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DOC for Tx of hypothyroidism in all species

levothyroxine (T4)

Liothyronine (T3)

Faster onset of action; shorter 1/2 life; more potent; may cause thyrotoxicosis

Used in dogs with intestinal malabsorption because it is more readily absorbed

Liothyronine (T3)

May be used in animals treated with glucocorticoid

Liothyronine (T3)

Tx of thyrotoxicosis

withdrawing the drug, beta blockers, and activated charcoal

Levothyroxine (T4)

allows for intracellular autoregulation and provides T3

Species in which commercial combinations of T4 to T3 (4:1) are not recommended

dogs

Tx of myxyedema coma in dogs

L-thyroxine sodium for injection IV or SC; warming the animal; artificial respiration; fluid, electrolytes, glucocorticoids for shock

Drugs that decrease thyroid levels

glucocorticoids, sulfonamides, anticonvulsants, phenylbutazone, salicylates, quinidine, mitotane, general anesthetics

Antithyroid drugs

thioureylenes (methimazole, propylthiouracil), iodides (lugol's iodine, potassium iodide), iodinated radiographic contrast agents (ipodate), antithyroid plants (cabbage, turnip, broccoli, and rapeseed)

MOA thioureylenes

inhibit synthesis of thyroid hormones by inhibiting organification and coupling

MOA iodides

inhibit thyroid hormone organification, inhibit preformed hormone secretion, reduce the size and vascularity of the thyroid gland, may inhibit the binding of iodine

MOA iodinated radiographic contrast agents

inhibits conversion of T4 and T3 in peripheral tissues, inhibit thyroid hormone synthesis and release

MOA antithyroid plants

contain goitrin which inhibits thyroid hormone synthesis

Tx of hyperthyroidism in cats

sx thyroidectomy, radioactive iodine, antithyroid drugs, beta blockers

Radioactive iodine therapy

selectively destroys thyroid tissue; has a 1/2 life of 8 days; treated cats must be hospitalized for 1-4 wks; can produce a premanent cure w/o sx; also used for thyroid adenocarcinoma; very safe, but very expensive

Antithyroid DOC in the cat

methimazole

Adverse effects of methimazole

anorexia, vomiting, lethargy, hepatic toxicity, blood disorders

Used for at large doses for a short period of time before sx to stabilize the patient

oral iodide therapy

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