Feline Comorbidities: Balancing Hyperthyroidism and Concurrent Chronic Kidney Disease

Geddes, Rebecca; Aguiar, Joana

Abstract

Practical relevance - Both hyperthyroidism and chronic kidney disease are common long-lasting conditions in older cats, which might be diagnosed concurrently or develop at different times. Hyperthyroidism may mask the presence of chronic kidney disease, and vice-versa by mechanisms here described. Hyperthyroidism treatment options should be carefully considered when chronic kidney disease has also been diagnosed.
Clinical challenges – Although it can be difficult to diagnose both hyperthyroidism and chronic kidney disease simultaneously given that one condition may mask the other and vice-versa, it is important to consider the presence of both diseases when examining an older cat presenting with vomiting, weight loss, polyuria/ polydipsia, anorexia or sarcopenia. The concurrent presence of hyperthyroidism and chronic kidney disease requires careful monitoring of glomerular filtration rate biomarkers and adequate and prompt support of kidney function when thyroid function is re-established. Iatrogenic hypothyroidism is a recognised complication of all available treatment options for hyperthyroidism which increases the incidence of azotaemia. Therapy with sodium-levothyroxine is recommended to cats that are hypothyroid and azotaemic.

Evidence base – Current literature and guidelines related to the pathophysiology, diagnosis and treatment recommendations for feline hyperthyroidism and chronic kidney disease.

Citation

Geddes, R., & Aguiar, J. (2022). Feline Comorbidities: Balancing Hyperthyroidism and Concurrent Chronic Kidney Disease. Journal of Feline Medicine and Surgery, https://doi.org/10.1177/1098612X221090390

• Journal Article Type: Review
• Acceptance Date: Apr 14, 2022
• Publication Date: Apr 28, 2022
• Deposit Date: Oct 29, 2021
• Publicly Available Date: Jul 15, 2022
• Print ISSN: 1098-612X
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1177/1098612X221090390