Primary hypothyroidism due to thyroid carcinoma in a feline / Hipotireoidismo primário devido a carcinoma de tireóide em um felino

Hypothyroidism is rarely observed in cats. This article reports the case of a thirteen-year-old feline with a one-year history of bilateral cervical swelling that had majorly grown in size two weeks prior to the animal's admission. The cat presented with dysphonia, lethargy, weight gain, and constipation. On physical examination, hypothermia was observed, with a rectal temperature of 36.5 ºC. Fine-needle aspiration cytology suggested thyroid neoplasia. The serum levels of total T4 and thyroid stimulating hormone (TSH), along with the exclusion of non-thyroid diseases, confirmed the diagnosis of hypothyroidism. This is the first report of feline hypothyroidism in Brazil secondary to thyroid neoplasia, classified as a follicular-compact carcinoma and confirmed by histopathology.

Hipotireoidismo é uma doença rara na espécie felina. Esse trabalho relata um felino de treze anos de idade com histórico de inchaço cervical bilateral há um ano, que havia crescido principalmente duas semanas antes da admissão do animal. O felino apresentava disfonia, letargia, ganho de peso e constipação. No exame físico, hipotermia foi observado com temperatura retal de 36,5 ºC. Citologia aspirativa de agulha fina sugeriu neoplasia de tireoide. A dosagem sérica de T4 total e TSH junto com a exclusão de doenças não tireoidianas confirmaram o diagnóstico de hipotireoidismo. Esse é o primeiro relato de hipotireoidismo felino no Brasil devido a uma neoplasia de tireoide, classificado como carcinoma folicular-compacto, confirmado na histopatologia.

Canine hypothyroidism with neurological disorders

Background: Hypothyroidism is characterized by hypofunction of the thyroid gland. It results in deficient production of thyroid hormones. Neurological disorders resulting from hypothyroidism are rare, which highlights the importance of this study. This study reports a case of hypothyroidism in a dog with neurological clinical signs, that was treated at the Universidade Estadual de Santa Cruz's Veterinary Hospital (HV-UESC). Case: A 4-year-old male intact Dogo Argentino breed dog, weighing 64 kg, presenting obesity, anorexia, prostration, walking in circles, and chronic dermatopathy was presented at HV-UESC. Upon physical examination, the animal presented a deficit of proprioception in the 4 limbs, with preserved superficial and deep pain. No alteration was observed in the ears, that could explained the clinical signs. In terms of dermatopathy, the animal presented symmetrical alopecia in the lateral region of the thighs and tail. Blood samples were collected for a complete blood count and biochemical tests of urea, creatinine, ALT, AST and cholesterol. Imaging radiography and ultrasonography were performed, which ruled out thoracic and abdominal changes that could be related to the case. Prior to receiving the blood test results, idiopathic encephalitis was suspected and enrofloxacin and prednisone were prescribed for 7 days. During the medication period, previous exams were provided, which indicated only increased cholesterol (500 mg/dL). The animal showed no improvement with the prescribed medication. In view of the clinical signs presented by the patient and the results of the additional tests, hormonal disease was suspected, compatible with hypothyroidism. Thus, hormonal tests of total T4, free T4, and TSH were requested, leading to verification of reduced total T4 (0.3 ng/dL) and free T4 (0.15 ng/dL) levels, and confirming the dysfunction of the thyroid gland. The previous treatment was suspended and thyroid hormone replacement was initiated. After 3 days of treatment, the neurological signs regressed and the animal became more active; after 30 days, the areas of alopecia decreased. Although the patient did not receive the recommended clinical follow-up for such cases, it was possible to establish the ideal levothyroxine dosage for the dog after appropriate adjustments, which permitted thyroid hormone levels to return to normal. Discussion: This report refers to a case of hypothyroidism in a giant dog breed. The dog in the report showed clinical signs of a dermatological, metabolic, and neurological nature, which is consistent with a lack of thyroid hormone. The main signs presented by the animal were neurological, such as walking in circles and a deficit of proprioception in the four limbs. These clinical signs are rarely mentioned in the literature associated with hypothyroidism. Laboratory abnormalities are correlated with the severity and chronicity of the disease. The animal showed a decrease in total T4 and free T4, which is to be expected in a hypothyroid animal. As a result, levothyroxine replacement treatment was initiated. The dose used for the dog, which is the recommended dose in the literature, greatly increased its total T4 levels. As a result, the dose was readjusted after a new clinical evaluation. The rate of metabolism and absorption of levothyroxine varies widely and is independent of weight. The patient showed quickly improvement in neurological signs, activity level, and serum cholesterol rate. Regarding dermatological signs and body condition, there was a more gradual improvement. This corroborates what is mentioned in the literature, which indicates that improvements can take many months

Thyroidectomy associated with chemotherapy in a dog presenting carcinoma in the thyroid gland / Tireoidectomia associada à quimioterapia em cão com carcinoma na glândula tireóide

This study aimed to describe a case of compact thyroid carcinoma in a dog, emphasizing the diagnosis, treatment, and clinical evolution. An 11-year-old mixed-breed male canine was attended at a private clinic, complaining of swelling in the ventral cervical region and difficulty breathing. A mass close to the thyroid gland was observed in the cervical ultrasound and a mixed tumor was identified by cytology. Based on follow-up exams, the therapeutic approach to be adopted was determined: total surgical resection of the right portion of the thyroid gland, together with the parathyroid glands, followed by chemotherapy with doxorubicin. The histopathology of the tissue removed confirmed the compact thyroid carcinoma. After thyroid removal, signs of hypothyroidism were confirmed by the hormonal dosage and the canine received hormone replacement with Levothyroxine as treatment, ceasing the symptoms. During routine follow-up, the presence of miliary pulmonary metastases was identified. The patient continued with the chemotherapy sessions, presenting a stable condition for almost 6 months after starting the treatment. However, clinical signs of dyspnea were manifested, resulting in a gradual worsening. Thus, the tutors chose to euthanize the animal after 9 months of treatment. According to the case described, thyroidectomy is an option of treatment for cases of thyroid carcinoma with wide dimensions. However, the technique's success depends on the effective and complete removal of the affected tissue due to the high frequency of metastases and the possible occurrence of secondary hypothyroidism.

