Mary Allen
Feline hyperthyroidism (FHT) na ɗaya daga cikin cututtukan da aka fi sani da tsofaffin kuliyoyi. Ganewa da magani ba su da sauƙi, amma jiyya da warkarwa suna yiwuwa.
Kimanin kashi 20% na kuliyoyi sama da shekaru goma ana bincikar su da aikin thyroid. Duk da haka, dole ne mu ɗauka cewa babu wani adadin kuliyoyi marasa lafiya da ba a iya ganewa ba. A cikin kuliyoyi tare da hyperthyroidism, wanda aka fi sani da hyperthyroidism na feline (FHT), ƙwayar thyroid mai cututtuka yana samar da ƙarin hormones kuma ya sake su cikin jini kamar T4 (thyroxine) da T3 (triiodothyronine).
An san cutar kawai tana shafar kuliyoyi tun 1979. An yi bincike da lura da yawa tun daga lokacin. Yawancin karatu sun sarrafa lambobin shari'o'i, bayanan dakin gwaje-gwaje, da nasarorin farfadowa, ta yadda a yau, shekaru 40 kawai daga baya, mun riga mun nuna babban ilimin tushen shaida game da wannan sabuwar cuta.
Shin cuta ce ta cikin gida da aka fi sani ko kuma cutar da ta fi yawa a cikin tsofaffin kuliyoyi? Hyperthyroidism ana haifar da shi a mafi yawan lokuta ta ƙwayoyin tumor mara kyau, wanda aka sani da aiki adenoma (adenoma = benign ƙari na glandular nama), sel wanda yawanci ana tsara su cikin nodules 2-20 mm a girman. Da wuya, a cikin kusan kashi 2% na lokuta, muna kuma samun adenocarcinoma a cikin glandar thyroid, mummunan nau'in hyperthyroidism. Yiwuwar ciwon daji yana ƙaruwa tare da tsawon lokacin jiyya na miyagun ƙwayoyi; bayan shekaru hudu kashi 20 ne.
A cikin 70-75% na lokuta, ana iya samun canje-canje a cikin duka thyroids. Kashi 20% na kuliyoyi marasa lafiya suna da ƙwayoyin ƙari ba kawai a cikin thyroid ba har ma da ectopically, i. H. a wani wuri, yawanci mediastinal a cikin thorax.
Bincike da gudanarwa
Sau da yawa ana gano hyperthyroidism na feline a lokacin gwajin jini na yau da kullun saboda alamun farko na cutar ba takamaiman ba ne. Idan cutar ta fi ci gaba, cat yana nuna alamun bayyanar cututtuka irin su asarar nauyi duk da karuwar yawan abinci, karuwar ƙishirwa, ko ciwon ciki.
Alamun gargajiya na FHT dangane da matakin cuta:
- nauyi asara
- Polyphagia (ƙaramar cin abinci)
- Polyuria (PU, ƙara yawan fitowar fitsari)
- Polydipsia (PD, ƙara yawan shan ruwa)
- Jawo mara nauyi
- gwaninta
- rashin natsuwa
- tashin hankali
- Tachycardia (ƙarin bugun zuciya) / tachypnea (ƙarin yawan numfashi)
- amai/zawo
- Rashin sha'awa, rashin ci, gajiya
Masu cat sukan yi kuskuren canje-canjen da ke da alaƙa da aikin thyroid a matsayin alamun tsufa na yau da kullun don haka kawai su ɗauki kyanwar su ga likitan dabbobi lokacin da cutar ta kasance cikin ci gaba. Marasa lafiya sau da yawa sun riga sun rasa 10-20% na nauyin jikinsu da ƙwayar tsoka.
Ana yin bincike tare da gwajin jini. T4 (thyroxine) ana auna shi akai-akai. Ƙaddamar da maganin T4 yana da hankali na 90% da ƙayyadaddun 100%, wanda ke nufin cewa ana iya amfani da shi sosai don tabbatar da ganewar asali. Kewayon tunani ya dogara da na'urar dakin gwaje-gwaje kuma koyaushe ana haɗa shi cikin rahotanni. Ƙara yawan maida hankali na wannan hormone a cikin jini dangane da daidaitattun alamun asibiti yana haifar da tabbacin ganewar asali. Sauran canje-canjen jini na iya haɗawa da ƙarar ALT (alanine aminotransferase) da ƙarar alkaline phosphatase.
