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Always consider hyperthyroidism and CKD together
Dr Rosanne Jepson
Dr Rosanne Jepson from the RVC spoke at BSAVA Congress 2015.
Management of concurrent CKD and hyperthyroidism is a delicate balancing act

Dr Rosanne Jepson from the RVC, London, speaking at a BSAVA Congress session on concurrent disease, tackled the subject of hyperthyroidism and chronic kidney disease.

She began by noting that both CKD and hyperthyroidism in cats have a median age of diagnosis of 12 years. "It is not surprising," she said, "that these two conditions can occur concurrently and complicate diagnosis."

A high proportion of azotaemic cats, that have been treated for hyperthyroidism, appear to have subsequent kidney damage as a consequence of hypertension. There is also a vasoconstrictive effect leading to tissue hypoxia and related renal pathology.

There is not much direct evidence of this link, but models suggest that it is not unreasonable to assume that when cats are diagnosed with hyperthyroidism they will also develop CKD. On the other hand, there are occasions when CKD can make the diagnosis of hyperthyroidism complicated.

There is some evidence that cats treated for hyperthyroidism have a reduced GFR and increased creatinine levels; and over-treatment can lead to iatrogenic hypothyroidism.

Cats that are azotaemic at the time of diagnosis of hyperthyroidism have a reduced life expectancy.

Dr Jepson warned that Free T4 may be detected in up to 20 per cent of cats that have non-thyroidal disease, so this test should always be carried out in conjunction with other tests, including those for renal function. In difficult cases, it is worth running a TSH test, T3 suppression and thyroid scintigraphy tests to try and confirm the diagnosis.

It is also important to monitor for hypothyroidism in azotaemic cats following hyperthyroidism therapy in case medical therapy needs modification. Dr Jepson warned clinicians to be cautious not to micromanage cases and thus make too many changes to therapy too frequently.

The aim is to manage therapy to maintain a healthy appetite and normal body weight. She urged veterinary professionals to use their clinical judgement in these cases and not rely solely on biochemical tests.

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Avian flu outbreak at RSPB Minsmere

News Story 1
 RSPB Minsmere nature reserve in Suffolk has confirmed an outbreak of highly pathogenic avian influenza on its site. The coastal nature reserve has seen an increase in dead birds recently, and has said that it is 'extremely concerned' about the potential impacts on bird populations, with 2021 and 2022 seeing the largest ever outbreak in the UK.

In a statement, RSPB said: "We appreciate that it is distressing, for both visitors and staff, to see dead or dying birds at our site but we ask that if visitors see any dead or unwell birds, they do not touch or go near them and that they report it to us at our Visitor Centre during its opening hours, or by emailing us on outside of these times."  

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Moredun Foundation Award opens for applications

The 2022-2023 Moredun Foundation Award (MFA) is now open for members, with up to £2,000 available for successful applicants.

The MFA honours the contribution that education, teamwork, life experience, and travel have made to the understanding of cattle health and welfare. Through its charitable endeavours, Moredun offers its members the opportunity to pursue projects that support personal development.

The prize is open to a wide range of project applications, including those that include producing educational tools, conducting a small research project, or studying farming methods in other nations. For more information and to apply, visit