Medicina Interna

The Hanbook of Feline Endocrinology

De: Edward C. Feldman, Federico Fracassi, Mark E. Peterson
ISBN: 9788821448379
2019, Edra
Capa dura
Páginas: 676

  • Developed by the most renowned experts in this field, this unique and practical handbook of feline endocrinology will be the most valuable tool for small animal veterinarians who want to deepen their understanding on the pathophysiology, clinical signs, diagnosis, treatment, and prognosis of every endocrine condition recognized in cats. Rather than have the authors treating cats as small dogs, a cat-only text will allow fully focused description of conditions in this one species. Allowing these experts in feline endocrinology space to fully teach us what they have learned about cats will result in a superior resource composed of text, figures, boxes, tables, algorithms, and videos (presented on an electronic version of the text).

  • SECTION 1 - HYPOTHALAMUS AND PITUITARY

    Chapter 1 Pituitary anatomy and physiology

    Pituitary anatomy

    Pituitary physiology

    Hormones of the adenohypophysis (AL)

    Hormones of the neurohypophysis

    Chapter 2 GH excess: acromegaly (hypersomatotropism)

    Background and history

    Incidence and pathogenesis

    Pituitary pathology

    Consequences of pituitary pathology

    Clinical features and diagnosis

    Treatment

    Prognosis

    Chapter 3 Other pituitary tumors

    Pituitary masses: hyperplasia, adenoma or carcinoma?

    Incidence and cell origins of pituitary tumors

    Effect of pituitary tumors on target organs and the direct effects of large tumors

    Functional consequences of autonomous hormone production

    Chapter 4 Pituitary surgery

    Introduction and general observations

    Surgical anatomy

    Imaging of the feline pituitary gland

    Pituitary adenomas

    Transsphenoidal hypophysectomy

    Postoperative care

    Complications after pituitary surgery

    Prognosis

    Chapter 5 Pituitary irradiation

    Introduction

    Clinical presentation

    Advanced imaging

    Role of radiation therapy

    Modalities of radiation therapy

    Nonfunctioning tumors

    Growth hormone-secreting pituitary tumors and acromegaly

    Adrenocorticotropic hormone-secreting pituitary tumors and feline Cushing’s disease

    Radiation-related adverse effects

    Chapter 6 Pituitary GH deficiency and pituitary dwarfism

    Introduction

    Etiopathogenesis

    Clinical features

    Differential diagnosis for failure to grow

    Diagnosis

    Treatment

    Chapter 7 Polyuria, polydipsia and diabetes insipidus

    Introduction

    Water requirements in healthy cats

    Urine concentrating ability in healthy cats

    Mechanisms of water retention

    Causes of polyuria and polydipsia in cats

    The diagnostic approach to polyuria and polydipsia

    Treatment of central diabetes insipidus

    Prognosis

    SECTION 2 - THYROID GLAND

    Chapter 8 Thyroid anatomy and physiology

    Anatomy of the feline thyroid gland

    General thyroid physiology

    Serum protein binding of thyroid hormones

    Hypothalamic-pituitary-thyroid axis

    Extrathyroidal metabolism of thyroid hormone

    Thyroid hormone kinetics in the cat

    Action of thyroid hormone

    Chapter 9 Hyperthyroidism: background, etiopathogenesis and changing prevalence of feline thyroid disease

    History of thyroid disease in cats

    Studies into the etiopathology of feline hyperthyroidism

    Epidemiology of hyperthyroidism: a common worldwide disorder of senior to geriatric cats

    Why has feline nodular goiter reached such epidemic proportions?

    Conclusions

    Chapter 10 Hyperthyroidism: clinical signs and physical examination findings

    Signalment

    Clinical signs

    Physical examination

    Chapter 11 Hyperthyroidism: laboratory diagnosis

    Clinicopathologic abnormalities associated with hyperthyroidism

    Thyroid hormone abnormalities associated with hyperthyroidism

    Other diagnostic tests

    Conclusion

    Chapter 12 Thyroid and kidney disease in cats

    Hyperthyroidism and chronic kidney disease (CKD)

