Department of Medicine, Animal Medical Center, New York, NY 10021.
We measured serum thyroxine (T4) and 3,3',5-triiodothyronine (T3) concentrations in hyperthyroid cats (hourly for 10 hours in 14 cats, and daily for 15 days in seven cats) to assess fluctuation in thyroid hormone levels. Over the 10-hour study period the coefficient of variation (CV) for serum T4 and T3 concentrations ranged from 6.4-22.6%(mean = 12.0 +/- 4.8%) and from 9.6-33.1%(mean = 17.5 +/- 6.3%), respectively. During the 15-day study period, CV for serum T4 ranged from 6.6-34.8%(mean = 18.4 +/- 9.3%), while CV for serum T3 ranged from 7.8-31.0%(mean = 20.1 +/- 8.6%). These CV values were significantly higher than the expected intra-assay CVs (T4 assay, 5.1%; T3 assay, 7.7%). In addition, some of the cats with mild hyperthyroidism showed one or more normal serum T4 and T3 values during the course of the respective study periods. There was no specific time during the 10-hour study period at which the cats consistently showed peak serum T4 or T3 concentrations. These results suggest that serum thyroid hormone concentrations are subject to a degree of fluctuation that exceeds the usual assay variation, and that cats with mild hyperthyroidism can, at a given time, exhibit normal serum T4 and T3 values. Therefore, a diagnosis of feline hyperthyroidism should not be excluded on the basis of the finding of a single normal serum T4 or T3 value in a cat with clinical signs and physical examination findings consistent with the disease.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1352 Boyd Avenue, St. Paul, MN 55108, USA. email@example.com
The indications, techniques, and expectations for radionuclide diagnostic studies on canine and feline thyroid glands are presented. In addition, the considerations surrounding radioiodine or external beam radiotherapy for benign and malignant thyroid disease are reviewed. The intent of this article is to familiarize primary care veterinarians with the utility of and outcome of the ionizing radiation-based diagnostic and therapeutic techniques for assessing and treating canine and feline thyroid disease.
Small Animal Clinical Studies, School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland. firstname.lastname@example.org
Hyperthyroidism remains a common endocrine disorder of cats. Although relatively easy to diagnose in classically presenting cats, the increased frequency of testing cats with early or mild disease has had significant implications for the diagnostic performance of many of the routine tests currently used. Further advances in the etiopathogenesis and earlier diagnosis are only likely with the advent of a species specific feline thyroid-stimulating hormone assay.
A review of sample handling considerations for reproductive and thyroid hormone measurement in serum or plasma.
Veterinary Diagnostic Laboratory, University of Minnesota, 1333 Gortner Avenue, St. Paul, MN 55108, USA. email@example.com
Inappropriate sample handling of blood, serum or plasma collected for the determination of hormone concentration may lead to inaccurate endocrine data and diagnoses. Many useful studies have been conducted to determine the potential effects of sample handling on measured hormone concentration. Unfortunately, because reported results frequently differ according to assay method, species studied and parameters measured, it is not always possible to predict the effect of specific sample handling scenarios as they are presented in practice. The objective of this review is to provide a summary of what has been reported in the literature regarding sample-handling procedures that may affect the measurement of hormone concentration in plasma or sera from animals being evaluated for reproductive function.
Advanced Veterinary Medical Imaging, 3047 Edinger Ave., Tustin CA 92780, USA.
Thyroid scintigraphy is a nuclear medicine procedure that produces a visual display of functional thyroid tissue based on the selective uptake of various radionuclides by thyroid tissue. Thyroid scintigraphy provides valuable information regarding both thyroid anatomy and physiology and can play an integral role in the diagnosis and management of cats with hyperthyroidism. Thyroid scintigraphy allows the direct visualization of the functional adenomatous thyroid tissue responsible for the development of hyperthyroidism. For this reason, thyroid scintigraphy will allow the diagnosis of hyperthyroidism before laboratory tests are consistently abnormal. Thyroid scintigraphy can also exclude a diagnosis of hyperthyroidism in cats with thyroid hormone elevations of nonthyroidal origin. Thyroid scintigraphy provides an additional method for determining the relative severity of thyroid disease that is less affected by the presence of concurrent nonthyroidal illness than laboratory evaluations. When treating hyperthyroid cats with radioiodine, the lowest effective dose should be administered. In an effort to administer the lowest radioiodine dose possible, the volume of adenomatous thyroid tissue present in the individual hyperthyroid cat should be considered. Thyroid scintigraphy provides an excellent method for evaluating the size of hyperfunctional thyroid tissue that is not limited by the presence of ectopic or intrathoracic thyroid tissue. Thyroid scintigraphy also provides valuable information in the diagnosis and evaluation of hyperthyroid cats with thyroid carcinoma.
