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Where are endocrine glands located
throughout the body?
Pituitary, Hpyothalamus, Thyroid, Thymus, Atrium, Pancreas, Ovaries/Testes, Adrenals, etc. TERM 2
What is a Hormone?
DEFINITION 2 A chemical produced by part of the body that has a regulatory effect on the body. A chemical messenger secreted by a gland, that is transported by the blood to a target organ or tissue where it produces a specific effect. TERM 3
How many thyroid glands does an animal
have compared to humans? And what are the
parts of the thyroid gland called?
DEFINITION 3 Animals have two thyroid glands, humans have one.The thyroid gland and the parathyroid gland. TERM 4
Function of the Thyroid Gland?
DEFINITION 4 Creates, stores and secretes thyroid hormones. Has Calcitonin which will decrease blood calcium. TERM 5
Why Iodine?
DEFINITION 5 Iodine is needed as central part of molecule Insufficient Iodine leads to goiter (in humans)
T3 vs. T
T4 is secreted into the bloodstream and then converted to active form (T3) by body cells as needed.- some T3 also secreted by thyroid but mostly T4T4 is formed detected by feedback systems TERM 7
Feedback System "Hot Pickup
Truck"
DEFINITION 7 Low levels of T4 stimulate the HYPOTHALAMUS - releases TRH - stimulates the anterior pituitary - releases TSH - stimulates the thyroid - release of T4 :) TERM 8
What are the Thyroid Hormone Effects?
DEFINITION 8 The development and differentiation in growing animalRegulation of metabolism TERM 9
Hypothyroidism is seen in which species?
DEFINITION 9 Dogs, horses, and cattle. TERM 10
Is Primary or Secondary Hypothyroidism most
common? Why?
DEFINITION 10 Primary hypothyroidism most common due to autoimmune destruction of the thyroid gland.
What is the Diagnosis for Hypothyroidism?
TSH Stimulation TestThyroid panel recommended - T4, T3, Free T4, Free T3, thyroid autoantibodies TERM 17
Treatment for Hypothyroidism:
DEFINITION 17 Thyroid Hormone Replacement Therapy- T replacementLevothyroxine: L-thyroxine - Name brand recommended above generics - Soloxine BID medication Monitor blood level TERM 18
Side Effects of Supplementation:
DEFINITION 18 Increased blood glucose (monitor diabetes closely)Caution in cardiac patients Drug interactions:- Ketamine and Telazol Hypertension and tachycardia- Digoxin decreased effectiveness of digoxin TERM 19
T4 overdose:
DEFINITION 19 Is RARE because has a wide therapeutic index Looks like HYPERthyroidism- Tachycardia- Agitation/ hyperactivity/ nervousness- PU/PD- Polyphagia- Panting TERM 20
What species is effected by Hyperthyroidism?
What is Hyperthyroidism?
DEFINITION 20 Common in older cats.Active tumor of the thyroid gland secretes T4 over and over again, and the tumor doesn't respond to feedback!
What are the clinical signs of
Hyperthyroidism?
Hyperactivity or weaknessChronic vomitingDiarrheaWeight lossTachycardiaPU/PD TERM 22
Diagnosis of Hyperthyroidism:
DEFINITION 22 Elevated T TERM 23
What are the treatment options for
Hyperthyroidism?
DEFINITION 23
- Radioactive Iodine2. Thyroidectomy3. Anti-thyroid Medications TERM 24
Radioactive Iodine?
DEFINITION 24
- Iodine 131 *One SQ injection The radioactive iodine is taken up by tumor cells preferentiallyRadioactive iodine somewhat spares normal thyroid tissueNo anesthesia necessarySide effects rareExpensive ($1,000 or more)Requires 3-7 day hospital stayTreatment of choice TERM 25
Thyroidectomy?
DEFINITION 25 Parathyroid glandsProblems with postoperative hypocalcemia very commonRisk of anesthesia & surgery in this patient
What is Type II Diabetes
Mellitus?
- Decrease in the number of insulin receptors on tissues (down - regulation)- Cell becomes insensitive to the effects of insulin- Non-insulin-dependent diabetes mellitus (NIDDM)*epidemic in humans TERM 32
What are the five Predisposing Factors of
Diabetes?
DEFINITION 32
- Genetics2. Pancreatitis3. Immune-mediated 4. Drugs5. Diet/Obesity TERM 33
Predisposing Factor: Genetics
DEFINITION 33 Female dogs > than male dogsPoodle, Cairn, Dachshund, Miniature Schnauzer, Beagle, Miniature Pinscher, German Shepherd, Golden Retriever, Samoyed.Cats: Neutered males slightly more common than females, but doesn't mean females don't. TERM 34
Predisposing Factor: Pancreatitis
DEFINITION 34 Repeated bouts of pancreatitis can result in loss of pancreatic tissue due to autodigestion. TERM 35
Predisposing Factor: Immune-mediated
Mechanisms (DOGS)
DEFINITION 35 Immune-mediated destruction of pancreatic tissue is the most common cause in dogs.
