Background Naturally occurring hypothyroidism in adult cats is rare, with only 4 cases reported. Objectives To describe the historical, clinical, laboratory, and scintigraphic features of adult cats with spontaneous hypothyroidism. Animals Seven adult cats referred for suspected hypothyroidism. Methods Prospective case series. We collected data on cats' signalment, clinical signs, results of physical examination, routine laboratory and thyroid hormone testing, and thyroid imaging (thyroid scintigraphy or ultrasound). We subsequently treated cats with levothyroxine and evaluated their response to treatment. Results Cats ranged from 3.5 to 11 years, with no apparent breed predilection; 6/7 cats were male. Only 2/7 cats were initially tested because of signs of hypothyroidism (hair-coat changes, lethargy, obesity); others were tested for routine thyroid monitoring or palpable thyroid nodules. Four were azotemic (serum creatinine, 2.2-3.4 mg/dL). Six of the cats had low serum thyroxine (T4 ) and free T4 (fT4 ) concentrations, whereas all 7 cats had high thyroid-stimulating hormone (TSH) concentrations. In 6/7 cats, thyroid scintigraphy revealed bilateral goiter with intense radionuclide uptake; imaging showed no visible thyroid tissue in the other. After levothyroxine treatment, serum concentrations of T4 and fT4 increased and TSH fell; high serum creatinine normalized in azotemic cats; and repeat imaging showed reduction in goiter size. Conclusions and clinical importance Primary hypothyroidism develops in adult cats, with a higher prevalence than previously thought. Most cats appear to develop a goitrous form of hypothyroidism associated with thyroid hyperplasia, whereas thyroid atrophy appears to be less common. With levothyroxine replacement, clinical and laboratory abnormalities improve or resolve.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jvim.15239

Spontaneous primary hypothyroidism in 7 adult cats.

Radioiodine therapy is commonly used in hyperthyroid cats and has a high success rate, ranging from 85–95%. As in humans, thyroid volume has been reported to influence radioiodine therapy outcome in hyperthyroid cats. The purpose of this study was to relate total thyroid volume, calculated by a newly constructed formula for feline patients (0.438 × length × width²), to the outcome of radioiodine therapy. To search for a correlation between total thyroid volume and therapy outcome, 167 hyperthyroid cats were included. Patients were categorised according to the administered radioiodine dose and therapy outcome. Our analysis did not show a significant relationship between an increasing total thyroid volume and the odds for a final low total thyroxine concentration (TT4; P = 0.3930) or a final hyperthyroid outcome (P = 0.0901). A significant relationship was found for an increase in the odds for a final low TT4 outcome with an increase in the number of foci detected on the pertechnetate thyroid scan (P = 0.0238). This was not true for a final hyperthyroid outcome (P = 0.7435). The number of detected foci was also significantly associated with the total thyroid volume (P = 0.0006). Findings indicated that the presence of multiple affected foci influences therapy outcome towards a low TT4 outcome. Bilateral hyperthyroidism and its potential effect on a final low TT4 outcome should therefore be addressed when informing owners of the possible outcomes of radioiodine therapy for their cat.

/pdf/effect-of-thyroid-volume-on-radioiodine-therapy-outcome-in-102sslap5f.pdf

Effect of thyroid volume on radioiodine therapy outcome in hyperthyroid cats

The effect of thyroid volume on radioiodine therapy outcome in hyperthyroid cats

In het eerste deel van dit overzichtsartikel worden de schildklieranatomie, fysiologie en pathofysiologie bij katten besproken. Vervolgens wordt de nadruk gelegd op hyperthyreoidie, de meest voorkomende schildkliergerelateerde aandoening bij katten. De diagnosestelling wordt verder besproken met nadruk op de medische beeldvorming. Scintigrafie is veruit de meest gebruikte en geschikte techniek om de schildklierfunctie te evalueren. Daarop wordt in het tweede deel van dit overzichtsartikel dieper ingegaan. Andere beeldvormingsmodaliteiten bieden geen evaluatie van de schildklierfunctie en zijn daarom van minder belang voor de diagnose en evaluatie van hyperthyreoidie.

https://biblio.ugent.be/publication/8500168/file/8500175.pdf

Hyperthyroidism in cats, part I : anatomy, physiology, pathophysiology, diagnosis and imaging

Hypothyroidism was a rare cause of rhabdomyolysis, which finally progressed to acute kidney injury (AKI). We compared nine patients with AKI secondary to hypothyroidism and six patients with severe hypothyroidism. Besides creatine kinase, globulin could be an alternative biomarker of rhabdomyolysis related to hypothyroidism.

https://www.onlinelibrary.wiley.com/doi/pdf/10.1002/ccr3.1393

Comparison between acute kidney injury (AKI) and non-AKI patients secondary to severe hypothyroidism.

We describe an interesting case of reversible renal impairment secondary to hypothyroidism. A 57-years-old man was referred from peripheral institution for evaluation of elevated serum creatinine. He had vague complaints of weakness, lethargy and muscle ache but no urinary symptoms. He was found to have hypothyroidism, and thyroid hormone replacement therapy (THRT) was started which resulted in reversal of the renal dysfunction. There was marked improvement in estimated glomerular filtration rate. 99mTc DTPA renal scans done before and after THRT suggested hypothyroidism responsible for this reversible renal impairment. Several studies have described the pathophysiology of diminished renal function in hypothyroidism. Few studies or case reports have shown total amelioration of renal impairment as seen in our patient. The etiology is presumed to be multifactorial, in which hemodynamic effects and a direct effect of thyroid hormone on the kidney play an important role. We suggest that patients with renal impairment of unknown cause have thyroid function tests undertaken as part of routine investigation.

https://www.tandfonline.com/doi/pdf/10.3109/0886022X.2013.824381

Hypothyroidism presenting as reversible renal impairment: an interesting case report

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Hypothyroidism presenting as reversible renal impairment: an interesting case report