Urine concentrating ability in cats with hyperthyroidism: Influence of radioiodine treatment, masked azotemia, and iatrogenic hypothyroidism

被引:3
|
作者
Peterson, Mark E. [1 ,2 ,4 ]
Rishniw, Mark [2 ,3 ]
机构
[1] Anim Endocrine Clin, 21 West 100th St, New York, NY USA
[2] Cornell Univ, Coll Vet Med, Ithaca, NY USA
[3] Vet Informat Network, Davis, CA USA
[4] Anim Endocrine Clin, 220 Manhattan Ave, New York, NY 10025 USA
关键词
I-131; CKD; feline; hypothyroidism; kidney; radioactive iodine; thyroid gland; urine specific gravity; GLOMERULAR-FILTRATION-RATE; STIMULATING HORMONE CONCENTRATION; RENAL-FUNCTION; KIDNEY-FUNCTION; SPECIFICITY; SENSITIVITY; GUIDELINES; THYROXINE; DIAGNOSIS; GRAVITY;
D O I
10.1111/jvim.16849
中图分类号
S85 [动物医学(兽医学)];
学科分类号
0906 ;
摘要
BackgroundHyperthyroid cats often have urine specific gravity (USG) values <1.035. It remains unclear how USG changes after treatment, if USG can be used to predict azotemia after treatment, or how iatrogenic hypothyroidism influences USG values.ObjectivesTo determine the proportion of hyperthyroid cats with USG <1.035 vs & GE;1.035; if USG changes after treatment; and whether USG <1.035 correlated with unmasking of azotemia or hypothyroidism.AnimalsSix hundred fifty-five hyperthyroid cats treated with radioiodine; 190 clinically normal cats.MethodsProspective, before-and-after study. Hyperthyroid cats had serum thyroxine, thyroid-stimulating hormone, and creatinine concentrations, and USG measured before and 6 months after successful treatment with radioiodine.Results Of untreated hyperthyroid cats, USG was =1.035 in 346 (52.8%) and <1.035 in 309 (47.2%). After treatment, 279/346 (80.6%) maintained USG & GE;1.035, whereas 67/346 (19.4%) became <1.035; 272/309 (88%) maintained USG <1.035, whereas 37/309 (12%) became & GE;1.035. Only 22/346 (6.4%) with USG =1.035 developed azotemia after treatment, compared with 136/309 (44%) with <1.035 (P < .001). Of cats remaining nonazotemic, 38% had USG <1.035, compared with 20% of normal cats (P < .001). The 137 cats with iatrogenic hypothyroidism had lower USG after treatment than did 508 euthyroid cats (1.024 vs 1.035), but USGs did not change after levothyroxine supplementation. USG <1.035 had high sensitivity (86.1%) but moderate specificity (65.2%) in predicting azotemia after treatment.Conclusions and Clinical Importance Hyperthyroidism appears not to affect USG in cats. However, cats with evidence of sub-optimal concentrating ability before radioiodine treatment (USG < 1.035) are more likely to develop azotemia and unmask previously occult chronic kidney disease. Iatrogenic hypothyroidism itself did not appear to affect USG values.
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页码:2039 / 2051
页数:13
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