describe the most common clinical signs and abnormalities that we see in these patients, what to look for in the routine bloodwork, how to know the different differential diagnoses and explain how to confirm a diagnosis of hyperthyroidism and differentiate it from non-thyroidal disease. 

Hyperthyroidism is a common disease that usually affects 10% of older cats, mainly 10 years old and above. It is a very slow developing disease, so it can be difficult for owners to realise that something is wrong. It is generally easy to diagnose and manage with a good to excellent prognosis, so it is important to have regular routine check-ups in adult cats to detect it at an early stage. 

Sarah begins the webinar by explaining that hyperthyroidism is a clinical syndrome resulting from excess circulating levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). In 96-98% of cases the cause of hyperthyroidism is due to adenomatous hyperplasia. Other cases may be due to thyroid carcinoma or unknown causes. 

The thyroid hormone increases metabolism, heart rate, blood pressure, GI motility and CNC activity. It also reduces sleep and body weight, which can be used as indicators to a possible case of hyperthyroidism. 

The most common clinical sign is weight loss, often despite a normal or increased appetite. Other common clinical signs include gastrointestinal signs (vomiting, diarrhoea), behavioural changes (restlessness, irritability, increased vocalisation), polydipsia and coat changes. Most cats with hyperthyroidism have a palpable goitre. 

Diagnosis is made by clinical signs, screening laboratory tests, thyroid hormone measurement, scintigraphy and if necessary, a thyroid function test. Sarah explains the importance of having differential diagnoses, which can be key to the patient’s diagnosis.

Routine laboratory profiles may reveal mild to moderate elevation of liver enzymes, erythrocytosis and leukocytosis. Evaluation of thyroid hormones is necessary to confirm the diagnosis of hyperthyroidism. Basal total thyroxine (T4) levels are elevated in most cats with hyperthyroidism, however in some cats other diagnostics, including free T4 and TSH testing, may be necessary to confirm the diagnosis.

If you are interested in this topic, I recommend watching this webinar. Sarah provides detailed information, studies, statistics, case examples and even mentions some books that can help us in our daily practice.

 

In June Sarah will be giving a continuation of this talk, and she will be discussing the treatment of hyperthyroidism in cats, don’t miss it!

 

 Going Live:Thu 30th June 2022, 8:30pm BST 

Common challenges and practical solutions in feline hyperthyroidism: Treatment

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