Objetivou-se, neste trabalho, descrever um caso de carcinoma compacto de tireoide em cão, enfatizando o diagnóstico, o tratamento e a evolução clínica. O paciente foi atendido em uma clínica particular, sendo um canino macho, sem raça definida, de 11 anos, com queixa de edema cervical ventral e dificuldade respiratória. Pela ultrassonografia cervical, foi observada uma massa próxima à glândula tireoide e pela citologia, um tumor misto. A partir dos exames de acompanhamento, foi determinada a conduta terapêutica a ser adotada: ressecção cirúrgica total da porção direita da glândula tireoide, junto às paratireoides, seguida de quimioterapia com doxorrubicina. A histopatologia do tecido removido confirmou o carcinoma compacto da tireoide. Após a remoção da tireoide, sinais de hipotireoidismo foram confirmados pela dosagem hormonal, sendo feita reposição hormonal com Levotiroxina, cessando os sintomas. Durante o acompanhamento de rotina, foi identificada a presença de metástase pulmonar miliar. O paciente continuou suas sessões de quimioterapia, mantendo um quadro estável por quase seis meses após o início do tratamento. No entanto, sinais clínicos de dispneia foram manifestados, com piora gradativa do quadro, tendo os tutores optado pela eutanásia do animal após nove meses do início do tratamento. De acordo com o exposto, conclui-se que a tireoidectomia é um tratamento de escolha para os casos de carcinoma de tireoide com amplas dimensões. Entretanto, o sucesso da técnica depende da remoção efetiva e completa do tecido afetado, devido à alta frequência de metástases, além de poder ser acompanhada por um quadro de hipotireoidismo secundário.

Disfunções endócrinas mais comuns e que podem afetar a atividade reprodutiva de cães / Endocrine dysfunctions that can affect reproductive activity in dogs

As disfunções hormonais podem interagir com eixo hipotalamo-hipófise-gônadas (H/H/G) resultando em alteração da espermatogênese e impactando negativamente a fertilidade dos machos. As endocrinopatias na espécie canina são mais frequentes nas fêmeas e muitas vezes os sinais clínicos iniciais envolvem alopecias e alterações de peso, comportamento e de metabolismo. As disfunções hormonais comuns em cães machos incluem o hipotireoidismo, hiperplasia prostática benigna e os tumores testiculares. Cães idosos geralmente apresentam alterações hormonais dependentes da idade, mas a literatura é escassa e conflitante em relação a esta condição, assim o objetivo dessa revisão é informar e atualizar conceitos relacionados às disfunções hormonais que podem causar infertilidade em cães machos com vistas a ferramentas mais modernas de diagnósticos e avaliação seminal.(AU)

Hormonal dysfunctions may interact with hypothalamus, pituitary, gonads (H/H/G) axis resulting in altered spermatogenesis and negatively impacting male fertility. Endocrinopathies in the canine species are more frequent in females and often the initial clinical signs involve alopecia and changes in weight, behavior, and metabolism. Common hormonal dysfunctions in male dogs include hypothyroidism, benign prostatic hyperplasia, and testicular tumors. Older dogs usually present age- dependent hormonal changes, but the literature is scarce and conflicting regarding this condition, thus the aim of this review is to inform and update concepts related to hormonal dysfunctions that can cause infertility in male dogs with a view to more modern diagnostic tools and seminal evaluation.(AU)

Epidermal renewal after treatment of primary canine hypothyroidism using levothyroxine

Background: Primary canine hypothyroidism, an endocrine disorder that causes imbalances in the hypothalamus-pituitarythyroid axis, is a common cause of endocrine dermatoses, which frequently presents with opaque dry brittle hair. Tissue changes are also visible, such as myxedema, hyperkeratosis, epidermal atrophy, alopecia, and others. This paper describes the skin changes caused by primary hypothyroidism in a female dog before and after treatment with levothyroxine. Case: This case study involved a 7-year-old Dalmatian bitch with a history of weight gain and changes such as rough dry brittle hair. For about a year, the dog also had also presented symmetrical erythematous and alopecia skin lesions in the regions of the hind limbs, lower back and tail, progressive lethargy and fatigue after exercise. A hemogram showed mild normocytic and normochromic regenerative anemia, as well as mild leukopenia and neutropenia. Biochemical tests revealed increased levels of creatinine, total cholesterol, and triglycerides. Skin biopsy revealed the presence of comedones in the epidermis and acanthosis and trichilemmal keratinization. Hormonal tests revealed high TSH and low free T4 and total T4 levels. A cervical ultrasound scan showed changes in the thyroid glands, with hypoechoic parenchyma, in addition to increased size of the right lobe, suggesting thyroiditis. Based on these exams, the patient was diagnosed with primary hypothyroidism, and treatment with levothyroxine was instituted. Discussion: Around 90% of dogs with hypothyroidism show a decrease in total T4 and about 65-75% of them show an increase in TSH levels. In endocrinopathy, there is a decrease in the expression of T3 receptors in the keratinocytes and genes responsible for epidermal renewal. Also, molecules that affect epidermal differentiation bind to intracellular receptors belonging to the steroid/thyroid hormone superfamily. In this study, however, the application of the minimum levothyroxine dose restored the normal epidermal pattern for the species and the remaining parameters returned to normal. The hormone T3 acts in the differentiation of keratinocytes, a fact that, although not yet proven, is believed to be indirect and mediated by the epidermal growth factor or by the expression of the genes responsible for the renewal of the epidermis. Besides, some effects on the epidermis caused by deficiency of thyroid hormones may be due to secondary vitamin A deficiency, which is necessary for epithelial differentiation and binding epidermal growth factor (EGF) to the cell. Still, there is a theory that sex hormones also affect the differentiation of the epidermis, as studies show that deficiency causes effects similar to those caused by hypothyroidism. Some studies indicate the investigation of the relationship between secondary vitamin D deficiency and the increased cellularity of the epidermis of the spayed hypothyroid female rats. Additionally, the mechanism of the formation of hyperkeratosis in hypothyroidism is not yet elucidated. T3 is known to regulate keratin gene expression and perhaps also epidermal maturation, epithelial cycle, and normal keratin synthesis. The single treatment with levothyroxine in the female dog was effective in promoting the restoration of gene expression to T3 in keratinocytes.

