title: Diagnosis of hyperthyroidism in cats with mild chronic kidney disease.
abstract: OBJECTIVE
  In cats with concurrent hyperthyroidism and non-thyroidal illnesses such as chronic kidney disease, total thyroxine concentrations are often within the laboratory reference range (19 to 55 nmol/l). The objective of the study was to determine total thyroxine, free thyroxine and/or thyroid-stimulating hormone concentrations in cats with mild chronic kidney disease.
  
  
  METHODS
  Total thyroxine, free thyroxine and thyroid-stimulating hormone were measured in three groups. The hyperthyroidism-chronic kidney disease group (n=16) had chronic kidney disease and clinical signs compatible with hyperthyroidism but a plasma total thyroxine concentration within the reference range. These cats were subsequently confirmed to be hyperthyroid at a later date. The chronic kidney disease-only group (n=20) had chronic kidney disease but no signs of hyperthyroidism. The normal group (n=20) comprised clinically healthy senior (>8 years) cats.
  
  
  RESULTS
  In 4 of 20 euthyroid chronic kidney disease cats, free thyroxine concentrations were borderline or high (> or =40 pmol/l). In the hyperthyroidism-chronic kidney disease group, free thyroxine was high in 15 of 16 cats, while thyroid-stimulating hormone was low in 16 of 16 cats. Most hyperthyroidism-chronic kidney disease cats (14 of 16) had total thyroxine greater than 30 nmol/l, whereas all the chronic kidney disease-only cats had total thyroxine less than 30 nmol/l.
  
  
  CONCLUSIONS
  The combined measurement of free thyroxine with total thyroxine or thyroid-stimulating hormone may be of merit in the diagnosis of hyperthyroidism in cats with chronic kidney disease.
authors.affiliation: Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, Herts AL9 7TA.
authors.forename: J
authors.initials: J
authors.lastname: Wakeling
authors.forename: K
authors.initials: K
authors.lastname: Moore
authors.forename: J
authors.initials: J
authors.lastname: Elliott
authors.forename: H
authors.initials: H
authors.lastname: Syme
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis*; D002415:Cats; D015897:Comorbidity; D005260:Female; D006980:Hyperthyroidism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000662:veterinary*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000662:veterinary*; D008297:Male; D012016:Reference Values; D012680:Sensitivity and Specificity; D013972:Thyrotropin / Q000097:blood*; D013974:Thyroxine / Q000097:blood*
chemical_list: D013972:Thyrotropin; D013974:Thyroxine