Endocrine System Notes

I.

Thyroid disease
A.

Negative feedback system

1.
Low concentrations of thyroid hormone, hypothalamus
releases a stimulating hormone called thyrotropin-releasing
hormone (TRH)
2.
Pituitary is stimulated, releases thyroid-stimulating
hormone (TSH)
3.
Follicular cells of the thyroid gland absorb iodine and
incorporate it into tyrosine molecules to produce T3 and T4
a)
b)

B.

T3: Triiodothyronine
T4: Tetraiodothyronine or thyroxine
(1)
Once taken up by cells, T4 is converted by tissues
to T3 by removing one iodine. Circulating T4 levels
provide the negative feedback to the hypothalamus and
pituitary to decrease release of TRH and TSH
(2)
The T3 form is the physiologically active form of the
hormone and causes changes associated with the thyroid
hormones

Hypothyroidism
1.
Primary hypothyroidism: decrease in thyroid hormone
production associated with disease or destruction of the thyroid
gland.
2.
Secondary hypothyroidism: the pituitary cannot produce
TSH; thyroid gland itself is perfectly healthy
3.
Tertiary hypothyroidism: hypothalamus is unable to
produce TRH; pituitary and thyroid are fine
4.
Goiter: hypothyroid condition due to lack of iodine in the
diet; without iodine, the thyroid cannot manufacture T3 or T4
a)
Increase in thyroid size caused by excessive stimulation
of the thyroid gland by TSH. The hypothalamus and pituitary
gland detect the low circulating levels of thyroid hormone and
increase output of TRH and TSH in attempt to raise T3 and T4
levels. In response to the stimulus from TSH, the thyroid cells
proliferate and the gland increases in size.
b)
Easily treated by feeding iodinated foods

5.
Canine hypothyroidism: functional thyroid tissue becomes
destroyed
6.
Signs of hypothyroid: lethargy, weight gain, heat-seeking,
bradycardia, decreased function of estrus cycle, hair loss, dry
and flakey skin

Endocrine System Notes

7.

Treatments
a)
Synthetic T4 (levothyroxine): drug of choice, allows each
tissue to individually convert T4 to T3 to meet its specific
metabolic need
(1)
The CNS has a high metabolic rate and therefore
has an increased requirement for thyroid hormone
(2)
Levothyroxine can trigger the natural negative
feedback mechanism, more closely emulates the normal
regulatory mechanism
b)
Synthetic T3 (liothyronine): bypasses regulation of local
tissue conversion of T4 to T3
(1)
Not preferred: can overdose organs with lesser
requirements for T3, more expensive, and must be
administered 3x daily
(2)
Liothyronine is used if levothyroxine therapy fails to
produce adequate blood concentrations of thyroid
hormone

C.
Hyperthyroidism: most common in cats associated with a
hormone-secreting thyroid tumor
1.
Signs of hyperthyroid: increased physical activity, diarrhea
from increased GI motility, weight loss despite a voracious
appetite, tachycardia, polydipsia
2.
Treatments
a)
Thyroidectomy: removal of the thyroid gland
b)
IV injection of radioactive iodine (131I): the radioactive
iodine is taken up and concentrated within active tumor cells,
causing them to receive a lethal dose of radioactivity while
sparing normal thyroid tissue
c)
Methimazole (tapazole): blocks the thyroid tumors ability
to produce T3 and T4
(1)
Lifelong medication
(2)
Side effects in approx. 20% of cats: vomiting and
anorexia
d)
Beta blockers: treat tachycardia associated with
hyperthyroidism

II.

Diabetes Mellitus
A.
Diabetes Mellitus is characterized by hyperglycemia and
glucosuria
B.
Major effect of insulin is to move glucose from the blood into
tissue cells. Insulin also causes the liver to store glucose as
glycogen and facilitates deposition of fat in adipose tissue

Endocrine System Notes

C.

Type one vs. type two

1.
Type one: insulin dependent diabetes mellitus (IDDM),
related to the number of functional pancreatic beta cells
a)
b)

2.

Destruction or lack of function of the pancreatic beta cells

Characterized by decreased insulin

Type two: non-insulin-dependent diabetes mellitus (NIDDM)

a)
Results from a decreased effectiveness of insulin even
though the pancreatic beta cells are potentially capable of
producing adequate insulin
b)
Causes: a decreased number of insulin receptors on
tissue cells, decreased sensitivity of insulin receptors present, or
a decreased sensitivity of the pancreatic beta cells to
hyperglycemia