Predisposing Factor: Immune-mediated
Mechanisms (CATS)
Amyloidosis in cats Form abnormal protein deposits in places in the pancreas and kidneys TERM 37
Predisposing Factor: Obesity
DEFINITION 37 Decreased receptors (down- regulation) TERM 38
Predisposing Factor: Drugs
DEFINITION 38 Chronic glucocorticoid administration Progestins - Megestrol acetate) Ovaban* Reversible with withdrawal of drug TERM 39
Diabetes Mellitus Clinical Signs:
DEFINITION 39 PolydipsiaPolyuriaPolyphagiaWeight loss+/- cataracts (dogs)+/- Plantigrade posture (cats) TERM 40
Clinical Signs: Why?
DEFINITION 40 Diabetes is a form of Starvation.Glucose cannot enter the cells - Need insulin in receptors for glucose to enter cellsExcept can still enter:- RBC's- Platelets- Nerve Tissue- Eyes (lens)
Transient Diabetes:
20% of cats will stop being diabetic all on their own!- d.t. reversible suppression of the pancreatic B-cells- waxing and waning of clinical signs- may progress to permanent diabetes TERM 47
Insulin Therapy
DEFINITION 47 Insulin LOWERS blood glucoseSQ injections required.... NO ORAL FORMS- Insulin is a protein- if administered orally, it will be degraded in the stomach by the hydrochloric acid TERM 48
How is insulin administered?
DEFINITION 48 BID administrationVary site of administration to prevent build up of scar tissueInsulin is measured in UNITSAlways keep refrigerated Roll bottle, NEVER SHAKE- Trauma inactivates insulin molecule and denatures the protein, also forms air bubbles which will alter the dose given. TERM 49
U-40 vs. U-
Insulin
DEFINITION 49 Number indicates # of units/ml- is a measure of activity of the insulin, like a concentrationMust use U-40 syringes for U- 40 insulin and U-100 syringes for U-100 insulin! TERM 50
What are the types of insulin?
DEFINITION 50 Source- animal vs. recombinantDuration of Effect
Based on Source: Animal Source
Derived from pancreatic tissue (extracted insulin)Pork = dog bc antigencially similar insulin- less antibody productionBeef = cat bc antigenically similar insulinMost animal source insulins have now left the market TERM 52
Based on Source: Recombinant Insulin
DEFINITION 52 Genetically engineered by people- Humulin * not very similar to dog or cat insulin- Lantus- Prozinc TERM 53
Based on Duration of
Effect
DEFINITION 53 Traditionally depended on the crystal size. Crystal size alters rate of absorption from the SQ site- Regular, NPH, Lente, Ultralente, PZI TERM 54
Based on Duration of Effect: short,
intermediate, ultra-long
DEFINITION 54 Short:- regular insulinIntermediate:- NPH- LenteUltra-long:- PZI- Glargine (Lantus)*newer analogs TERM 55
Regular Insulin:
DEFINITION 55 Rapid onset, short durationEmergencies onlyGiven IV in fluids, or IM
Currently available (all are synthetic)
Human recombinant productsProzinc (cats)Glargine (cats)Vetsulin (dogs)Newer human combination products and insulin analogs TERM 62
Along with Insulin Therapy, the patient
needs....
DEFINITION 62 Dietary constancyExercise therapyEstrogen effects - spay! TERM 63
Dietary Therapy
DEFINITION 63 Dogs need an increased fiber diet because it decreases insulin needs- Hills W/DCats need low CHO and high protein- Purina DM, Hills M/DCanned food for cats ( low CHO )Waltham low fatPurina DCOIams Optimal Weight Control Diet TERM 64
Client Education
DEFINITION 64 The #1 cause of death in diabetic dogs and cats is not the disease itself, it's the owner's frustration with the disease!Hypoglycemia is of more clinical importance than transient hyperglycemia because patient can easily die of hypoglycemia TERM 65
Client Communication
DEFINITION 65 Give written instructions for owner to take homeSchedule 30- min appointment to educate Demonstrate:- SQ injection Change site of administration to prevent build up of scar tissue How to measure insulin Roll bottle, do not shake! Keep refrigerated
If fed animal, give (blank) If doesn't eat,
(blank) If unsure (blank) given, (blank)
- Insulin2. Don't give insulin, call doctor3. Don't give any more insulin! -WHY? Risk of hypoglycemia TERM 67
What do we see in animals with
Hypoglycemia?
DEFINITION 67 WeaknessTremblingSeizuresPU/PD Weight lossAttitude*FEED THEM! Karo corn syrup onthe gums TERM 68
What do we monitor for
Hypoglycemia?
DEFINITION 68 Clinical signs:- PU/PD- Weight loss- AttitudeFructosamine level Glucose level TERM 69
How do we monitor Urine Checks?
DEFINITION 69 Weekly once regulatedGlucotest sprinkles in litter Diastix TERM 70
How do we measure Glucose Curve?
DEFINITION 70 Feed the animalGive normal dose of insulinMonitor blood glucose every 2 hours for 12 hours (24 if SID)Adjust dose accordingly once the curve is finished