Evidence of pituitary hypoplasia associated with partial central diabetes insipidus in a young Persian cat

Background: Congenital anomalies are an uncommon pituitary hypofunction cause associated to multiple hormone deficiencies. Congenital hyposomatotropism is often related to an inherited anomaly, characterized mainly by delayed growth. It is not uncommon to find associated thyroid-stimulating hormone and gonadotropin deficiencies. Pituitary malformation may be associated to progressive cystic lesion expansion. Central diabetes insipidus (CDI) is another rare disease associated to polyuria (PU) and polydipsia (PD) secondary to antidiuretic hormone (ADH) deficient secretion. The aim of this report is to describe a likely case of pituitary hypoplasia, associated with partial CDI in a cat. Case: A 9-month-old unneutered male Persian cat weighing 2 kg was presented due to severe polyuria and polydipsia associated with growth deficit when compared with its sibling. After clinical and laboratory evaluations during the months in which the patient was monitored, reduced serum concentration of insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH), thyroid hormones, and testosterone were documented, confirming the diagnosis of hyposomatotropism, hypogonadism, and secondary hypothyroidism. Furthermore, therapeutic diagnosis with desmopressin revealed partial central diabetes insipidus (CDI). As the sibling showed normal development aging 13-months, a radiographic examination of the forelimb (carpus) was performed on both cats. There was lack of growth plate fusion in the patient, without any other evidence of dysgenesis, whereas complete epiphyseal closure was observed in the sibling. Despite therapeutic prescriptions of desmopressin and levothyroxine, the owners refused further follow-up to the...

Evidence of pituitary hypoplasia associated with partial central diabetes insipidus in a young Persian cat

Background: Congenital anomalies are an uncommon pituitary hypofunction cause associated to multiple hormone deficiencies. Congenital hyposomatotropism is often related to an inherited anomaly, characterized mainly by delayed growth. It is not uncommon to find associated thyroid-stimulating hormone and gonadotropin deficiencies. Pituitary malformation may be associated to progressive cystic lesion expansion. Central diabetes insipidus (CDI) is another rare disease associated to polyuria (PU) and polydipsia (PD) secondary to antidiuretic hormone (ADH) deficient secretion. The aim of this report is to describe a likely case of pituitary hypoplasia, associated with partial CDI in a cat. Case: A 9-month-old unneutered male Persian cat weighing 2 kg was presented due to severe polyuria and polydipsia associated with growth deficit when compared with its sibling. After clinical and laboratory evaluations during the months in which the patient was monitored, reduced serum concentration of insulin-like growth factor-1 (IGF-1), thyroid-stimulating hormone (TSH), thyroid hormones, and testosterone were documented, confirming the diagnosis of hyposomatotropism, hypogonadism, and secondary hypothyroidism. Furthermore, therapeutic diagnosis with desmopressin revealed partial central diabetes insipidus (CDI). As the sibling showed normal development aging 13-months, a radiographic examination of the forelimb (carpus) was performed on both cats. There was lack of growth plate fusion in the patient, without any other evidence of dysgenesis, whereas complete epiphyseal closure was observed in the sibling. Despite therapeutic prescriptions of desmopressin and levothyroxine, the owners refused further follow-up to the...(AU)

Efeito do hipotireoidismo materno na expressão espaço-temporal de mediadores imunológicos e população de células natural killers na decídua e na glândula metrial de ratas / Effect of maternal hypothyroidism on the spatiotemporal expression of immunological mediators and population of Natural Killers cells in decidua and metrial gland of rats

Estudou-se o efeito do hipotireoidismo materno na expressão espaço-temporal de mediadores imunológicos e na população de células natural killers (NK) na decídua e na glândula metrial de ratas durante a gestação. Avaliou-se a detecção imunoistoquímica de interferon γ (IFNγ), do fator inibidor de migração (MIF), da interleucina 15 (IL15), do óxido nítrico sintase induzível (iNOS), a marcação com lectina DBA para evidenciação das células NK uterinas DBA+ e a expressão gênica de Ifnγ e Nos2. O hipotireoidismo aumentou o iNOS aos sete dias, a IL15 e o MIF aos 10 e 12 dias, o IFNγ e o MIF aos 14 DG e a expressão dos transcritos gênicos para iNos aos 12 e 19 dias e para Ifnγ aos 14 DG. O hipotireoidismo reduziu a imunomarcação de MIF e lectina DBA aos sete dias, lectina DBA aos 10 e 14 DG, IFNγ aos 12 dias, e a expressão de Ifnγ aos 10 e 19 DG e de iNOS aos 12, 14 e 19 DG, bem como reduziu seus transcritos gênicos aos 10 e 14 DG. Conclui-se que o hipotireoidismo compromete o perfil imunológico na interface materno-fetal ao longo da gestação, particularmente por reduzir o fator anti-inflamatório iNOS e a população de células uNK DBA+.(AU)

