Pituitary dwarf 

Low GF, Low IGF-I, no response to GH stimuation

normal ACTH

German shepard 

Carnelian Bear dog 

(weimaeaner, spitz, min pin) 

"Honey I shrunk the dog" - Proportionate dwarf

Retention of primary guard hairs 

retained puppy coat 

No response to GH stimulation 

Low GH, Low IGF-I 

How many hormones are effected. 

If it is just the GH then it will be propotionate, but if other hormones are involved it may develop disproportionate.

**basal GH levels are not determinate**

Check the basal IGF-I level 

GH stimulation testing 

Thyroid stimulation testing

Poor - guarded 

usually do not last 5 yers without medical intervention 

Can lead to diabete mellitus, acromegaly

Acromegaly 

GH abnormality clinical manifestation 

Dogs - mainly iatrogenic progesterone initiated

-

Cats - neoplasia

Large head, big feet

hypertrophy of soft tissue of face and mouth 

Widened interdental space

increased inspiratory noise (snoring) 

**appreciate changes in individual animals**

Growth hormone is diabeticogenic.

True or False?

**consistant with diabetes mellitus II**

Hyperglycemia 

elevated alk phos/ALT

Glucosuria 

hypercholestrolemia 

SODIUM 

Osmolality - number of osmoles per kilogram solvent 

derp - Antidiuretic 

conserves water 

Increase water intake (drink) 

Decrease water excretion (urine)

>>>this results in conserved water and increase extracellular fluid vlume  

Osmoreceptors - effected by only 1% change 

where is takes a 10% change for baroreceptors 

Aquaporins in the collecting duct cells that allows water to come back into the cell - DECREASING the water in the urine and thus urine volume. 

Increased permeability of the distal tubule and collecting ducts to reabsorp water 

Diabetes insipidus is a problem with which hormone?

A) Glucose 

B) Insulin 

C) ADH

D) All of the above

E) None of the above

C) ADH 

there is a lack of ADH production or lack of renal response to ADH 

Nephrogenic Diabetes insipidus occurs when ADH is not being produced.

True or False?

FALSE - that is central Diabetes Insipidus 

which is much less common although has been seen in hed trauma cases 

Which of the following is correct regarding Diabetes insipidus?

A) Polydipsia initiates polyuria 

B) Polyuria can be controlled by limiting water intake 

C) Most are acquired and nephrogenic 

D) Can be caused by sepsis because endotoxin inhibits ADH release

Answer: C) Most are acquired and nephrogenic 

a- polyuric first, compensatory polydipsia

b- dont limit water without knowing underlying cause 

d- endotoxin competitive for ADH binding sites

Bone formation 

muscular activity 

cardiac function 

cellular biochemistry 

coagulation 

When blood ionized calcium increases, PTH:

increases or decreases?

H - hyperparathyroidism 

A - Addisons disease 

R - Renal disease 

D - hypervitaminosis D 

I - Idiopathic 

O - osteolysis 

N - Neoplasia 

S - Systemic granuloma 

PU/PD 

the rest are general symptoms 

listlessness, urine incont., weakness, excercise intolerance, inappetance

OVER the age of 7 years of age

No sex prediliction 

Keeshond !!

HYPERCALCEMIA OF MALIGNANCY !!

Dog: lymphoma, andenocarcinoma of the anal sac 

Cat: Lymphoma, squamous cell carcinoma

FEMALES 

med to LARGER breeds 

Younger age at diagnosis

Mixed breed

STD POODLE, portuguese water dog, bearded collie, lab, leonberger

Addisons disease may clinically present similar to what other diseases? 

What Clinical signs are indicated in the similarities?

May look like RENAL FAILURE 

this is because there will be an elevated BUN (over creatinine) and Isosthenuria 

OR GI OBSTRUCTION

from GI signs

Microcardia 

Megaesophaus 

ECG abnormalities 

Typical = glucocorticoid and mineralocorticoid deficient 

Atypical = Glucocorticoid deficient ONLY, this may mean they have normal electrolyte balances, may never need mineralocorticoid supplementation 

Glucagon

Growth hormone

epinephrine 

Cortisol

Severe intestinal disease 

-IBD, Histopasmosis, PLE

Starvation 

- VERY UNCOMMON, only end stage with cachexia

Fulminant hepatic failure (acute or chronic) 

Congnital hepatic disease (PSS)

Severe hepatocellular injury (toxicity - like cats with acetominofen)

*if hepatic disease there will be other things missing like cholesterol*

Gylcogen storage disease 

Lack of diabetogenic hormones

-Hyposomatotropism (lack of GH) 

-Addisons disease (lack of cortisol) 

Too much insulin

-Iatrogenic (insulin therapy overdose) 

-excess endogenous insulin (insulin secreting tumor)

Insulinoma

PARANEOPLASTIC from

-lymphoma

-leiomyoma

-leiomyosarcoma

-multiple myeloma

and more

Neuroglcopenia 

- lack of glucose to brain 

- causes weakness, ataxia, convulsions

- most prevalent in animals

Sympathoadrenal stimulation 

- diabetogenic hormones: Epinephrine

- stimulated by hypoglycemia

- increases HR 

- restlessness, muscle tremors 

- more-so in humans than animals 

Lymphoma

that would cause a paraneoplastic hypoglycemia 

Hepatic disease 

bile acid profile and hepatic work up 

Addisons

ACTH stimulation 

SEPSIS 

thoracic and abdominal radiographs 

look for abscesses 

Insulinoma

insulin, glucose levels 

Tumor of the beta cells of the pancreas - autonomously secretes insulin causing hypoglycemia. 

(common in ferrets, uncommon in dogs, rare in cats)

LARGE breed dogs more common, 9-10 yo

*most are malignant and have metastisized at diagnosis*

How many cases of insulinomas are metastatic at the time of diagnosis?

Most of these are malignant or benign?

50% are metastatic at diagnosis 

80% are malignant 

Liver mass - causing decreased glucose production 

chek abdominal radiographs, liver panel, thoracic radiographs, insulin and glucose levels 

What drugs can cause hyperglycemia when administered?

*She is not testing us on this per-say, but its good to know*

Xylazine 

Ketamine

Morphine

Phenothiazines

megestrol acetate (cats) 

IV fluids with dextrose 

Catecholamine release 

Glucocorticoids (endogenous release, exogenous admin) 

--blood glucose can exceed renal threshold and glucouria can be found.

Cats 

less likely in dogs 

Satiety center of brain requires insulin to transport Glucose in for proper function 

With no insulin there is no glucose getting to this part of the brain and the satiety center is not triggered to inhibit feeding center. So the animal will eat and eat and eat.

twice a day 

Unless you are Dr. Morrison's dog

Negative Urine ketones 

Urine glucose may be present 

Eliminate clinical signs 

Blood glucose curve between 100-220 

DIABETES - - 

the diabetic nephropathy is VERY deteriminant of diabetes 

Which of the following is true about the presentation of Diabetes?

A) Dogs are more likely to present obese than cats 

B) Cats are more difficult to regulate glucose

C) Diabetic nephropathy will commonly present in cats and dogs

D) Cats are more likely to be diagnosed in early stages of diabetes

Answer: B) Cats are more difficult to regulate the glucose levels on because stress hyperglycemia is a bigger problem and they have issues with insulin sensitivity

A) Cats are more likely to present obese 

C) Diabetic nephropathy is more common in cats 

D) Cats are more likely to present with advanced diasease 

Improves peripheral insulin utilization 

improves weight control 

decrease fat stores 

Improves muscle mass 

**avoid extreme exertion