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Abstract
ObjectivesThe primary objective of this study was to report the prevalence and magnitude of elevated liver enzyme activity in feline hyperthyroidism using a large cohort of cats presenting for iodine-131 treatment. The secondary objective was to determine if elevated liver enzyme activity was a reversible process following successful iodine-131 treatment.MethodsCases that presented for a single iodine-131 treatment were retrospectively reviewed. Short-term and long-term follow-up clinicopathologic data was then reviewed for the secondary objective.ResultsTwo hundred seventeen hyperthyroid cats met the inclusion criteria for the primary objective. In total, 123/217 (56.7%) of the cats had at least one liver enzyme elevation on their chemistry panel, with alanine transaminase activity being the most common. All cats who were successfully treated with iodine-131 had liver enzyme activity within the reference range at short-term follow-up and long-term follow-up points.Conclusion and RelevanceOur study demonstrates that elevated liver values are common in cats presenting for iodine-131 treatment. Additionally, our study demonstrates that even when liver values are markedly elevated prior to treatment, the liver enzyme activity will return to normal after successful resolution of hyperthyroidism using iodine-131 treatment. Investigation into hepatobiliary disease and liver function tests for cats with a diagnosis of hyperthyroidism may be unnecessary as the liver values will likely return to normal with successful iodine-131 treatment.
Highlights
Feline hyperthyroidism is a widely recognized disease that is characterized by functional thyroid nodular hyperplasia or neoplasia [1–3]
One study with 19 hyperthyroid cats treated with I-131 could not demonstrate an association with abnormalities in the sonographic appearance of the hepatic parenchyma or liver functional variables in hyperthyroid cats regardless of the degree of elevated liver enzymes (ELEZ) (78.94% of the cats had ELEZ), and the liver enzymes (LEZ) in these cats after I-131 therapy had no significant difference with age-matched healthy control cats [15]
Records dated between November 2012 and December 2017 at Veterinary Specialty and Emergency Center in Levittown, Pennsylvania were retrospectively searched for cats receiving I-131 for treatment of feline hyperthyroidism
Summary
Feline hyperthyroidism is a widely recognized disease that is characterized by functional thyroid nodular hyperplasia or neoplasia [1–3]. ELEZ are common, with up to 76% of patients having at least one liver function test abnormality, and the ELEZ are often reversible once the patient achieves a euthyroid state, and there is no correlation with histopathologic lesions and ELEZ [14]. One study with 19 hyperthyroid cats treated with I-131 could not demonstrate an association with abnormalities in the sonographic appearance of the hepatic parenchyma or liver functional variables (serum bile acids, albumin, ammonia, cholesterol, and blood urea nitrogen) in hyperthyroid cats regardless of the degree of ELEZ (78.94% of the cats had ELEZ), and the liver enzymes (LEZ) in these cats after I-131 therapy had no significant difference with age-matched healthy control cats [15]
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