Авторы: Andrew Bugbee, Renee Rucinsky, Sarah Cazabon, Heather Kvitko-White, Patty Lathan, Amy Nichelason, Liza Rudolph.

Перевод: Грачева Д. В., ветеринарный врач интернальной медицины, СВК «Белый клык».
Редактор перевода: Смирнова О. О., к.б.н., ветеринарный врач-терапевт, эндокринолог.


Ветеринарные врачи регулярно сталкиваются с различными эндокринопатиями у собак и кошек и должны уметь их лечить. Чаще всего эти состояния включают гипотиреоз у собак, гиперадренокортицизм у собак (синдром Кушинга), гипоадренокортицизм у собак (болезнь Аддисона) и гипертиреоз у кошек. Сахарный диабет у собак и кошек не рассматривается в этих рекомендациях, но описан в ранее опубликованных руководствах¹. Эти эндокринопатии могут протекать в явной форме или иметь минимальные клинические проявления, особенно на ранних стадиях заболевания. Диагноз ставится на основании клинических признаков или отклонений при физикальном обследовании, тщательного сбора анамнеза, интерпретации результатов определения концентраций гормонов и исключения сопутствующих заболеваний, которые могут затруднить постановку точного диагноза. Раннее вмешательство при наличии эндокринопатий позволяет избежать тяжелых синдромов, которые могут повлиять на качество жизни пациентов и привести к вторичным повреждениям органов и летальному исходу. Эти рекомендации Американской ассоциации ветеринарных клиник (англ. American Animal Hospital Association; AAHA) призваны помочь практикующим врачам в практическом пошаговом подходе к диагностике и лечению четырех наиболее распространенных эндокринопатий у собак и кошек.
В руководстве представлена информация о каждой эндокринопатии, даются определение и клиническая характеристика заболевания. В дополнение к четырем основным заболеваниям, описанным в руководстве, также рассматриваются три менее распространенные эндокринопатии у кошек: гиперальдостеронизм, гипотиреоз и гиперадренокортицизм. Эти рекомендации не охватывают все эндокринные нарушения у кошек и собак, но предоставляют основу для точной диагностики и эффективного лечения наиболее распространенных эндокринных заболеваний. Практикующим врачам будет полезно ознакомиться с обширной литературой, чтобы получить дополнительные клинические сведения о каждом заболевании. В руководстве рассматриваются четыре основные эндокринопатии с использованием инновационного категориального подхода к диагностике, основанного на клинических проявлениях, как это было описано ранее в руководстве Американской академии семейных врачей (англ. American Academy of Family Physicians; AAFP) 2016 года по лечению гипертиреоза у кошек². Этот подход включает оценку клинических симптомов, предоставленных лечащим врачом, в сочетании с историей болезни, предоставленной владельцем. Клинические проявления различных заболеваний сведены в таблицу, которая представляет собой краткий рекомендательный справочник и содержит информацию о последующих шагах диагностики и лечения. К таблице прилагается более подробное описание каждого заболевания со ссылками на опубликованные источники, т.е. контекстуальная информация, способствующая принятию обоснованных клинических решений.
Наиболее эффективные ветеринарные практики признают важность привлечения владельцев к заботе о здоровье их питомцев. Взаимодействие с клиентами осуществляется комплексно, с участием всей команды специалистов. Информированность и вовлеченность каждого участника лечебного процесса способствуют более строгому соблюдению рекомендаций по терапии и улучшению клинических исходов.

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