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Peer-reviewed veterinary case report

Measuring free T4 in dogs with non-thyroid illness

By Bennaim, Michael et al.·Published in Research in veterinary science·2022·University College Dublin Veterinary Hospital·View original on PubMed

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Original publication title: Free thyroxine measurement by analogue immunoassay and equilibrium dialysis in dogs with non-thyroidal illness.

Species:
dog

Plain-English summary

A group of dogs with various non-thyroidal illnesses (NTI) had their thyroid hormone levels tested to see if a specific test (free T4 by analogue immunoassay, or fT4a) could help diagnose hypothyroidism. The results showed that dogs with more severe NTI had lower fT4a levels, but the test didn't provide much additional information compared to the total T4 test. In fact, some dogs with low total T4 still had normal fT4a levels, making it hard to tell if they had hypothyroidism or just NTI. Overall, the study suggests that fT4a isn't a reliable way to differentiate between these conditions in dogs.

People also search for: dog thyroid problems · hypothyroidism symptoms in dogs · dog low thyroid treatment

Abstract

OBJECTIVES: Measurement of free T4 by analogue immunoassay (fT4a) is popular but its ability to differentiate hypothyroidism from non-thyroidal illness (NTI) is unclear. The aims were to assess fT4a concentrations in dogs with NTI and to explore diagnostic agreement with total T4 and free T4 measured by equilibrium dialysis (fT4d). METHODS: fT4a was measured in dogs classified with mild, moderate and severe NTI. Total T4 and fT4d were measured in a subgroup of these dogs. RESULTS: 146 dogs were included of which 84, 35 and 27 had mild, moderate and severe NTI, respectively. Median (range) fT4a concentrations (pmol/L) were significantly lower (P&#xa0;=&#xa0;0.023 and P&#xa0;<&#xa0;0.001) in dogs with severe (3.86 (3.86-23.60)) compared with moderate (11.10 (3.86-34.70)) and mild (15.25 (3.86-48.60)) NTI. Overall, 49 (33.6% [95% CI, 26.4-41.6]) dogs had low fT4a concentration. All thyroid hormones were measured in 74 dogs. Agreement was substantial between total T4 and fT4a (&#x3ba;=0.79 [95% CI, 0.65-0.92]) and fT4a and fT4d (&#x3ba; =0.63 [95% CI, 0.47-0.79]) but moderate between total T4 and fT4d (&#x3ba;=0.49 [95% CI, 0.32-0.66]). Of 42 dogs with low total T4 concentration, five (11.9% [95% CI, 5.19-24.99]) and 18 (42.9% [95% CI, 29.12-57.80]) had fT4a and fT4d within reference interval, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE: fT4a and fT4d cannot be used interchangeably. Measurement of fT4a provides limited further diagnostic information over measurement of total T4 in dogs with NTI. This study raises concerns regarding the ability of fT4a to differentiate NTI from hypothyroidism in dogs with low total T4 concentrations.

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Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/35430462/