Southern Counties Veterinary Specialists, Hampshire, UK.
Cordoba, Spain.
J Vet Intern Med. 2024 Mar-Apr;38(2):931-941. doi: 10.1111/jvim.16993. Epub 2024 Feb 5.
There is a possibility that an incorrect diagnosis of hypothyroidism could be made in euthyroid dogs, and the prevalence of hypothyroidism in the dog population remains unknown.
To retrospectively assess the percentage of dogs diagnosed with, and treated for, hypothyroidism at first opinion practice which are likely to be hypothyroid and require levothyroxine supplementation.
One hundred two client-owned dogs were included in this study.
The computerized databases of 7 first opinion practices were searched to identify dogs treated with levothyroxine supplementation. Three European College of Veterinary Internal Medicine-Companian Animals (ECVIM-CA) diplomates independently assigned 1 of 4 clinical assessments to each case as follows: confirmed or likely hypothyroid, hypothyroidism suspected but not confirmed, hypothyroidism considered unlikely, and no reason to suspect hypothyroidism. They commented as to whether or not they thought levothyroxine supplementation was appropriate.
The clinical assessments of "confirmed or likely hypothyroid"; "Hypothyroidism suspected but not confirmed"; "Hypothyroidism considered unlikely"; and "No reason to suspect hypothyroidism" was assigned respectively by Clinician 1 to 38.2%, 5.9%, 3.9%, and 52% of cases, by Clinician 2 to 48%, 22.6%, 22.6%, 6.9% of cases, and by Clinician 3 to 55.9%, 11.8%, 13.7% and 18.6%. Clinician 1, Clinician 2, and Clinician 3 considered levothyroxine supplementation not indicated in 58.8%, 52.9%, and 45.1% of cases, respectively.
These results support the concern that hypothyroidism might be overly and incorrectly diagnosed in first opinion practice, and that thyroid function testing should be performed only in those dogs with a high pretest probability of the disease.
在甲状腺功能正常的犬中,可能会出现甲状腺功能减退症的误诊,而犬群中甲状腺功能减退症的患病率尚不清楚。
回顾性评估首次就诊时被诊断为甲状腺功能减退症并接受甲状腺素替代治疗的犬中,哪些犬可能患有甲状腺功能减退症并需要补充左甲状腺素。
本研究纳入了 102 只患犬。
检索了 7 家首次就诊的动物医院的计算机化数据库,以确定接受左甲状腺素替代治疗的犬。3 位欧洲兽医内科学会-小动物专家委员会(ECVIM-CA)认证兽医分别对每例病例进行以下 4 种临床评估中的 1 种评估:确诊或疑似甲状腺功能减退症、疑似但未确诊的甲状腺功能减退症、不太可能发生甲状腺功能减退症、无理由怀疑甲状腺功能减退症。他们还对是否认为补充左甲状腺素是恰当的进行了评价。
临床评估为“确诊或疑似甲状腺功能减退症”、“疑似但未确诊的甲状腺功能减退症”、“不太可能发生甲状腺功能减退症”和“无理由怀疑甲状腺功能减退症”的病例数,由临床医生 1 分别分配给 38.2%、5.9%、3.9%和 52%的病例,由临床医生 2 分配给 48%、22.6%、22.6%和 6.9%的病例,由临床医生 3 分配给 55.9%、11.8%、13.7%和 18.6%的病例。临床医生 1、临床医生 2 和临床医生 3 认为不应给 58.8%、52.9%和 45.1%的病例补充左甲状腺素。
这些结果支持这样一种观点,即在首次就诊时,甲状腺功能减退症可能被过度且不正确地诊断,并且只有那些疾病预测试验概率较高的犬才应进行甲状腺功能检测。