Mary Allen
Feline hyperthyroidism (FHT) yog ib yam kab mob uas tshwm sim hauv cov miv laus. Kev kuaj mob thiab kev kho mob tsis yooj yim, tab sis kev kho thiab kho tau zoo.
Kwv yees li 20% ntawm cov miv uas muaj hnub nyoog kaum xyoo raug kuaj pom tias muaj cov thyroid ua haujlwm ntau dhau. Txawm li cas los xij, peb yuav tsum xav tias tsis muaj qhov tsis txaus ntseeg ntawm cov miv uas tsis muaj kab mob. Hauv miv nrog hyperthyroidism, tseem hu ua feline hyperthyroidism (FHT), cov kab mob thyroid cov ntaub so ntswg tsim ntau cov tshuaj hormones thiab tso tawm rau hauv cov hlab ntsha li T4 (thyroxine) thiab T3 (triiodothyronine).
Tus kab mob tsuas yog paub tias cuam tshuam rau miv txij li xyoo 1979. Ntau qhov kev tshawb fawb thiab kev soj ntsuam tau tsim txij thaum ntawd los. Cov kev tshawb fawb suav tsis txheeb tau ua tiav cov lej, cov ntaub ntawv hauv chav kuaj, thiab kev kho mob ua tiav, yog li niaj hnub no, tsuas yog 40 xyoo tom qab, peb tuaj yeem nthuav qhia ntau yam pov thawj-raws li kev paub txog tus kabmob tshiab no.
Puas yog cov kab mob uas muaj ntau tshaj plaws hauv cov miv lossis cov qog nqaij hlav tshaj plaws hauv cov miv? Hyperthyroidism yog tshwm sim nyob rau hauv feem ntau ntawm cov neeg mob los ntawm benign qog hlwb, hu ua ib tug haumxeeb qog adenoma (adenoma = benign qog ntawm cov qog nqaij hlav), cov hlwb uas feem ntau tau teeb tsa rau hauv cov nodules 2-20 mm loj. Tsis tshua muaj, nyob rau hauv kwv yees li 2% ntawm cov neeg mob, peb kuj pom adenocarcinomas nyob rau hauv cov thyroid caj pas, malignant daim ntawv ntawm hyperthyroidism. Qhov tshwm sim ntawm carcinoma nce nrog lub sijhawm ntawm kev kho tshuaj; Tom qab plaub xyoos nws yog 20%.
Hauv 70-75% ntawm cov neeg mob, kev hloov pauv tuaj yeem pom hauv ob lub thyroids. 20% ntawm cov miv mob muaj cov qog hlwb tsis yog hauv cov thyroid nkaus xwb tab sis kuj ectopically, i. H. lwm qhov, feem ntau yog mediastinal hauv lub thorax.
Kev kuaj mob thiab kev tswj xyuas
Thaum ntxov feline hyperthyroidism feem ntau kuaj pom thaum lub sij hawm niaj hnub kuaj ntshav vim tias cov tsos mob thaum ntxov ntawm tus kab mob no tsis yog tshwj xeeb. Yog tias tus kab mob siab dua, tus miv pom cov tsos mob xws li poob phaus txawm tias muaj kev noj zaub mov ntau ntxiv, nqhis dej ntau, lossis mob plab.
Cov tsos mob classic ntawm FHT nyob ntawm theem kab mob:
- poob phaus
- Polyphagia (kev noj zaub mov ntau ntxiv)
- Polyuria (PU, nce zis tso zis)
- Polydipsia (PD, haus dej ntau ntxiv)
- plua plav
- suab
- nyob tsis tswm
- txhoj puab heev
- tachycardia (ntau lub plawv dhia) / tachypnea (ua pa nce ntxiv)
- ntuav / raws plab
- Apathy, poob qab los noj mov, lethargy
Cov tswv miv feem ntau yuam kev cov kev hloov pauv uas cuam tshuam nrog cov thyroid ua haujlwm dhau los ua ib qho cim ntawm kev laus thiab yog li tsuas yog coj lawv tus menyuam mus rau tus tsiaj thaum tus kab mob nyob rau theem siab. Cov neeg mob feem ntau twb poob 10-20% ntawm lawv lub cev qhov hnyav thiab cov leeg nqaij.
