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Feline Hyperthyroidism: Complicated Cases Management
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Hyperthyroidism is the most common endocrine condition in cats. But elderly cats commonly have more than one condition. When hyperthyroidism is accompanied by chronic kidney disease or cardiac disease, hypertension or even diabetes, extra care is needed to avoid exacerbating one of the comorbidities. HYPERTHYROIDISM AND CHRONIC KIDNEY DISEASE
The most common combination with hyperthyroidism in older cats is chronic kidney disease (CKD). The majority of cats develop CKD as they age, thus finding these two conditions in the same cat is not surprising. Hyperthyroidism may contribute to renal pathology through increased angiotensin II inducing tubulointerstitial fibrosis with hypertension potentially predisposing to microinfarcts and proteinuriainduced tubular inflammation.
However, in many cases, the hypermetabolic state that includes increased cardiac output that results in increased renal blood flow and glomerular filtration rate (GFR) that can mask a decline in renal function. This makes diagnosing CKD in hyperthyroid cats difficult as standard parameters (urea, creatinine and SDMA) measure GFR. [...]
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