Endocrine disease from an owner’s viewpoint

March 15th, 2016

As vets I think sometimes we (OK then, I ) get caught up in the diagnosis and treatment of our patients to the exclusion of all else. This is, after all, what we are trained to do and what is expected of us. In this post I will try and step back and consider endocrine disease (diseases of the body’s hormones) from an owner’s point of view.

Let’s consider the more common endocrine diseases of cats and dogs:

1/Diabetes Mellitus

When we talk about “Diabetes” we mean, almost invariably, sugar diabetes or diabetes mellitus. In pets this is caused by a relative or absolute lack of insulin. Insulin producing cells in the pancreas have been destroyed. It is equivalent to type 1 or juvenile onset diabetes in humans, so it cannot be treated and controlled by drugs, diet and exercise. You will have to inject your dog or cat with insulin twice a day (these days it is ALWAYS twice a day). This freaks some owners out. I trot out something that my father said when I was learning to drive; when you first learn to drive you think steering is the hard part. When your pet has diabetes you think the injections will be the hard part. They won’t. After a week you will be quite confident. Even one truly needle-phobic client is making a good fist of them with an insulin pen, so relax. You will need to set aside some money for repeat glucose testing, the continuing cost of insulin and syringes, and someone needs to be there twice a day to inject the pet. All that said, follow the mantra of a sportswear company (they’re not sponsoring my website so I’m not name-checking them ) and JUST DO IT! You will save your pets life and enjoy many more months or years of good quality life together. Early detection and treatment is the key – increased thirst and appetite are often the most obvious symptoms. Stabilising a sick diabetic is way harder so get on to this early.

For cats the news is even better. I can stabilise most diabetic acts using a minimalist approach as an out patient, on a special diet and with one visit to the clinic a week, There will be some cost involved but it is not likely to be unaffordable. Cats are fascinating creatures and can drift in and out of a diabetic state, so not all cats need to be treated for life.

2/Hypothyroidism in dogs (underactive thyroid – never seen in cats in practice)

An overweight, slothful dog of any age should have thyroid function tested. There are grey areas with the blood tests so you may get a yes, a definite no or a maybe for an underactive thyroid. Trial treatment may be appropriate. Treatment is easy with twice a day pilling and very satisfying as the weight falls off and your dog’s demeanour improves rapidly. Thyroid function affects many body processes so other symptoms may occur and resolve with treatment. The only reason you wouldn’t treat this is if I’ve missed it (or you don’t let me run the blood test)! Sadly, most overweight dogs do NOT have thyroid or adrenal gland disease (see below) – they are just fed too much.

3/Hyperthyroidism in cats (overactive thyroid – very rarely seen in dogs)

The classic hyperthyroid cat is old,thin and has a ravenous appetite. Unfortunately a wide spectrum of clinical signs are possible with hyperthyroidism, and a diabetic cat may present with the signs I’ve just described. Diagnosis is not usually difficult provided a thyroid test is included in the blood work. Cats with thyroid hormone levels approaching the upper limit of normal are almost certainly becoming hyperthyroid, but most affected cats have levels well above the normal range.

Treatment however, will present you with some challenges unless you feel confident giving your cat tablets. For the first two weeks of treatment you will need to pill your puss three times a day (yes, I know that’s really inconvenient but you just have to) and then, after a second blood test, you drop down to twice daily pilling. There is a cream you can rub on the inside of your cats ear but it’s (comparatively) rubbish. The tablets work really well so “stiffen the sinews, summon up the blood” and get pilling. Your cat will gain weight, feel better, have lower blood pressure and less risk of heart disease.

4/Hypoadrenocorticism in dogs ( underactive adrenal glands – Addison’s disease )

Addison’s is an emergency. Addison’s patients cannot cope with stress, and lack other steroid hormones that stabilise membranes and bodily functions. Following transient episodes of vomiting and diarrhoea, these patients often present as really unwell. Serum electrolyte changes ( electrolytes are included in routine blood work) are highly suggestive and an adrenal function test is diagnostic. Recovery is prompt,usually, but patients require treatment for life. It’s worth it as the dogs are normal on their medication. Owners are (usually) delighted.

5/Hyperadrenocorticism in dogs ( overactive adrenal glands – Cushing’s disease )

Now having spent all of this post telling you how rewarding you’ll find treating a whole heap of conditions, and how doable it all is, we come to Cushing’s and I have to be a little more guarded. Cushing’s disease is an underdiagnosed and undertreated disease. The more you look for it the more you’ll find ( and trust me, I don’t need to drum up business ). Usually, and there are exceptions, Cushing’s is a disease of middle aged and older dogs. In addition, I have to tell you that treating the older Cushing’s patient will not extend their life. So why do it? Why go through the expense of diagnostic adrenal tests, medication and regular follow up blood testing? Well, you may not lengthen your dog’s life (they are not usually acutely ill – just overweight,lethargic, hungry,thirsty and with a poor hair coat and pot belly) but boy do you improve the quality of their lives! For this blinding insight you have to thank the very good owners who have bitten the bullet and gone through diagnosis and treatment. I can’t tell you how satisfying it has been to give some lovely dogs and great people a good result. Do consider treatment – I don’t think you’ll regret it!

And finally, a note on blood testing for some of the conditions described above. Fast your pet overnight, and pill them 4 hours before we draw blood. In practice, as we usually close appointments at 11am so I can start on the day’s surgery, you may have to get up a little early that day.



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