Kev kuaj ntshav yog tsim los ntawm kev kuaj ntshav. T4 (thyroxine) yog ntsuas txhua hnub. Kev txiav txim siab ntawm cov ntshav T4 muaj qhov rhiab heev ntawm 90% thiab qhov tshwj xeeb ntawm 100%, uas txhais tau hais tias nws tuaj yeem siv tau zoo heev kom paub meej qhov kev kuaj mob. Qhov kev siv ntau yog nyob ntawm cov cuab yeej kuaj thiab ib txwm suav nrog hauv cov ntawv ceeb toom. Kev nce hauv qhov concentration ntawm cov tshuaj hormones no hauv cov ntshav hauv kev sib txuas nrog cov tsos mob sib xws ua rau muaj kev kuaj pom tseeb. Lwm cov kev hloov ntshav yuav suav nrog nce ALT (alanine aminotransferase) thiab nce alkaline phosphatase.
Hauv cov kab mob unilateral, cov thyroid loj tuaj yeem kuaj pom los ntawm palpation thiab sib piv rau lwm sab. Txawm li cas los xij, ntau tus miv tsis yog qhov txawv txav ntawm palpation lossis tsis muaj T4 qhov tseem ceeb tshaj qhov kev siv ntau yam. Txawm li cas los xij, yog tias cov tsos mob tshwm sim qhia tias hyperthyroidism, cov miv no yuav tsum rov kuaj dua hauv 2-4 lub lis piam. Tsis tas li ntawd, lwm yam kab mob uas muaj cov tsos mob zoo sib xws yuav tsum raug cais tawm.
Lwm qhov kev kuaj mob qog noj ntshav uas paub zoo xws li kev txiav txim siab ntawm T4 dawb hauv kev sib npaug ntawm kev lim ntshav, TSH kuaj, T3 kev sim tshuaj tiv thaiv, thiab kev kuaj TSH / TRH stimulation yog tsis tuaj yeem ua rau tus miv tsis ntxiv ib qho txiaj ntsig rau kev kuaj mob.
Cov miv uas muaj cov tsos mob thiab T4 qhov tseem ceeb nyob rau hauv ib nrab ntawm cov ntaub ntawv siv yuav tsum tau muab cais thiab kho raws li hyperthyroid. Tib yam siv rau cov miv uas tsis tau (tsis tau) qhia cov tsos mob classic tab sis pom T4 qhov tseem ceeb tshaj qhov kev siv ntau yam hauv ob qhov kev ntsuas. Cov kab mob uas muaj cov tsos mob zoo ib yam li FHT suav nrog:
- ntshav qab zib mellitus,
- plab hnyuv malabsorption/maldigestion,
- gastrointestinal neoplasia, xws li B. alimentary lymphoma.
Qhia meej cov kab mob sib kis
Cov miv hyperthyroid zoo li cov hnub nyoog nruab nrab mus rau cov hnub nyoog siab tshaj thiab yog li ntawd kuj muaj lwm yam kab mob geriatric. Cov neeg mob no yuav tsum tau txais kev kho mob rau FHT thiab lwm yam kab mob thiab yuav tsum tau saib xyuas tsis tu ncua. Cov kab mob hauv qab no feem ntau cuam tshuam nrog FHT:
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mob plawv,
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ntshav siab,
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kab mob retina,
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mob raum mob (CKD),
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mob plab zom mov, tsis muaj cobalamin, malabsorption,
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insulin tsis kam,
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mob pancreatitis.
Txhawm rau kom tau txais daim duab tag nrho ntawm tus mob cuam tshuam rau miv, kuaj hauv chav kuaj, ntsuas ntshav siab, kuaj qhov muag, x-rays/ultrasound scans, thiab - nyob ntawm seb cov tsos mob - lwm yam kev ntsuam xyuas yuav tsum tau ua.
