SECTION I Differential diagnoses for owner chief concerns and physical examination findings
Chapter 1 Growth retardation. 1
Federico Fracassi, Dolores Pérez Alenza, Hans S. Kooistra
¦ Pathophysiology. 1
¦ Diagnostic approach. 1
Chapter 2 Alopecia . 5
Francesco Albanese
¦ Pathophysiology. 5
¦ Classification and clinical signs. 5
¦ Diagnostic approach. 5
Chapter 3 Weight loss. 9
Sean E. Hulsebosch
¦ Pathophysiology. 9
¦ Clinical signs. 12
¦ Diagnostic approach. 12
Chapter 4 Polyuria and polydipsia . 15
Stijn J.M. Niessen, Federico Fracassi, Sara Galac
Edward C. Feldman
¦ Physiology and pathophysiology. 15
¦ Definitions and initial considerations. 15
¦ Signalment, history, physical examination. 16
¦ Diagnostic approach . 16
¦ Diagnosis. 16
Chapter 5 Polyphagia. 19
Dan Rosenberg
¦ Pathophysiology. 19
¦ Diagnostic approach. 22
Chapter 6 Exercise intolerance. 25
M. Montserrat Diaz Espineira
¦ Pathophysiology . 25
¦ Clinical signs. 26
¦ Diagnostic approach. 26
Chapter 7 Obesity. 29
Alexander German
¦ Etiology and pathophysiology. 29
¦ Clinical signs. 29
¦ Diagnostic approach. 29
¦ Therapy. 32
¦ Prevention of obesity 34
Chapter 8 Hypertension. 35
Rosanne E. Jepson
¦ Pathophysiology. 35
¦ Clinical signs. 35
¦ Diagnostic approach . 37
¦ Diagnosis. 37
¦ Considerations for treatment. 37
SECTION II Differential diagnoses for clinicopathologic abnormalities
Chapter 9 Hyperglycemia. 41
Florian Z. Zeugswetter
¦ Pathophysiology. 41
¦ Clinical signs. 41
¦ Diagnostic approach. 41
Chapter 10 Hypoglycemia. 45
Federico Fracassi
¦ Pathophysiology . 45
¦ Clinical signs. 46
¦ Diagnostic approach. 46
Chapter 11 Low thyroxine. 49
Robert E. Shiel
¦ Pathophysiology. 49
¦ Clinical signs. 50
¦ Diagnostic approach. 50
Chapter 12 Hyperlipidemia. 53
Panagiotis G. Xenoulis
¦ Pathophysiology . 53
¦ Clinical signs. 53
¦ Diagnostic approach . 53
¦ Diagnosis. 53
¦ Treatment. 54
Chapter 13 Hyperkalemia. 59
Daniel K. Langlois
¦ Pathophysiology. 59
¦ Clinical signs. 60
¦ Diagnostic approach. 60
Chapter 14 Hypokalemia. 63
Ghita Benchekroun
¦ Pathophysiology . 63
¦ Clinical signs. 64
¦ Diagnostic approach . 64
Chapter 15 Hypernatremia. 67
Chiara Valtolina
¦ Pathophysiology . 67
¦ Clinical signs . 67
¦ Diagnostic approach . 68
Chapter 16 Hyponatremia. 71
Chiara Valtolina
¦ Pathophysiology. 71
¦ Clinical signs . 71
¦ Diagnosis . 72
Chapter 17 Hypocalcemia. 75
Santiago Teyssandier
¦ Pathophysiology. 75
¦ Clinical signs. 75
¦ Diagnostic approach. 76
Chapter 18 Hypercalcemia . 79
Antonio Maria Tardo
¦ Pathophysiology. 79
¦ Clinical signs. 80
¦ Diagnostic approach. 80
¦ Diagnosis. 81
¦ Therapy. 81
Chapter 19 Proteinuria. 85
Tim Williams
¦ Pathophysiology. 85
¦ Clinical signs. 86
¦ Diagnostic approach. 86
¦ Treatment. 88
SECTION III Techniques and procedures
Chapter 20 Blood pressure measurements . 89
Paula García San José, María Dolores Pérez Alenza
¦ Blood pressure measurement techniques. 89
¦ Indications for blood pressure measurement . 91
Chapter 21 Glucose monitoring . 93
Francesca Del Baldo
¦ Measurement of blood glucose using automated
chemistry analyzers . 93
¦ Use of portable blood glucose meter devices. 93
¦ Continuous glucose monitoring systems . 95
¦ Flash glucose monitoring systems. 96
¦ New technologies . 97
Chapter 22 Hormone measurements . 99
Peter A. Graham
¦ Types of assays . 99
¦ Binding proteins and free hormone measurement . 101
¦ Validation, verification, and quality. 102
¦ Transferability of results. 103
SECTION IV Endocrinologic diseases
Chapter 23 Hypothalamus and pituitary gland:
