Hypothyroidism associated with acromegaly and insulin‐resistant diabetes mellitus in a<scp>S</scp>amoyed

Johnstone, Thurid; Terzo, Eloisa; Mooney, Carmel T.

doi:10.1111/avj.12237

Cited by 8 publications

(4 citation statements)

References 37 publications

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“…Primary hypothyroidism in dogs is associated with increased release of GH and IGF-1 concentrations, most likely due to transdifferentiation of TSH-producing cells to cells producing cTSH and GH. 1,13,16 As T4 and cTSH were normal, hypothyroidism was considered unlikely in our dog. It was decided to pursue workup for acromegaly as a next step and perform any further evaluation for hypothyroidism (free T4 by dialysis, T4 autoantibodies) only if the respective test results would come back normal.…”

Section: Discussionmentioning

confidence: 84%

Acromegaly due to a pituitary tumor in a dog – diagnosis, therapy and long-term follow-up

Reusch

Burkhardt

Meier

et al. 2019

SAT

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Acromegaly due to a pituitary tumor has so far only been described in 3 dogs. The present case report describes a 7-year-old male-castrated Labrador Retriever which was referred because of difficultto-control diabetes. Physical examination revealed markedly enlarged head, tongue and paws, widened interdental spaces and thickening of the skin in the head and neck area. IGF-1 and GH were increased and the latter continued to be abnormal after somatostatin application. Computed tomography demonstrated a space-occupying lesion in the pituitary gland and the diagnosis of acromegaly due to a GH-producing tumor of the pituitary was made. The dog underwent radiation therapy with a 6MV linear accelerator (3×8Gy) and improved substantially. Two and a half years after radiation therapy the dog developed lethargy and anorexia and was euthanized. Necropsy was not permitted. This case report represents the description of a dog suffering from pituitary-dependent acromegaly which was successfully treated and had a long-term survival

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Section: Discussionmentioning

confidence: 84%

Acromegaly due to a pituitary tumor in a dog – diagnosis, therapy and long-term follow-up

Reusch

Burkhardt

Meier

et al. 2019

SAT

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“…The etiology of IR in HO is poorly understood and likely multifactorial. Some animal studies showed the excess secretion of growth hormone may contribute to IR in some hypothyroid dogs, but this has not yet been documented in clinical cases [ 29 ]. Our study points to plasma Hcy levels as one potential factor that may contribute to IR.…”

Section: Discussionmentioning

confidence: 99%

Novel Clinical Evidence of an Association between Homocysteine and Insulin Resistance in Patients with Hypothyroidism or Subclinical Hypothyroidism

Yang

Yao

et al. 2015

PLoS ONE

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ObjectiveHypothyroidism (HO) can induce significant metabolic dysfunction and increase cardiovascular disease risk. In the present study, we investigated the relationship between homocysteine (Hcy) and insulin resistance (IR) in patients with HO or subclinical hypothyroidism (SHO).MethodsA total of 270 subjects were enrolled. All subjects were divided into the following three groups: HO, SHO and control. Plasma levels of Hcy were measured, and each patient’s homeostatic index of insulin resistance (HOMA-IR) was calculated. Statistical analyses were carried out to evaluate the correlations among groups and to determine the predictors of IR in patients with HO or SHO.ResultsThe HOMA-IR value was significantly higher in the HO group than in the SHO and control groups. Plasma levels of Hcy were markedly increased in the HO group compared with those of the SHO group and controls. In addition, plasma levels of Hcy were positively correlated with the HOMA-IR values in both the HO and SHO groups. Multiple linear regression models showed that plasma levels of Hcy and free thyroxine (FT4) were the only predictors of HOMA-IR in patients with HO or SHO.ConclusionsPlasma levels of Hcy and HOMA-IR were increased in patients with HO or SHO. Our results suggest that HO and SHO may increase the risk for atherogenesis and cardiovascular disease by increased IR. The increased IR induced by hyperhomocysteinemia in patients with HO or SHO may partially explain this adverse effect.

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“…The recognition of acromegalic features [ 78 ] in intact bitches should represent a stronger recommendation for spaying since the acromegalic phenotype can be considered a biomarker of the GH influence [ 178 ] ( Figure 7 ). However, it is important to note that the acromegaly phenotype in dogs may rarely occur due to pituitary somatotrophs [ 179 , 180 ] or due to primary hypothyroidism [ 181 , 182 , 183 ]. Despite P4-controlled GH’s negative influence on insulin sensitivity being documented only during diestrus, continued intermittent GH exposure over the next estrus cycles can predict increased cumulative risk for DM, especially due to aging effects on beta-cell function [ 10 ].…”

Section: How To Best Manage Progesterone-related Diabetes Mellitus?mentioning

confidence: 99%

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Pöppl,

Lopes,

Nogueira

et al. 2024

Animals

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Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. This narrative review aims to provide relevant detailed information on (1) the canine estrus cycle and its impact on canine diabetes mellitus (CDM) etiology and management, (2) the role of pyometra as a further cause of insulin resistance, and (3) useful individual therapeutic and preventive strategies. PRDM is recognized due to diestrus, exogenous progestogen exposure, pregnancy, and P4-production ovarian dysfunction. Pyometra represents additional inflammatory and septic negative influence on insulin sensitivity, and its diagnosis associated with CDM is therapeutically challenging. The estrus cycle’s hormone fluctuations seem to modulate peripheric insulin sensibility by influencing insulin receptor (IR) affinity and its binding capacity, as well as modulating tyrosine kinase activity. Pyometra was shown to negatively influence IR compensatory mechanisms to insulin resistance causing glucose intolerance. Spaying and pregnancy termination may cause diabetes remission in PRDM cases in a median time of 10 days (1–51). Pharmacological annulment of progesterone effects may benefit patients unable to undergo surgery; however, remission chances are virtually null. The ALIVE (Agreeing Language in Veterinary Endocrinology) project proposed new criteria for CDM diagnoses and subclinical diabetes recognition. These new concepts may increase the frequency of a PRDM diagnosis and, even more, its relevance. Spaying represents a preventive measure against pyometra and PRDM that should be individually assessed in light of its recognized benefits and harms.

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Hypothyroidism associated with acromegaly and insulin‐resistant diabetes mellitus in aSamoyed

Cited by 8 publications

References 37 publications

Acromegaly due to a pituitary tumor in a dog – diagnosis, therapy and long-term follow-up

Acromegaly due to a pituitary tumor in a dog – diagnosis, therapy and long-term follow-up

Novel Clinical Evidence of an Association between Homocysteine and Insulin Resistance in Patients with Hypothyroidism or Subclinical Hypothyroidism

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

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