Kev sim rau qhov xav tias FHT nyob ntawm qhov kev tshawb pom ntxiv
- Ntshav kuaj T4
- Ntshav kuaj hematology
- Kev kuaj ntshav kuaj chemistry (piv txwv li lub raum qhov tseem ceeb, daim siab qhov tseem ceeb, qabzib, fructosamine)
- Urinalysis (kev sib nqus tshwj xeeb, zis protein creatinine piv / UPC)
- rau cov tsos mob plab kuj Spec.PL (pancreas-specific lipase) thiab cobalamin
- Palpation ntawm cov thyroid caj pas thiab lub plab mog
- ntsuas ntshav ntsuas
- Auscultation lub plawv, lub hauv siab X-ray
- echocardiography
- mob plab hauv ultrasound
- Kev kuaj qhov muag/retina
- Tej zaum scintigraphy
txiav txim siab kho
Tom qab tag nrho cov duab ntawm tus neeg mob tau tsim, qhov kev txiav txim siab kho raws li nram no. Thawj lub hom phiaj yog stabilization, vim hais tias cov miv feem ntau tsis tshua muaj emaciated, unappetizing, thiab nthuav tawm nrog kev mob plab. Ib qho teeb meem loj ntawm hyperthyroidism yog mob hnyav lossis mob pancreatitis. Cov miv uas raug mob yuav tsum tau kho IV thiab kho cov tsos mob kom txog thaum lawv tuaj yeem pub lawv tus kheej ntxiv. Ntxig lub raj pub mis tuaj yeem pab txhawb txoj kev kho.
Cov kauj ruam tom ntej yog los kho lub xeev euthyroid kom sai li sai tau, i. H. ib qho mob uas theem T4 hauv cov ntshav yog nyob rau hauv qis dua ib nrab ntawm cov ntaub ntawv siv. Thawj qhov kev kuaj mob tom qab pib kho tshuaj yuav siv li ob mus rau peb lub lis piam tom qab. Lub raum qhov tseem ceeb yuav tsum tau kuaj xyuas thaum lub sijhawm kuaj xyuas no. Hyperthyroidism tuaj yeem npog CKD (mob raum mob) los ntawm kev txo qis rau lub raum los ntawm kev ua kom lub raum perfusion thiab nce dej kom tsawg. Tsis tas li ntawd, vim qhov poob ntawm cov leeg nqaij hauv cov tsiaj cuam tshuam, creatinine tsis muaj tseeb thiab tsis tuaj yeem kuaj pom CKD uas twb muaj lawm. Hauv cov miv no, tom qab pib ua tiav ntawm kev kho mob thiab cov thyroid hormones ib txwm muaj, CKD tshwm sim raws li kev phiv tshuaj. Cov tswv miv yuav tsum paub txog thaum thawj zaug kev kho mob tias qhov no tuaj yeem tshwm sim vim tias muaj qhov ua tau tias lawv cov miv twb muaj kab mob raum tsis tuaj yeem.
Tsis zoo li lwm cov lus qhia, miv uas tau lees paub CKD thiab azotemia (ntau dhau urea hauv cov ntshav) ntawm cov thyroid kho yuav tsum tau kho tib yam li cov miv uas muaj lub raum noj qab haus huv. Lub hom phiaj yuav tsum yog los kho tus miv T4 hauv qab nruab nrab ntawm kev siv ntau yam. Kev sim ua kom lub raum tsis zoo los ntawm kev tawm hauv cov miv "me ntsis hyperthyroid" los ntawm kev kho mob hauv FHT ua rau peb muaj kev nyab xeeb tsis raug. Nyob rau hauv sib piv, nce T4 ua rau kom ua rau lub renin-angiotensin-aldosterone system (RAAS) ua rau muaj zog cardiac output, ntim overload, sodium retention, lub raum kub siab, thiab glomerular sclerotherapy, thaum kawg ua rau kev loj hlob ntawm CKD thiab ua phem rau cov mob. . Txawm li cas los xij, kev kuaj xyuas yuav tsum tau ua tsis tu ncua kom tsis txhob muaj iatrogenic (tus kws kho mob ua rau mob) hypothyroidism ntawm txhua tus nqi.
