title: Within- and between-examiner agreement for two thyroid palpation techniques in healthy and hyperthyroid cats.
abstract: Thyroid gland palpation is an important aid for diagnosing feline hyperthyroidism in an early stage to prevent development of deleterious complications. Our objectives were to assess within- and between-examiner agreement for two thyroid gland palpation techniques in cats and to correlate palpation results with ultrasonographic thyroid measurements. Nine client-owned hyperthyroid (12.6 +/- 2.4 years) and 10 healthy control cats (7.4 +/- 5.4 years) entered this prospective study. Both thyroid glands of all cats were palpated twice by three blindfolded clinicians with the classic palpation technique [technique 1 (T1)] and the technique described by Norsworthy GD, Adams VJ, McElhaney MR, Milios JA [(2002a) Relationship between semi-quantitative thyroid palpation and total thyroxine concentration in cats with and without hyperthyroidism. Journal of Feline Medicine and Surgery 4, 139-143] [technique 2 (T2)]. A semi-quantitative score from 1 to 6 was assigned to the gland size. After clipping of the ventral cervical region, another palpation session followed by ultrasonography of the thyroid glands was performed. Average weighted kappa-values within- and between-examiners were 0.864 and 0.644 for T1 and 0.732 and 0.532 for T2. T1 did lead to significantly smaller within- (P=0.007) and between-examiner (P=0.048) differences than T2. Significant correlation coefficients (P<0.001) between the palpation scores of both techniques and ultrasonographic thyroid lobe length (T1: 0.43; T2: 0.38) were observed. No significant difference before and after clipping was found (T1: P=0.503; T2: P=0.607). The first time that all cats were palpated by either technique, significant score differences between control and hyperthyroid cats were observed both for T1 (P=0.002) and T2 (P=0.003). Both feline thyroid gland palpation techniques have good within- and between-examiner agreements. Based on this study, the classic palpation technique is preferred.
authors.affiliation: Faculty of Veterinary Medicine, Department of Small Animal Medicine and Clinical Biology, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium. dominique.paepe@ugent.be
authors.forename: Dominique
authors.initials: D
authors.lastname: Paepe
authors.forename: Pascale
authors.initials: P
authors.lastname: Smets
authors.forename: Ingrid
authors.initials: I
authors.lastname: van Hoek
authors.forename: Jimmy
authors.initials: J
authors.lastname: Saunders
authors.forename: Luc
authors.initials: L
authors.lastname: Duchateau
authors.forename: Sylvie
authors.initials: S
authors.lastname: Daminet
mesh_terms: D000818:Animals; D016022:Case-Control Studies; D002371:Cat Diseases / Q000097:blood / Q000175:diagnosis*; D002415:Cats; D005260:Female; D006980:Hyperthyroidism / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D008297:Male; D009929:Organ Size; D010173:Palpation / Q000379:methods / Q000592:standards / Q000662:veterinary*; D010808:Physical Examination / Q000379:methods / Q000592:standards / Q000662:veterinary*; D011237:Predictive Value of Tests; D013961:Thyroid Gland / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000473:pathology*; D013974:Thyroxine / Q000097:blood; D014463:Ultrasonography
chemical_list: D013974:Thyroxine