Endocrine emergencies

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This chapter considers the causes, clinical signs, diagnosis and management of the following endocrine emergencies: diabetic ketoacidosis, insulinoma, hypoadrenocorticism, hyperaldosteronism, hyperadrenocorticism, hyperparathyroidism, hypoparathyroidism and phaeochromocytoma.

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16.2 The effects of insulin and glucagon on lipolysis and ketone production.
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16.6 (a) An electrocardiogram from a dog with hypoadrenocorticism. The potassium was measured as 8.9 mmol/l at the time of the recording. Atrial activity is suppressed, T waves are larger and peaked, and there are periods of arrest. (b) After emergency treatment the potassium had decreased to 6.4 mmol/l. P waves are now visible, the heart rate has increased and the T wave is much smaller.
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16.7 Dorsoventral thoracic radiograph from a dog with acuteonset dyspnoea. The radiograph shows hyperlucency of the lung fields on the right side. The right caudal lobe pulmonary artery extends to the 11th intercostal space and is of increased diameter with a club-shaped appearance to its terminal aspect. There is also an alveolar pattern in the left cranial lung lobe, which may represent an additional area of pulmonary thromboembolism or a different disease process such as aspiration pneumonia.
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16.8 (a) Thromboelastography (TEG) tracing from a dog in a hypercoagulable state. (b) Tracing from a normal dog for comparison. (c) The two TEG tracings shown in (a) and (b) overlying each other to highlight the differences.
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16.9 Lateral abdominal radiograph from a dog showing retroperitoneal haemorrhage due to rupture of an adrenal mass. The image shows dramatic enlargement and streaking of the retroperitoneal space (boxed) with effacement of the kidneys.
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16.10 A Keeshond recovering from surgery to remove a parathyroid nodule.
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16.11 Ultrasound examination of the ventral neck usually reveals a parathyroid nodule, appearing as an echolucent mass (arrowed) within thyroid tissue.
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16.12 The right hind limb of a Bichon Frise dog with primary hypoparathyroidism following treatment with intravenous calcium that extravasated from the intravenous catheter into the subcutaneous tissue. The limb was salvaged but it took many weeks of dressings and skin reconstruction.
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