The goal of this study was to evaluate the effect of maternal hypothyroidism on the spatiotemporal expression of immunological mediators and population of Natural Killers cells in decidua and metrial gland of rats. Interferon gamma (IFNγ), migration inhibitory factor (MIF), interleukin 15 (IL15), inducible nitric oxide synthase (iNOS), and DBA-Lectin labeling for evidence of uNK DBA+ cells in decidua and genetic expression of Ifnγ and iNos by real-time RT-PCR were evaluated. Hypothyroidism increased protein expression of iNOS at 7 days, IL15 and MIF at 10 and 12 days, IFNγ and MIF at 14 DG in the decidua and/or metrial gland and the gene transcripts for iNOS at 12 and 19 days and for Inf at 14 DG. In addition, hypothyroidism reduced the protein expression of MIF and DBA-Lectin at 7 days, DBA-Lectin at 10 and 14 DG, IFNγ at 12 days, and the gene transcript to Ifnγ at 10 and 19 DGs. Hypothyroidism also reduced the protein expression of iNOS at 12, 14 and 19 DG and reduced its gene transcripts at 10 and 14 DGs. It is concluded that hypothyroidism compromises the immunology profile at the maternal-fetal interface throughout pregnancy, particularly by reducing the anti-inflammatory factor iNOS and population of uNK DBA+ cells.(AU)

Efeito do hipotireoidismo materno na expressão espaço-temporal de mediadores imunológicos e população de células natural killers na decídua e na glândula metrial de ratas / Effect of maternal hypothyroidism on the spatiotemporal expression of immunological mediators and population of Natural Killers cells in decidua and metrial gland of rats

Estudou-se o efeito do hipotireoidismo materno na expressão espaço-temporal de mediadores imunológicos e na população de células natural killers (NK) na decídua e na glândula metrial de ratas durante a gestação. Avaliou-se a detecção imunoistoquímica de interferon γ (IFNγ), do fator inibidor de migração (MIF), da interleucina 15 (IL15), do óxido nítrico sintase induzível (iNOS), a marcação com lectina DBA para evidenciação das células NK uterinas DBA+ e a expressão gênica de Ifnγ e Nos2. O hipotireoidismo aumentou o iNOS aos sete dias, a IL15 e o MIF aos 10 e 12 dias, o IFNγ e o MIF aos 14 DG e a expressão dos transcritos gênicos para iNos aos 12 e 19 dias e para Ifnγ aos 14 DG. O hipotireoidismo reduziu a imunomarcação de MIF e lectina DBA aos sete dias, lectina DBA aos 10 e 14 DG, IFNγ aos 12 dias, e a expressão de Ifnγ aos 10 e 19 DG e de iNOS aos 12, 14 e 19 DG, bem como reduziu seus transcritos gênicos aos 10 e 14 DG. Conclui-se que o hipotireoidismo compromete o perfil imunológico na interface materno-fetal ao longo da gestação, particularmente por reduzir o fator anti-inflamatório iNOS e a população de células uNK DBA+.(AU)

The goal of this study was to evaluate the effect of maternal hypothyroidism on the spatiotemporal expression of immunological mediators and population of Natural Killers cells in decidua and metrial gland of rats. Interferon gamma (IFNγ), migration inhibitory factor (MIF), interleukin 15 (IL15), inducible nitric oxide synthase (iNOS), and DBA-Lectin labeling for evidence of uNK DBA+ cells in decidua and genetic expression of Ifnγ and iNos by real-time RT-PCR were evaluated. Hypothyroidism increased protein expression of iNOS at 7 days, IL15 and MIF at 10 and 12 days, IFNγ and MIF at 14 DG in the decidua and/or metrial gland and the gene transcripts for iNOS at 12 and 19 days and for Inf at 14 DG. In addition, hypothyroidism reduced the protein expression of MIF and DBA-Lectin at 7 days, DBA-Lectin at 10 and 14 DG, IFNγ at 12 days, and the gene transcript to Ifnγ at 10 and 19 DGs. Hypothyroidism also reduced the protein expression of iNOS at 12, 14 and 19 DG and reduced its gene transcripts at 10 and 14 DGs. It is concluded that hypothyroidism compromises the immunology profile at the maternal-fetal interface throughout pregnancy, particularly by reducing the anti-inflammatory factor iNOS and population of uNK DBA+ cells.(AU)

Minimum dose of levothyroxine restored the autonomic balance on a Dalmatian female dog with primary hypothyroidism

Background: Hypothyroidism is an endocrine disease that leads to a reduction in the hormones thyroxine (T3) and triiodothyronine (T4), which therapy with levothyroxine restores the clinical signs related to the metabolic rate. Due to the influence of thyroid hormones on the heart, which is under the constant influence of the autonomic nervous system (ANS), dogs with hypothyroidism can develop bradycardia, arrhythmia, and dysautonomia. Heart rate variability (HRV) assesses autonomic modulation by the Holter method, which is scarce in dogs. We aimed to report the cardiac and autonomic effects of the primary hypothyroidism untreated and treated with levothyroxine in a canine case by Holter monitoring. Case: A 7-year-old female Dalmatian, weighing 36 kg, was referred for clinical evaluation due to apathy, weight gain, low hair quality, and lethargy. On physical examination, alopecic lesions on the hind limbs and tail, as well as bradycardia with a heart rate (HR) of 40-50 beats per minute (bpm) were observed, in addition to a 3/6 mitral murmur and 2/6 tricuspid murmur. Given the suspicion of thyroid gland disorder, the blood hormonal measurement revealed an increase in thyroidstimulating hormone (TSH; 0.65 ng/mL) and a decrease in free T4 (0.11 ng/mL) and total T4 (0.44 ng/mL), confirming primary hypothyroidism. Therapy was started with a minimum dose of levothyroxine (0.913 mg, every 12 h), which clinical signs were restored in 5 months of treatment, with weight loss, hair growth, and active behavior. To assess the impact of untreated and treated hypothyroidism on the patient’s ANS, a Holter monitoring exam was performed for 24 h before and after therapy. Before treatment, the average HR was 75 bpm, and the HR2.0s), 1st-degree atrioventricular blocks (AVB), six...