Kwv yees li ntawm ib ntawm tsib tus miv uas muaj cov thyroid ntau dhau kuj muaj qhov nce BI. Qhov kev nce ntshav siab no tuaj yeem tshwm sim los ntawm FHT thiab kho nws tuaj yeem rov qab los ntshav siab li qub. Kev tshuaj xyuas ntshav siab thaum lub sijhawm kho kev tswj hwm ntawm hyperthyroidism yog qhov tseem ceeb los txheeb xyuas thiab kho cov ntshav siab uas tsis yog FHT. Tib yam muaj tseeb rau cov tsos mob plawv, uas tej zaum yuav muaj feem cuam tshuam nrog FHT thiab tuaj yeem txhim kho tau zoo nrog euthyroid cessation. Txawm li cas los xij, kev kuaj echocardiographic yuav tsum tau ua hauv cov xwm txheej no.
Cov kev xaiv kho mob
FHT yog ib yam mob uas ua rau muaj kev phom sij rau lub neej thiab yuav tsum tau kho kom tsim kom muaj tus mob euthyroid hauv miv. Tshuaj, noj cov zaub mov, kev phais mob, thiab xov tooj cua txoj kev kho muaj kev kho mob.
tshuaj
Lub active ingredient methimazole tau pom zoo rau miv raws li ib tug ntsiav tshuaj thiab raws li ib tug qab tov yuav tsum tau muab ob zaug ib hnub twg. Carbimazole, kuj pom zoo rau miv, yog metabolized rau methimazole hauv lub cev thiab muaj cov nyhuv tib yam. Ob leeg thaiv thyroid peroxidase thiab yog li txo qis biosynthesis ntawm cov thyroid hormones.
Kev kho mob nrog cov neeg ua haujlwm no tuaj yeem ua neej nyob lossis ib ntus kom ruaj khov rau cov miv uas tseem tab tom phais lossis kev kho radioiodine. Hauv kwv yees li 18% ntawm tag nrho cov neeg mob, txawm li cas los xij, methimazole lossis carbimazole ua rau muaj kev phiv. Qhov no tuaj yeem yog:
- qhov mob anorexia
- ntuav
- pruritus thiab excoriations ntawm lub ntsej muag
- nkees
- hepathopathies, jaundice
- nce nyiam los ntshav
Cov kev mob tshwm sim no tuaj yeem tshwm sim tam sim lossis tsuas yog tom qab kev tswj hwm rau ib mus rau ob lub hlis. ntuav thiab tsis qab los noj mov feem ntau yog nyob ntawm koob tshuaj thiab ploj tom qab txo koob tshuaj. Thaum muaj lwm yam kev mob tshwm sim, cov tshuaj yuav tsum tau txiav tam sim ntawd thiab lwm yam kev kho mob yuav tsum tau txiav txim siab.
Thaum kho cov tshuaj thyroid, tus tswv miv yuav tsum tau qhia kom meej. Cov khoom xyaw nquag tuaj yeem muaj cov nyhuv teratogenic (malformation-ua rau tib neeg), uas yog vim li cas nws thiaj li pom zoo kom hnav hnab looj tes thaum tuav lawv thiab cov ntsiav tshuaj yuav tsum tsis txhob faib. Kev tswj hwm nrog lub npe hu ua "cov hnab tshos" lossis "trojans" uas koj tuaj yeem nkaum cov tshuaj yog ib lub tswv yim zoo. Cov tshuaj methimazole yog palatable heev thiab feem ntau miv txaus siab coj nws.
Lwm txoj hauv kev uas tseem tsis tau pom zoo rau cov miv hauv lub tebchaws Yelemes yog methimazole gel uas tso cai rau cov tshuaj nquag nqus tau los ntawm transdermally. Ntawm no, ib yam nkaus, cov hnab looj tes yuav tsum tau hnav thaum lub sijhawm thov. Rau cov miv uas xav tau koob tshuaj ntau, cov gel siv tau ntau heev. Tab sis daim ntawv thov tshuaj no zoo heev zam los ntawm ntau tus miv.
