Kopecny Lucy, Higgs Paul, Hibbert Angie, Malik Richard, Harvey Andrea M
1 Small Animal Specialist Hospital, Sydney, Australia.
2 Eastcott Veterinary Referrals, Swindon, UK.
J Feline Med Surg. 2017 Jun;19(6):559-567. doi: 10.1177/1098612X16634392. Epub 2016 Mar 10.
Objectives This study sought to evaluate how Australian veterinarians approach management and monitoring of feline hyperthyroidism and compare these results with a similar survey recently performed in the UK. Methods An invitation to complete an online survey was sent to veterinarians in all states and territories of Australia. The survey comprised questions relating to management of hyperthyroidism, use of antithyroid drugs vs radioiodine treatment vs surgical thyroidectomy, in addition to demographic information for respondents. Results A total of 546 clinicians completed the survey. The most commonly preferred treatments for long-term management of feline hyperthyroidism were antithyroid medications (305/546; 56%) and radioiodine (210/546; 38%), with substantially more respondents selecting radioiodine when cost was removed as a consideration (425/546; 78%). However, most respondents had treated or referred few cases for radioiodine (median 2). Most veterinarians (500/546; 92%) used antithyroid medications either long term or prior to definitive treatment of hyperthyroidism. For medical management, 45% (244/546) of veterinarians used twice-daily carbimazole. Half of respondents (274/546) aimed to maintain the total thyroxine concentration anywhere within the laboratory reference interval in hyperthyroid cats without chronic kidney disease. Blood pressure monitoring was uncommon. Surgical thyroidectomy was rarely performed. Conclusions and relevance Radioiodine was more frequently preferred by Australian veterinarians compared with those in the UK, likely associated with greater availability, reduced cost and shorter hospitalisation times in this jurisdiction, although antithyroid medications were the most frequently used treatment modality. Barriers remain to its utilisation, however, including perceived cost, misconceptions with regard to expected success rate and accessibility. Recent changes to recommendations on the management and monitoring of hyperthyroid cats do not appear to have been widely adopted by veterinarians at this time.
目的 本研究旨在评估澳大利亚兽医如何处理猫甲状腺功能亢进的管理和监测，并将这些结果与最近在英国进行的类似调查结果进行比较。方法 向澳大利亚所有州和领地的兽医发送了一份完成在线调查的邀请。该调查包括与甲状腺功能亢进管理、抗甲状腺药物与放射性碘治疗与手术甲状腺切除术的使用相关的问题，以及受访者的人口统计学信息。结果 共有546名临床医生完成了调查。猫甲状腺功能亢进长期管理最常用的治疗方法是抗甲状腺药物（305/546；56%）和放射性碘（210/546；38%），当不考虑成本时，选择放射性碘的受访者大幅增加（425/546；78%）。然而，大多数受访者治疗或转诊的放射性碘病例很少（中位数为2）。大多数兽医（500/546；92%）长期或在甲状腺功能亢进的确定性治疗之前使用抗甲状腺药物。对于药物管理，45%（244/546）的兽医使用每日两次的卡比马唑。一半的受访者（274/546）旨在将无慢性肾病的甲状腺功能亢进猫的总甲状腺素浓度维持在实验室参考区间内的任何水平。血压监测并不常见。手术甲状腺切除术很少进行。结论及相关性 与英国兽医相比，澳大利亚兽医更常选择放射性碘，这可能与该辖区放射性碘供应更多、成本降低和住院时间缩短有关，尽管抗甲状腺药物是最常用的治疗方式。然而，其使用仍存在障碍，包括感知成本、对预期成功率和可及性的误解。目前关于甲状腺功能亢进猫管理和监测的建议的近期变化似乎尚未被兽医广泛采用。
