Thyroid function tests during nonthyroidal illness syndrome and recovery in acutely ill dogs.
dog
hypothyroidism
normalization
sick
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
30 Nov 2023
30 Nov 2023
Historique:
received:
01
05
2023
accepted:
13
11
2023
medline:
30
11
2023
pubmed:
30
11
2023
entrez:
30
11
2023
Statut:
aheadofprint
Résumé
Nonthyroidal illness syndrome (NTIS) can result in thyroid function test alterations that mimic hypothyroidism. The duration of NTIS-induced changes in dogs is not well-described. Document alterations in thyroid function tests during NTIS and recovery, and the time necessary for their resolution. From 103 dogs sampled, 25 euthyroid dogs with acute, resolvable illness having a low serum total thyroxine (TT4) concentration on admission were analyzed. Prospective observational study. Serum TT4 concentration was measured in 103 dogs within 4 hours of admission. If below the reference interval (RI), subsequent serum samples were obtained every 24 hours from admission until discharge (acute phase) and at 2 weeks and 4 weeks after discharge (recovery phase). Serum samples were submitted for batch measurement of serum TT4, free thyroxine (fT4), total 3,5,3'-triiodothyronine (TT3), and thyroid-stimulating hormone (TSH) concentrations. In the cohort of dogs analyzed, serum TT4, TT3, and fT4 concentrations were below the RI in 100%, 80%, and 16% at admission; 20%, 80%, and 0% at discharge; 4%, 8%, and 0% at 2 weeks; and 0%, 0%, and 0% at 4 weeks, respectively. Serum TSH concentration was within the RI in 100% at admission and discharge, and above the RI in 4% and 12% at 2 weeks and 4 weeks, respectively. Naturally occurring NTIS in dogs induces alterations in thyroid function tests during acute illness and recovery. Measurement of serum TT4 concentration 2 to 4 weeks after discharge or serum fT4 concentration by ED during illness is recommended for accurate assessment of thyroid function in acutely ill dogs.
Sections du résumé
BACKGROUND
BACKGROUND
Nonthyroidal illness syndrome (NTIS) can result in thyroid function test alterations that mimic hypothyroidism. The duration of NTIS-induced changes in dogs is not well-described.
OBJECTIVES
OBJECTIVE
Document alterations in thyroid function tests during NTIS and recovery, and the time necessary for their resolution.
ANIMALS
METHODS
From 103 dogs sampled, 25 euthyroid dogs with acute, resolvable illness having a low serum total thyroxine (TT4) concentration on admission were analyzed.
METHODS
METHODS
Prospective observational study. Serum TT4 concentration was measured in 103 dogs within 4 hours of admission. If below the reference interval (RI), subsequent serum samples were obtained every 24 hours from admission until discharge (acute phase) and at 2 weeks and 4 weeks after discharge (recovery phase). Serum samples were submitted for batch measurement of serum TT4, free thyroxine (fT4), total 3,5,3'-triiodothyronine (TT3), and thyroid-stimulating hormone (TSH) concentrations.
RESULTS
RESULTS
In the cohort of dogs analyzed, serum TT4, TT3, and fT4 concentrations were below the RI in 100%, 80%, and 16% at admission; 20%, 80%, and 0% at discharge; 4%, 8%, and 0% at 2 weeks; and 0%, 0%, and 0% at 4 weeks, respectively. Serum TSH concentration was within the RI in 100% at admission and discharge, and above the RI in 4% and 12% at 2 weeks and 4 weeks, respectively.
CONCLUSIONS AND CLINICAL IMPORTANCE
CONCLUSIONS
Naturally occurring NTIS in dogs induces alterations in thyroid function tests during acute illness and recovery. Measurement of serum TT4 concentration 2 to 4 weeks after discharge or serum fT4 concentration by ED during illness is recommended for accurate assessment of thyroid function in acutely ill dogs.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : American Kennel Club Canine Health Foundation
ID : 02686-A
Informations de copyright
© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.