Caspary Institute and the Bobst Hospital of The Animal Medical Center, New York, NY, USA. firstname.lastname@example.org
The diagnosis of hyperthyroidism, one of the most common disorders affecting elderly cats, is usually straightforward and considered routine by most practitioners. Nowadays, however, most cats suffering from hyperthyroidism tend to be diagnosed earlier and at a milder stage of the disease than those cats diagnosed 10 to 25 years ago. There are, in fact, a growing number of cats with clinical signs of hyperthyroidism and palpably large thyroid glands whose baseline serum total thyroid hormone concentrations are within the normal or borderline range, making diagnosis problematic. This paper reviews the available tests used to confirm a diagnosis of hyperthyroidism in cats and discusses their overall usefulness.
Centre Hospitalier Universitaire Vétérinaire (CHUV), Faculty of Veterinary Medicine, University of Montreal, C.P. 5000, Saint-Hyacinthe, Quebec. email@example.com
Thirteen cats, newly diagnosed with hyperthyroidism, were treated with a transdermal formulation of methimazole at a dose of 5 mg (0.1 mL)(concentration of 50 mg/mL) applied to the internal ear pinna every 12 h for 28 d. Baseline hematologic and biochemical values, along with serum thyroxine (T4) levels, were obtained on presentation (day 0). Cats were evaluated at 14 d (D14) and 28 d (D28) following transdermal therapy. At each visit, a physical examination, a complete blood cell count, a serum biochemical analysis, and a serum T4 evaluation were performed. Ten cats completed the study. Clinical improvement, as well as a significant decrease in T4, was noted in all cats. Serum T4 measured at D14 and D28 were significantly lower at 27.44 nmol/L, s = 37.51 and 14.63 nmol/L, s = 10.65, respectively (P < 0.0001), as compared with values at D0 (97.31 nmol/L, s = 37.55). Only 1 cat showed a cutaneous adverse reaction along with a marked thrombocytopenia. The results of this prospective clinical study suggest that transdermal methimazole is an effective and safe alternative to conventional oral formulations.
Thyroid to salivary ratios determined by technetium-99m pertechnetate imaging in thirty-two euthyroid cats.
Todd D Henrikson, Laura J Armbrust, James J Hoskinson, George A Milliken, Karen J Wedekind, Claudia A Kirk, Raymond F Nachreiner
Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA.
Thyroid to salivary (TS) ratio is the most commonly used scintigraphic parameter for differentiating euthyroid and hyperthyroid cats. Studies to determine the normal TS ratio have been performed in small cat populations. In this study, the TS ratio was determined in 32 cats between 8 and 13 years of age. The study population was documented to be euthyroid based on normal initial and 6-week follow-up serum thyroid concentrations and normal T3 suppression tests. All images were obtained with a low-energy all-purpose collimator between 20 and 40 min after the injection of approximately 111 MBq (3.0 mCi) pertechnetate. Manual regions of interest (ROI) were made of the thyroid and salivary glands of the ventral image A 95% prediction interval based on the natural log of the TS ratio was computed to provide a normal range of 0.48-1.66. This range is similar to previous studies, but suggests a slightly higher upper limit than previously reported.
Feline Clinic, University of Edinburgh Hospital for Small Animals, Easter Bush Veterinary Clinics, Midlothian, Scotland EH25 9RG. Danielle.Gunn-Moore@ed.ac.uk
Feline endocrinopathies (excluding diabetes mellitus) include hyperthyroidism, hypothyroidism, acromegaly, hyposomatotropism, diabetes insipidus, hyperadrenocorticism, primary sex hormone-secreting adrenal tumors, primary hyperaldosteronism, pheochromocytoma, hypoadrenocorticism, hyperparathyroidism, and hypoparathyroidism. Each of these conditions will be discussed including their prevalence, cause, clinical signs, diagnosis, treatment options, and prognosis.