Minimum dose of levothyroxine restored the autonomic balance on a Dalmatian female dog with primary hypothyroidism

Background: Hypothyroidism is an endocrine disease that leads to a reduction in the hormones thyroxine (T3) and triiodothyronine (T4), which therapy with levothyroxine restores the clinical signs related to the metabolic rate. Due to the influence of thyroid hormones on the heart, which is under the constant influence of the autonomic nervous system (ANS), dogs with hypothyroidism can develop bradycardia, arrhythmia, and dysautonomia. Heart rate variability (HRV) assesses autonomic modulation by the Holter method, which is scarce in dogs. We aimed to report the cardiac and autonomic effects of the primary hypothyroidism untreated and treated with levothyroxine in a canine case by Holter monitoring. Case: A 7-year-old female Dalmatian, weighing 36 kg, was referred for clinical evaluation due to apathy, weight gain, low hair quality, and lethargy. On physical examination, alopecic lesions on the hind limbs and tail, as well as bradycardia with a heart rate (HR) of 40-50 beats per minute (bpm) were observed, in addition to a 3/6 mitral murmur and 2/6 tricuspid murmur. Given the suspicion of thyroid gland disorder, the blood hormonal measurement revealed an increase in thyroidstimulating hormone (TSH; 0.65 ng/mL) and a decrease in free T4 (0.11 ng/mL) and total T4 (0.44 ng/mL), confirming primary hypothyroidism. Therapy was started with a minimum dose of levothyroxine (0.913 mg, every 12 h), which clinical signs were restored in 5 months of treatment, with weight loss, hair growth, and active behavior. To assess the impact of untreated and treated hypothyroidism on the patients ANS, a Holter monitoring exam was performed for 24 h before and after therapy. Before treatment, the average HR was 75 bpm, and the HR<50 bpm occurred during 05 h 20 min 36 s. Still, 320 pause events (>2.0s), 1st-degree atrioventricular blocks (AVB), six...(AU)

Tratamento prévio com trilostano e levotiroxina em subdose dificultam diagnóstico de hipotireoidismo canino / Previous treatment with trilostane and levotiroxin in subdosis difficult the diagnosis of canine hypothyroidism

Background: hypothyroidism is a disease of clinical importance that causes multisystem disorders, which can be confused with other endocrinopathies. Rapid and accurate diagnosis is necessary in order to avoid worsening of the clinical manifestation. The use of drugs in a wrong way can directly imply the difficulty of the diagnostic approach, since they may cause changes in the biochemical profiles, which are of great importance as markers in diseases of animals with low thyroid function.Case: The case reports a German Spitz male, one year old and six months old, neutered, who presented bilateral do not cause itching alopecia, being treated by another professional for endocrine and fungal affections. In this same medical appointment were neglected biochemical and hematological profile exams. The exams that had been performed were skin scrapings, which showed growth of fungi and bacteria, besides the measurement of thyroid hormones as TSH, T4L (T4 free) e T3, and also the low-dose dexamethasone suppression test. Based on the findings the therapy instituted by such professional was the administration of itraconazole (ITL®), levothyroxine sodium (compounded drugs) and trilostane (compounded drugs). With absence of clinical improvement, the guardian came to the hospital veterinary, in search of a second diagnostic opinion, where during the collection of information at the time of the anamnesis the patient presented lethargy, drowsiness and absence of hair on both sides. During the clinical examination, the animal presented mild bradycardia and a slightly diminished rectal temperature; in the dermatological evaluation the presence of pup pelt, cutaneous hyperpigmentation and hair thinning in the abdominal area were noted. From this evaluation, hematological exams were requested, which had altered the presence of lymphocytosis, and biochemical tests, where changes in the cholesterol and triglyceride levels were expected, but they were within the normal range.[...](AU)

Tratamento prévio com trilostano e levotiroxina em subdose dificultam diagnóstico de hipotireoidismo canino / Previous treatment with trilostane and levotiroxin in subdosis difficult the diagnosis of canine hypothyroidism

Background: hypothyroidism is a disease of clinical importance that causes multisystem disorders, which can be confused with other endocrinopathies. Rapid and accurate diagnosis is necessary in order to avoid worsening of the clinical manifestation. The use of drugs in a wrong way can directly imply the difficulty of the diagnostic approach, since they may cause changes in the biochemical profiles, which are of great importance as markers in diseases of animals with low thyroid function.Case: The case reports a German Spitz male, one year old and six months old, neutered, who presented bilateral do not cause itching alopecia, being treated by another professional for endocrine and fungal affections. In this same medical appointment were neglected biochemical and hematological profile exams. The exams that had been performed were skin scrapings, which showed growth of fungi and bacteria, besides the measurement of thyroid hormones as TSH, T4L (T4 free) e T3, and also the low-dose dexamethasone suppression test. Based on the findings the therapy instituted by such professional was the administration of itraconazole (ITL®), levothyroxine sodium (compounded drugs) and trilostane (compounded drugs). With absence of clinical improvement, the guardian came to the hospital veterinary, in search of a second diagnostic opinion, where during the collection of information at the time of the anamnesis the patient presented lethargy, drowsiness and absence of hair on both sides. During the clinical examination, the animal presented mild bradycardia and a slightly diminished rectal temperature; in the dermatological evaluation the presence of pup pelt, cutaneous hyperpigmentation and hair thinning in the abdominal area were noted. From this evaluation, hematological exams were requested, which had altered the presence of lymphocytosis, and biochemical tests, where changes in the cholesterol and triglyceride levels were expected, but they were within the normal range.[...]

