Hormonal Imbalances in Veterinary Medicine
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This assignment provides a comprehensive review of hormonal imbalances in veterinary medicine, covering topics such as hypoadrenocorticism, diabetes mellitus, hyperthyroidism, and more. It includes a list of references from various peer-reviewed articles and online resources, offering a detailed understanding of the pathogenesis, clinical features, and management strategies for these endocrine disorders.
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Running head: Veterinary Terminology
Veterinary Terminology
Name of the Student
Name of the University
Author Note
Veterinary Terminology
Name of the Student
Name of the University
Author Note
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1Veterinary Terminology
Homeostasis:
This is a self controlling system that allows a stable biological system to be
maintained in the form of a dynamic equilibrium, through series of inter related changes.
There are three components in a homeostatic system, namely the receptor, effectors
and control. The control can be intrinsic (local control that work in local environments) and
extrinsic control (through the actions of nervous system, endocrine system or neurohormonal
actions) (d.umn.edu, 2018). The control can be through a system of positive and negative
feedback mechanisms. The feedback system works in a manner that allows the maintenance
of consistency in the system (Nayak, 2018). In the negative feedback, the action of the
effectors causes a negative effect on the change, and thus the effect of the negative feedback
system has suppressive action on the response. AN example of negative feedback system is
the maintenance of body temperature (Cunningham, 2007; Aspinall & Cappello, 2015).
Variables controlled by the homeostatic system are: body temperature, levels of
calcium, glucose, respiratory gases, oxygen levels, sodium, calcium potassium, pH on the
plasma or blood; regulation of blood pressure; maintaining osmotic balance; cerebrospinal
fluid composition and regulating gene expression and balance of energy metabolism
(Nakamura, 2011).
Comparison of diseases:
Hyperadrenocorticism Vs Hypoadrenocorticism
Hyperadrenocorticism Hypoadrenocorticism
What is This is a disease that is identified by
persistently elevated levels of cortisol
in the system. It is also known as
This disease is identified by a deficit
in the production of
adrenocorticotropic hormone, and low
Homeostasis:
This is a self controlling system that allows a stable biological system to be
maintained in the form of a dynamic equilibrium, through series of inter related changes.
There are three components in a homeostatic system, namely the receptor, effectors
and control. The control can be intrinsic (local control that work in local environments) and
extrinsic control (through the actions of nervous system, endocrine system or neurohormonal
actions) (d.umn.edu, 2018). The control can be through a system of positive and negative
feedback mechanisms. The feedback system works in a manner that allows the maintenance
of consistency in the system (Nayak, 2018). In the negative feedback, the action of the
effectors causes a negative effect on the change, and thus the effect of the negative feedback
system has suppressive action on the response. AN example of negative feedback system is
the maintenance of body temperature (Cunningham, 2007; Aspinall & Cappello, 2015).
Variables controlled by the homeostatic system are: body temperature, levels of
calcium, glucose, respiratory gases, oxygen levels, sodium, calcium potassium, pH on the
plasma or blood; regulation of blood pressure; maintaining osmotic balance; cerebrospinal
fluid composition and regulating gene expression and balance of energy metabolism
(Nakamura, 2011).
Comparison of diseases:
Hyperadrenocorticism Vs Hypoadrenocorticism
Hyperadrenocorticism Hypoadrenocorticism
What is This is a disease that is identified by
persistently elevated levels of cortisol
in the system. It is also known as
This disease is identified by a deficit
in the production of
adrenocorticotropic hormone, and low
2Veterinary Terminology
Cushing’s Syndrome, and affects older
and geriatric dogs (Barbosa et al.,
2016)
levels of cortisol in the blood. This
disease affects middle aged or young
dogs most commonly (Lathlan &
Thompson, 2018).
