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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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Practices urged to audit neutering data

News Story 1
 RCVS Knowledge has called on vet practices to audit their post-operative neutering outcomes.

It follows the release of the 2024 NASAN benchmarking report, which collates data from neutering procedures performed on dogs, cats and rabbits.

The benchmarking report enables practices in the UK and Ireland to compare their post-operative outcomes to the national average. This includes the rate of patients lost to follow-up, which in 2024 increased to 23 per cent.

Anyone from the practice can submit the data using a free template. The deadline for next report is February 2026.

Visit the RCVS Knowledge website to complete an audit. 

Click here for more...
News Shorts
New guidance for antibiotic use in rabbits

New best practice guidance on the responsible use of antibiotics in rabbits has been published by the BSAVA in collaboration with the Rabbit Welfare Association & Fund (RWA&F).

The guidance is free and has been produced to help veterinary practitioners select the most appropriate antibiotic for rabbits. It covers active substance, dose and route of administration all of which are crucial factors when treating rabbits owing to the risk of enterotoxaemia.

For more information and to access the guide, visit the BSAVALibrary.