    Effect of hyperthyroidism on serum test results of renal function

    Effect of hyperthyroidism on urinary markers of renal function

    Effect of hyperthyroidism on systolic blood pressure

    Effect of treatment of hyperthyroidism on renal function

    Effect of azotemia on how hyperthyroid cats are managed

    Suggested management strategies for hyperthyroid cats with CKD

    Chapter 13 Thyroid imaging

    Introduction

    Thyroid embryology, radiographic anatomy, and ectopic thyroid tissue

    Normal thyroid

    Hyperthyroidism

    Ectopic thyroid

    Thyroid carcinoma

    Thyroid cysts

    Hypothyroidism

    Chapter 14 Treatment of hyperthyroidism: antithyroid drugs

    Considerations prior to initiating therapy with antithyroid drugs

    Mechanism of action of antithyroid drugs

    Formulations of antithyroid drugs

    Dosages of antithyroid drugs

    Adverse reactions with antithyroid drugs

    Monitoring cats treated with antithyroid drugs

    Other drugs of interest in managing hyperthyroid cats

    Success rate and survival in hyperthyroid cats managed with an antithyroid drug

    Renal function and hyperthyroidism

    Conclusion

    Chapter 15 Treatment of hyperthyroidism: surgical thyroidectomy

    Introduction and overview

    Anatomy of the thyroid gland and surrounding structures

    Preoperative evaluation

    General anesthesia

    Feline thyroidectomy techniques

    Perioperative complications

    Postoperative recurrence of hyperthyroidism

    Surgical excision of thyroid adenocarcinoma

    Summary and conclusions

    Chapter 16 Treatment of hyperthyroidism: radioiodine

    Introduction

    Advantages and disadvantages of radioiodine treatment of hyperthyroidism

    Principles of radioiodine treatment

    Specific indications for radioiodine treatment

    Patient selection and preparation before radioiodine treatment

    Thyroid scintigraphy for evaluation of hyperthyroid cats before 131I treatment

    Estimation of the radioiodine dose to administer to cats with hyperthyroidism

    Adverse effects or complications associated with radioiodine treatment

    Follow-up thyroid function testing after radioiodine treatment

    Prognosis after radioiodine treatment

    Chapter 17 Treatment of hyperthyroidism: diet

    General nutritional assessment for the hyperthyroid cat

    Weight loss and muscle wasting

    Nutrients needed for the hyperthyroid cat

    Nutritional management of feline hyperthyroidism: feeding alow-iodine diet

    Chapter 18 Treatment of hyperthyroidism: severe, unresponsive, or recurrent hyperthyroidism

    Introduction

    Etiology and pathogenesis of severe, unresponsive or recurrent hyperthyroidism

    Correlation between the severity and duration of hyperthyroidism and the severity of clinical signs

    Causes for treatment failure

    Therapy for severe, unresponsive hyperthyroidism

    Summary

    Chapter 19 Hypothyroidism

    Introduction

    Causes of hypothyroidism

    Clinical subtypes of hypothyroidism

    Naturally occurring, congenital hypothyroidism in kittens and junior cats

    Naturally occurring hypothyroidism in adult cats

    Iatrogenic hypothyroidism in adult cats

    Refractory hypothyroidism

    SECTION 3 - CALCIUM AND PARATHYROID GLANDS

    Chapter 20 Hypercalcemia

    Overview

    Calcium physiology

    Laboratory testing

    Initial investigation in hypercalcemic cats

    Differential diagnosis of hypercalcemia

    Chapter 21 Feline primary hypoparathyroidism and hypocalcemia

    Introduction

    Distribution of calcium in the body

    Control of calcium (Ca) homeostasis

    Hypocalcemia in people and dogs

    Hypoparathyroidism in cats

    Differential diagnosis of hypocalcemia

    Diagnostic testing

    Treatment

    SECTION 4 - ADRENAL GLANDS

    Chapter 22 Adrenal anatomy and physiology

    Adrenal anatomy

    Adrenal physiology

    Chapter 23 Cushing’s syndrome (hypercortisolism)

    Introduction

    Etiology

    Clinical features

    Clinicopathological findings

    Endocrine testing

    Diagnostic imaging

    Treatment

    Prognosis

    Chapter 24 Primary hyperaldosteronism (Conn’s syndrome)

    Introduction

    Primary hyperaldosteronism

    Chapter 25 Other adrenal cortical tumors and pheochromocytoma

    Introduction and differential diagnosis

    Working up a feline adrenal mass

    Excessive progesterone production

    Combined excesses in progesterone and aldosterone

    Excessive androgen or estradiol production

    Pheochromocytoma

    Non-functional adrenal tumors

    Chapter 26 Adrenal surgery via open and laparoscopic approaches

    Introduction

    Diagnostic evaluation

    Case selection

    Patient preparation

    Surgical techniques

    Post-operative care

    Complications

    Chapter 27 Feline hypoadrenocorticism

    Introduction

    Prevalence

    Causes

    Age, breed and gender

    Clinical signs

    Clinical pathology

    Diagnostic imaging

    Electrocardiography and echocardiography

    Endocrine tests

    Differential diagnoses

    Treatment

    Prognosis

    Chapter 28 Glucocorticoid therapy

    Physiology

    Pharmacology

    Therapeutic applications

    Adverse effects

    Glucocorticoid reduction protocol

    SECTION 5 - ENDOCRINE PANCREAS

    Chapter 29 Anatomy, histology and physiology of the feline endocrine pancreas

    Anatomy of the feline pancreas

    Cell types

    Cross-differentiation

    General function of islet hormones

    Secretory control

    Relative importance of pancreatic hormones and their contribution to the pathophysiology of diabetes mellitus

    Pancreatic amyloid as the most typical histological finding in diabetes mellitus

    Chapter 30 Pathogenesis and clinical observations of uncomplicated diabetes mellitus