Deficient/Excess
condition
Caused by excess production of
cortisol
Caused by underproduction of cortisol
Aetiology Excessive secretion of
adrenocorticotropic hormones due to
neuroendocrine tumours. It can also be
due to adrenal carcinoma or adrenal
hyperplasic syndrome (Raff et al.,
2014). Due to this, the
adrenocorticotropic hormone keeps on
being produced regardless of the levels
of cortisol in blood (Barbosa et al.,
2016)
This can be caused because of atrophy
or damage or destruction of the
cortical region of the adrenal gland,
because of which glucocorticoids and
minerelocorticoids are produced
insufficiently. The destruction of the
cortical cells can e either immune
mediated or due to fungal infection,
neoplasia, trauma, amyloidosis or
coagulopathy (Lathlan & Taylor,
2005)
Signs Polyuria/Polydispsia; enlargement of
the abdomen; Polyphagia; muscular
weakness; lethargy; heat intolerance;
alopecia; skin becomes thin and are
prone to bruises and striation; skin
hyperpigmentation; Calcinosis; atrophy
of testis; facial paralysis; pyoderma;
anestrus sebborhea and
Pseudomyotonia (Cunningham, 2007).
Fluctuating levels of chlorine, sodium
and potassium ions; persistent
gastroenteritis; hypochloremia;
hyperkalemia; hypoatremia;
bradycardia; renal dysfunction;
collapse of circulatory system; low
blood pressure; dehydration;
weakness; anorexia; diarrhea; low
blood glucose levels; loss of weight
and hyperpigmentation of dermis
Cushing’s Syndrome, and affects older
and geriatric dogs (Barbosa et al.,
2016)
levels of cortisol in the blood. This
disease affects middle aged or young
dogs most commonly (Lathlan &
Thompson, 2018).
Deficient/Excess
condition
Caused by excess production of
cortisol
Caused by underproduction of cortisol
Aetiology Excessive secretion of
adrenocorticotropic hormones due to
neuroendocrine tumours. It can also be
due to adrenal carcinoma or adrenal
hyperplasic syndrome (Raff et al.,
2014). Due to this, the
adrenocorticotropic hormone keeps on
being produced regardless of the levels
of cortisol in blood (Barbosa et al.,
2016)
This can be caused because of atrophy
or damage or destruction of the
cortical region of the adrenal gland,
because of which glucocorticoids and
minerelocorticoids are produced
insufficiently. The destruction of the
cortical cells can e either immune
mediated or due to fungal infection,
neoplasia, trauma, amyloidosis or
coagulopathy (Lathlan & Taylor,
2005)
Signs Polyuria/Polydispsia; enlargement of
the abdomen; Polyphagia; muscular
weakness; lethargy; heat intolerance;
alopecia; skin becomes thin and are
prone to bruises and striation; skin
hyperpigmentation; Calcinosis; atrophy
of testis; facial paralysis; pyoderma;
anestrus sebborhea and
Pseudomyotonia (Cunningham, 2007).
Fluctuating levels of chlorine, sodium
and potassium ions; persistent
gastroenteritis; hypochloremia;
hyperkalemia; hypoatremia;
bradycardia; renal dysfunction;
collapse of circulatory system; low
blood pressure; dehydration;
weakness; anorexia; diarrhea; low
blood glucose levels; loss of weight
and hyperpigmentation of dermis
3Veterinary Terminology
(Klein & Peterson, 2010).
Diagnosis Adrenocorticotropic stimulation tests;
measurement of Creatinine to cortisol
ratio in the urine; intravenous and oral
test of low and high dose
dexamethasone suppression; analysis
of the concentration of
adrenocorticotropic hormone in the
plasma; Complete count of blood.
Diagnostic imaging techniques like
thoracic and abdominal radiograph,
ultrasound of abdomen, computerized
tomographic test or magnetic
resonance imaging test of the brain
(Barbosa et al., 2016).
Adrenocorticotropic stimulation test;
analyzing medical history, clinical
signs and abnormalities in laboratory
tests; radiograph of thoracic region;
ultrasound of the abdomen and
electrocardiogram test (Adler et al.,
2016).