Alamo Feline Health Center, San Antonio, TX 78232, USA.
Client-owned cats underwent surgery to remove palpable cervical masses in cats with normal total T4 values and no clinical signs of hyperthyroidism, renal disease, or hyperparathyroidism. Non-functional thyroid and parathyroid adenomas were found and identified by histopathological examination. The significance of these findings is discussed in relation to palpating a goiterous mass in an asymptomatic cat.
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Biogenic Amine and Corticotrophin-Releasing Factor Concentrations in Hypothalamic Paraventricular Nucleus and Biogenic Amine Levels in the Median Eminence of Normal Dogs, Chronic Dexamethasone-Treated Dogs, and Dogs with Naturally-Occurring Pituitary-Dependent Hyperadrenocorticism (Canine Cushing's Disease).
The Department of Medicine, The Animal Medical Center and Research Animal Resource Center, Cornell University Medical College, New York, New York, USA.
Abstract We measured dopamine, norepinephrine, serotonin and epinephrine concentrations in the paraventricular nucleus and median eminence, and corticotrophin-releasing factor levels in the paraventricular nucleus. Tissue was isolated by micropunch technique from hypothalami of normal dogs, dogs treated for one week with dexamethasone (1 mg/kg/day) and dogs with spontaneous pituitary-dependent hyperadrenocorticism. Concentrations of corticotrophin-releasing factor and most of the neurotransmitters were found to be similar between our three groups of dogs. However, we found the mean dopamine concentration in the median eminence tissue to be significantly decreased in dogs with Cushing's disease and in steroid-treated dogs. Epinephrine levels were elevated in the hypothalamic paraventricular nucleus of steroid-treated dogs.
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing.
Until recently, the diagnosis of hyperthyroidism in cats was thought to be simple; however, not all cases of the disease are straightforward. Although single resting serum thyroid-hormone determinations may well be adequate to confirm the diagnosis, in many cases, the diagnosis of feline hyperthyroidism requires more extensive investigation.
Evaluation of two reagent strips and three reflectance meters for rapid determination of blood glucose concentrations.
Department of Medicine, Cornell University Medical College, New York, New York.
We evaluated three reflectance meters (Accu-Chek II, Glucometer II, and Glucoscan 2000) and two reagent strips (Chemstrip bG and Glucostix) for accuracy and precision in determining blood glucose concentrations in the dog. To evaluate accuracy, we compared results of blood glucose determinations performed on 95 samples using the various strips and meters vs. the glucose concentrations obtained using the glucose-oxidase method on a Beckman Glucose Analyzer. Accuracy was evaluated statistically using least squares regression analysis. To evaluate precision, samples in various ranges of blood glucose concentration were tested repeatedly (20 times within a 1-hour period) on the same reflectance meter. Coefficient of variation (CV) was determined to evaluate reproducibility of results. Overall, there were significant correlations (P less than 0.001) between the laboratory glucose values and the blood glucose concentrations obtained with Chemstrip bG (r = 0.976), Glucostix (r = 0.904), Accu-Chek II (r = 0.986), Glucometer II (r = 0.911) and Glucoscan 2000 (r = 0.944). In the precision study, all three meters had excellent CVs in the normal range (3.6% to 4.9%). However, Accu-Chek II was found to be more precise in the hypoglycemic and hyperglycemic ranges (3.6% and 2.6%, respectively) than either Glucometer II (8.8% and 5.4%) or Glucoscan 2000 (7.8% and 8.2%). The results of this study indicate that all of the meters and reagent strips tested are highly accurate in determining blood glucose concentrations in the dog. However, both in terms of accuracy and reproducibility of results, Accu-Chek II and Chemstrip bG, gave the highest correlation coefficients and, as such, are probably of the greatest clinical value.
Effects of low dosages of intravenous dexamethasone on serum cortisol concentrations in the normal cat.
Department of Medicine, Animal Medical Center, Cornell University Medical College, New York, New York.
