Lee Hayoon, Lee Dohee, Park Jooyoung, Yun Taesik, Koo Yoonhoi, Chae Yeon, Kang Byeong-Teck, Yang Mhan-Pyo, Kim Hakhyun
Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, 28644, South Korea.
Acta Vet Hung. 2023 Jul 31;71(2):96-100. doi: 10.1556/004.2023.00815. Print 2023 Oct 17.
A 16-year-old castrated male Persian cat was presented with weight loss, anorexia and dyspnoea. Tachycardia and tachypnoea were observed upon presentation. The cat was previously diagnosed with hyperthyroidism and left ventricular hypertrophy and received methimazole, but was subsequently not followed up and treated appropriately. Thoracic radiography revealed mild pleural effusion, interstitial lung pattern, moderate cardiomegaly and moderate-to-severe dilation of the pulmonary artery and pulmonary vein. On echocardiography, the left ventricular hypertrophy, identified earlier, shoed partial regression. Therefore, the previous myocardial hypertrophy was diagnosed as a hypertrophic cardiomyopathy phenotype related to hyperthyroidism. ST-segment elevation was identified on electrocardiography, and the thyroid profile examination revealed increased total thyroxine and free thyroxine and decreased thyroid-stimulating hormone levels, suggesting myocardial injury and uncontrolled hyperthyroidism, respectively. In addition, normal N-terminal pro-B-type natriuretic peptide and high cardiac troponin I levels were found. Based on these findings, the observed congestive heart failure was considered as a sequel of myocardial injury caused by uncontrolled hyperthyroidism. Clinical signs resolved after intravenous administration of furosemide and butorphanol, oxygen supply and thoracocentesis. Furosemide and pimobendan were additionally administered, and the cat was discharged. This case demonstrates that myocardial damage due to chronic uncontrolled hyperthyroidism may cause heart failure in cats.
一只16岁去势雄性波斯猫出现体重减轻、厌食和呼吸困难症状。就诊时观察到心动过速和呼吸急促。该猫先前被诊断为甲状腺功能亢进和左心室肥厚，并接受过甲巯咪唑治疗，但随后未得到适当的随访和治疗。胸部X线检查显示轻度胸腔积液、间质肺纹理、中度心脏肥大以及肺动脉和肺静脉中度至重度扩张。超声心动图检查显示，先前发现的左心室肥厚有部分消退。因此，先前的心肌肥厚被诊断为与甲状腺功能亢进相关的肥厚型心肌病表型。心电图检查发现ST段抬高，甲状腺功能检查显示总甲状腺素和游离甲状腺素升高，促甲状腺激素水平降低，分别提示心肌损伤和未控制的甲状腺功能亢进。此外，还发现N末端脑钠肽前体水平正常而心肌肌钙蛋白I水平升高。基于这些发现，观察到的充血性心力衰竭被认为是未控制的甲状腺功能亢进导致心肌损伤的后遗症。静脉注射呋塞米和布托啡诺、供氧和胸腔穿刺后，临床症状得到缓解。另外给予了呋塞米和匹莫苯丹，该猫出院。本病例表明，慢性未控制的甲状腺功能亢进引起的心肌损伤可能导致猫的心衰。
