Description
Although thyroid nodules have been observed since 1964, feline hyperthyroidism was first reported as recently as 1979. Since then the incidence has only increased, becoming the commonest endocrine disorder in older cats. It is estimated that there are in the region of 100,000 cases in the UK. The well-known clinical presentation of weight loss despite polyphagia, tachycardia and palpable goitre, together with helpful laboratory tests, makes it usually (but not always) a straightforward diagnosis, and cases are now often detected at earlier stages in the disease process. A recent survey has shown a reported incidence of at least 20% amongst cats in Ireland in 2013.
This webinar does not discuss the clinical condition, or diagnosis, or treatment doses. Instead it reviews current thinking on possible aetiology, with consideration of dietary factors, potential thyroid disrupters and other associations that have been described repeatedly in epidemiological surveys. Based on this current understanding, possible prevention strategies are described as currently recommended in the USA. Whilst recognising that there is no certainty that following these strategies will affect disease incidence, they are logical in attempting to reduce feline exposure to potentially avoidable risk factors. This opportunity to perhaps positively influence disease risk is likely to be of interest to the most committed cat-owning clients, particularly those with previous or current experience of feline hyperthyroidism.
In the context of this increasing disease incidence, the second half of the webinar reviews papers looking at the client experience of medicating (orally and transdermally) and using iodine-restricted diet, and clinical outcomes for methimazole, iodine-restricted diet and radioiodine. Outcome data include control of hyperthyroidism, and, where available, client perception and patient life expectancy. Although a number of treatment options are available, the most appropriate treatment will vary between patients. It is hoped that this overview will facilitate evidence-based medicine when choosing treatment strategies, relevant for the general practitioner for whom this is a frequent diagnosis.
Andrew Bodey qualified from Bristol in 1989, and spent 2 years in mixed practice in Staffordshire before moving to companion animals in the south east. In 1995 he joined Bishopton Veterinary Group in Ripon, obtaining his CertVR in 2003. From this he further developed his interest in ionizing radiation, and solved his frustration at having to refer hyperthyroid cats either to Glasgow or Newmarket by establishing the first radio-iodine unit in the North of England, in 2008. In the process he reduced the minimum hospitalization period in the UK to 2 weeks. In September 2013 he founded the Hyperthyroid Cat Centre, near Wetherby, providing radio-iodine treatment on a much larger scale, and further reduced the minimum hospitalization period to 7 days. He also has a current active interest in clinical research, participating in the Clinical Research Outreach Program run by Dr Mark Holmes at Cambridge.