The suppressive effects of three different low dosages of dexamethasone (5, 10 and 15 micrograms kg-1) on serum cortisol concentrations were evaluated in 10 normal cats. On four different days, serum was collected before and at two, four, six and eight hours after the intravenous administration of saline or dexamethasone. Following the administration of saline, no significant difference in mean serum cortisol concentrations was noted between the basal or postinjection values. In contrast, mean serum cortisol concentrations decreased significantly (P less than 0.05) by two hours and remained significantly below mean basal values eight hours after injection of all three dosages of dexamethasone. The degree of cortisol suppression became progressively greater as the dosages of dexamethasone were increased. After administration of the highest dose of dexamethasone (15 micrograms kg-1), serum cortisol decreased to below 5 ng ml-1 by two to four hours and remained suppressed (under 5 ng ml-1) eight hours after injection in all cats. In contrast, two of the 10 cats showed a slight escape from cortisol suppression by eight hours after injection of dexamethasone at the dosage of 10 micrograms kg-1, whereas a dosage of 5 micrograms kg-1 failed to suppress cortisol concentrations below 10 ng ml-1 at any of the sampling times in one cat and was associated with increasing serum cortisol concentrations at eight hours after injection in three cats.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Medicine, Animal Medical Center, New York, New York.
The oral and intravenous disposition of the anti-thyroid drug propylthiouracil (PTU) was determined in six clinically healthy cats and four cats with naturally occurring hyperthyroidism. Compared with the normal cats, the mean plasma elimination half-life of PTU was significantly (P less than 0.001) shorter in the hyperthyroid cats (77.5 +/- 5.8 minutes compared with 125.5 +/- 3.7 minutes) and the total body clearance of PTU was significantly (P less than 0.05) more rapid in the cats with hyperthyroidism (5.1 +/- 0.8 ml kg-1 min-1 compared with 2.7 +/- 0.2 ml kg-1 min-1). Following oral administration, both the bioavailability (59.7 +/- 4.9 per cent compared with 73.3 +/- 3.7 per cent) and peak plasma concentrations (14.5 +/- 1.6 micrograms ml-1 compared with 18.9 +/- 0.9 micrograms ml-1) of PTU were significantly (P less than 0.05) lower in the hyperthyroid cats than in the control cats. No difference was noted, however, between the apparent volume of distribution for PTU in the two groups of cats. Overall, results of this study indicate that the oral bioavailability of PTU is decreased and PTU disposition is accelerated in cats with hyperthyroidism.
Animal Medical Center, New York, NY 10021.
The Doppler ultrasonic recording technique was used to measure systolic and diastolic blood pressures indirectly in 28 cats with naturally occurring renal failure, 39 cats with hyperthyroidism, and 33 clinically normal cats. The mean systolic and diastolic blood pressures in the normal cats were 118.4 +/- 10.6 mm Hg and 83.8 +/- 12.2 mm Hg, respectively. In the cats with chronic renal failure, both the systolic (146.6 +/- 25.4 mm Hg) and diastolic (96.6 +/- 15.2 mm Hg) blood pressures were significantly higher (P less than 0.0001 and P less than 0.01, respectively) than in the normal cats. Elevations in systolic and/or diastolic blood pressure were recorded in 17 (61%) of the 28 cats with chronic renal failure. In the 39 untreated hyperthyroid cats, both the mean systolic (167.9 +/- 28.9 mm Hg) and diastolic (111.6 +/- 21.5 mm Hg) pressures also were significantly higher (P less than 0.0001) than normal. Increased systolic and/or diastolic blood pressure was recorded in 34 (87%) of the 39 hyperthyroid cats. In seven cats with hyperthyroidism that were reevaluated two to four months after successful treatment of the hyperthyroid state, there was a significant fall in mean systolic pressure (P less than 0.05) from a pretreatment value of 159.5 +/- 15.4 mm Hg to a posttreatment value of 132.0 +/- 1.62 mm Hg. Overall, the results of this study indicate that mild to moderate hypertension is common in cats with chronic renal failure and in cats with untreated hyperthyroidism. In addition, the hypertension appears to be reversible following successful treatment of the hyperthyroid state.
Animal Medical Center, New York, New York 10021.
