Adipsic Hypernatremia in a Dog with Antithyroid Antibodies in Cerebrospinal Fluid and Serum

Abstract

ABSTRACT. A 4-year-old, male Labrador retriever, weighing 27 kg, presented with abrupt clinical signs including mental retardation, circling and head pressing. The dog never ingested water by choice. An adipsia of the dog was persisted and developed to hypernatremia with artifactual hyperchloremia. Serial endocrine results and image findings were suggestive of a hypothyroidism. The dog revealed the presence of antithyroid antibodies in the cerebrospinal fluid and serum. With the administration of levothyroxine sodium, his neurologic signs were alleviated within the first week of treatment and adipsia was also resolved.

Adipsia and hypernatraemia in a 6-month-old Staffordshire bull terrier

“…This syndrome has been documented as a congenital disorder of young miniature Schnauzers (Crawford, Kittelson & Fink 1984;Shimokawa Miyama et al 2009;Van Heerden, Geel & Moor 1992). It has also been reported in several dogs (Chapman, Petrua & Neiger 2009;Crawford, Kittelson & Fink 1984;Hawks et al 1991;Kang et al 2007;Van Heerden, Geel & Moor 1992) and a cat that had an intracranial B-cell lymphoma (Morrison & Fales-Williams 2006).…”

“…Normal physiological responses to increased plasma osmolality include the release of ADH and the stimulation of the thirst centre in the hypothalamus. Animals with adipsic or hypodipsic disorders make no effort to drink water despite their severely elevated plasma osmolality and sodium levels (Kang et al 2007). Hypodipsic hypernatraemia has been documented in dogs as a congenital disorder caused by brain malformation (Schaer 2008).…”

Primary adipsia and severe hypernatremia in a Pit Bull dog

“…To our knowledge, this is the first case of primary adipsia observed in a Pit Bull dog. An altered mental state is common, since neurological signs develop due to persistent hyperosmolarity of the extracellular fluid, which severely affects the cells of the central nervous system, leading to the observed clinical abnormalities (KANG et al 2007). As noted in this case, the worsening of neurological signs is common during rehydration as a consequence of cerebral edema, which developed due to a rapid drop in sodium levels (RIGGS, 2002).…”

“…Primary hypodipsia or adipsia is an uncommon disease (RIGGS 2002). In veterinary medicine, few reports show no structural abnormalities in the central nervous system (CRAWFORD et al 1984, KANG et al 2007. In these cases, the absence of thirst occurs due to a malfunction in the hypothalamic receptors, which are unable to detect an increase in plasma osmolality and thus generate stimuli that signal the need for water intake, generating adipsia.…”