Références
Docter R, Krenning EP, de Jong M, Hennemann G. The sick euthyroid syndrome: changes in thyroid hormone serum parameters and hormone metabolism. Clin Endocrinol (Oxf). 1993;39:499-518.
De Groot LJ. Dangerous dogmas in medicine: the nonthyroidal illness syndrome. J Clin Endocrinol Metab. 1999;84:151-164.
Kantrowitz LB, Peterson ME, Melián C, Nichols R. Serum total thyroxine, total triiodothyronine, free thyroxine, and thyrotropin concentrations in dogs with nonthyroidal disease. J Am Vet Med Assoc. 2001;219:765-769.
Mooney CT, Shiel RE, Dixon RM. Thyroid hormone abnormalities and outcome in dogs with non-thyroidal illness. J Small Anim Pract. 2008;49:11-16.
Ramsey IK, Evans H, Herrtage ME. Thyroid-stimulating hormone and total thyroxine concentrations in euthyroid, sick euthyroid and hypothyroid dogs. J Small Anim Pract. 1997;38:540-545.
Peterson ME, Melián C, Nichols R. Measurement of serum total thyroxine, triiodothyronine, free thyroxine, and thyrotropin concentrations for diagnosis of hypothyroidism in dogs. J Am Vet Med Assoc. 1997;211:1396-1402.
Elliott DA, King LG, Zerbe CA. Thyroid hormone concentrations in critically ill canine intensive care patients. J Vet Emerg Crit Care. 1995;5:17-23.
Wiersinga WM, van den Berghe G. Nonthyroidal illness syndrome. In: Braverman LE, ed. Cooper DS: Werner & Ingbar's The Thyroid: A Fundamental and Clinical Text. 10th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:203-217.
Warner MH, Beckett GJ. Mechanisms behind the non-thyroidal illness syndrome: an update. J Endocrinol. 2010;205:1-13.
Bacci V, Schussler GC, Kaplan TB. The relationship between serum triiodothyronine and thyrotropin during systemic illness. J Clin Endocrinol Metab. 1982;54:1229-1235.
Chopra IJ. Simultaneous measurement of free thyroxine and free 3,5,3′-triiodothyronine in undiluted serum by direct equilibrium dialysis/radioimmunoassay: evidence that free triiodothyronine and free thyroxine are normal in many patients with the low triiodothyronine syndrome. Thyroid. 1998;8:249-257.
Surks MI, Hupart KH, Pan C, et al. Normal free thyroxine in critical nonthyroidal illnesses measured by ultrafiltration of undiluted serum and equilibrium dialysis. J Clin Endocrinol Metab. 1988;67:1031-1039.
Hamblin PS, Dyer SA, Mohr VS, et al. Relationship between thyrotropin and thyroxine changes during recovery from severe hypothyroxinemia of critical illness. J Clin Endocrinol Metab. 1986;62:717-722.
Wehmann RE, Gregerman RI, Burns WH, Saral R, Santos GW. Suppression of thyrotropin in the low-thyroxine state of severe nonthyroidal illness. N Engl J Med. 1985;312:546-552.
Schoeman JP, Goddard A, Herrtage ME. Serum cortisol and thyroxine concentrations as predictors of death in critically ill puppies with parvoviral diarrhea. J Am Vet Med Assoc. 2007;231:1534-1539.
Schoeman JP, Herrtage ME. Serum thyrotropin, thyroxine and free thyroxine concentrations as predictors of mortality in critically ill puppies with parvovirus infection: a model for human paediatric critical illness? Microbes Infect. 2008;10:203-207.
van Zyl E, Leisewitz AL, Atkinson BK, et al. Serial changes in the concentration of cortisol and thyroid hormones in Beagle dogs infected with Babesia rossi. Ticks Tick Borne Dis. 2023;14:102107.
Oikonomidis IL, Theodorou K, Papaioannou E, et al. Serial measurement of thyroid hormones in hospitalised dogs with canine parvoviral enteritis: incidence of non-thyroidal illness syndrome and its association with outcome and systemic inflammatory response syndrome. Vet J. 2021;274:105715.