    Introduction

    Prevalence and epidemiology

    Risk factors

    Pathophysiologic mechanisms

    DM and pancreatitis

    Clinical and laboratory findings

    Survival and prognostic factors

    Chapter 31 Diabetic ketosis, ketoacidosis, and the hyperosmolar syndrome

    Introduction

    Glucose homeostasis

    Clinical presentation of DKA and HHS

    Principles of management of DKA and HHS

    Fluid and electrolyte therapy

    Insulin therapy

    Additional supportive therapy in DKA and HHS

    Prognosis of DKA and HHS in cats

    Chapter 32 Insulin treatment of diabetes mellitus

    Aims of the treatment and management plan

    Insulin therapy

    Choosing an insulin

    Frequency of insulin administration, initial insulin dose and change in the type of insulin

    Storage, mixing and dilution of insulin

    Owner education

    Insulin dosing pens

    Chapter 33 Gastrointestinal hormones and the use of non-insulin therapies for diabetes mellitus

    Introduction

    Incretin hormones physiology and pharmacology

    Metformin

    Glipizide

    Acarbose

    SGLT-2 antagonists

    Challenges in managing feline DM and potential uses of non-insulin therapies

    Chapter 34 Dietary management for diabetes mellitus

    Overview

    Learning outcomes

    Case 1: feeding cats that refuse or dislike their “diabetes diet”

    Case 2: an insulin overdosed diabetic cat that has just recovered from a severe “hypo” (neuroglycopenia)

    Case 3: non-prescription diet alternatives

    Case 4: achieving weight loss in a diabetic cat

    Case 5: managing diabetes in a cat with concurrent disease

    Case 6: the client has looked up a lot of information about diabetes in cats on the internet

    Chapter 35 Monitoring diabetes in cats

    Clinical signs

    Blood glucose monitoring

    Continuous glucose monitoring systems (CGMS) and flash glucose monitoring systems

    Urine glucose measurement

    Fructosamine concentration

    Glycated hemoglobin

    Chapter 36 Diabetic remission

    Definition of diabetic remission

    Physiology of diabetic remission

    Incidence of diabetic remission

    Predictors of diabetic remission

    Maximizing the likelihood of diabetic remission

    Identification and management of the diabetic cat in remission

    Prognosis and diabetic relapse

    Conclusions

    Chapter 37 The unstable diabetic

    Overview

    Initial goals of therapy and factors that influence remission

    Classification of diabetes mellitus and relevance to unstable diabetic cats

    Inappropriate choice of insulin

    Inappropriate dosing

    Choice of intensive versus conservative insulin management of newly-diagnosed diabetics

    Client factors

    Underlying diseases

    Rebound hypoglycemia (Somogyi)

    The brittle diabetic

    Monitoring

    Other management strategies

    Conclusion

    Chapter 38 Hypoglycemia

    Introduction

    Pathophysiology of hypoglycemia

    Blood glucose measurement

    Differential diagnoses

    Specific diseases or syndromes associated with hypoglycemia in cats

    Diagnostic approach

    Treatment of hypoglycemia

    SECTION 6 - BLOOD PRESSURE, BODY CONDITION AND NUTRITION

    Chapter 39 Feline obesity

    Epidemiology

    Pathophysiology of obesity

    Obesity-related diseases

    Treatment

    Chapter 40 Disorders of lipid metabolism

    Introduction

    The basics of lipoprotein metabolism

    Definitions and measurement of feline serum lipid concentrations

    Effect of lipemia on the measurement of other analytes

    Causes of feline hyperlipidemia

    Clinical consequences of hyperlpidemia in cats

    Diagnostic approach to cats with hyperlipidemia

    Treatment of feline hyperlipidemia

    Chapter 41 Cachexia and sarcopenia

    Cachexia

    Sarcopenia

    Diagnosis of cachexia and sarcopenia

    Potential interventions for cachexia and sarcopenia

    Practical approach to treatment of cachexia and sarcopenia in cats

    Conclusion

    Chapter 42 Hypertension

    Introduction

    Measurement of blood pressure incats

    Defining hypertension and deciding when to treat

    Consequences of hypertension

    Endocrine causes of hypertension

    Management of hypertension

    Annex Conversion tables

    Conversion to Systeme International (SI) Units

  • Edward C. Feldman, DVM

    DACVIM (Small Animal Internal Medicine) Emeritus Professor of Small Animal Internal Medicine University of California, Davis Davis, California USA

    Federico Fracassi, DVM

    DECVIM-CA (Internal Medicine) Associate Professor of Small Animal Internal Medicine Department of Veterinary Medical Sciences University of Bologna Italy

    Mark E. Peterson, DVM

    DACVIM (Small Animal Internal Medicine) Animal Endocrine Clinic New York, NY Adjunct Professor of Medicine Department of Clinical Sciences Cornell University, College of Veterinary Medicine Ithaca, NY USA

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