Congenital secondary hypothyroidism evidences in a dog

Background: Deficiency of thyroid hormones thyroxine (T4) and triiodothyronine (T3) results in multisystemic disease described as hypothyroidism (HpoT). Secondary HpoT is defined by TSH decreased production and, therefore, thyroid hormones. This condition is rare in dogs, accounting for less than 5% of cases. The objective of this report is to describe evidence of congenital secondary hypothyroidism in a mongrel dog and therapeutic response obtained.Case: A 3-year-old neutered male mongrel dog was brought to the veterinarian with a history of overweight without polyphagia, associated with discrete alopecia, poor quality skin and hair coat, lethargy and evident exercise intolerance. Physical examination revealed a body condition score of seven (1 to 9 scale), disqueratosis, pyoderma, ventral cervical alopecia, hair thinning on the posterior surface of the pelvic limbs and nonpalpable thyroid. A body conformation characterized by disproportionate dwarfism was observed. Owners provided a former patient´s X-ray (18 months of age), showing growth plate non-closure in vertebral bodies. Results of a complete blood count (CBC) and serum biochemical profile were within normal limits except for elevated fructosamine (459 µmol/L; reference range: 170-338 µmol/L) and total cholesterol (558 mg/dL; reference range: 135-270 mg/dL). Analyses of the hormone profile showed decreased levels of canine thyroid-stimulating hormone (cTSH) 0.03 ng/mL (reference range: 0.05-0.5 ng/mL), free thyroxine by equilibrium dialysis (fdT4) 0.57 ng/dL (reference range: 0.8-3.0 ng/dL), and total thyroxine (tT4) 5.1 ng/mL (reference range: 15-30 ng/mL). A distal forelimb X-ray was performed and showed opened epiphyseal growth plates from radius and ulnar bones. The patient was discharged with sodium levothyroxine (20 µg/kg PO q 24 hr) until re-evaluation...

Congenital secondary hypothyroidism evidences in a dog

Background: Deficiency of thyroid hormones thyroxine (T4) and triiodothyronine (T3) results in multisystemic disease described as hypothyroidism (HpoT). Secondary HpoT is defined by TSH decreased production and, therefore, thyroid hormones. This condition is rare in dogs, accounting for less than 5% of cases. The objective of this report is to describe evidence of congenital secondary hypothyroidism in a mongrel dog and therapeutic response obtained.Case: A 3-year-old neutered male mongrel dog was brought to the veterinarian with a history of overweight without polyphagia, associated with discrete alopecia, poor quality skin and hair coat, lethargy and evident exercise intolerance. Physical examination revealed a body condition score of seven (1 to 9 scale), disqueratosis, pyoderma, ventral cervical alopecia, hair thinning on the posterior surface of the pelvic limbs and nonpalpable thyroid. A body conformation characterized by disproportionate dwarfism was observed. Owners provided a former patient´s X-ray (18 months of age), showing growth plate non-closure in vertebral bodies. Results of a complete blood count (CBC) and serum biochemical profile were within normal limits except for elevated fructosamine (459 µmol/L; reference range: 170-338 µmol/L) and total cholesterol (558 mg/dL; reference range: 135-270 mg/dL). Analyses of the hormone profile showed decreased levels of canine thyroid-stimulating hormone (cTSH) 0.03 ng/mL (reference range: 0.05-0.5 ng/mL), free thyroxine by equilibrium dialysis (fdT4) 0.57 ng/dL (reference range: 0.8-3.0 ng/dL), and total thyroxine (tT4) 5.1 ng/mL (reference range: 15-30 ng/mL). A distal forelimb X-ray was performed and showed opened epiphyseal growth plates from radius and ulnar bones. The patient was discharged with sodium levothyroxine (20 µg/kg PO q 24 hr) until re-evaluation...(AU)

Aortic stenosis with abnormal eccentric left ventricular remodeling secondary to hypothyroidism in a Bourdeaux Mastiff / Estenose aórtica com remodelamento excêntrico anormal do ventrículo esquerdo secundário ao hipotireoidismo em um cão Dogue de Bordeaux

This paper describes a case of congenital aortic stenosis with eccentric left ventricular hypertrophy associated with hypothyroidism in a 1-year-old Bourdeaux Mastiff dog. The dog had ascites, apathy, alopecic and erythematous skin lesions in different parts of the body. A two-dimensional echocardiogram revealed aortic valve stenosis, with poststenotic dilation in the ascending aorta. The same exam showed eccentric hypertrophy and dilation of the left ventricle during systole and diastole. Aortic stenosis usually results in concentric left ventricular hypertrophy instead of eccentric hypertrophy; and therefore, this finding was very unusual. Hypothyroidism, which is uncommon in young dogs, may be incriminated as the cause of ventricular dilation, making this report even more interesting. Because hypothyroidism would only result in dilatation, the eccentric hypertrophy was attributed to pressure overload caused by aortic stenosis. Thus, cardiac alterations of this case represent a paradoxical association of both diseases.

