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    Hi everyone

    I was just reading though some w/e notes in prep for my interview and I came across a surgery called a bilateral thyroidectomy, under which I had cleverly written "like thyroidectomy but both"....

    Now I've seen a fair few thyroidectomies and the vet only ever removed the affected tissue from one side. Due to my bad memory I can't remember exactly the procedure, but surely the bilateral part means they remove tissue from both thyroid glands?

    I'm just curious... What about the affect of this on the cat? I know about the importance of maintaing the parathyroid artery and tissue, but surely removing most of the gland on both sides means they won't produce enough thyroxin - which is important for metabolism and growth?

    Please somebody correct me if I'm making absolutely no sense and have got my science all wrong - I'm not a vet yet (but will hopefully be! ) so please tell me if I'm utterly wrong!

    THANK YOU!
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    You're right in that bilateral will mean removing both sides of the thyroid gland. My understanding is that to remove one of the lobes of the thryoid in a hyperthyroid case it will cause a decrease in hormone production straight after the operation (as only one lobe is there now!) But, if the underlying cause of the hyperthryoidism hasn't been treated then it will result in the remaining lobe becoming more and more enlarged as it is now sort of 'compensating' for the removed lobe as well. So, if you are unable to remove the underlying issue, then you may be better removing both lobes to start with and then treating the case as a hypo and administering T4.
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    Thank you, that's very helpful
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    (Original post by BeckyR1993)
    Hi everyone

    I was just reading though some w/e notes in prep for my interview and I came across a surgery called a bilateral thyroidectomy, under which I had cleverly written "like thyroidectomy but both"....

    Now I've seen a fair few thyroidectomies and the vet only ever removed the affected tissue from one side. Due to my bad memory I can't remember exactly the procedure, but surely the bilateral part means they remove tissue from both thyroid glands?
    Yes.

    I'm just curious... What about the affect of this on the cat? I know about the importance of maintaing the parathyroid artery and tissue, but surely removing most of the gland on both sides means they won't produce enough thyroxin - which is important for metabolism and growth?
    Hyperthyroidism rarely affects young or growing animals so the impact on thyroxine on growth is of little concern. As for normal metabolism in some cases it's easier to treat hypothyroidism with thyroid hormone analogues following thyroidectomy than it is trying to treat chronic non responsive hyperthyroidism.
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    (Original post by kookabura)
    You're right in that bilateral will mean removing both sides of the thyroid gland. My understanding is that to remove one of the lobes of the thryoid in a hyperthyroid case it will cause a decrease in hormone production straight after the operation (as only one lobe is there now!) But, if the underlying cause of the hyperthryoidism hasn't been treated then it will result in the remaining lobe becoming more and more enlarged as it is now sort of 'compensating' for the removed lobe as well. So, if you are unable to remove the underlying issue, then you may be better removing both lobes to start with and then treating the case as a hypo and administering T4.
    Chronic hyperthyroidism is in the vast majority of cases caused by benign neoplasia which also typically affects both glands. The main rationale behind unilateral thyroidectomy is to reduce the risk of post op hypocalcaemia. By removing only one side and then monitoring the patients calcium metabolism for several weeks post op you get quite a good idea of how well you preserved the parathyroid glands. Then if you compromised the animal's ability to maintain calcium homeostasis by disrupting the blood supply and/or removing the intracapsular tissue the animal at least has one functioning parathyroid gland. On the otherhand if you jump in and perform a bilateral thyroidectomy and damage both parathyroid glands in the process the animal is buggered.
 
 
 
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