Study rationale:Veterinary practitioners often perform geriatric health screening in cats. Unfortunately, scientific information regarding clinical and laboratory abnormalities and normal blood pressure values in elderly cats is scarce. This prospective study evaluated routine health screening tests in apparently healthy middle-aged and old cats.Protocol:One hundred cats of 6 years and older underwent blood pressure measurement, physical examination, blood and urine analysis, indirect fundoscopy and bilateral Schirmer tear tests.Findings:Mean systolic blood pressure (SBP) was 133.6 ± 21.5 mmHg. Increased SBP (>160 mmHg) was observed in eight cats, submandibular lymphadenopathy in 32, gingivitis in 72, heart murmur in 11, thyroid goitre in 20, increased creatinine in 29, hyperglycaemia in 25, increased total thyroxine in three, feline immunodeficiency virus positivity in 14, crystalluria in 41, borderline proteinuria in 25 and overt proteinuria in two. Mean tear production was very similar for both eyes an...

Routine health screening: findings in apparently healthy middle-aged and old cats.

Background Cats are the most popular pet in the United States and much of Northern Europe. Although 78% of owners consider their cats to be family members, many cats, particularly seniors, do not receive appropriate preventive care. One of the main obstacles to owner compliance is the lack of a clear recommendation by the veterinary team. Guidelines can help veterinarians to minimize this obstacle, strengthen the human–pet–veterinary bond, and improve the quality of life of cats. Goals The goals of this article are to assist veterinarians to: – Deliver consistent high-quality care to senior cats. – Promote longevity and improve the quality of life of senior cats by: recognizing and controlling health risk factors; facilitating and promoting early detection of disease; improving or maintaining residual organ function; and delaying the progression of common conditions. – Define aspects of screening, diagnosis, treatment and anesthesia of senior cats.

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American association of feline practitioners. Senior care guidelines.

Clinical context:Since 1979 and 1980 when the first reports of clinical feline hyperthyroidism (FHT) appeared in the literature, our understanding of the disease has evolved tremendously. Initially...

2016 AAFP Guidelines for the Management of Feline Hyperthyroidism.

Background:

In humans, subclinical hyperthyroidism is diagnosed when serum thyroid hormone concentrations are within the reference range but thyroid stimulating hormone (TSH) concentration is subnormal. In a previous study, a higher prevalence of thyroid nodular disease was found in euthyroid geriatric cats with undetectable TSH (<0.03 ng/mL) compared to those with detectable TSH concentrations, suggesting subclinical hyperthyroidism might also exist in cats.



Hypothesis:

Euthyroid cats with undetectable TSH concentrations have subclinical hyperthyroidism and may subsequently develop overt signs of hyperthyroidism.



Animals:

One-hundred four client-owned cats.



Methods:

In this prospective cohort study, euthyroid geriatric (≥9 years) cats were recruited during routine health checks. Plasma biochemistry was performed at baseline and every 6 months thereafter. Total thyroxine and TSH concentrations were determined annually. Short-term follow-up data (within 14 months of recruitment) were used to detect variables at entry that were predictive of the diagnosis of hyperthyroidism, using univariable analysis followed by multivariable logistic regression analysis. Log rank analysis was used to test the association of initial TSH concentration with diagnosis of hyperthyroidism during the total available follow-up.



Results and Conclusions:

Median (range) follow-up was 26 (0–54) months and annual incidence of hyperthyroidism during the study was 7.4%. Cats that became hyperthyroid within 14 months had higher ALKP activity (P = 0.02) and higher prevalence of goiter (P = .03) at baseline than controls. Cats with undetectable TSH at baseline (29/104; 28%) were significantly (P < .001) more likely to be diagnosed with hyperthyroidism. However, not all cats with undetectable TSH became hyperthyroid during the study.

Evaluation of Predictors for the Diagnosis of Hyperthyroidism in Cats

Clinical challenges:In older cats presenting with clinical features of hyperthyroidism, confirmation of a diagnosis of thyroid disease is usually straightforward. However, the potential for false-negative and false-positive results exists with all thyroid function tests (especially in the context of routine screening of asymptomatic cats) and leads to clinical dilemmas. For example, a high serum T4 value may be found in a cat that lacks clinical signs of hyperthyroidism, or hyperthyroidism may be suspected in a cat with normal total T4 concentrations.Practical relevance:To avoid unnecessary treatment and potentially adverse effects in a euthyroid cat, thyroid function tests must always be interpreted in the light of the cat’s history, clinical signs, physical examination findings and other laboratory findings.Evidence base:In this article the author reviews the use of commonly recommended thyroid function tests, focusing on clinical scenarios that present diagnostic difficulties. In doing so, he draws on ...

More than just T₄: diagnostic testing for hyperthyroidism in cats.

In 155 cats, both with and without clinical signs of hyperthyroidism, total thyroxine (TT4) concentrations were compared to a sensitive, semi-quantitative thyroid palpation technique. On the basis of TT4 concentrations, 23 of the 155 cats were classified as hyperthyroid. The size of individual thyroid glands was scored between ‘0’ (non-palpable) and a maximum of ‘6’. One or more enlarged thyroid glands (score >0) were palpated in 22 of the 23 hyperthyroid cats and in 78 of the 132 euthyroid cats. However, none of the 132 euthyroid cats had a thyroid lobe score of greater than ‘3’ whereas 18 of the 23 hyperthyroid cats had a thyroid lobe score of ‘4’ or greater, and in two of the five that had scores below ‘4’ there was evidence of intrathoracic functional thyroid tissue on scintigraphy.

Relationship between Semi-Quantitative Thyroid Palpation and Total Thyroxine Concentration in Cats with and without Hyperthyroidism

Client-owned cats underwent surgery to remove palpable cervical masses in cats with normal total T4 values and no clinical signs of hyperthyroidism, renal disease, or hyperparathyroidism. Non-functional thyroid and parathyroid adenomas were found and identified by histopathological examination. The significance of these findings is discussed in relation to palpating a goiterous mass in an asymptomatic cat.

G D Norsworthy

Papers

Relationship between Semi-Quantitative Thyroid Palpation and Total Thyroxine Concentration in Cats with and without Hyperthyroidism

Palpable Thyroid and Parathyroid Nodules in Asymptomatic Cats