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Feline Comorbidities: Balancing hyperthyroidism and concurrent chronic kidney disease
Rebecca Geddes1, Joana Aguiar2
1Clinical Sciences and Services, Royal Veterinary College, University of London, London, UK.
Journal of Feline Medicine and Surgery
|April 28, 2022
Summary
Diagnosing hyperthyroidism and chronic kidney disease (CKD) in older cats is challenging as one condition can mask the other. Careful monitoring and management are crucial for concurrent cases.
Area of Science:
- Veterinary Medicine
- Endocrinology
- Nephrology
Background:
- Hyperthyroidism and chronic kidney disease (CKD) are prevalent in aging cats.
- These conditions can coexist and influence each other's clinical presentation and diagnosis.
- Masking effects between hyperthyroidism and CKD complicate simultaneous diagnosis.
Purpose of the Study:
- To review the mechanisms by which hyperthyroidism and CKD can mask each other.
- To discuss diagnostic challenges and considerations for concurrent feline hyperthyroidism and CKD.
- To outline treatment strategies and potential complications for cats with both conditions.
Main Methods:
- Literature review of current scientific articles and clinical guidelines.
- Analysis of diagnostic and therapeutic approaches for feline hyperthyroidism and CKD.
- Synthesis of information on pathophysiology, clinical signs, and management.
Main Results:
- Hyperthyroidism can mask CKD by increasing glomerular filtration rate, while CKD may present with non-specific signs overlapping with hyperthyroidism.
- Concurrent diagnosis requires vigilant assessment of clinical signs like vomiting, weight loss, and polyuria/polydipsia.
- Iatrogenic hypothyroidism is a risk post-treatment, potentially worsening azotaemia.
Conclusions:
- Simultaneous diagnosis of hyperthyroidism and CKD in cats is complex due to masking effects.
- Careful monitoring of kidney function biomarkers is essential during and after hyperthyroidism treatment.
- Prompt management of kidney function and consideration of levothyroxine therapy for hypothyroid, azotaemic cats are recommended.
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