The purpose of this study was to develop a T3 suppression test to help in the diagnosis of mild hyperthyroidism in cats. We evaluated the response in circulating T4 concentrations to exogenous T3 (liothyronine) administration in 44 clinically normal cats, 77 cats with hyperthyroidism, and 22 cats with nonthyroidal disease. The test was performed by first collecting blood samples for basal serum T4 and T3 determinations, administering liothyronine at an oral dosage of 25 micrograms three times daily for seven doses, and, on the morning of the third day, again collecting serum samples for T4 and T3 determinations 2 to 4 hours after the seventh dose of liothyronine. The mean basal serum concentrations of T4 (53.1 nmol/L) and T3 (1.8 nmol/L) were significantly higher in the cats with hyperthyroidism than in the normal cats (T4 = 25.3 nmol/L, T3 = 1.3 nmol/L) and the cats with nonthyroidal disease (T4 = 29.5 nmol/L, T3 = 1.4 nmol/L); however, there was a great deal of overlap of basal values between the three groups of cats. Of the 77 cats with mild hyperthyroidism, 41 (53%) had serum T4 values and 55 (71%) had T3 values that were within the established normal ranges. After administration of liothyronine, mean serum T4 concentrations fell much more markedly in the normal cats and the cats with nonthyroidal disease than in the hyperthyroid cats.(ABSTRACT TRUNCATED AT 250 WORDS)
Research Animal Resource Center, Cornell University Medical College, Ithaca, New York.
As expertise among small animal practitioners grows, feline hyperthyroidism is being diagnosed earlier in the course of the disease. There are, in fact, a growing number of cats with clinical signs of hyperthyroidism and palpably large thyroid glands whose serum total thyroxine (T4) and triiodothyronine (T3) concentrations are within the normal or borderline range. This condition can be referred to as "occult" hyperthyroidism. Early detection and treatment of feline hyperthyroidism presents an obvious advantage in avoiding some of the deleterious effects of chronic thyroid hormone excess (eg, cardiomyopathy). Recent advances have been made in the diagnosis of occult hyperthyroidism in cats. It has been found, for instance, that serum thyroid hormone concentrations can fluctuate in and out of the normal range in some cats with hyperthyroidism. Recent work also has laid the groundwork for use of a T3 suppression test as an aid in the diagnosis of early, mild, or occult hyperthyroidism in cats. The purpose of this chapter is to discuss these and other developments, as well as to discuss some of the problems confronted in diagnosing occult hyperthyroidism in cats.
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Thyroid Research Unit, Mount Sinai School of Medicine, The Mount Sinai Hospital and the James J. Peters VA Medical Center, New York, New York, USA.
The maternal physiological changes that occur in normal pregnancy induce complex endocrine and immune responses. During a normal pregnancy, thyroid gland volume may enlarge, and thyroid hormone production increases. Hence, the interpretation of thyroid function during gestation needs to be adjusted according to pregnancy-specific ranges. The elevated prevalence of gestation-related thyroid disorders (10%-15%) and the important repercussions for both mother and fetus reported in multiple studies throughout the world denote, in our opinion, the necessity for routine thyroid function screening both before and during pregnancy. Once thyroid dysfunction is suspected or confirmed, management of the thyroid disorder necessitates regular monitoring in order to ensure a successful outcome. The aim of treating hyperthyroidism in pregnancy with antithyroid drugs is to maintain serum thyroxine (T(4)) in the upper normal range of the assay used with the lowest possible dose of drug, whereas in hypothyroidism, the goal is to return serum thyroid-stimulating hormone (TSH) to the range between 0.5 and 2.5 mU/L.
J Vet Intern Med. ;23 (5):1025-30 19678886
Optimal testing for thyroid hormone concentration after treatment with methimazole in healthy and hyperthyroid cats.
