Endocrinology: diabetes, thyroid, adrenal glands
Diagnosis and management of diabetes, thyroid disease and adrenal disease in dogs and cats — from hormone tests to setting up treatment and regular check-ups.
What it involves
Hormones control metabolism, appetite, body weight, skin and thirst. When a gland produces too much or too little of them, the signs are non-specific and build up slowly: the animal gains or loses weight, drinks more, loses hair, becomes weaker. Endocrinology is the field that pieces these signs together into a diagnosis and manages treatment over years.
The most common diseases we deal with are diabetes (dogs and cats), hypothyroidism (dogs), hyperthyroidism (cats), overactivity of the adrenal cortex — Cushing's disease (dogs) — and underactivity of the adrenal glands — Addison's disease (dogs). Diagnosis is based on hormone tests and dynamic tests, and ultrasound assesses the adrenal glands, pancreas and thyroid.
Treatment of hormonal diseases is usually lifelong therapy: insulin, tablets, diet. Our role is to set the dose so that the animal feels well, and to teach you how to observe it at home.
When it is used
It is worth coming for a consultation when the animal clearly gains or loses weight without a change in diet, drinks and passes urine more than before, has symmetrical hair loss, thin skin, a “pendulous” abdomen, recurrent infections, or when blood tests show raised glucose, cholesterol or liver enzymes.
Animals already under treatment need rechecks every 3–6 months, and more often while the insulin dose is being adjusted.
Indications: symptoms that should prompt a visit
- A dog drinks a lot, passes a lot of urine and is losing weight despite a ravenous appetite.
- An older cat eats huge amounts, yet still loses weight and is nervous.
- A dog is gaining weight, is lethargic, loses hair on its flanks and has cold, rough skin.
- A dog has a “pot-bellied” abdomen, thin skin, pants and drinks a great deal.
- A young dog has recurrent episodes of weakness, vomiting and diarrhoea with no clear cause.
- A blood test has shown raised glucose or an abnormal thyroid hormone level.
- A cat has suddenly started walking on the hocks of its hind legs.
Conditions for which we use it in particular
Diagnostics beforehand
The starting point is a blood count, biochemistry and urinalysis from our laboratory — glucose, fructosamine, cholesterol, liver enzymes, urine specific gravity and urine glucose. We then measure hormones: T4 and TSH (thyroid), cortisol in dynamic tests (adrenal glands), and, where needed, additional parameters sent to an external laboratory.
An abdominal ultrasound assesses the size of the adrenal glands, the pancreas and the liver; in cats with hyperthyroidism we also check the kidneys and heart (echocardiography), because the disease puts strain on them. Blood pressure measurement is part of the assessment.
How it proceeds
The first visit lasts about 45 minutes: history, examination, blood and urine sampling, ultrasound. Dynamic tests (e.g. ACTH stimulation) require 1–2 hours in the practice — we give a drug and take blood at set intervals. We discuss results from our in-house laboratory the same day, and those sent to an external laboratory within 2–5 days.
Once a diagnosis is made, we set the treatment and teach you the practical tasks: giving insulin, measuring glucose at home with a glucometer, keeping a diary of drinking and weight. The insulin dose is checked using a glucose curve (a stay of several hours or home measurements) after 1–2 weeks, then less often.
Aftercare
Treatment of hormonal diseases takes place at home. What matters most are fixed times for meals and medication, weighing once a week and monitoring how much the animal drinks. If your pet is on insulin, it is worth keeping honey or glucose at home in case of hypoglycaemia (trembling, weakness, disorientation).
We plan check-ups every 3–6 months with a blood test. Please call immediately if a pet on insulin refuses to eat, vomits, is lethargic or has seizures, and, in Addison's disease, with any sudden weakness.
Frequently asked questions
Can a cat with diabetes recover?
In some cats, when insulin is started early and combined with a low-carbohydrate diet, the disease goes into remission and insulin is no longer needed. This cannot be promised, but it is worth aiming for.
Will I be able to give insulin at home?
Yes — the needles are very thin and most animals do not notice the injection. We practise it together during the visit until you feel confident.
How long does the diagnosis of Cushing's disease take?
Usually two visits: the first with basic tests and an ultrasound, the second with a hormone test lasting several hours. The diagnosis needs to be confirmed because treatment is long-term.
Do thyroid tablets have to be taken for life?
In hypothyroidism in a dog — yes. In hyperthyroidism in a cat, medication is one of the options; the alternatives are a therapeutic diet or, in selected cases, definitive treatment at a referral centre.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Have questions about endocrinology: diabetes, thyroid, adrenal glands?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.