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Güssow A, Thalmeier S, Gostelow R, Langenstein J, Foerster G, Bauer N, Hazuchova K. Method Validation and Establishment of Reference Intervals for an Insulin-like Growth Factor-1 Chemiluminescent Immunoassay in Cats. Vet Sci 2023; 10:575. [PMID: 37756097 PMCID: PMC10534906 DOI: 10.3390/vetsci10090575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
Previously, radioimmunoassay (RIA) has been the only assay to measure insulin-like growth factor-1 (IGF-1) to diagnose hypersomatotropism (HS). Due to radiation concerns, availability, and the cost of IGF-1 RIA, validation of assays for automated analysers such as a chemiluminescent immunoassay (CLIA) is needed. The aim of this study was to validate a CLIA for measurement of feline IGF-1 (IMMULITE 2000® XPi, Siemens Medical Solutions Diagnostics, Malvern, PA, USA) compared to IGF1 RIA, establish reference interval (RI), and determine a cut-off value for diagnosis of HS in diabetic cats. Validation of assay performance included precision, linearity, and recovery studies. Right-sided RI was determined using surplus serum of 50 healthy adult cats. Surplus serum samples of diabetic cats with known IGF-1 concentration with (n = 32/68) and without HS (n = 36/68) were used for method comparison with RIA. The cut-off for diagnosis of HS was established using receiver operating characteristic (ROC) analysis. The intra-assay coefficient of variation (CV) was ≤4.7%, and the inter-assay CV was ≤5.6% for samples with low, medium, and high IGF-1 concentration. Linearity was excellent (R2 > 0.99). The correlation between CLIA and RIA was very high (rs = 0.97), with a mean negative bias for CLIA of 24.5%. The upper limit of RI was 670 ng/mL. ROC analysis showed an area under the curve of 0.94, with best cut-off for diagnosis of HS at 746 ng/mL (sensitivity, 84.4%; specificity, 97.2%). The performance of CLIA was good, and the RI and cut-off for HS diagnosis established in this study allow for CLIA to be used in routine work-up of diabetic cats.
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Affiliation(s)
- Arne Güssow
- Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University, 35392 Giessen, Germany
| | - Sabine Thalmeier
- Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University, 35392 Giessen, Germany
| | - Ruth Gostelow
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield AL9 7TA, UK
| | | | | | - Natali Bauer
- Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University, 35392 Giessen, Germany
| | - Katarina Hazuchova
- Clinic for Small Animals (Internal Medicine, Clinical Pathology and Clinical Pathophysiology), Justus-Liebig-University, 35392 Giessen, Germany
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Lutz B, Betting A, Kovacevic A, Durand A, Gurtner C, Kaiponen TS, Kooistra H, Campos M, Cui Y. Dilated cardiomyopathy in a cat with congenital hyposomatotropism. JFMS Open Rep 2022; 8:20551169221086437. [PMID: 35368737 PMCID: PMC8973070 DOI: 10.1177/20551169221086437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 7-month-old domestic shorthair cat was presented for evaluation of stunted growth, recurrent hypoglycaemia during the first months of its life and altered mentation. Complete blood count and biochemistry were unremarkable, except for mildly elevated serum creatinine concentration (despite low muscle mass) and concurrent isosthenuria. Hyposomatotropism was diagnosed based on persistent low circulating insulin-like growth factor 1 concentrations and a lack of response of circulating growth hormone (GH) concentration after the administration of GH-releasing hormone. Other endocrinopathies such as hypothyroidism and hypoadrenocorticism were excluded. MRI of the brain revealed a fluid-filled empty sella tursica, consistent with a pituitary cyst and atrophy/hypoplasia of the pituitary. Echocardiography was unremarkable at the time of diagnosis of hyposomatotropism. Three months later, ovariohysterectomy revealed immature ovaries, raising the suspicion of luteinising and follicle-stimulating hormone deficiency. At 1 year of age, the cat developed congestive heart failure secondarily to dilated cardiomyopathy (DCM) with severely reduced left ventricular systolic function and died a few days later. Pathology showed atrophy of the adenohypophysis, epithelial delineation of the pituitary cysts, mild cardiomegaly, multifocal fibrosis of the left ventricle and a mild, multifocal, chronic epicarditis. Relevance and novel information GH deficiency is a very rare endocrinopathy in cats. This is the first case to describe the development of DCM with concurrent hyposomatotropism, which has previously been reported in human medicine. Other notable abnormalities that could be related to GH deficiency are juvenile self-limiting hypoglycaemia, behavioural changes and possible nephropathy.
