Looney Andrea, Wakshlag Joseph
From the Anesthesia Services, Massachusetts Veterinary Referral Hospital, Woburn, Massachusetts (A.L.); and the Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York (J.W.).
J Am Anim Hosp Assoc. 2017 Mar/Apr;53(2):111-118. doi: 10.5326/JAAHA-MS-6385.
An 8 yr old female spayed golden retriever presented for a routine exam during which ventral cervical soft tissue masses were identified. History included weight loss, increased activity and appetite, gagging, and occasional diarrhea. Exam findings included a body condition score of 4/9 and palpable ventral cervical nodules. A serum thyroxine (T4) value was 8.0 ug/dL (normal = 0.8-3.5ug/dL). Doppler systolic blood pressure readings ranged from 200-210 mmHg (normal systolic blood pressure <150 mmHg). The diagnosis was hyperthyroidism due to active thyroid masses. Due to financial constraints, the owner elected conservative management. Initial treatment with methimazole resulted in a decreased T4 value of 5.0 ug/dL at approximately 4 mo after initiation of treatment. A commercially available iodine-restricted feline diet was fed and this resulted in further reduction in serum T4 levels, improved sleeping cycles, reduced anxiety, and reduced systolic blood pressure. A temporary suspension of iodine-restricted feline diet for 2 mo resulted in increases in serum T4 concentrations, which, subsequently, decreased with re-introduction of the diet. Roughly 10 mo after initiation of the therapeutic diet and 16 mo after intial diagnosis, the dog remains relatively normal clinically despite active growing cervical masses with T4 concentration of 2.3 ug/dL.
一只8岁已绝育的雌性金毛猎犬前来进行常规检查，在此过程中发现颈部腹侧软组织有肿块。病史包括体重减轻、活动量和食欲增加、作呕以及偶尔腹泻。检查结果包括身体状况评分为4/9以及可触及的颈部腹侧结节。血清甲状腺素（T4）值为8.0微克/分升（正常范围 = 0.8 - 3.5微克/分升）。多普勒收缩压读数范围为200 - 210毫米汞柱（正常收缩压<150毫米汞柱）。诊断为由于活跃的甲状腺肿块导致的甲状腺功能亢进。由于经济限制，主人选择保守治疗。用甲巯咪唑进行初始治疗，在开始治疗约4个月后T4值降至5.0微克/分升。喂食市售的低碘猫粮，这导致血清T4水平进一步降低、睡眠周期改善、焦虑减轻以及收缩压降低。低碘猫粮暂停喂食2个月导致血清T4浓度升高，随后随着重新引入该饮食而降低。在开始治疗性饮食约10个月以及初次诊断后16个月，尽管颈部肿块仍在活跃生长，但这只狗的T4浓度为2.3微克/分升，临床上仍相对正常。
