|
News 2012 Veterinarian of the Year On April 21, 2012, Dr. Mark Peterson was declared the 2012 Veterinarian of the Year by the Veterinary Medical Ass
|
|
2012 Veterinarian of the Year
On April 21, 2012, Dr. Mark Peterson was declared the 2012 Veterinarian of the Year by the Veterinary Medical Association of New York City.
This award was given to Dr. Peterson in recognition of his many services to the veterinary profession and his contributions to the Veterinary Medical Association of New York City.
Upcoming Events
Dr. Peterson is busy getting ready for a local CE lecture called "CE & the City" on May 19th. Then on May 23rd, he's off to State College, PA, to speak at the Annual Spring Clinic of the Pennsylvania Veterinary Medical Association. Soon after, he will be traveling to New Orleans to lecture at the ACVIM Forum.
One of Dr. Peterson's lectures at the ACVIM Forum will deal with his research findings following analysis of the largest group of thyroid scans of hyperthyroid cats ever done. The ultimate goals of this study are to define the incidence of ectopic thyroid tumors and thyroid carcinoma in these cats, and to determine if prevalence of large goiters and thyroid carcinoma increases over time in hyperthyroid cats on long-term medical treatment.
New Edition of Endocrine Book Soon to be Released
Dr. Peterson's newest book will hit shelves soon: the fourth edition of the BSAVA Manual of Canine and Feline Endocrinology. With 30 contributing veterinarians and 28 chapters, this book will cover the full gamut of endocrinology. |
CE & the City
New York, New York, May 19, 2012
* Hyperthyroidism and Thyroid Tumors in Cats and Dogs: Pitfalls in Diagnosis and Treatment
13th Annual Spring Clinic of the Pennsylvania Veterinary Medical Association
State College, Pennsylvania, May 23, 2012
* Feline Hyperthyroid Update: Some Things Old But Everything New
* Diagnostic Testing for Canine and Feline Hypothyroidism
* Update on the Diagnosis and Medical Management of Hypercalcemia in Dogs and Cats
* Insulin Choices for the Diabetic: Which Preparations Work Best?
* Diagnostic Testing for Cushing's Syndrome- Confusion or Clarity?
* Management of Canine Cushing's Syndrome: An Update
2012 ACVIM Forum
New Orleans, Louisiana, May 30 - June 2, 2012
* The Problem Diabetic: Acromegaly, Cushing’s, and Other Causes of Insulin Resistance
* Research Abstract: Thyroid Scintigraphic Findings in 917 Cats with Hyperthyroidism
Fairfield County Veterinary Medical Association
Fairfield County, Connecticut, June 20, 2012
* Nutritional Management of Feline Hyperthyroidism |
 Figure 1: Beau the Boxer |
Beau is a 6-year-old, male neutered Boxer weighing 80 pounds who was referred to Dr. Peterson for evaluation of severe polyuria, polydipsia, and incontinence (Figure 1).
About a year before referral, Beau was examined because of weight gain and thinning of his hair coat. Routine laboratory testing was normal except for the finding of a low serum T4 and free T4 concentrations. Hypothyroidism was diagnosed and thyroid hormone supplementation (L-T4; 0.6 mg, BID) was instituted.
Beau responded will to the L-T4 replacement with hair regrowth and an increase in energy. However, a few weeks later, Beau developed a progressive increase in thirst and urination (about 160 oz per day) with urinary incontinence. A urinary tract infection was diagnosed and treatment with antibiotics (Baytril) was instituted. Initially, Beau responded with a decrease in polyuria and polydipsia (PU/PD), but the signs recurred shortly thereafter. He was put back on the antibiotics but failed to show any response. Rather, his PU/PD worsened.
Further workup showed a consistently low urinary specific gravity (1.004-1.009). Results of Beau's CBC, serum chemistry panel and complete urinalysis (including culture) were negative. An ACTH stimulation test and a urine cortisol:creatinine ratio were both normal, excluding Cushing's syndrome. Serum thyroid testing showed a normal 6-hour post-pill T4 result, excluding hyperthyroidism. A tentative diagnosis of psychogenic polydipsia was made and Beau was started on Prozac (60 mg per day), no change was noted in his polydipsia or polyuria. |
Based on Beau's continued severe PU/PD and exclusion of other more common causes (e.g., renal disease, Cushing's syndrome, hypercalcemia), a tentative diagnosis of diabetes insipidus was made. Desmopressin (DDAVP) eyedrops were prescribed, but Beau resisted the intraconjunctival application. Therefore, the desmopressin formulation was changed to oral tablets (0.2 mg, BID). Despite an increase in the oral desmopressin dose to 0.3 mg TID, no decrease in water consumption or urine volume was noted. In accord with that, serial urine collections revealed no increase in Beau's urine specific gravity, with all values less than 1.010.
Based upon Beau's lack of response to either intraconjunctival or oral desmopressin, the dog was referred to the Animal Endocrine Clinic for evaluation. On physical examination, Beau's weight and body condition score were normal, and no abnormalities were found. Because all other major differentials had already been excluded, I still felt that diabetes insipidus and psychogenic polydipsia were the two major differentials.