Treatment Medical treatment can include
administration of trilostane, mitotane,
I-deprenyl and ketocon zole. Surgical
treatment can also be used for
removing the tumours in adrenal or
pituitary glands (Barbosa et al., 2016).
This disease requires emergency
medical assistance, where intravenous
drip of saline should be administered.
For shock, dexamethasone sodium
phosphate or pednisolone sodium
succinate is needed.. Also,
replacement therapy for
minerelocorticoids should be
considered (Lathlan & Thompson,
2018).
Whether common
in
This is more common in Canines Common in canines
(Klein & Peterson, 2010).
Diagnosis Adrenocorticotropic stimulation tests;
measurement of Creatinine to cortisol
ratio in the urine; intravenous and oral
test of low and high dose
dexamethasone suppression; analysis
of the concentration of
adrenocorticotropic hormone in the
plasma; Complete count of blood.
Diagnostic imaging techniques like
thoracic and abdominal radiograph,
ultrasound of abdomen, computerized
tomographic test or magnetic
resonance imaging test of the brain
(Barbosa et al., 2016).
Adrenocorticotropic stimulation test;
analyzing medical history, clinical
signs and abnormalities in laboratory
tests; radiograph of thoracic region;
ultrasound of the abdomen and
electrocardiogram test (Adler et al.,
2016).
Treatment Medical treatment can include
administration of trilostane, mitotane,
I-deprenyl and ketocon zole. Surgical
treatment can also be used for
removing the tumours in adrenal or
pituitary glands (Barbosa et al., 2016).
This disease requires emergency
medical assistance, where intravenous
drip of saline should be administered.
For shock, dexamethasone sodium
phosphate or pednisolone sodium
succinate is needed.. Also,
replacement therapy for
minerelocorticoids should be
considered (Lathlan & Thompson,
2018).
Whether common
in
This is more common in Canines Common in canines
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4Veterinary Terminology
canine/feline/both
Hypercalcemia Vs Hypocalcemia:
Hypercalcemia Hypocalcemia
What is: This disease is characterized by elevated
levels of serum calcium or ionized
calcium in blood (de Brito et al., 2017).
In this disease, the levels of
calcium in the blood become
very low (Quader, 2015).
Deficiency/Excessive
conditions
Excess calcium concentration in blood Deficient calcium concentration
in blood
Aetiology: Apocrine gland adenocarcinoma;
Acromegaly; lymphoma; multiple
myeloma; skeletal lesions; neoplasia of
the bone or hyperparathyroidism. The
condition is caused when excess calcium
is released from the bones into the blood,
absorption of excess calcium in the
gastrointestinal tract or increase
uptake/decreased excretion of calcium by
kidneys. Over secretion can be due to
over activity of thyroid, cancer,
dehydration or even some medications
(de Brito et al., 2017)
The disease is caused due to
inadequate production of vitamin
D, hypoparathyroidism or
hormonal resistance. Such
condition can be due to
eclamsia, puerperal tetany,
enema toxicity, rickets, and
blood transfusions (Quader,
2015).
Signs: Excess thirst and urination; upset
stomach; nausea; vomiting; constipation;
weakness of muscles; depression; cardiac
Encephalopathy; muscular
cramps; hyperflexia;
laryngiospasm; seizures
canine/feline/both
Hypercalcemia Vs Hypocalcemia:
Hypercalcemia Hypocalcemia
What is: This disease is characterized by elevated
levels of serum calcium or ionized
calcium in blood (de Brito et al., 2017).
In this disease, the levels of
calcium in the blood become
very low (Quader, 2015).