A cikin cututtukan da ba a taɓa gani ba, ana iya gano haɓakar thyroid a wasu lokuta ta hanyar palpation da kwatanta zuwa wancan gefe. Koyaya, kuliyoyi da yawa ba na al'ada ba ne akan palpation kuma suna da ƙimar T4 sama da kewayon tunani. Koyaya, idan alamun asibiti sun nuna hyperthyroidism, yakamata a sake gwada waɗannan kuliyoyi a cikin makonni 2-4. Bugu da ƙari, ya kamata a cire wasu cututtuka masu irin wannan bayyanar cututtuka.
Sauran sanannun gwaje-gwajen gwaje-gwaje na thyroid kamar ƙaddarar T4 kyauta a cikin daidaitattun daidaito, gwaje-gwajen TSH, gwajin gwagwarmayar T3, da gwaje-gwajen motsa jiki na TSH / TRH ko dai ba zai yiwu ba don cat ba ya ƙara wani darajar ga ganewar asali.
Cats tare da alamun asibiti da ƙimar T4 a cikin babban rabi na kewayon tunani yakamata a rarraba su kuma a bi da su azaman hyperthyroid. Hakanan ya shafi kuliyoyi waɗanda basu (har yanzu) suna nuna alamun alamun gargajiya amma sun nuna ƙimar T4 sama da kewayon tunani a cikin ma'auni biyu. Cututtuka masu kama da FHT sun haɗa da:
- ciwon sukari mellitus,
- gastrointestinal malabsorption / maldigestion,
- gastrointestinal neoplasia, misali B. lymphoma alimentary.
Bayyana yiwuwar kamuwa da cututtuka
Maganin hyperthyroid sun kasance masu matsakaicin shekaru zuwa tsufa kuma saboda haka suna da haɗari ga wasu cututtuka na geriatric. Ya kamata waɗannan marasa lafiya su sami magani don FHT da sauran cututtuka kuma a kula da su akai-akai. Cututtuka masu zuwa yawanci suna da alaƙa da FHT:
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cututtukan zuciya,
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hawan jini,
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cututtuka na retinal,
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Ciwon koda na kullum (CKD),
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cututtukan gastrointestinal, rashi cobalamin, malabsorption,
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insulin juriya,
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pancreatitis.
Don samun cikakken hoto game da yanayin kyanwar da abin ya shafa, gwaje-gwajen dakin gwaje-gwaje, ma'aunin hawan jini, gwajin ido, hasken x-ray/ duban dan tayi, kuma - ya danganta da alamun - ya kamata a gudanar da wasu gwaje-gwajen biyo baya.
Gwaje-gwaje don FHT da ake zargi ya dogara da ƙarin binciken
- Gwajin jini T4
- Gwajin jini na jini
- Gwajin jini na sinadarai na asibiti (esp. ƙimar koda, ƙimar hanta, glucose, fructosamine)
- Urinalysis (takamaiman nauyi, furotin creatinine rabo / UPC)
- ga alamun gastrointestinal kuma Spec.PL (pancreas-specific lipase) da cobalamin
- Palpation na thyroid gland shine yake da ciki
- auna jini
- Auscultation zuciya, kirji X-ray
- echocardiography
- ciki duban dan tayi
- Jarabawar ido/retinal
- Yiwuwar scintigraphy
yanke shawara na far
Bayan da aka ƙirƙiri cikakken hoto na mai haƙuri, shawarar farfesa ta biyo baya. Manufar farko ita ce kwanciyar hankali, saboda kuliyoyi sau da yawa suna da rashin ƙarfi, rashin jin daɗi, kuma an gabatar da su tare da cututtuka na ciki. Mummunan rikitarwa na hyperthyroidism shine m ko na kullum pancreatitis. Cats da abin ya shafa suna buƙatar magani na IV da kuma alamun bayyanar cututtuka har sai sun sake ciyar da kansu. Shigar da bututun ciyarwa zai iya tallafawa maganin.
