Case Report: Technetium-99m Pertechnetate Scintigraphy Findings in a Dog With Iodine Deficiency-Induced Goitrous Hypothyroidism

病例报告:碘缺乏性甲状腺肿性甲状腺功能减退症犬的锝-99m高锝酸盐闪烁显像结果

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Abstract

There is only one previous report of canine goitrous hypothyroidism caused by iodine deficiency from 1986. The present case report describes the novel diagnostic methods and long-term outcomes of a dog diagnosed with goitrous hypothyroidism caused by iodine deficiency. A 4-year-old neutered, female Pomeranian dog presented with a cervical mass, lethargy, and inactivity. The dog had a history of eating home-cooked diets sold by a private seller for 1 year. The physical examination and ultrasonography showed two bilaterally symmetric masses in the mid-cervical area (left, 1.8 × 1.4 cm; right, 2.3 × 1.8 cm), and they were suspected to be the thyroid glands. To identify the function of the thyroid gland, the basal concentrations of thyroid hormones [total T4 (tT4) and thyroid-stimulating hormone (TSH)] were measured and a TSH stimulation test was performed: baseline tT4, 0.5 μg/dL (reference interval, 1-4 μg/dL), baseline TSH, 0.81 μg/dL (reference interval, 0.05-0.42 μg/dL), and post-tT4, 1 μg/dL (6 h after the injection of TSH). The values indicated primary hypothyroidism. The urinary iodine concentration was 302 μg/L, which was markedly lower than that of normal dogs (1,289 μg/L). Thyroid scintigraphy with technetium-99m pertechnetate was also performed to quantify the activity of the thyroid gland, and the thyroid-to-salivary ratio was 3.35. Based on the results of these examinations and patient history, the dog was diagnosed with diet-induced (iodine deficiency) goitrous hypothyroidism. The dog was treated with iodine (62.5 μg/day). At 31 days after treatment, clinical signs and thyroid hormones were normalized (tT4, 1.3 μg/dL; TSH, 0.24 μg/dL). One year after treatment, the dog was well with normal concentrations of thyroid hormones (tT4, 1.8 μg/dL; TSH, 0.27 μg/dL) and a partially reduced goiter (left, 1.6 × 1.1 cm; right, 1.2 × 0.9 cm). This is the first case to describe novel diagnostic methods and long-term outcomes of a dog diagnosed with goitrous hypothyroidism caused by iodine deficiency.

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