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ABSTRACT OF THE WEEK

Journal of Small Animal Practice
Volume 61 | Issue 8 (August 2020)

Clinical features and outcome of functional thyroid tumours in 70 dogs.

J Small Anim Pract. August 2020;61(8):504-511.
V F Scharf1, M L Oblak2, K Hoffman3, O T Skinner4, K M Neal5, C J Cocca6, D J Duffy7, M L Wallace8
1 College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, North Carolina, USA.; 2 Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.; 3 Nicholas School of the Environment, Duke University, 9 Circuit Drive, Box 90328, Durham, North Carolina, USA.; 4 Veterinary Health Center, University of Missouri, 900 E Campus Dr., Columbia, Missouri, 65211, USA.; 5 College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, Georgia, 30602, USA.; 6 College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.; 7 College of Veterinary Medicine, North Carolina State University, 1060 William Moore Dr., Raleigh, North Carolina, USA.; 8 College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, Georgia, 30602, USA.
© 2020 British Small Animal Veterinary Association.

Abstract

OBJECTIVE:To describe the clinical features and outcome of functional thyroid tumours in dogs.
MATERIALS AND METHODS:Retrospective multi-institutional study of 70 dogs diagnosed with thyroid mass and concurrent hyperthyroidism. Clinical data regarding presentation, treatment, outcome and functional thyroid status were retrieved.
RESULTS:Overall median survival of dogs with functional thyroid tumours was 35.1 months and 1- and 3-year survival rates were 83 and 49%, respectively. Median survival time was 72.6 months for dogs treated with surgical excision and 15.7 months for dogs that did not receive surgery. Of the 50 dogs treated by surgery and for which thyroid status was known following treatment, 64% developed hypothyroidism after surgery. Histopathologically confirmed metastasis was identified in 3% of dogs.
CLINICAL SIGNIFICANCE:Dogs with functional thyroid tumours may survive a long time after surgical excision, although post-operative hypothyroidism is common.

Companion Notes

Retrospective, multicenter report on the clinical features and outcome of functional thyroid tumors in 70 dogs

   

Introduction on thyroid tumors in the dog

- account for 1.1-3.8% of canine cancers

- most common endocrine tumor

- treatment of choice is surgical excision

- reported median survival: up to 38 months

- some advocate adjuvant chemotherapy, radiation therapy, or radioiodide

- concerning fixed tumors not amenable to surgical resection

- median survival with radiation therapy: up to 24 months

- median survival with radioiodide therapy: up to 30 months

- reported proportion of functional thyroid tumors: 0-31%

- texts suggest 10% of affected dogs show concurrent hyperthyroidism

   

Study design

- study population: dogs seen at 5 institutions

- dogs with a thyroid mass and elevated initial serum thyroxine (T4)

- inclusion criteria:

- confirmation of thyroid mass by imaging

(ultrasonography, CT, or scintigraphy)

Or

- consistent physical examination

(palpation of ventral cervical mass)

- with confirmatory histopathology or cytology

- clinical signs defined as consistent with hyperthyroidism

- polyuria

- polydipsia

- polyphagia

- weight loss

- hyperactivity or restlessness

- thyroid hormone levels at presentation obtained for all dogs

- procedure: records from 10-18 retrospectively reviewed

   

Results

- outcome

- overall median survival: 35.1 months

- median survival time for dogs treated with surgical excision: 72.6 months

- median survival time for dogs not treated with surgical excision: 15.7 months

- 1-year survival rate: 83%

- 3-year survival rate: 49%

- among the 50 dogs treated by surgery with known thyroid status postop

- 64% developed hypothyroidism after surgery

- 3% had histopathologically confirmed metastasis identified

- 4 dogs were suspected to have metastases at presentation

- locoregional lymphadenopathy, 2

- pulmonary nodules, 2

- history & signalment

- median age at presentation: 10 years of age with a range of 5-15

- median weight: 25 kg with a range of 5-53 kg

- breeds represented by 3 or more cases

- Labrador retriever, 12 of the 70

- golden retriever, 4

- boxer, 4

- Shetland sheepdog, 3

- neutered sex:M, 34 cases (7 more dogs were intact sex:M)

- median duration from onset of clinical signs to presentation: 61 days

- presenting owner complaints

- palpable mass, 25 of the 70 dogs

- polyuria, 22

- polydipsia, 22

- weight loss, 17

- restlessness/anxiety, 8

- polyphagia, 7

- panting, 7

- cough, 7

- dysphagia/regurgitation, 4

- lethargy, 3

- dyspnea/exercise intolerance, 2

- hyporexia, 2

- vomiting, 2

- hindlimb weakness, 1

- clinicopathology

- abnormal parameters seen in 3 or more cases

- increased alanine transaminase, 18 of the 70

- increased alkaline phosphatase, 16

- hypercalcemia, 6

- proteinuria, 6

- hyperglycemia, 4

- elevated BUN, 4

- hypernatremia, 3

- hyposthenuria, 3

- bacteriuria, 3

- neutrophilia, 3

- monocytosis, 3

- specific tumor location available for 51 dogs

- 9 were ectopic (1 at unspecified ectopic location)

- 4 originated from the basihyoid bone

- 2 in cranial mediastinum

- 1 at thoracic inlet

- 1 in right ventricular outflow tract

- of 63 tumors with laterality specified

- 10 were bilateral

- auscultation

- heart murmur, 14 dogs

- tachycardia, 7

- 1 was diagnosed with atrial and ventricular premature complexes

- median percent elevation of TT4 above upper boundary of reference: 56%

(TT4 = initial total thyroxine)

- histopathology: carcinoma, 55 of 63 cases

- treatment

- definitive or palliative treatment, 67 dogs

(alone or in combination)

- surgical excision

- only therapy in 49 cases

- surgery with chemotherapy (carboplatin), 6

- surgery with methimazole, 6

- surgery with radiation, 2

- radiation alone, 2

- methimazole alone, 2

   

“Both dogs treated with methimazole alone remained hyperthyroid at 10 and 349 days following initiation of therapy. One dog that started methimazole before surgery became hypothyroid from methimazole treatment before excision of the tumour and was administered thyroid hormone supplementation preoperatively.”

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