Your data on MRCVSonline
The nature of the services provided by Vision Media means that we might obtain certain information about you.
Please read our Data Protection and Privacy Policy for details.

In addition, (with your consent) some parts of our website may store a 'cookie' in your browser for the purposes of
functionality or performance monitoring.
Click here to manage your settings.
If you would like to forward this story on to a friend, simply fill in the form below and click send.

Your friend's email:
Your email:
Your name:
 
 
Send Cancel

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.

Become a member or log in to add this story to your CPD history

Vets to run marathon for World Animal Protection

News Story 1
 Two recently graduated veterinary surgeons will be running the London Marathon in April to raise money for the charity World Animal Protection.

Alex Bartlett and Maeve O'Neill plan to run the race together if they are given the same start times.

Dr O'Neill said: "You're always limited in what you can do to help animals, so it is nice to raise money for a charity that helps animals around the world."

Dr Bartlett added: "I have never run a marathon before and am excited to run my first one for such a good cause!"

Both Dr Bartlett and Dr O'Neill have fundraising pages online. 

Click here for more...
News Shorts
BSAVA releases new Guide to Procedures

The British Small Animal Veterinary Association (BSAVA) has published a new edition of its Guide to Procedures for Small Animal Practice.

It has added four new procedures; cystostomy tube placement, endotracheal intubation, point-of-care ultrasound and wet-to-dry dressings.

BSAVA says that it is an essential step-by-step guide to diagnostic and therapeutic procedures performed in practice. The textbook includes new images and illustrations, as well as high-definition videos for use prior to procedures.

Nick Bexfield and Julia Riggs, editors of the new edition, said: "We have built upon the success of the previous editions by responding to the feedback received from the BSAVA readership, and hope this new guide helps to further increase the confidence and accuracy with which these procedures are performed."

Print copies are available in the BSAVA store, with a digital version in the BSAVA library.