Juvenile Panhypopituitarism in a Dog – What are the Therapeutic Challenges?
Notice bibliographique
Résumé
Background: Juvenile panhypopituitarism is an endocrinopathy that affects young dogs and must be differentiated from other causes of height disorders, as one could have a deficiency of one or more adenohypophysis hormones, besides growth hormone. Diagnosis consists of excluding endocrine and non-endocrine causes. Treatment requires administration of heterologous porcine growth hormone or progestins, as well as supplementing other hormones that are deficient in the circulation. The prognosis for these patients tends to be unfavorable and they have a shorter life expectancy. The present case aimed to report the therapeutic challenges in a dog diagnosed with juvenile panhypopituitarism. Case: This study presents the case of a 6-month-old crossbred Labrador/Brazilian Fila dog, not neutered, 6.7 kg of body weight (body condition score 5/9), with a growth disorder and persistence of the puppy coat, when compared to other members of the same litter. During inspection, it was possible to observe an undersized dog and soft puppy coat, besides no bone irregularities or joint tenderness was noted. The other physical examination parameters were within the normal range for the species. No changes in complete blood count and only increases in urea, cholesterol and alkaline phosphatase activity were observed. Thyroid and abdominal ultrasound (US) examination did not reveal any remarkable changes. After serum dosage of insulin-like growth factor, thyroxine, thyrostimulating hormone, and cortisol, the patient was diagnosed with juvenile panhypopituitarism and underwent therapy with medroxyprogesterone and thyroid hormone supplementation. Monitoring was instituted at intervals of 3, 6, and 12 weeks, and currently every 3 or 4 months and the IGF-1 values normalized after 6 months with. After 8 months of therapy, the patient had good body growth and bone mineralization compared to the time of diagnosis. However, skeletal development was completed only 12 months after hormone replacement, accompanied by the presence of vertebral osteophytes and coxofemoral osteoarticular alterations. Considering chronic use of progestins, ovariosalpingohysterectomy (OSH) was recommended, but for personal reasons, the owners chose to do not submit her to surgery. After 18 months of treatment, the dog starts to exhibit prostration, selective appetite, and increased abdominal volume. After imaging exam, she was forwarded for OSH, due to consistent findings of pyometra. Subsequently, even the supervision of possible comorbidities involved in the chronic use of progestins was maintained at half-yearly intervals, the bitch returned to the service with skin thickening, increased limb volume, and macroglossia after 60 months of therapy. At this point IGF-1 values were higher when compared to the previous measurements and the application of medroxyprogesterone was suspended. Its supplementation was reintroduced only after 8 months when IGF-1 was significantly reduced. To date, the patient is close to 6 years of age and with a good quality of life. Discussion: The greatest therapeutic challenge for these patients involves dealing with the adverse effects of progestins, mainly related to reproductive disorders and alopecia at the application site, as well as maintaining adequate hormone replacement in order to avoid hypersomatotropism. Although longevity is lower in these individuals, the patient in this report has achieved six years of age and has had an excellent quality of life so far. Keywords: adenohypophysis, growth hormone, pituitary dwarfism, thyrostimulating hormone.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».