Cardiac Disease Related to Primary Hyperthyroidism in a 20-Year-Old Mule.
Kaitlin BrownElizabeth Williams LouieToby Pinn-WoodcockErin PearsonGarett B PearsonJacqueline MarrEileen S HackettLaura Rath BrownKatharyn J MitchellPublished in: Animals : an open access journal from MDPI (2024)
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.
Keyphrases
- left ventricular
- case report
- heart failure
- left atrial
- hypertrophic cardiomyopathy
- cardiac resynchronization therapy
- mitral valve
- acute myocardial infarction
- aortic stenosis
- atrial fibrillation
- physical activity
- catheter ablation
- squamous cell carcinoma
- spinal cord
- mental health
- blood pressure
- risk factors
- mechanical ventilation
- locally advanced
- coronary artery disease
- coronary artery bypass
- percutaneous coronary intervention
- ultrasound guided
- body weight
- electronic health record
- pulmonary hypertension
- prefrontal cortex
- gestational age