Panciera DL, Ritchey JW, Ward DL. Endotoxin-induced nonthyroidal illness in dogs. Am J Vet Res. 2003;64:229-234.
Saridomichelakis MN, Xenoulis PG, Chatzis MK, et al. Thyroid function in 36 dogs with leishmaniosis due to Leishmania infantum before and during treatment with allopurinol with or without meglumine antimonate. Vet Parasitol. 2013;197:22-28.
Vail DM, Panciera DL, Ogilvie GK. Thyroid hormone concentrations in dogs with chronic weight loss, with special reference to cancer cachexia. J Vet Intern Med. 1994;8:122-127.
Shiel RE, Brennan SF, Omodo-Eluk AJ, Mooney CT. Thyroid hormone concentrations in young, healthy, pretraining greyhounds. Vet Rec. 2007;161:616-619.
Gaughan KR, Bruyette DS. Thyroid function testing in Greyhounds. Am J Vet Res. 2001;62:1130-1133.
Sheerer KN, Couto CG, Marin LM, et al. Haematological and biochemical values in North American Scottish deerhounds. J Small Anim Pract. 2013;54:354-360.
Panakova L, Koch H, Kolb S, Mueller RS. Thyroid testing in Sloughis. J Vet Intern Med. 2008;22:1144-1148.
van Geffen C, Bavegems V, Duchateau L, De Roover K, Daminet S. Serum thyroid hormone concentrations and thyroglobulin antibodies in trained and non-trained healthy whippets. Vet J. 2006;172:135-140.
Seavers A, Snow DH, Mason KV, Malik R. Evaluation of the thyroid status of basenji dogs in Australia. Aust Vet J. 2008;86:429-434.
Daminet S, Ferguson DC. Influence of drugs on thyroid function in dogs. J Vet Intern med. 2003;17:463-472.
Panciera DL, Refsal KR, Sennello KA, Ward DL. Effects of deracoxib and aspirin on serum concentrations of thyroxine, 3,5,3′-triiodothyronine, free thyroxine, and thyroid-stimulating hormone in healthy dogs. Am J Vet Res. 2006;67:599-603.
Daminet S, Croubels S, Duchateau L, et al. Influence of acetylsalicylic acid and ketoprofen on canine thyroid function tests. Vet J. 2003;166:224-232.
Gulikers KP, Panciera DL. Evaluation of the effects of clomipramine on canine thyroid function tests. J Vet Intern Med. 2003;17:44-49.
Boothe DM, Perkins J. Disposition and safety of zonisamide after intravenous and oral single dose and oral multiple dosing in normal hound dogs. J Vet Pharmacol Ther. 2008;31:544-553.
Harper A, Blackwood L, Mason S. Investigation of thyroid function in dogs treated with the tyrosine kinase inhibitor toceranib. Vet Comp Oncol. 2020;18:433-437.
Hume KR, Rizzo VL, Cawley JR, Balkman CE. Effects of toceranib phosphate on the hypothalamic-pituitary-thyroid axis in tumor-bearing dogs. J Vet Intern Med. 2018;32:377-383.
Kenefick SJ, Neiger R. The effect of trilostane treatment on circulating thyroid hormone concentrations in dogs with pituitary-dependent hyperadrenocorticism. J Small Anim Pract. 2008;49:139-143.
Liu PM, Zhang XM, Wu W, Li JM, Tang Y. Comparison of cardiac electrophysiologic effects of experimental hypothyroidism and chronic oral amiodarone administration in dogs. Chin Med J (Engl). 1994;107:375-379.
Wolff EDS, Bilbrough G, Moore G, Guptill L, Scott-Moncrieff JC. Comparison of 2 assays for measuring serum total thyroxine concentration in dogs and cats. J Vet Intern Med. 2020;34:607-615.
Ziglioli V, Panciera DL, Troy GC, Monroe WE, Boes KM, Refsal KR. Effects of levothyroxine administration and withdrawal on the hypothalamic-pituitary-thyroid axis in euthyroid dogs. J Vet Intern Med. 2017;31:705-710.