Kev kuaj ntshav T4 qib thiab, yog tias tsim nyog, lwm yam kev ntsuas tau pom zoo tom qab peb, rau, kaum, thiab 20 lub lis piam. Txawm tias cov neeg mob ruaj khov yuav tsum tau kuaj ntshav txhua 12 lub lis piam vim tias FHT yog kab mob qog nqaij hlav thiab tuaj yeem ua rau cov qog loj hlob zuj zus, yog li cov koob tshuaj yuav tsum tau kho.
Lwm qhov teeb meem nrog kev kho tshuaj yog kev ua raws li tus tswv. Hmoov tsis zoo, cov tsos mob tsis zoo tam sim ntawd tom qab tso tseg cov ntsiav tshuaj, tab sis tsuas yog cov txheej txheem ntawm cov kab mob maj mam. Peb feem ntau tsuas pom cov miv dua thaum tus mob ua rau muaj kev phom sij rau lub neej.
cov pluas noj
Kev noj zaub mov yog qhov kev xaiv zoo rau cov miv uas nyob ib leeg thiab sab hauv tsev. Cov nyhuv yog raws li kev noj zaub mov uas cov ntsiab lus iodine raug txo kom tsawg kawg nkaus. Txij li cov thyroid caj pas tsis tuaj yeem tsim cov thyroid hormones yam tsis muaj iodine ua lub tsev thaiv, kev tsim tawm tau txo qis. Txawm li cas los xij, nws yuav tsum tau xyuas kom meej tias tus miv tsis muaj lwm yam khoom noj uas nws tuaj yeem haus iodine.
phais
Kev tshem tawm ntawm cov thyroid caj pas yog qhov yooj yim tshaj plaws tab sis tsis yog qhov kev xaiv zoo tshaj plaws rau kev kho FHT. Nws tuaj yeem pab tau yog tias tsuas yog ib sab raug cuam tshuam thiab yog tias tsis muaj ectopic thyroid cov ntaub so ntswg hauv qhov chaw nkag tsis tau, xws li B. hauv lub thorax. Txawm tias yav tas los siab heev T4 qhov tseem ceeb twb nyob rau hauv ib txwm ntau yam nyob rau hnub tom qab ua hauj lwm. Hmoov tsis zoo, cov thyroid adenomas zoo li kis mus rau ob sab, ua rau lub sijhawm rov tshwm sim thaum cov qog hauv cov qog seem pib loj hlob. Kev tshem tawm ntawm ob lub qog tsis yog txoj kev xaiv vim hais tias, ua ntej, muaj kev pheej hmoo tias tsawg dhau cov qog parathyroid (epithelial lub cev lossis cov qog parathyroid) nyob hauv lub cev, uas ua rau muaj kev phom sij rau lub neej tsis muaj cov tshuaj hormones parathyroid.
radioiodine kev kho mob
Cov txheej txheem kub hauv kev kho mob ntawm FHT yog radioiodine therapy. Nws yog tib qho kev xaiv uas ua rau kev kho mob. Feem ntau, kev kho mob ib leeg yog txaus thiab yuav luag 95% ntawm cov miv uas kho tau zoo rau lub neej. Radioactive iodine accumulates nyob rau hauv cov thyroid hlwb. Nws concentrates yuav luag tshwj xeeb ntawm cov qog nqaij hlav ntau dua thiab ua rau lawv puas tsuaj. Tsis muaj tshuaj loog yog tsim nyog rau kev kho mob. Qhov tsis zoo ntawm qhov kev kho no yog qhov tsim nyog ntev ntawm kev mus pw hauv tsev kho mob, uas, txawm li cas los xij, nws txawv ntawm qhov chaw mus rau qhov chaw (tsawg kawg yog plaub hnub, mus txog plaub lub lis piam, kuj nyob ntawm cov cai lij choj, xws li kaum hnub hauv Norderstedt veterinary clinic). Lub sijhawm no, tus menyuam miv tsis raug tso cai tuaj xyuas. Lwm qhov tsis zoo yog tias daim ntawv kho mob no tsis muaj nyob txhua qhov chaw. Muaj cov nqe lus sib txawv raws li tus nqi hais txog: kev kho radioiodine yog kim npaum li kev kho tshuaj nrog rau kev kuaj ntshav tsim nyog hauv ib xyoos lossis tshaj li qhov seem ntawm lub neej. Raws li kev tshawb fawb, lub neej expectancy tom qab radioiodine therapy yog ob zaug ntev npaum li cov miv kho nrog methimazole.
