Safety of orally administered,<scp>USP</scp>‐compliant levothyroxine sodium tablets in dogs

Hare, Jonathan; Morrow, Carla M.K.; Caldwell, John; Lloyd, William E.

doi:10.1111/jvp.12457

Cited by 4 publications

(5 citation statements)

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“…Dogs in group 2 had the highest prevalence of dermatologic problems. It is unlikely that this reflects an adverse effect of the treatment itself as thyroxine supplementation is usually well tolerated [ 28 ]. Only in rare cases, hypersensitivity reactions affecting the skin have been demonstrated where inactive ingredients of the levothyroxine tablet were the suspected cause [ 29 ], however as there was no question to evaluate either the onset of signs it is not possible to draw any conclusion to the underlying aetiology of the skin problems and GSD`s are a breed predisposed for atopy and pyoderma [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Wellbeing, quality of life, presence of concurrent diseases, and survival times in untreated and treated German Shepherd dogs with dwarfism

et al. 2021

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Background Pituitary dwarfism (PD) in German Shepherd dogs (GSD) is a rare endocrinopathy. Cause and inheritance of the disease are well characterized, but the overall survival time, presence of concurrent diseases, quality of life (QoL) and influence of different treatment options on those parameters is still not well investigated. The aim of this study was to obtain data regarding the disease pattern of GSD with PD and to investigate the impact of treatment. Methods 47 dogs with dwarfism (presumably PD) and 94 unaffected GSD serving as controls were enrolled. Data were collected via a standardized questionnaire, which every owner of a participating dog had completed. Dogs with PD were grouped based on three categories of treatment: Group 1 (untreated), group 2 (treated with levothyroxine), group 3 (treated with thyroxine and progestogens or with growth hormone (GH)). Groups were compared using One-Way-Anova, Kruskal-Wallis test or Wilcoxon-rank-sum test. Categorical analysis was performed using Two-Sample-Chi-Squared-test. Results Dogs treated with thyroxine and gestagen or GH were significantly taller and heavier compared to all other dogs with PD. Quality of life was best in dogs with PD treated with thyroxine and similar to unaffected GSD. Treatment increased survival time in dogs with PD independent of the treatment strategy. Dogs receiving thyroxine and progestogens or GH did not develop chronic kidney disease (CKD). Conclusion GSD with PD should be treated at least for their secondary hypothyroidism to increase survival time. Additional treatment with progestogens or GH improves body size and seems to protect against the occurrence of CKD.

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Section: Discussionmentioning

confidence: 99%

Wellbeing, quality of life, presence of concurrent diseases, and survival times in untreated and treated German Shepherd dogs with dwarfism

et al. 2021

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“…The literature data indicate that the most useful for assessment of thyroid function in dogs are serum total and free thyroxine (tT4, fT4) and thyrotropin (TSH) concentrations, while the determination of antithyroid antibodies is less important (Daminet and Paradis 2000, Boretti et al 2003, Diaz Espineira et al 2007, Randolph et al 2015. The "golden standard" for diagnostic procedures in dogs with suspected hypothyroidism nowadays is the TSH stimulation test, however the results of simultaneous measurement of tT4 and TSH concentration is the best indicator of overall thyroid functional status and thus gives the best chance of diagnosing this disease (Boretti and Reusch 2004, Diaz Espineira et al 2007, Higgs et al 2014, Bianchi et al 2015, Hare et al 2018.…”

Section: Discussionmentioning

confidence: 99%

Polish Journal of Veterinary Sciences

Taszkun

Milczak

Kalisz

et al. 2021

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Serum concentration of thyroid hormones in healthy dogs varies according to age, sex, breed or professional activity. The aim of this study was to determine the influence of both age and dogs' work involvement on TSH and thyroid hormones values. Thyroid-stimulating hormone (TSH), total thyroxine (tT4) and free thyroxine (fT4) were tested in the serum of 57 healthy, German Shepherd dogs. The dogs were divided into study groups according to age: dogs aged 3 to 6 years (A), dogs over the age of 6 years (B) and involvement: police-working dogs (C) and accompanying animals (D). Mean values of TSH, tT4 and fT4 ranged from 0.19 to 0.31 ng/ml, 15.58 to 17.25 nmol/L and 11.83 to 17.89 pmol/L, respectively. The highest values of TSH were in group B and the lowest were in group A, while there was an inverse dependence in case of fT4 concentration. The highest mean values of tT4 were in dogs in group C and the lowest in group B. There were statistically significant differences in TSH (p=0.007) and fT4 (p=0.003) concentrations between the age groups. The results indicate that a dog's age is an important factor in the case of thyroid profile results interpretation.