Department of Small Animal Clinical Sciences, Michigan State University, East Lansing, MI 48824-1314, USA. firstname.lastname@example.org
BACKGROUND Methimazole suppresses thyroid hormone synthesis and is commonly used to treat feline hyperthyroidism. The degree of variation in thyroid hormone concentrations 24 hours after administration of methimazole and optimal time for blood sampling to monitor therapeutic efficacy have not been determined. OBJECTIVE To assess thyroid hormone concentration variation in serum of normal and hyperthyroid cats after administration of methimazole. ANIMALS Four healthy cats and 889 retrospectively acquired feline thyroid hormone profiles. METHODS Crossover and retrospective studies. In the crossover study, healthy cats were treated with increasing doses of oral methimazole until steady state of thyroid suppression was achieved. Thyroid hormones and thyroid stimulating hormone (TSH) were serially and randomly monitored after methimazole. Paired t-tests and a 3-factor analysis of variance were used to determine differences between thyroid hormone concentrations in treated and untreated cats in the crossover study. Thyroid profiles from methimazole-treated hyperthyroid cats were retrieved from the Diagnostic Center for Population and Animal Health database and reviewed. Linear regression analysis evaluated relationships of dosage (mg/kg), dosing interval (q24h versus q12h), and time after methimazole to all thyroid hormone concentrations. RESULTS All serum concentrations of thyroid hormones were significantly suppressed and TSH was significantly increased for 24 hours after administration of oral methimazole in healthy cats (P <.005). In hyperthyroid cats, there were no significant relationships between thyroid hormone concentrations and time postpill or dosing interval. CONCLUSIONS Timing of blood sampling after oral methimazole administration does not appear to be a significant factor when assessing response to methimazole treatment.
Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Endocrinology Metabolism and Nutrition, Fatih-Istanbul, Turkey.
OBJECTIVE Patients with hyperthyroidism occasionally need rapid restoration to the euthyroid state. In view of the increased enterohepatic circulation of thyroxine (T4) and triiodothyronine (T3) in thyrotoxicosis, and metabolic effects of konjac glucomannan in gastrointestinal system, we aimed to determine the activity of glucomannan in treatment of hyperthyroidism. METHODS A prospective, randomized, placebo-controlled, one-blind study design was used with newly diagnosed 48 hyperthyroid patients (30 patients with Graves' disease and 12 with multinodulary goitre). They were assigned to one of the following treatment groups: I) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and glucomannan (Propol) 2 x 1.3 gr daily for two months; II) methimazole 2 x 10 mg, propranolol 2 x 20 mg, and placebo powder daily for two months. RESULTS No differences were detected from the point of view of the baseline thyroid hormone levels between groups (p > 0.05). Further analyses revealed that the patients receiving glucomannan at the end of the second, fourth and sixth weeks of the study had significantly lower serum T3, T4, FT3 and FT4 levels than the patients who received placebo (p < 0.05). TSH was not different between the two groups at any specific time (p > 0.05). At week 8, thyroid hormone levels were not shown any differences. The glucomannan-treated group had a more rapid decline in all four serum thyroid hormone levels than the placebo-treated group. CONCLUSIONS We believe our preliminary results indicate that glucomannan may be a safe and easily tolerated adjunctive therapeutic agent in the treatment of thyrotoxicosis. This combination therapy seems most effect during first weeks of treatment of a hyperthyroid patient.
Measurement of thyroid hormones (thyroxine, T4; triiodothyronine, T3) in captive nondomestic felids.
Departamento de Reprodução Animal da Faculdade de Medicina Veterinária e Zootecnia da Universidade de São Paulo, Brazil.
The aim of this research was to obtain basic values for the evaluation of thyroid function in nondomestic felids. Serum thyroid hormone concentrations (thyroxine, T4; triiodothyronine, T3) were measured by radioimmunoassay in 145 cats, representing nine species of captive nondomestic felids: jaguar (Panthera onca), n = 49; puma (Puma concolor), n = 10; ocelot (Leopardus pardalis), n = 22; oncilla (Leopardus tigrinus), n = 12; geoffroy (Oncifelis geoffroyi), n = 4; jaguarundi (Herpailurus yaguarondi), n = 8; margay (Leopardus wiedii), n = 7; lion (Panthera leo), n = 26; and tiger (Panthera tigris), n = 7. For each species, mean +/- SEM of T3 and T4, respectively, were as follows: jaguar, 0.56 +/- 0.03 and 9.7 +/- 0.8 ng/ml; puma, 0.67 +/- 0.04 and 11.2 +/- 1.2 ng/ml; ocelot, 0.48 +/- 0.03 and 13.8 +/- 1.5 ng/ml; oncilla, 0.43 +/- 0.03 and 10.0 +/- 1.6 ng/ml; geoffroy, 0.44 +/- 0.04 and 8.0 +/- 0.16 ng/ml; jaguarundi, 0.7 +/- 0.03 and 5.0 +/- 1.0 ng/ml; margay, 0.48 +/- 0.04 and 12.2 +/- 2.3 ng/ml; lion, 0.43 +/- 0.02 and 5.7 +/- 2.6 ng/ml; and tiger, 0.66 +/- 0.03 and 12.6 +/- 0.9 ng/ml. Within species, T3 and T4 concentrations did not differ (P > 0.05) between males and females.