Deficiency/Excessive
conditions
Excess calcium concentration in blood Deficient calcium concentration
in blood
Aetiology: Apocrine gland adenocarcinoma;
Acromegaly; lymphoma; multiple
myeloma; skeletal lesions; neoplasia of
the bone or hyperparathyroidism. The
condition is caused when excess calcium
is released from the bones into the blood,
absorption of excess calcium in the
gastrointestinal tract or increase
uptake/decreased excretion of calcium by
kidneys. Over secretion can be due to
over activity of thyroid, cancer,
dehydration or even some medications
(de Brito et al., 2017)
The disease is caused due to
inadequate production of vitamin
D, hypoparathyroidism or
hormonal resistance. Such
condition can be due to
eclamsia, puerperal tetany,
enema toxicity, rickets, and
blood transfusions (Quader,
2015).
Signs: Excess thirst and urination; upset
stomach; nausea; vomiting; constipation;
weakness of muscles; depression; cardiac
Encephalopathy; muscular
cramps; hyperflexia;
laryngiospasm; seizures
5Veterinary Terminology
arrhythmia or palpitations (Adam et al.,
2016).
(Mittendorf et al., 2004).
Diagnosis The disease can be diagnosed on the
basis of high levels of calcium, low
levels of phosphorus of the blood;
azotemia; low specific gravity if urine.
Other tests include: ultrasonography;
explorative surgery and measurement of
serum parathyroid hormone (Adam et al.,
2016).
Diagnosis can be done by
estimating the levels of
phosphate, parathyroid hormone,
phosphate, alkaline phosphatase,
vitamin d and calcium ion in
blood and cyclic Adenosine
monophosphate and phosphate
in the urine (Refsal et al., 2001).
Treatment Administration of glucocorticoids,
diuretics, mithramycin, calcitonin and
bisphosphonate. Intravenous fluid
replacement therapy; and also surgical
removal of the thyroid gland (Adam et
al., 2016).
Intravenous administration of
gluconate, oral administration of
calcium and vitamin D (Refsal et
al., 2001).
Whether common in
canine/feline/both
Common in canine Common in both
Hyperthyroidism Vs Hypothyroidism
Hyperthyroidism Hypothyroidism
What is This disease is characterized by the over
activity of thyroid gland causing
elevated levels of the thyroid hormones.
It is also known as Grave’s disease
(Daminet & Hill, 2017).
This disease is characterized by
the underproduction of thyroid
hormones by a less active thyroid
gland (Kent et al., 2016).
arrhythmia or palpitations (Adam et al.,
2016).
(Mittendorf et al., 2004).
Diagnosis The disease can be diagnosed on the
basis of high levels of calcium, low
levels of phosphorus of the blood;
azotemia; low specific gravity if urine.
Other tests include: ultrasonography;
explorative surgery and measurement of
serum parathyroid hormone (Adam et al.,
2016).
Diagnosis can be done by
estimating the levels of
phosphate, parathyroid hormone,
phosphate, alkaline phosphatase,
vitamin d and calcium ion in
blood and cyclic Adenosine
monophosphate and phosphate
in the urine (Refsal et al., 2001).
Treatment Administration of glucocorticoids,
diuretics, mithramycin, calcitonin and
bisphosphonate. Intravenous fluid
replacement therapy; and also surgical
removal of the thyroid gland (Adam et
al., 2016).
Intravenous administration of
gluconate, oral administration of
calcium and vitamin D (Refsal et
al., 2001).
Whether common in
canine/feline/both
Common in canine Common in both
Hyperthyroidism Vs Hypothyroidism
Hyperthyroidism Hypothyroidism
What is This disease is characterized by the over
activity of thyroid gland causing
elevated levels of the thyroid hormones.
It is also known as Grave’s disease
(Daminet & Hill, 2017).
This disease is characterized by
the underproduction of thyroid
hormones by a less active thyroid
gland (Kent et al., 2016).
6Veterinary Terminology
Deficiency/Excessive
conditions
Excess thyroid hormone Deficient thyroid production
Aetiology The disease can be caused because of
over activity or enlargement of the
gland thereby producing excess thyroid
hormones. The enlargement can be due
to malignant or non-malignant tumours
in the thyroid gland Daminet & Hill,
2017).