Panciera DL, MacEwen EG, Atkins CE, Bosu WT, Refsal KR, Nachreiner RF. Thyroid function tests in euthyroid dogs treated with L-thyroxine. Am J Vet Res. 1990;51:22-26.
Braitman LE. Confidence intervals assess both clinical significance and statistical significance. Ann Intern Med. 1991;114:515-517.
Kaptein EM, Kaptein JS, Chang EI, et al. Thyroxine transfer and distribution in critical nonthyroidal illnesses, chronic renal failure, and chronic ethanol abuse. J Clin Endocrinol Metab. 1987;65:606-616.
Vierhapper H, Laggner A, Waldhäusl W, Grubeck-Loebenstein B, Kleinberger G. Impaired secretion of TSH in critically ill patients with ‘low T4-syndrome’. Acta Endocrinol. 1982;101:542-549.
van den Berghe G, de Zegher F, Baxter RC, et al. Neuroendocrinology of prolonged critical illness: effects of exogenous thyrotropin-releasing hormone and its combination with growth hormone secretagogues. J Clin Endocrinol Metab. 1998;83:309-319.
Fliers E, Guldenaar SE, Wiersinga WM, et al. Decreased hypothalamic thyrotropin-releasing hormone gene expression in patients with nonthyroidal illness. J Clin Endocrinol Metab. 1997;82:4032-4036.
Kaptein EM, Robinson WJ, Grieb DA, Nicoloff JT. Peripheral serum thyroxine, triiodothyronine and reverse triiodothyronine kinetics in the low thyroxine state of acute nonthyroidal illness: a noncompartmental analysis. J Clin Invest. 1982;69:526-535.
Vos RA, de Jong M, Bernard BF, Docter R, Krenning EP, Hennemann G. Impaired thyroxine and 3,5,3′-triiodothyronine handling by rat hepatocytes in the presence of serum of patients with nonthyroidal illness. J Clin Endocrinol Metab. 1995;80:2364-2370.
Peeters RP, Wouters PJ, Kaptein E, Van Toor H, Visser TJ, Van den Berghe G. Reduced activation and increased inactivation of thyroid hormone in tissues of critically ill patients. J Clin Endocrinol Metab. 2003;88:3202-3211.
Hennemann G, Docter R, Friesema EC, et al. Plasma membrane transport of thyroid hormones and its role in thyroid hormone metabolism and bioavailability. Endocr Rev. 2001;22:451-476.
Chopra IJ, Huang TS, Beredo A, Solomon DH, Chua Teco GN. Serum thyroid hormone binding inhibitor in nonthyroidal illnesses. Metabolism. 1986;35:152-159.
Wilcox RB, Nelson JC, Tomei RT. Heterogeneity in affinities of serum proteins for thyroxine among patients with non-thyroidal illness as indicated by the serum free thyroxine response to serum dilution. Eur J Endocrinol. 1994;131:9-13.
Bennaim M, Shiel RE, Evans H, Mooney CT. Free thyroxine measurement by analogue immunoassay and equilibrium dialysis in dogs with non-thyroidal illness. Res Vet Sci. 2022;147:37-43.
Wood MA, Panciera DL, Berry SH, Monroe WE, Refsal KR. Influence of isoflurane general anesthesia or anesthesia and surgery on thyroid function tests in dogs. J Vet Intern Med. 2009;23:7-15.
Alipour F, Emami MR, Mohri M. Endocrine and oxidative stress characteristics in different anesthetic methods during pneumoperitoneum in dogs. Comp Clin Pathol. 2018;27:1667-1673.
Sauvé F, Paradis M, Refsal KR, Moreau M, Beauchamp G, Dupuis J. Effects of oral administration of meloxicam, carprofen, and a nutraceutical on thyroid function in dogs with osteoarthritis. Can Vet J. 2003;44:474-479.
Giunti M, Troia R, Battilani M, et al. Retrospective evaluation of circulating thyroid hormones in critically ill dogs with systemic inflammatory response syndrome. J Vet Sci. 2017;18:471-477.