Peer-reviewed veterinary case report
Thyroid hormone test comparison in hyperthyroid and sick cats
By Brassard, Camille et al.·Published in Journal of feline medicine and surgery·2026·Virginia-Maryland Regional College of Veterinary Medicine, United States·View original on PubMed →
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Original publication title: Comparison of thyrotropin concentrations measured by bulk acoustic wave technology and chemiluminescence in hyperthyroid cats and cats with non-thyroidal illness.
- Species:
- cat
Plain-English summary
A group of hyperthyroid cats were tested for thyroid-stimulating hormone (TSH) levels using two different methods: a new bulk acoustic wave technology and a standard chemiluminescent assay. The new test showed high accuracy in identifying hyperthyroid cats but was less sensitive, meaning it missed some cases compared to the standard test. In some cases, hyperthyroid cats had detectable TSH levels with the new test but not with the standard one. While the new method is promising, it cannot completely rule out hyperthyroidism if the results are normal.
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Abstract
ObjectivesA thyrotropin (also known as thyroid-stimulating hormone [TSH]) assay using bulk acoustic wave (TSH-BAW) technology is a sensitive and specific test for diagnosing hyperthyroidism; however, the effect of various types of non-thyroidal illness (NTI) have not been evaluated with this assay. The objectives of this study were to compare serum TSH concentrations using the TSH-BAW and a currently available TSH chemiluminescent immunoassay (TSH-CLIA) in hyperthyroid cats, cats with NTI and healthy cats, as well as to compare sensitivity and specificity for diagnosing hyperthyroidism.MethodsA prospective cross-sectional study was conducted comparing the TSH concentration of 37 hyperthyroid, 32 healthy and 32 NTI cats using the TSH-CLIA and TSH-BAW assays. The effect of disease severity was evaluated with hyperthyroidism and NTI.ResultsThe TSH-BAW had a lower sensitivity (78%, 95% confidence interval [CI] 62-90) and negative predictive value (89%, 95% CI 79-95) but higher specificity (97%, 95% CI 89-100) and positive predictive value (94%, 95% CI 79-99) than the TSH-CLIA. The median serum TSH concentration was significantly different between hyperthyroid cats and both healthy and NTI cats with both assays ( <0.01) but was not different between NTI and healthy cats (TSH-CLIA = 0.168, TSH-BAW = 0.673). Eight (21.6%) hyperthyroid cats had a detectable TSH-BAW but undetectable TSH-CLIA concentration, with seven (18.9%) having a TSH-BAW within the reference interval. A total of 12 (18.8%) non-hyperthyroid cats (four [12.5%] healthy cats and eight [25%] NTI cats) had an undetectable TSH-CLIA compared with only two (6%) cats (one [3%] healthy cat and one [3%] NTI cat) with the TSH-BAW assay. The proportion of cats with an undetectable serum TSH concentration was significantly higher with the TSH-CLIA than the TSH-BAW in NTI cats ( = 0.008). This was especially evident in NTI cats suffering from moderate to severe illnesses ( = 0.025).Conclusions and relevanceThe TSH-BAW has a high specificity for detecting hyperthyroidism and identifies a normal serum TSH concentration in non-hyperthyroid cats more often than the TSH-CLIA. However, a normal result cannot be used to rule out hyperthyroidism.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/41222090/