Since neither the intraconjunctival nor oral forms of desmopressin had been effective in controlling Beau's PU/PD, we changed the route of desmopressin administered to subcutaneous injection (4 μg, BID). Within 2 days, all of Beau's clinical signs of increased thirst, urination and incontinence had completely resolved.
Follow-up contact with the owner 3 months later revealed that excellent control of clinical signs has continued on twice daily administration of the injectable desmopressin. |
Comments
I've found that desmopressin administered by subcutaneous injection to be the most effective route of administration for dogs with diabetes insipidus (1-3). The duration of action is longer after subcutaneous injection than when administered orally or via the conjunctival sac. And because of the smaller subcutaneous doses required to control signs (about 15% and 40% of the oral and conjunctival doses, respectively), the cost of treatment is greatly reduced (3).
References
1. Randolph JF, Nichols R, Peterson ME: Diseases of the hypothalamus and pituitary. In: Birchard SJ, Sherding RG (eds): Manual of Small Animal Practice (Third Edition), Philadelphia, Saunders Elsevier, pp 398-408, 2006.
2. Nichols R, Peterson ME: Investigation of polyuria and polydipsia, In: Mooney C.T., Peterson M.E. (eds), Manual of Canine and Feline Endocrinology (Fourth Ed), Quedgeley, Gloucester, British Small Animal Veterinary Association, 2012; 215-220.
3. Peterson ME: What drugs do we use to treat diabetes insipidus? Insights into Veterinary Endocrinology (blog post, January 13, 2011). |
Transitioning Hyperthyroid Cats from Methimazole to Hill’s y/d: If It Ain’t Broke, Don't Fix It!
My patient is a 15-year old, F/S, DSH cat with a 2-year history of hyperthyroidism.
How Glucocorticoids Affect the Complete Blood Count
What are the effects of glucocorticoids on the results of a hemogram (complete blood count)?
Medical Treatment for Adrenal Tumors in Dogs with Cushing's Syndrome: Mitotane or Trilostane
My patient is a 13-year old, FS, Dachshund who has been morbidly obese for most of her life.
Treatment of Diabetic Cataracts in Dogs
My patient is a 7-year old male Terrier that has been treated for diabetes mellitus for the past 2 years.
How Does the New Generic Cosyntropin Compare to Cortrosyn for ACTH Stimulation Testing?
Comparison of IV and IM Formulations of Synthetic ACTH for ACTH Stimulation Tests in Healthy Dogs
Can Foods Containing Sugar Be Fed to Diabetic Dogs?
Why is sugar included as an ingredient in some dog foods such as Natural Balance Dog Food Rolls.
How to Accurately Measure 0.25- or 0.5-Units Doses of U-100 Insulin
I'm tying to locate a supplier of insulin syringes (U-100) graduated in 0.25 to 0.5-unit increments.
Dietary Hyperthyroidism in Dogs
While hypothyroidism is a common endocrine disorder in dogs, canine hyperthyroidism is rare.
Oral Hypoglycemic Drugs for Dogs with Diabetes
I have a 11-year old, male neutered Yorkshire terrier that has been diagnosed with diabetes mellitus.
Hypertension and Hyperthyroidism in Cats: What's the Correlation?
My patient is a 15-year old, FS, DSH cat who was successfully treated with radioiodine a year ago.
Stem Cell Therapy for Thyroid Disease in Cats and Dogs
Stem cell therapy is coming into the limelight for animals and humans. I've read of its success treating diabetes, so wonder about the thyroid as well.
Do Cats with Hyperthyroidism in Cats Ever Go Into Spontaneous Remission?
Gracie, our 8-year old, spayed female DSH has just been diagnosed with hyperthyroidism, based on the finding of a high serum T4 value (12.4 μg/dl; reference range, 1-4.7 μg/dl). |
The Animal Endocrine Clinic is the only clinic of its kind in the country that specializes in the diagnosis and treatment of cats and dogs with endocrine disorders. Dr. Peterson has set up two NY clinics (Manhattan and Bedford Hills) to service clients from New York City, Long Island, Westchester County, New Jersey and Connecticut.
This Clinic is separated into three divisions: the Endocrine Clinic, dedicated to diagnosing and treating dogs and cats with endocrine disorders; the Hypurrcat treatment center designed for treating hyperthyroid cats with radioactive iodine (I-131); and Nuclear Imaging for Animals, a state-of-the-art medical imaging facility where we use radioactive tracers to perform nuclear scanning (scintigraphy) for diagnosing of thyroid, bone, liver, and kidney diseases in dogs and cats.
The Animal Endocrine Clinic is a referral-only hospital, and does not offer prophylactic or routine care. We can be reached by phone at (212) 362-2650 or (914) 864-1631; by email at info@animalendocrine.com or on the web at www.animalendocrine.com. |
|
|
|
|