Mataki na gaba shine a mayar da yanayin euthyroid da sauri, i. H. yanayin da matakin T4 a cikin jini yana cikin ƙananan rabin kewayon tunani. Bincika na farko bayan fara maganin miyagun ƙwayoyi yana faruwa makonni biyu zuwa uku bayan haka. Yakamata a rika duba kimar koda yayin wannan binciken. Hyperthyroidism na iya rufe CKD (cututtukan koda na yau da kullun) ta hanyar rage ƙimar koda ta hanyar ƙara yawan ƙwayar koda da ƙara yawan ruwa. Bugu da ƙari, saboda asarar ƙwayar tsoka a cikin dabbobin da aka shafa, creatinine yana da ƙananan ƙananan kuma ba za a iya gano CKD da ke yanzu ba. A cikin waɗannan kuliyoyi, bayan nasarar farawar jiyya da matakan hormone thyroid na al'ada, CKD yana bayyana azaman sakamako mai illa na miyagun ƙwayoyi. Yakamata a sanar da masu cat a lokacin zaman jiyya na farko cewa hakan na iya faruwa saboda akwai yuwuwar cewa cat ɗinsu ya riga ya kamu da cutar koda da ba a iya ganewa.
Sabanin sauran shawarwari, kuliyoyi masu CKD da aka sani da azotemia (yawan urea a cikin jini) akan maganin thyroid yakamata a bi da su koyaushe kamar yadda kuliyoyi masu lafiya kodan. Manufar dole ne a kula da cat's T4 a ƙasa da tsakiyar kewayon tunani. Ƙoƙarin kiyaye matakan koda ta hanyar barin cat "kadan hyperthyroid" daga rashin jiyya na FHT yana ba mu ma'anar tsaro ta ƙarya. Sabanin haka, haɓakar T4 yana haifar da kunna tsarin renin-angiotensin-aldosterone (RAAS) wanda ke haifar da ƙara yawan fitarwar zuciya, haɓakar ƙarar, riƙewar sodium, hauhawar jini na koda, da glomerular sclerotherapy, a ƙarshe yana haifar da ci gaban CKD da tabarbarewar yanayin. . Duk da haka, dole ne a gudanar da gwaje-gwaje akai-akai don kauce wa iatrogenic (likita ta haifar da hypothyroidism) a kowane farashi.
Kusan ɗaya cikin kuliyoyi biyar tare da thyroid mai yawan aiki shima yana da haɓakar BI. Wannan karuwar hawan jini na iya faruwa ta hanyar FHT kuma magance shi na iya mayar da hawan jini zuwa al'ada. Duban hawan jini yayin kula da maganin hyperthyroidism yana da mahimmanci don ganowa da kuma kula da hauhawar jini wanda ba FHT ba. Hakanan gaskiya ne ga alamun cututtukan zuciya, waɗanda ke da alaƙa da FHT kuma yana iya haɓakawa tare da dakatarwar euthyroid. Duk da haka, ya kamata a gudanar da gwajin echocardiographic a cikin waɗannan lokuta.
Zaɓuɓɓukan warkewa
FHT yanayi ne mai barazanar rai kuma dole ne a bi da shi don kafa yanayin euthyroid a cikin cat. Magani, abinci, tiyata, da kuma radioiodine farfadowa ana samun magani.
magani
Abubuwan da ke aiki methimazole an yarda da su don kuliyoyi azaman kwamfutar hannu kuma azaman bayani mai daɗi da za a ba su sau biyu a rana. Carbimazole, kuma an yarda da kuliyoyi, an daidaita shi zuwa methimazole a cikin jiki kuma yana da tasiri iri ɗaya. Dukansu suna toshe thyroid peroxidase kuma don haka rage biosynthesis na thyroid hormones.
Jiyya tare da waɗannan wakilai na iya zama tsawon rai ko na ɗan lokaci don daidaita cat ɗin da ke jiran tiyata ko maganin radioiodine. A cikin kusan 18% na duk marasa lafiya, duk da haka, methimazole ko carbimazole yana haifar da sakamako masu illa. Wannan na iya zama:
- anorexia
- aman
- pruritus da excoriations a kan fuska
- kasala
- hepatopathies, jaundice
- ƙãra hali na zubar jini
Wadannan illolin na iya faruwa nan da nan ko kuma bayan gudanarwa na wata daya zuwa biyu. Amai da asarar ci yawanci sun dogara da kashi kuma suna ɓacewa bayan rage kashi. Idan akwai wani sakamako masu illa, yakamata a daina maganin nan da nan kuma a yi la'akari da wasu zaɓuɓɓukan magani.