Cov ntsiab lus
Nws yog ib qho tseem ceeb rau kev qhia tus tswv thiab tsim ib qho kev npaj kho mob rau tus kheej. Tsiaj welfare yog qhov tseem ceeb. Lub hom phiaj yog kom tau txais T4 qib hauv qis dua ib nrab ntawm kev siv ntau yam thiab khaws lawv nyob ntawd. Lwm yam kab mob xws li CKD, cardiomyopathies, ntshav siab, thiab lwm yam yuav tsum tau kho thiab suav nrog kev saib xyuas tsis tu ncua. Qhov kev saib xyuas no yog qhov tseem ceeb vim tias cov kab mob geriatric, tshwj xeeb tshaj yog mob qog nqaij hlav FHT, yuav raug kev loj hlob, thiab cov txheej txheem kho mob yuav tsum tau hloov kho tas li kom tus neeg mob lub neej zoo.
Lus Nug Nquag Nug
Yuav ua li cas tus miv nrog ib tug overactive thyroid cwj pwm?
Cov tsos mob ntawm cov thyroid overactive nyob rau hauv miv yog Restlessness. Hyperactivity. Kev xav (polyphagia).
Ntev npaum li cas tus miv uas muaj cov thyroid ua haujlwm ntau dhau?
Cov txheej txheem kub hauv kev kho mob ntawm FHT yog radioiodine therapy. Nws yog tib qho kev xaiv uas ua rau kev kho mob. Feem ntau, kev kho mob ib leeg yog txaus thiab yuav luag 95% ntawm cov miv uas kho tau zoo rau lub neej.
Yuav ua li cas koj thiaj paub tias miv puas raug mob?
Rub rov qab, rhiab rau kov, aggressiveness, crouched posture, los yog limping qhia tias tus tsiaj raug kev txom nyem. Ntxiv nrog rau kev coj cwj pwm, koj tuaj yeem nrhiav lwm cov tsos mob uas yuav qhia qhov tseeb dua vim li cas koj tus miv raug kev txom nyem.
Yuav ua li cas pub miv nrog cov thyroid overactive?
Cov miv uas muaj cov thyroid ntau dhau yuav tsum tsuas yog noj Hills Feline y / d, vim tias cov ntsiab lus iodine ntau dua ntawm lwm cov khoom noj negates cov txiaj ntsig ntawm kev kho mob.
Dab tsi tshuaj rau hyperthyroidism hauv miv?
Kev kho mob rau hyperthyroidism ib txwm pib nrog kev tswj hwm ntawm cov ntsiav tshuaj uas muaj cov khoom xyaw thiamazole thiab carbimazole. Cov no tau pom zoo siv ob zaug ib hnub thiab tiv thaiv kev tsim cov thyroid hormones, qhov ntau dua, qhov ntau lawm.
Dab tsi pab hyperthyroidism hauv miv?
Hyperthyroidism hauv miv tuaj yeem kho nrog tshuaj. Ob qho tshuaj "Tiamazol" thiab "Carbimazole" txo qis cov thyroid hormones. Qhov no normalizes ntau ntau cov tshuaj hormones hauv cov ntshav. Cov koob tshuaj yuav tsum tau muab ob zaug ib hnub.
Tus miv puas tuaj yeem quaj?
Zoo li tib neeg, miv tuaj yeem quaj thiab hnov mob. Txawm li cas los xij, tsis muaj kev sib txuas ntawm lub kua muag thiab kev xav, vim cov miv qhia lawv txoj kev xav txawv.
Tus miv suab li cas thaum nws quaj?
Acoustic quaj: tu siab mewing, meowing, los yog qw. Txo cov menyuam kawm ntawv. Ceev ceev twitching thiab flicking ntawm tus Tsov tus tw.