anatomy and physiology. 107
Roberto Chiocchetti
¦ Anatomy. 107
¦ Physiology. 108
Chapter 24 Growth hormone disorders. 111
Federico Fracassi, Annemarie M.W.Y. Voorbij
¦ Physiologic effect. 111
¦ Hypersomatotropism (acromegaly). 112
¦ Pituitary dwarfism. 114
Chapter 25 Vasopressin-related disorders
of water homeostasis. 119
Hans S. Kooistra
¦ Syndrome of inappropriate ADH release. 120
¦ Diabetes insipidus. 121
¦ Primary polydipsia. 123
¦ Primary adipsia. 124
Chapter 26 Anatomy and physiology of the thyroid gland. 127
Lisa Stammeleer
¦ Anatomy. 127
¦ Physiology . 127
Table of contents XXI
Chapter 27 Canine hypothyroidism. 129
Andrea Corsini, Tera Pijnacker
¦ Etiology. 129
¦ Clinical features. 131
¦ Endocrine testing. 134
¦ Diagnostic imaging. 138
¦ Treatment. 139
¦ Prognosis. 139
Chapter 28 Thyroid tumors and hyperthyroidism. 143
Sylvie Daminet, Miguel Campos
¦ Etiology. 143
¦ Clinical features . 144
¦ Diagnostic imaging . 144
¦ Diagnosis . 146
¦ Therapy. 146
¦ Prognosis. 148
Chapter 29 Anatomy and physiology of parathyroid
glands and calcium metabolism. 151
Rodolfo Oliveira Leal
¦ Anatomy of the canine parathyroid glands. 151
¦ Parathyroid physiology and its role in calcium
homeostasis . 151
Chapter 30 Primary hyperparathyroidism. 155
Rodolfo Oliveira Leal
¦ Etiology. 155
¦ Clinical features. 155
¦ Clinicopathological findings. 156
¦ Endocrine tests . 156
¦ Diagnostic imaging. 157
¦ Diagnosis. 158
¦ Therapy. 159
¦ Post-treatment management. 160
¦ Histopathology . 160
¦ Prognosis. 160
¦ Parathyroids and concurrent endocrine diseases . 160
Chapter 31 Hypoparathyroidism:
naturally occurring and iatrogenic. 163
Barbara J Skelly
¦ Pathogenesis of PTH deficiency . 163
¦ Signalment of animals with hypoparathyroidism. 163
¦ History and clinical manifestation
of hypoparathyroidism. 164
¦ Diagnostic procedures and endocrine testing. 165
¦ Treatment. 166
¦ Does hungry bone syndrome exist in dogs?. 167
¦ Acute management of symptomatic hypocalcemia. 167
¦ Concurrent conditions complicating the management
of primary idiopathic hypoparathyroidism. 167
¦ Long-term treatment and prognosis . 168
Chapter 32 Anatomy and physiology
of the adrenal glands. 169
Darja Pavlin
¦ Anatomy . 169
¦ Physiology . 169
Chapter 33 Hypoadrenocorticism. 171
Nadja S. Sieber-Ruckstuhl, Felicitas S. Boretti
¦ Etiology. 171
¦ Clinical features. 172
¦ Clinicopathological findings. 172
¦ Endocrine testing. 174
¦ Diagnostic imaging. 176
¦ Treatment. 176
¦ Prognosis. 181
Chapter 34 Cushing’s syndrome. 183
Pathogenesis and clinical manifestations 183
Carolina Arenas, Carlos Melián
¦ Pathogenesis. 183
¦ Epidemiology. 184
¦ Clinical features. 184
¦ Clinicopathological findings. 186
Endocrine testing 188
Sara Galac
¦ Low-dose dexamethasone suppression test. 188
¦ Urinary cortisol-to-creatinine ratio. 188
¦ ACTH stimulation test. 189
¦ Endogenous ACTH . 191
¦ High-dose dexamethasone suppression test. 191
Diagnostic imaging 192
Henk van den Broek and Stefanie Veraa
¦ Abdominal ultrasonography . 192
¦ Computed tomography. 193
¦ Magnetic resonance imaging . 194
General treatment considerations 196
Sara Galac
Medical treatment 197
Stefania Golinelli
¦ Adrenal-directed drugs (traditional options). 197
¦ Adrenal-directed drugs (future options) . 203
¦ Pituitary-directed drugs. 203
Surgical treatment: trans-sphenoidal
hypophysectomy 207
Björn Meij and Sara Del Magno
¦ Preoperative evaluation. 207
¦ Surgical anatomy and diagnostic imaging. 207
¦ Preoperative management and surgical technique. 208