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Affiliation(s)
- Bérénice Lutz
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Adeline Betting
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Alan Kovacevic
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Alexane Durand
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Corinne Gurtner
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Taina S Kaiponen
- Institute of Animal Pathology, Department of Infectious Diseases and Pathobiology, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Hans Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Miguel Campos
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
| | - Yi Cui
- Division of Small Animal Internal Medicine, Department of Clinical Veterinary Medicine, Vetsuisse Faculty University of Bern, Bern, Switzerland
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Evaluation of Weight Gain, Clinicopathological and Radiographic Changes after Early Diagnosis and Treatment of Congenital Hypothyroidism in Cats. Vet Sci 2022; 9:vetsci9030140. [PMID: 35324868 PMCID: PMC8950234 DOI: 10.3390/vetsci9030140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/11/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023] Open
Abstract
Congenital hypothyroidism is uncommon in cats. This case report describes weight gain, clinicopathological and radiographic changes after early diagnosis and treatment of congenital hypothyroidism in three British shorthair cats’ siblings. Data were assessed at 53 (diagnosis), 83, 185 and 365 days of age. Correlations between serum insulin-like growth factor-1 (IGF-1) and body weight, levothyroxine dose, total thyroxine, and thyroid-stimulating hormone concentrations were evaluated. The body weights of the congenital hypothyroid kittens were compared with those of their two healthy siblings and British shorthair kittens of the same age. At diagnosis, the congenital hypothyroid kittens showed a significantly lower body weight compared to the healthy siblings (p = 0.03). After diagnosis, oral levothyroxine supplementation was started. The difference in body weight was no longer observed after one month of treatment. The clinical signs, clinicopathological and radiographic abnormalities ameliorated after one month of treatment. IGF-1 concentration was significantly positively correlated with body weight (rs = 0.80, p < 0.002). In conclusion, resolution of the clinical signs, achieving a consistent within-breed weight, and improvement of the clinicopathological and radiographic parameters demonstrated the importance of the early diagnosis and treatment of feline congenital hypothyroidism.
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Načeradská M, Návojová Horáčková K, Fridrichová M. Case Report: Human Recombinant Growth Hormone Therapy in a DSH Cat Presented With Dwarfism. Front Vet Sci 2021; 8:773355. [PMID: 34881322 PMCID: PMC8645647 DOI: 10.3389/fvets.2021.773355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/20/2021] [Indexed: 12/19/2022] Open
Abstract
A 6-month-old kitten, male, domestic shorthair cat was presented with dwarfism, ocular and nasal discharge, and Ascaris infestation. Congenital hyposomatotropism was diagnosed on the basis of serum level of insulin-like growth factor-1 (IGF-I). The cat was treated with human recombinant growth hormone for 9 weeks. After that, his liver enzymes became elevated, and the therapy was discontinued. His IGF-I levels were normal at the end of the therapy. Normal IGF-I was present 3 months after discontinuation of therapy with human recombinant growth hormone and even half a year after the discontinuation. All other comorbidities were addressed with the therapy. The cat is now the size of normal cats, living with the first author.