Este trabalho descreve um caso de estenose aórtica congênita com hipertrofia excêntrica do ventrículo esquerdo associado ao hipotireoidismo em um cão Dogue de Bordeaux. O cão, de um ano de idade, apresentava ascite, apatia, lesões cutâneas alopécicas e eritematosas generalizadas. Na ecocardiografia bidimensional foi observada estenose da valva aórtica, com dilatação pós-estenótica em aorta ascendente. Foi detectado, no mesmo exame, hipertrofia excêntrica e dilatação do ventrículo esquerdo em sístole e diástole. Usualmente, como consequência, a estenose aórtica causa hipertrofia concêntrica do ventrículo esquerdo e não hipertrofia excêntrica, sendo este achado infrequente em tal cardiopatia. O hipotireoidismo, incomum em cães jovens, pode representar a causa da dilatação ventricular observada, o que torna mais relevante esse relato. Como no hipotireoidismo é esperado apenas dilatação, a hipertrofia excêntrica supostamente é atribuída à sobrecarga de pressão causada pela estenose aórtica. Dessa forma, as alterações cardíacas deste caso representam uma associação paradoxal das duas afecções.

Aortic stenosis with abnormal eccentric left ventricular remodeling secondary to hypothyroidism in a Bourdeaux Mastiff / Estenose aórtica com remodelamento excêntrico anormal do ventrículo esquerdo secundário ao hipotireoidismo em um cão Dogue de Bordeaux

This paper describes a case of congenital aortic stenosis with eccentric left ventricular hypertrophy associated with hypothyroidism in a 1-year-old Bourdeaux Mastiff dog. The dog had ascites, apathy, alopecic and erythematous skin lesions in different parts of the body. A two-dimensional echocardiogram revealed aortic valve stenosis, with poststenotic dilation in the ascending aorta. The same exam showed eccentric hypertrophy and dilation of the left ventricle during systole and diastole. Aortic stenosis usually results in concentric left ventricular hypertrophy instead of eccentric hypertrophy; and therefore, this finding was very unusual. Hypothyroidism, which is uncommon in young dogs, may be incriminated as the cause of ventricular dilation, making this report even more interesting. Because hypothyroidism would only result in dilatation, the eccentric hypertrophy was attributed to pressure overload caused by aortic stenosis. Thus, cardiac alterations of this case represent a paradoxical association of both diseases.(AU)

Este trabalho descreve um caso de estenose aórtica congênita com hipertrofia excêntrica do ventrículo esquerdo associado ao hipotireoidismo em um cão Dogue de Bordeaux. O cão, de um ano de idade, apresentava ascite, apatia, lesões cutâneas alopécicas e eritematosas generalizadas. Na ecocardiografia bidimensional foi observada estenose da valva aórtica, com dilatação pós-estenótica em aorta ascendente. Foi detectado, no mesmo exame, hipertrofia excêntrica e dilatação do ventrículo esquerdo em sístole e diástole. Usualmente, como consequência, a estenose aórtica causa hipertrofia concêntrica do ventrículo esquerdo e não hipertrofia excêntrica, sendo este achado infrequente em tal cardiopatia. O hipotireoidismo, incomum em cães jovens, pode representar a causa da dilatação ventricular observada, o que torna mais relevante esse relato. Como no hipotireoidismo é esperado apenas dilatação, a hipertrofia excêntrica supostamente é atribuída à sobrecarga de pressão causada pela estenose aórtica. Dessa forma, as alterações cardíacas deste caso representam uma associação paradoxal das duas afecções.(AU)

Intoxicação natural e experimental por Leucaena leucocephala em equinos / Natural and experimental Leucaena leucocephala poisoning in horses

Este trabalho investigou as principais alterações clínicas e dermatopatológicas de equinos intoxicados natural e experimentalmente por Leucaena leucocephala. Os surtos ocorreram nos estados de São Paulo e Goiás, onde seis cavalos após a ingestão de casca e/ou folhas de L. leucocephala apresentaram alopecia, principalmente na crina e cauda. Nesses animais o diagnóstico foi baseado na observação da ingestão da planta e dos sinais clínicos. Nos animais intoxicados experimentalmente, foi realizado o exame clínico, biópsias da pele das regiões de crina, dorso e cauda e foi feita dosagem sérica de tri-iodotironina (T3) e tiroxina (T4). Alopecia da crina e cauda foi o principal sinal clínico observado, seguido de anorexia, emagrecimento e apatia em todos os equinos. Os níveis de T3 e T4 total apresentaram redução significativa (p≤0,05) na terceira semana de ingestão da leucena quando comparado aos níveis basais. As alterações histológicas observadas nas biópsias de pele demonstram acentuada telogenização dos folículos pilosos ao final dos experimentos. Os achados clínico-patológicos em equinos intoxicados são semelhantes aos observados em ruminantes. A intoxicação experimental de equinos por L. leucocephala evidenciou o acentuado declínio dos níveis dos hormônios tireoideanos, sugerindo efeito bociogênico da mimosina e seus compostos derivados, com hipotireoidismo transitório e alopecia devido à acentuada redução da atividade folicular.(AU)

This paper reports the main clinical changes of natural and experimentally poisoning by Leucaena leucocephala in horses. Outbreaks of poisoning occurred in São Paulo and Goiás States, where six horses after ingestion of bark and/or leaves of the plant showed alopecia mainly in mane and tail. The diagnosis was based on the observation of plant intake and clinical signs. In horses experimentally poisoned, clinical examination was performed and skin biopsies were taken from mane, back and tail regions, and triiodothyronine (T3) and thyroxine (T4) serum levels were assayed. Alopecia in mane and tail was the main clinical sign, accompanied by anorexia, weight loss and lethargy in all horses. T3 and total T4 showed significant decrease in serum levels (p≤0.05) in the third week of leucaena intake compared with baseline levels. Marked telogenization of hair follicles at the end of the experiments were observed in skin biopsies. The clinical and pathological findings in poisoned horses are similar to those observed in ruminants. Experimental poisoning of horses by the plant highlights the marked decline in levels of thyroid hormones, suggesting goitrogenic effect of mimosine and its derived compounds, with transient hypothyroidism and alopecia due to accentuated reduction in follicular activity.(AU)