¦ Postoperative care. 209
¦ Prognosis. 209
Surgical treatment: adrenalectomy 213
Sebastiaan A. van Nimwegen
¦ Surgical anatomy and disease staging. 213
¦ Complications and perioperative measures . 214
¦ Surgical approach. 214
¦ Outcome and prognosis. 216
Radiation therapy 217
Maurice Zandvliet and Jérôme Benoit
¦ Types of radiation therapy . 217
XXII Table of contents
¦ Treatment considerations . 217
¦ Radiation-associated toxicity. 219
¦ Outcomes of pituitary radiotherapy . 219
Chapter 35 Adrenal tumors (all but cortisol-secreting
and pheochromocytoma). 229
Viviani De Marco
¦ Hyperaldosteronism. 229
¦ Steroid precursors and sex hormone-secreting
adrenal tumors. 229
¦ Adrenal incidentaloma: hormonally silent adrenal
tumors . 230
Chapter 36 Pheochromocytoma. 233
Marit F. van den Berg
¦ Etiology. 233
¦ Clinical features. 233
¦ Clinicopathological findings . 234
¦ Diagnostic imaging . 234
¦ Diagnosis . 235
¦ Therapy. 237
¦ Prognosis. 238
Chapter 37 Anatomy and physiology of the canine
endocrine pancreas . 241
Thomas A. Lutz
¦ Anatomy of the canine pancreas. 241
¦ Endocrine cell types. 241
¦ Function of islet hormones. 241
¦ Secretory control of islet hormones. 242
Chapter 38 Diabetes mellitus . 245
Pathogenesis, clinical manifestations,
and diagnosis 245
Lucy Davidson
¦ Pathogenesis. 245
¦ Clinical manifestations. 246
¦ Diagnosis. 247
General treatment considerations 250
Federico Fracassi
¦ The importance of the owner and therapeutic goals . 250
¦ Initiating insulin therapy. 250
¦ Owner education . 250
¦ Dietary recommendations. 250
¦ Exercise. 251
Insulin therapy and other treatment options 252
Chen Gilor, Linda Fleeman
¦ Goals of therapy for the individual patient. 252
¦ Choosing the best insulin . 253
¦ The ultimate goal of insulin therapy: mimic physiologic
insulin delivery . 253
¦ Insulin pharmacology in dogs. 256
¦ Guidelines for starting insulin therapy and adjusting
the dose. 258
¦ Compliance, adherence, convenience, and cost. 259
¦ Syringe versus pen administration. 259
¦ Managing inappetence and gastrointestinal signs. 260
Dietary management of diabetes 261
Linda Fleeman, Charlotte Bjørnvad
¦ Recommendations regarding diet choice. 261
¦ Management of postprandial hyperglycemia
in diabetic dogs . 261
Monitoring a diabetic patient 266
Francesca Del Baldo
¦ Clinical signs. 266
¦ Blood glucose monitoring. 266
¦ Continuous glucose monitoring systems . 270
¦ Urine glucose measurement. 271
¦ Glycated proteins. 272
The unstable diabetic 275
Diego Miceli
¦ Management factors. 275
¦ Causes of insulin resistance. 277
¦ Investigation of diabetic instability . 279
Long-term complications and prognosis 281
Álan G. Pöppl
¦ Ophthalmic long-term complications. 281
¦ Neurological long-term complications . 282
¦ Systemic hypertension and diabetic cardiomyopathy. 282
¦ Diabetic nephropathy . 282
¦ Gastrointestinal complications. 283
¦ Lipodystrophy . 283
¦ Prognosis. 283
Diabetic ketosis, diabetic ketoacidosis
and the hyperosmolar hyperglycemic state 284
Eleonora Malerba
¦ Etiology. 284
¦ Clinical features. 286
¦ Diagnosis. 286
¦ Therapy and prognosis for diabetic ketoacidosis. 286
¦ Therapy and prognosis for hyperosmolar hyperglycemic
state. 289
Chapter 39 Insulinoma. 297
Johan P. Schoeman
¦ Pathogenesis and clinical manifestations. 297
¦ Signalment. 297
¦ Clinical signs. 298
¦ Diagnostic procedures. 298
¦ Clinicopathological findings. 298
¦ Endocrine testing. 299
¦ Diagnostic imaging. 299
¦ Treatment. 300
¦ Prognosis. 302
Index. 305