A hyperthyroid patient with measurable thyroid-stimulating hormone concentration - a trap for the unwary.
Department of Medicine, Tan Tock Seng Hospital, Singapore.
INTRODUCTION In a patient with hyperthyroidism, the detection of elevated thyroid hormone concentration with measurable thyroid-stimulating hormone (TSH) value poses considerable diagnostic difficulties. CLINICAL PICTURE This 38-year-old lady presented with clinical features of thyrotoxicosis. Her serum free thyroxine concentrations were unequivocally elevated [45 to 82 pmol/L (reference interval, 10 to 20 pmol/L)] but the serum TSH values were persistently within the reference interval [0.49 to 2.48 mIU/L (reference interval, 0.45 to 4.5 mIU/L)]. TREATMENT Investigations excluded a TSH-secreting pituitary adenoma and a thyroid hormone resistance state and confirmed false elevation in serum TSH concentration due to assay interference from heterophile antibodies. The patient was treated with carbimazole for 18 months. OUTCOME The heterophile antibody-mediated assay interference disappeared 10 months following the initiation of treatment with carbimazole, but returned when the patient relapsed. It disappeared again 2 months after the initiation of treatment. CONCLUSIONS Clinicians should be aware of the potential for interference in immunoassays, and suspect it whenever the test results seem inappropriate to the patient's clinical state. Misinterpretation of test values, arising as a result of assay interference, may lead to misdiagnosis, unnecessary and at times expensive investigations, delay in initiation of treatment and worst of all, the initiation of inappropriate treatment.
Circulating thyroid hormone levels in recycled turkey breeder hens during a short day prelighting period and renewal of photosensitivity for egg production.
Department of Poultry Science, College of Agriculture and Life Sciences, North Carolina State University, Raleigh, 27695-7608, USA. email@example.com
Two experiments were conducted with yearling turkey hens at the end of their first season of egg laying. The purpose was to examine changes in plasma thyroid hormone levels during recycling and renewal of photosensitivity for egg production. Plasma concentrations of thyroid hormones were determined weekly or biweekly for 8 wk following a change from existing photoperiods of long days (LD) to short days (SD) and during the associated complete renewal (recycling) of photosensitivity for egg production. In both experiments, neither thyroxine (T4) nor triiodothyronine (T3) declined from starting values during the SD exposure but plasma T3 increased significantly from LD controls. There were no significant treatment effects (SD vs. LD) for T4 in either experiment. The increase in T3 was 101 and 145% in Experiments 1 and 2, respectively, and extended over the 8-wk SD treatment period in a parabolic fashion. The T3/T4 ratio was also significantly increased in the SD treatments of both experiments as compared to LD controls. Plasma concentrations of T3, but not T4, clearly changed during recycling and renewal of photosensitivity for egg production in breeder hens. These results were consistent with a participation of plasma T3 in promoting photosensitivity and diminishing photorefractoriness in turkey hens during SD-induced recycling.
Departamento de Biología Funcional y Ciencias de la Salud, Area de Fisiología, Facultad de Ciencias, Universidad de Vigo, Spain. firstname.lastname@example.org
The actions of glutamate (L-Glu), and glutamate receptor agonists on serum thyroid hormones (T4 and T3) and TSH levels have been studied in conscious and freely moving adult male rats. The excitatory amino acids (EAA), L-Glu, N-methyl-D-aspartate (NMDA), kainic acid (KA) and domoic acid (Dom) were administered intraperitoneally. Blood samples were collected through a cannula implanted in the rats jugular 0--60 min after injection. Thyroid hormone concentrations were measured by enzyme immunoassay, and thyrotrophin (TSH) concentrations were determined by radioimmunoassay. The results showed that L-Glu (20 and 25 mg/kg) and NMDA (25 mg/kg) increased serum thyroxine (T4), triiodothyronine (T3) and TSH concentrations. Serum thyroid hormone levels increased 30 min after treatment, while serum TSH levels increased 5 min after i.p. administration, in both cases serum levels remained elevated during one hour. Injection of the non-NMDA glutamatergic agonists KA (30 mg/kg) and Dom (1 mg/kg) produced an increase in serum thyroid hormones and TSH levels. These results suggest the importance of EAAs in the regulation of hormone secretion from the pituitary-thyroid axis, as well as the importance of the NMDA and non-NMDA receptors in this stimulatory effect.
