Brown Kaitlin, Williams Louie Elizabeth, Pinn-Woodcock Toby, Pearson Erin, Pearson Garett B, Marr Jacqueline, Hackett Eileen S, Rath Brown Laura, Mitchell Katharyn J
Department of Clinical Sciences, Cornell University, Ithaca, NY 14850, USA.
New Hampshire Veterinary Diagnostic Laboratory, University of New Hampshire, Durham, NH 03824, USA.
Animals (Basel). 2024 Jun 1;14(11):1660. doi: 10.3390/ani14111660.
Primary hyperthyroidism is a rarely diagnosed endocrinopathy in equids and there have been no previous reports of structural and functional cardiac changes associated with hyperthyroidism in these species. This case report investigates a 20-year-old mule gelding that presented for a three-month history of thin body condition despite polyphagia, with a heart murmur and elevated free and total thyroid hormone concentrations. On presentation, physical exam revealed a body condition score of two out of nine, persistent tachycardia, pansystolic heart murmur and firm bilateral ventral proximal cervical masses. Bloodwork confirmed markedly elevated free T4, total T4 and T3 concentrations. Echocardiogram demonstrated left ventricular concentric hypertrophy with increased ventricular and atrial systolic function. Bilateral thyroidectomy was performed under standing sedation without complications. Histopathology demonstrated adenocarcinoma of the left thyroid gland and multiple adenomas with osseous metaplasia within the right thyroid. The mule was supplemented with levothyroxine sodium two weeks post-op after a thyroid panel demonstrated undetectable concentrations. Polyphagia resolved following surgery and the mule began gaining weight. Echocardiographic changes improved but did not resolve at two years post-operative. Continued bi-annual follow up and monitoring of thyroid levels was recommended. This case represents the first documentation of hemodynamically relevant cardiac remodeling in an equid associated with primary hyperthyroidism.
原发性甲状腺功能亢进是马属动物中一种罕见的内分泌疾病，此前尚无关于这些物种中与甲状腺功能亢进相关的心脏结构和功能变化的报道。本病例报告研究了一匹20岁的雄性骡子，该骡子尽管食欲亢进，但身体状况消瘦已有三个月病史，伴有心脏杂音以及游离甲状腺激素和总甲状腺激素浓度升高。就诊时，体格检查显示身体状况评分为九分制中的两分，持续心动过速，全收缩期心脏杂音以及双侧颈部近端腹侧有坚实肿块。血液检查证实游离T4、总T4和T3浓度明显升高。超声心动图显示左心室向心性肥厚，心室和心房收缩功能增强。在站立镇静下进行了双侧甲状腺切除术，无并发症。组织病理学显示左甲状腺腺癌，右甲状腺内有多个伴有骨化生的腺瘤。术后两周，在甲状腺功能检查显示甲状腺激素浓度无法检测到时，给骡子补充了左甲状腺素钠。术后食欲亢进症状消失，骡子开始体重增加。术后两年，超声心动图变化有所改善，但未完全恢复。建议继续每半年进行随访并监测甲状腺水平。本病例是马属动物中与原发性甲状腺功能亢进相关的血流动力学相关心脏重塑的首次记录。