Lokacin daidaitawa zuwa maganin thyroid, dole ne a sanar da mai mallakar cat daki-daki. Abubuwan da ke aiki na iya samun tasirin teratogenic (masu haifar da lahani) a cikin mutane, wanda shine dalilin da ya sa yana da kyau a sanya safar hannu yayin sarrafa su kuma dole ne a raba allunan. Gudanarwa tare da abin da ake kira "aljihuna kwaya" ko "trojans" wanda zaku iya ɓoye kwayoyin cutar shine kyakkyawan ra'ayi. Maganin methimazole yana da daɗi sosai kuma yawancin kuliyoyi sun yarda da shi.
Wani madadin da har yanzu ba a yarda da kuliyoyi ba a Jamus shine gel na methimazole wanda ke ba da damar abun da ke aiki don ɗaukar transdermally. Anan ma, dole ne a sa safar hannu yayin aikace-aikacen. Ga kuliyoyi waɗanda ke buƙatar babban kashi, adadin gel ɗin da za a yi amfani da shi yana da girma sosai. Amma wannan aikace-aikacen miyagun ƙwayoyi yana da jurewa da kyan gani da yawa.
Duban matakin jini na T4 kuma, idan ya cancanta, ana ba da shawarar sauran sigogi bayan makonni uku, shida, goma, da 20. Ko da majiyyata masu tsattsauran ra'ayi yakamata a gwada jini kowane mako 12 saboda FHT cuta ce ta ƙari kuma tana iya yin muni tare da haɓakar ƙari, sa'an nan dole ne a daidaita adadin.
Wata matsala tare da maganin miyagun ƙwayoyi shine bin mai mallakar. Abin takaici, alamun ba su daɗaɗa nan da nan bayan dakatar da allunan, amma kawai a hankali tsarin cututtuka. Mu sau da yawa kawai muna sake ganin kuliyoyi lokacin da yanayin ya kasance mai ban mamaki ga barazanar rai.
abinci
Abincin abinci shine kyakkyawan zaɓi na warkewa ga kuliyoyi waɗanda ke zaune su kaɗai da cikin gida. Tasirin ya dogara ne akan abincin da aka rage abun ciki na aidin zuwa mafi ƙarancin buƙata. Tun da glandon thyroid ba zai iya haɗa hormones na thyroid ba tare da aidin a matsayin tushen ginin ginin ba, ana rage yawan samarwa. Duk da haka, dole ne a tabbatar da cewa cat ba shi da wata hanyar abinci da za ta iya cinye iodine.
tiyata
Cire thyroid gland shine mafi sauƙi amma ba mafi kyawun zaɓi don magance FHT ba. Zai iya zama da amfani idan gefe ɗaya kawai ya shafi kuma idan babu ectopic thyroid nama a wuraren da ba za a iya isa ba, misali B. a cikin thorax. Ko da a baya maɗaukakin darajar T4 sun riga sun kasance cikin kewayon al'ada a ranar bayan aikin. Abin takaici, adenoma na thyroid suna yadawa zuwa bangarorin biyu, wanda ke haifar da sake dawowa lokacin da ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar ƙwayar cuta ta fara girma. Cire dukkanin glandon thyroid ba shine hanyar da za a zaba ba saboda, da farko, akwai haɗarin cewa ƙananan ƙwayoyin parathyroid (jikin epithelial ko glandon parathyroid) sun kasance a cikin jiki, wanda ke haifar da rashin lafiyar parathyroid hormone.