Thyroid Research Unit, School of Life Sciences, Vigyan Bhawan, D.A. University, Khandwa Road, Indore, 452 017, India.
The effects of fenugreek seed extract on the alterations in serum thyroid hormone concentrations were studied in adult male mice and rats. Simultaneously, hepatic lipid peroxidation (LPO) and the activities of the antioxidant enzymes, viz superoxide dismutase (SOD) and catalase (CAT) were examined. Administration of methi seed extract (0.11 g kg body wt.(-1) day(-1) for 15 days) to both mice and rats significantly decreases serum triiodothyronine (T(3)) concentration and T(3)/T(4) ratio, but increases thyroxine (T(4)) levels and body weight. While hepatic LPO and CAT activities were not altered, a significant decrease in SOD activity was observed in both the animal models. These findings suggest that fenugreek seed extract induced inhibition in T(4)to T(3) conversion is not peroxidation-mediated and the inhibition in SOD activity could be the result of a decrease in the protein anabolic hormone, T3.
Cadmium induced thyroid dysfunction in chicken: hepatic type I iodothyronine 5'-monodeiodinase activity and role of lipid peroxidation.
Thyroid Research Unit, School of Life Sciences, D.A. University, Vigyan Bhawan, Indore, India.
Administration of cadmium chloride (2.5 mg/kg body weight/day) to chickens daily for 15 days decreased serum triiodothyronine (T3) concentration (by 68.75%) without altering the levels of serum thyroxine (T4). Hepatic 5'-monodeiodinase (5'D-I) and superoxide dismutase (SOD) activities were also decreased (by 90.47% and 20.81% respectively) with a concomitant increase in lipid peroxidation (LPO, by 206.25%). Administration of the antioxidant vitamin E (alpha-tocopherol, 5 mg/kg body weight on alternate days) to cadmium intoxicated chickens restored thyroid function by maintaining normal hepatic 5'D-I activity and serum thyroid hormone concentrations. It also prevented cadmium-induced increase in LPO. We conclude that the metal-induced inhibition in hepatic 5'D-I activity is mediated through LPO.
Department of Medicine, Animal Medical Center, New York, NY 10021.
We evaluated serum T4 and T3 concentrations before and after administration of thyrotropin releasing hormone (TRH) in 35 cats with mild to moderate hyperthyroidism, 15 cats with nonthyroidal disease, and 31 clinically normal cats. The TRH stimulation test was performed by collecting blood for serum T4 and T3 determinations before and 4 hours after IV administration of 0.1 mg/kg TRH. Mean basal serum thyroid hormone concentrations in hyperthyroid cats were significantly (P <.05) higher than concentrations in normal cats and in those with nonthyroidal disease, but there was considerable overlap among the 3 groups. After administration of TRH, mean serum T4 concentrations increased significantly in all groups of cats, whereas mean T3 concentrations increased significantly in normal cats and in those with nonthyroidal disease, but not in cats with hyperthyroidism. The absolute difference between mean basal and TRH-stimulated serum concentrations of T4 in cats with hyperthyroidism (10.7 nmol/L) was significantly lower than the difference in the cats with nonthyroidal disease (20.0 nmol/L) and in clinically normal cats (28.3 nmol/L), but there was considerable overlap in values among groups. The mean value for relative change in serum T4 concentration after TRH was significantly lower in cats with hyperthyroidism (18.9%) than in those with nonthyroidal disease (110.0%) and in clinically normal cats (130.2%). Serum T4 concentrations increased by > 50% in all normal cats and cats with nonthyroidal disease, whereas only 4 (11.4%) of the 35 hyperthyroid cats had an increase of > 50% after TRH administration.(ABSTRACT TRUNCATED AT 250 WORDS)