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Background: There is a possibility that an incorrect diagnosis of hypothyroidism could be made in euthyroid dogs, and the prevalence of hypothyroidism in the dog population remains unknown. Objectives: To retrospectively assess the percentage of dogs diagnosed with, and treated for, hypothyroidism at first opinion practice which are likely to be hypothyroid and require levothyroxine supplementation. Animals: One hundred two client‐owned dogs were included in this study. Materials and Methods: The computerized databases of 7 first opinion practices were searched to identify dogs treated with levothyroxine supplementation. Three European College of Veterinary Internal Medicine—Companian Animals (ECVIM‐CA) diplomates independently assigned 1 of 4 clinical assessments to each case as follows: confirmed or likely hypothyroid, hypothyroidism suspected but not confirmed, hypothyroidism considered unlikely, and no reason to suspect hypothyroidism. They commented as to whether or not they thought levothyroxine supplementation was appropriate. Results: The clinical assessments of "confirmed or likely hypothyroid"; "Hypothyroidism suspected but not confirmed"; "Hypothyroidism considered unlikely"; and "No reason to suspect hypothyroidism" was assigned respectively by Clinician 1 to 38.2%, 5.9%, 3.9%, and 52% of cases, by Clinician 2 to 48%, 22.6%, 22.6%, 6.9% of cases, and by Clinician 3 to 55.9%, 11.8%, 13.7% and 18.6%. Clinician 1, Clinician 2, and Clinician 3 considered levothyroxine supplementation not indicated in 58.8%, 52.9%, and 45.1% of cases, respectively. Conclusion: These results support the concern that hypothyroidism might be overly and incorrectly diagnosed in first opinion practice, and that thyroid function testing should be performed only in those dogs with a high pretest probability of the disease. [ABSTRACT FROM AUTHOR]

Background: Hypertension is common in older cats. There is limited evidence for predictors of survival after diagnosis. Hypothesis/Objectives: Investigate blood pressure assessment (BPA) and hypertension diagnosis in cats attending UK primary care practices (PCPs) and factors that influence survival. Animals Cats (347 889) attending 244 UK PCPs enrolled in the VetCompass program between January 1, 2012, and December 31, 2013. Cats identified as hypertensive (282) were included in descriptive and survival analyses. Methods: All electronic patient records (EPRs) were searched to identify cats that potentially had received BPA. EPRs were read in detail to identify those that had BPA. The proportion that received BPA was evaluated using a stratified analysis and the incidence of hypertension estimated. A retrospective cohort study was used to investigate survival after diagnosis (Cox proportional hazard model). Results: Estimated incidence risk was 19.5% (95% confidence interval [CI], 17.5‐21.6) from the estimated 1.34% (1.30%‐1.38%) of cats that received BPA. Few cats had BPA more than once after diagnosis (median, 1; interquartile range [IQR], 0‐3), with only 9.9% of diagnosed hypertensive cats having urine protein:creatinine ratio determined. Cats diagnosed as a result of monitoring of pre‐existing disease had improved survival (hazard ratio [HR], 0.58; 95% CI, 0.37‐0.89; P = .01) compared to cats diagnosed after clinical signs were recognized. Cats that had an amlodipine dose change had improved survival (HR, 0.56; 95% CI, 0.36‐0.87; P = .01) compared to those with no dose change. Conclusions and clinical importance: These data suggest improved blood pressure monitoring in clinical practice may decrease the morbidity associated with hypertension. [ABSTRACT FROM AUTHOR]

Background: Visual impairment (VI) has been associated with an increased risk of cognitive decline and dementia, however studies using objective measures of visual function are lacking. Therefore, we investigated the association between objectively‐measured VI and risk of incident all‐cause dementia in two large population‐based prospective cohorts. Method: Cox‐proportional hazards models were used to assess the association between VI and incident all‐cause dementia in 62,311 UK Biobank (UKB) and 7,506 EPIC‐Norfolk participants aged ≥60 years and dementia free at baseline. In both cohorts, visual acuity was measured with habitual correction (glasses or contact lenses) using a logarithm of the minimum angle of resolution (LogMAR) chart with the participant sitting 4 metres away. VI was defined as a score of ≥0.24 LogMAR, which is the threshold used to meet UK driving standards. In both cohorts, incident dementia was ascertained through cohort‐wide linkage to longitudinal hospital inpatient and death registry records, and, additionally, mental health data in EPIC‐Norfolk. Result: In UKB and EPIC‐Norfolk, respectively, 3,918 (6.3%) and 470 (6.2%) participants were visually impaired at baseline, and over 8 years (mean=6.5) and 14.5 years (mean=9.6) of follow‐up, 373 and 535 participants developed all‐cause dementia. In UKB, VI was associated with double the risk of developing all‐cause dementia when adjusting for age, sex, ethnicity, socioeconomic status, education, alcohol consumption, smoking, body mass index, self‐reported diabetes and cardiovascular disease (Hazard Ratio (HR)=2.06, 95% Confidence Interval (CI) 1.54‐2.75). In EPIC‐Norfolk, VI was associated with almost a 50% increased risk of developing all‐cause dementia when adjusting for the same covariates (HR=1.49, 95% CI 1.16‐1.92). After excluding participants who were diagnosed with all‐cause dementia within the first three years of follow‐up to account for reverse causation, the HRs were 1.86 (95% CI 1.32‐2.61) and 1.44 (95% CI 1.10‐1.88) in UKB and EPIC‐Norfolk, respectively. Conclusion: In two large, independent, cohorts of healthy, late middle‐ to older‐aged adults, VI was associated with an increased risk of developing all‐cause dementia. These findings suggest that VI could potentially be a modifiable risk factor for dementia or target for identifying those at high risk of the condition. [ABSTRACT FROM AUTHOR]