radioiodine far
Ma'aunin zinare a cikin jiyya na FHT shine maganin radioiodine. Shi ne kawai zaɓin da ke kaiwa ga waraka. A mafi yawan lokuta, magani guda ɗaya ya isa kuma kusan kashi 95% na kuliyoyi da aka yi musu magani suna da lafiya ga rayuwa. Iodin rediyoaktif yana tarawa a cikin ƙwayoyin thyroid. Yana maida hankali kusan keɓanta akan ƙwayoyin ƙari masu aiki da yawa kuma yana lalata su. Babu maganin sa barci ya zama dole don maganin. Lalacewar wannan farfagandar ita ce tsawon lokacin da ake buƙata na asibiti, wanda, duk da haka, ya bambanta sosai daga wuri zuwa wuri (aƙalla kwanaki huɗu, har zuwa makonni huɗu, kuma ya danganta da majalisar dokoki, misali kwanaki goma a asibitin dabbobi na Norderstedt). A wannan lokacin, ba a yarda a ziyarci kyanwa ba. Wani hasara kuma shi ne cewa ba a samun wannan nau'in magani a ko'ina. Akwai maganganu daban-daban dangane da farashin: maganin radioiodine yana da tsada kamar maganin miyagun ƙwayoyi gami da gwajin jini da ake buƙata a kowace shekara ko fiye da sauran tsawon rayuwa. Kamar yadda bincike ya nuna, tsawon rayuwa bayan maganin radioiodine ya ninka na kuliyoyi da methimazole sau biyu.
summary
Yana da mahimmanci don ilmantar da mai shi da haɓaka tsarin jiyya ɗaya. Jindadin dabbobi shine mafi mahimmanci. Manufar ita ce samun matakan T4 a cikin ƙananan rabin kewayon tunani kuma ajiye su a can. Sauran cututtuka irin su CKD, cardiomyopathies, hawan jini, da dai sauransu ya kamata a yi amfani da su kuma a sanya su cikin kulawa akai-akai. Wannan saka idanu yana da mahimmanci saboda cututtukan geriatric, musamman cutar kumburi FHT, suna ƙarƙashin ci gaba, kuma dole ne a daidaita ka'idojin jiyya don kula da ingancin rayuwar mai haƙuri.
Tambayoyin Tambaya
Yaya cat mai aikin thyroid ke aiki?
Alamun alamomin aikin thyroid a cikin kuliyoyi shine rashin natsuwa. Yawan aiki. Ciwon kai (polyphagia).
Har yaushe cat mai aikin thyroid zai iya rayuwa?
Ma'auni na zinariya a cikin jiyya na FHT shine maganin radioiodine. Shi ne kawai zaɓin da ke kaiwa ga waraka. A mafi yawan lokuta, magani guda ɗaya ya isa kuma kusan kashi 95% na kuliyoyi da aka yi musu magani suna da lafiya ga rayuwa.
Yaya za ku san idan cat yana shan wahala?
Ja da baya, taushin taɓawa, tashin hankali, murƙushe matsayi, ko rame yana nuna dabbar tana shan wahala. Baya ga hali, kuna iya neman wasu alamomin da za su ba da cikakkiyar alamar dalilin da yasa cat ɗin ku ke shan wahala.
Abin da za a ciyar da kuliyoyi tare da aikin thyroid?
Cats masu ciwon thyroid kawai yakamata a ciyar da Hills Feline y/d, saboda babban abun ciki na iodine na sauran ciyarwar yana hana tasirin jiyya.
Menene magani don hyperthyroidism a cikin kuliyoyi?
Jiyya don hyperthyroidism koyaushe yana farawa tare da gudanar da allunan da ke ɗauke da sinadarai masu aiki thiamazole da carbimazole. Wadannan ana gudanar da su mafi kyau sau biyu a rana kuma suna hana samar da hormones na thyroid, mafi girma da kashi, ƙananan samarwa.
Menene taimaka hyperthyroidism a cikin cats?
Hyperthyroidism a cikin kuliyoyi za a iya bi da su tare da kwayoyi. Magunguna guda biyu "Thiamazol" da "Carbimazole" suna rage samar da hormones na thyroid. Wannan yana daidaita yawan matakan hormone a cikin jini. Ya kamata a ba da kashi sau biyu a rana.
Cat zai iya yin kuka?
Kamar mutane, kuliyoyi na iya yin kuka kuma suna jin motsin rai. Duk da haka, babu wata alaƙa tsakanin hawaye da jin dadi, saboda cats suna bayyana motsin zuciyar su daban.
Yaya kyanwa ke yin sauti lokacin da yake kuka?
Kukan Acoustic: mewing meowing, ko ihu. Ragewar ɗalibai. Saurin jujjuyawa da fizgar wutsiya.