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“…Ainda, por meio da análise dos resultados hormonais de TSH, T4L e T3 solicitados em um primeiro momento, foi possível evidenciar alteração da função tireoidiana, uma vez que o TSH estava com valores elevados (3,0 ng/dL), indicando uma maior necessidade de estimulação da tireoide para produção e liberação de T4L, já que o mesmo se encontrava em níveis muito baixos no organismo (menor que 0,04 ng/dL) [7]. Sendo assim, fica claro que mesmo com uma superestimulação endógena da hipófise pelo mecanismo de feedback negativo para liberação do TSH, a glândula tireoide não estava respondendo a esse hormônio, e como consequência disso a tireoide não conseguia produzir a quantidade necessária de T4L para o organismo [5].…”

Section: Discussionunclassified

“…Ressalta-se ainda que o uso em baixa dose de levotiroxina (medicamento manipulado) dificultou o diagnóstico definitivo de hipotireoidismo, visto que a suplementação com baixa dosagem não melhorou o quadro dermatológico. Além disso, terapias instituídas com levotiroxina tendem a diminuir os níveis séricos de colesterol e triglicerídeos [7], mesmo que em doses baixas. Porém, a ação sobre os níveis séricos de T4 e TSH podem ou não se encontrar dentro dos valores desejados, visto que o mais indicado para um controle eficiente seria o T4 dentro dos valores de referência.…”

Section: Discussionunclassified

“…Porém, a ação sobre os níveis séricos de T4 e TSH podem ou não se encontrar dentro dos valores desejados, visto que o mais indicado para um controle eficiente seria o T4 dentro dos valores de referência. O TSH se manteria abaixo dos níveis séricos indicando que a suplementação exógena está sendo eficiente, devido a não estimulação hipofisária através de feedback negativo [7]. O paciente em questão apresentava os níveis bioquímicos sem alteração devido a reposição exógena mesmo que em dose de 5 µg/kg, porém os testes de função da tireoide se demonstraram a ineficácia do tratamento [5].…”

Section: Discussionunclassified

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Previous Treatment with Trilostane and Levotiroxin in Subdosis Difficult the Diagnosis of Canine Hypothyroidism

Carneiro

Vanz

Barcellos

2018

Acta Scientiae. Vet.

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Background: hypothyroidism is a disease of clinical importance that causes multisystem disorders, which can be confused with other endocrinopathies. Rapid and accurate diagnosis is necessary in order to avoid worsening of the clinical manifestation. The use of drugs in a wrong way can directly imply the difficulty of the diagnostic approach, since they may causechanges in the biochemical profiles, which are of great importance as markers in diseases of animals with low thyroid function.Case: The case reports a German Spitz male, one year old and six months old, neutered, who presented bilateral do not cause itching alopecia, being treated by another professional for endocrine and fungal affections. In this same medical appointment were neglected biochemical and hematological profile exams. The exams that had been performed were skin scrapings,which showed growth of fungi and bacteria, besides the measurement of thyroid hormones as TSH, T4L (T4 free) e T3, and also the low-dose dexamethasone suppression test. Based on the findings the therapy instituted by such professional was the administration of itraconazole (ITL®), levothyroxine sodium (compounded drugs) and trilostane (compounded drugs). With absence of clinical improvement, the guardian came to the hospital veterinary, in search of a second diagnostic opinion, where during the collection of information at the time of the anamnesis the patient presented lethargy, drowsiness and absence of hair on both sides. During the clinical examination, the animal presented mild bradycardia and a slightly diminished rectal temperature; in the dermatological evaluation the presence of pup pelt, cutaneous hyperpigmentation and hair thinning in the abdominal area were noted. From this evaluation, hematological exams were requested, which had altered the presence of lymphocytosis, and biochemical tests, where changes in the cholesterol and triglyceride levels were expected, but they were within the normal range. Hormone measurement showed decreased TSH and T4L levels within the reference range. Thyroid ultrasonography demonstrated a hypoplastic gland, while the assessment of abdominal organs were preserved. Based on this, the new therapy instituted was the increase of levothyroxine sodium (Puran®) dose with the withdrawal of other drugs that were being administered to the patient. Over the course of five months, the tutor returned because of lack of improvement in the condition, where he returned to present symptoms such as drowsiness, apathy and indisposition. Thus, a new battery of tests was requested, where the biochemical and hormonal parameters were within the normal range. Due to TSH being within normal, it was decided to change the medication for another version of human levothyroxine sodium (Synthroid®), which has been presenting satisfactory results so far.Discussion: In cases of patients, even when young, when they present bilateral symmetrical alopecia, complementary exams such as scraping of the skin and hair, trichrome and fungal culture, together with hemogram and biochemical profile, are necessary for discarding of endocrinopathies other than hypothyroidism. Treatments instituted with drugs such as trilostan cause changes in laboratory tests, which may make diagnosis difficult. Treatment with levothyroxine sodium expected in patients with hypothyroidism, and serum TSH and T4L levels should be monitored for evaluation of treatment efficacy. The present study demonstrated that the inadequate treatment made diagnosis difficult due to hematological andbiochemical alterations.Keywords: alopecia, dog, endocrine dermatopathy, hypothyroidism, levothyroxine, trilostane.

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Safety of orally administered,USP‐compliant levothyroxine sodium tablets in dogs

Cited by 4 publications

References 56 publications

Wellbeing, quality of life, presence of concurrent diseases, and survival times in untreated and treated German Shepherd dogs with dwarfism

Wellbeing, quality of life, presence of concurrent diseases, and survival times in untreated and treated German Shepherd dogs with dwarfism

Polish Journal of Veterinary Sciences

Previous Treatment with Trilostane and Levotiroxin in Subdosis Difficult the Diagnosis of Canine Hypothyroidism

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