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- Title
Cardiac Disease Related to Primary Hyperthyroidism in a 20-Year-Old Mule.
- Authors
Brown, Kaitlin; Williams Louie, Elizabeth; Pinn-Woodcock, Toby; Pearson, Erin; Pearson, Garett B.; Marr, Jacqueline; Hackett, Eileen S.; Rath Brown, Laura; Mitchell, Katharyn J.
- Abstract
Simple Summary: Historically, there have been very few reports of elevated thyroid hormone (hyperthyroidism) due to thyroid dysfunction in equid species (horses, mules, donkeys, zebras). Hyperthyroidism is a relatively common problem in cats and humans. Increased appetite, weight loss and muscle wasting, elevated heart rate and elevated blood pressure are common clinical signs in these species. In the few case reports of hyperthyroid horses, they often present with weight loss and increased appetite, but there have not been any documented cardiac changes (elevated heart rate, heart murmur, elevated blood pressure) in these patients. The mule investigated in this case report presented with a persistently elevated heart rate and systolic murmur. Cardiac imaging revealed structural changes consistent with those seen in other hyperthyroid mammals. This case report documents the diagnosis, treatment and management and provides long-term follow up of endocrine and cardiac disease in a mule with primary hyperthyroidism. Primary hyperthyroidism is a rarely diagnosed endocrinopathy in equids and there have been no previous reports of structural and functional cardiac changes associated with hyperthyroidism in these species. This case report investigates a 20-year-old mule gelding that presented for a three-month history of thin body condition despite polyphagia, with a heart murmur and elevated free and total thyroid hormone concentrations. On presentation, physical exam revealed a body condition score of two out of nine, persistent tachycardia, pansystolic heart murmur and firm bilateral ventral proximal cervical masses. Bloodwork confirmed markedly elevated free T4, total T4 and T3 concentrations. Echocardiogram demonstrated left ventricular concentric hypertrophy with increased ventricular and atrial systolic function. Bilateral thyroidectomy was performed under standing sedation without complications. Histopathology demonstrated adenocarcinoma of the left thyroid gland and multiple adenomas with osseous metaplasia within the right thyroid. The mule was supplemented with levothyroxine sodium two weeks post-op after a thyroid panel demonstrated undetectable concentrations. Polyphagia resolved following surgery and the mule began gaining weight. Echocardiographic changes improved but did not resolve at two years post-operative. Continued bi-annual follow up and monitoring of thyroid levels was recommended. This case represents the first documentation of hemodynamically relevant cardiac remodeling in an equid associated with primary hyperthyroidism.
- Subjects
DONKEYS; THYROID gland; WEIGHT gain; HYPERTHYROIDISM; LEFT ventricular hypertrophy; ENDOCRINE diseases; SYMPTOMS
- Publication
Animals (2076-2615), 2024, Vol 14, Issue 11, p1660
- ISSN
2076-2615
- Publication type
Article
- DOI
10.3390/ani14111660