Intoxicação natural e experimental por Leucaena leucocephala em equinos / Natural and experimental Leucaena leucocephala poisoning in horses

Este trabalho investigou as principais alterações clínicas e dermatopatológicas de equinos intoxicados natural e experimentalmente por Leucaena leucocephala. Os surtos ocorreram nos estados de São Paulo e Goiás, onde seis cavalos após a ingestão de casca e/ou folhas de L. leucocephala apresentaram alopecia, principalmente na crina e cauda. Nesses animais o diagnóstico foi baseado na observação da ingestão da planta e dos sinais clínicos. Nos animais intoxicados experimentalmente, foi realizado o exame clínico, biópsias da pele das regiões de crina, dorso e cauda e foi feita dosagem sérica de tri-iodotironina (T3) e tiroxina (T4). Alopecia da crina e cauda foi o principal sinal clínico observado, seguido de anorexia, emagrecimento e apatia em todos os equinos. Os níveis de T3 e T4 total apresentaram redução significativa (p≤0,05) na terceira semana de ingestão da leucena quando comparado aos níveis basais. As alterações histológicas observadas nas biópsias de pele demonstram acentuada telogenização dos folículos pilosos ao final dos experimentos. Os achados clínico-patológicos em equinos intoxicados são semelhantes aos observados em ruminantes. A intoxicação experimental de equinos por L. leucocephala evidenciou o acentuado declínio dos níveis dos hormônios tireoideanos, sugerindo efeito bociogênico da mimosina e seus compostos derivados, com hipotireoidismo transitório e alopecia devido à acentuada redução da atividade folicular.(AU)

This paper reports the main clinical changes of natural and experimentally poisoning by Leucaena leucocephala in horses. Outbreaks of poisoning occurred in São Paulo and Goiás States, where six horses after ingestion of bark and/or leaves of the plant showed alopecia mainly in mane and tail. The diagnosis was based on the observation of plant intake and clinical signs. In horses experimentally poisoned, clinical examination was performed and skin biopsies were taken from mane, back and tail regions, and triiodothyronine (T3) and thyroxine (T4) serum levels were assayed. Alopecia in mane and tail was the main clinical sign, accompanied by anorexia, weight loss and lethargy in all horses. T3 and total T4 showed significant decrease in serum levels (p≤0.05) in the third week of leucaena intake compared with baseline levels. Marked telogenization of hair follicles at the end of the experiments were observed in skin biopsies. The clinical and pathological findings in poisoned horses are similar to those observed in ruminants. Experimental poisoning of horses by the plant highlights the marked decline in levels of thyroid hormones, suggesting goitrogenic effect of mimosine and its derived compounds, with transient hypothyroidism and alopecia due to accentuated reduction in follicular activity.(AU)

Intoxicação natural e experimental por Leucaena leucocephala em equinos

ABSTRACT: This paper reports the main clinical changes of natural and experimentally poisoning by Leucaena leucocephala in horses. Outbreaks of poisoning occurred in São Paulo and Goiás States, where six horses after ingestion of bark and/or leaves of the plant showed alopecia mainly in mane and tail. The diagnosis was based on the observation of plant intake and clinical signs. In horses experimentally poisoned, clinical examination was performed and skin biopsies were taken from mane, back and tail regions, and triiodothyronine (T3) and thyroxine (T4) serum levels were assayed. Alopecia in mane and tail was the main clinical sign, accompanied by anorexia, weight loss and lethargy in all horses. T3 and total T4 showed significant decrease in serum levels (p0.05) in the third week of leucaena intake compared with baseline levels. Marked telogenization of hair follicles at the end of the experiments were observed in skin biopsies. The clinical and pathological findings in poisoned horses are similar to those observed in ruminants. Experimental poisoning of horses by the plant highlights the marked decline in levels of thyroid hormones, suggesting goitrogenic effect of mimosine and its derived compounds, with transient hypothyroidism and alopecia due to accentuated reduction in follicular activity.

RESUMO: Este trabalho investigou as principais alterações clínicas e dermatopatológicas de equinos intoxicados natural e experimentalmente por Leucaena leucocephala. Os surtos ocorreram nos estados de São Paulo e Goiás, onde seis cavalos após a ingestão de casca e/ou folhas de L. leucocephala apresentaram alopecia, principalmente na crina e cauda. Nesses animais o diagnóstico foi baseado na observação da ingestão da planta e dos sinais clínicos. Nos animais intoxicados experimentalmente, foi realizado o exame clínico, biópsias da pele das regiões de crina, dorso e cauda e foi feita dosagem sérica de tri-iodotironina (T3) e tiroxina (T4). Alopecia da crina e cauda foi o principal sinal clínico observado, seguido de anorexia, emagrecimento e apatia em todos os equinos. Os níveis de T3 e T4 total apresentaram redução significativa (p0,05) na terceira semana de ingestão da leucena quando comparado aos níveis basais. As alterações histológicas observadas nas biópsias de pele demonstram acentuada telogenização dos folículos pilosos ao final dos experimentos. Os achados clínico-patológicos em equinos intoxicados são semelhantes aos observados em ruminantes. A intoxicação experimental de equinos por L. leucocephala evidenciou o acentuado declínio dos níveis dos hormônios tireoideanos, sugerindo efeito bociogênico da mimosina e seus compostos derivados, com hipotireoidismo transitório e alopecia devido à acentuada redução da atividade folicular.