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Affiliation(s)
- Martina Načeradská
- Department of Veterinary Sciences, Faculty of Agrobiology, Food and Natural Resources, Czech University of Life Sciences in Prague, Prague, Czechia.,Veterinární ordinace MVDr. Martiny Načeradské, Prague, Czechia
| | | | - Michaela Fridrichová
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Prague, Czechia
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König ML, Henke D, Adamik K, Pérez Vera C. Juvenile hyposomatotropism in a Somali cat presenting with seizures due to intermittent hypoglycaemia. JFMS Open Rep 2018; 4:2055116918761441. [PMID: 29552354 PMCID: PMC5846957 DOI: 10.1177/2055116918761441] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Case summary A 3-month-old intact male Somali cat was evaluated for a history of seizures, hypoglycaemia and mental dullness 4 weeks after being bitten in the head by a dog. The cat’s body size and weight were approximately half that of his littermates and its haircoat was woolly, with fewer guard hairs. Multiple hypoglycaemic episodes were documented over a period of 4 weeks, which resolved rapidly after correction of the hypoglycaemia. Juvenile hyposomatotropism was presumptively diagnosed by demonstrating low circulating levels of insulin-like growth factor 1 and after exclusion of other endocrine and non-endocrine causes of small stature and hypoglycaemia. The cat’s intermittent hypoglycaemia resolved spontaneously within 1 month and the cat never showed any more neurological signs. Nevertheless, the physical retardation and the coat abnormalities remained unchanged. A year later, the cat was diagnosed with chronic kidney disease IRIS stage 2. Relevance and novel information Hyposomatotropism is an extremely rare feline endocrinopathy. This is the second case reported in the veterinary literature, and the only one to describe hypoglycaemic events associated with growth hormone deficiency. Although hypoglycaemia is one of the most common disease manifestations in children with pituitary dwarfism, this has not yet been reported in veterinary medicine.
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Affiliation(s)
- Maya Laura König
- Department of Clinical Veterinary Studies, Vetsuisse Faculty of Bern, Bern, Switzerland
| | - Diana Henke
- Animal Clinic of Hasenberg, Stuttgart, Germany
| | - Katja Adamik
- Department of Clinical Veterinary Studies, Vetsuisse Faculty of Bern, Bern, Switzerland
| | - Cristina Pérez Vera
- Department of Clinical Veterinary Studies, Vetsuisse Faculty of Bern, Bern, Switzerland
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Quante S, Fracassi F, Gorgas D, Kircher PR, Boretti FS, Ohlerth S, Reusch CE. Congenital hypothyroidism in a kitten resulting in decreased IGF-I concentration and abnormal liver function tests. J Feline Med Surg 2010; 12:487-90. [DOI: 10.1016/j.jfms.2010.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2010] [Indexed: 11/15/2022]
Abstract
A 7-month-old male kitten was presented with chronic constipation and retarded growth. Clinical examination revealed disproportional dwarfism with mild skeletal abnormalities and a palpable thyroid gland. The presumptive diagnosis of congenital hypothyroidism was confirmed by low serum total thyroxine (tT4) concentration prior to and after the administration of thyroid stimulation hormone (TSH), increased endogenous TSH concentration and abnormal thyroid scintigraphic scan. The kitten had abnormal liver function tests and decreased insulin-like growth factor 1 (IGF-1) concentration, both of which returned to normal in correspondence with an improvement of the clinical signs after 6 weeks of thyroxine therapy. Congenital hypothyroidism is a rare disease that may present with considerable variation in clinical manifestation. In cases in which clinical signs are ambiguous, disorders such as portosystemic shunt and hyposomatotropism have to be taken into account as differential diagnosis. As hypothyroidism may be associated with abnormal liver function tests and low IGF-1 concentrations, test results have to be interpreted carefully.
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Affiliation(s)
- Saskia Quante
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Federico Fracassi
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Daniela Gorgas
- Division of Clinical Radiology, Vetsuisse Faculty, University of Berne, Switzerland
| | - Patrick R. Kircher
- Division of Clinical Radiology, Vetsuisse Faculty, University of Berne, Switzerland
| | - Felicitas S. Boretti
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Stefanie Ohlerth
- Section of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Switzerland
| | - Claudia E. Reusch
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Switzerland
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