This can be caused by the
idiopathic atrophy (due to the
reduction of thyroid parenchyma
cells or lymphocytic thyroiditis
(due to damaged thyroid
follicles) of the thyroid. (Kent et
al., 2016).
Signs Loss of weight; increase in thirst,
appetite and urinary flow; diarrhea;
vomiting; hyperactive disorders; the fur
coat appears unkempt, greasy or matted;
restlessness or aggressiveness; elevated
rate of heartbeats; weakness; breathing
difficulties and even depression
Daminet & Hill, 2017).
Fall of hair/fur; lethargy;
weakness; slow beating of heart;
obesity and lowering of
temperature of body (Kent et al.,
2016; Klein & Danzi, 2016).
Diagnosis Diagnosis can be done by checking the
thyroid gland for enlargements;
monitoring heart rate and blood
pressure; analysis of the levels of
thyroid hormone and monitoring kidney
and cardiac functions Daminet & Hill,
2017; Volckaert et al., 2016).
Analysis of the levels of
thyroxin; stimulation tests for
thyroid stimulating hormone and
Thyrotropin releasing hormone;
ultrasonography and
Scintigraphy of thyroid and
equilibrium dialysis test
(Peterson, 2015).
Treatment Iodine therapy; dietary therapy
(restricting iodine intake in diet);
Oral levothyroxine and
Intravenous levothyroxine.
Deficiency/Excessive
conditions
Excess thyroid hormone Deficient thyroid production
Aetiology The disease can be caused because of
over activity or enlargement of the
gland thereby producing excess thyroid
hormones. The enlargement can be due
to malignant or non-malignant tumours
in the thyroid gland Daminet & Hill,
2017).
This can be caused by the
idiopathic atrophy (due to the
reduction of thyroid parenchyma
cells or lymphocytic thyroiditis
(due to damaged thyroid
follicles) of the thyroid. (Kent et
al., 2016).
Signs Loss of weight; increase in thirst,
appetite and urinary flow; diarrhea;
vomiting; hyperactive disorders; the fur
coat appears unkempt, greasy or matted;
restlessness or aggressiveness; elevated
rate of heartbeats; weakness; breathing
difficulties and even depression
Daminet & Hill, 2017).
Fall of hair/fur; lethargy;
weakness; slow beating of heart;
obesity and lowering of
temperature of body (Kent et al.,
2016; Klein & Danzi, 2016).
Diagnosis Diagnosis can be done by checking the
thyroid gland for enlargements;
monitoring heart rate and blood
pressure; analysis of the levels of
thyroid hormone and monitoring kidney
and cardiac functions Daminet & Hill,
2017; Volckaert et al., 2016).
Analysis of the levels of
thyroxin; stimulation tests for
thyroid stimulating hormone and
Thyrotropin releasing hormone;
ultrasonography and
Scintigraphy of thyroid and
equilibrium dialysis test
(Peterson, 2015).
Treatment Iodine therapy; dietary therapy
(restricting iodine intake in diet);
Oral levothyroxine and
Intravenous levothyroxine.
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7Veterinary Terminology
surgery (removal of the gland);
medications (like anti thyroid medicine)
Daminet & Hill, 2017; Volckaert et al.,
2016)
Regular follow-ups are needed
for long term care (Peterson,
2015).
Whether common in
canine/feline/both
Common in feline Common in canine
Diabetes Mellitus:
Diabetes Mellitus is a metabolic disease in which the blood glucose levels becomes
elevated that consequently affects the metabolism in the body. The disease has 2 distinct
types: Type 1 and type 2. Type 1 diabetes mellitus is caused due to the underproduction of
insulin while type 2 diabetes is due to a resistance to the hormone by the cells and tissues of
the body (Vetmed.wsu.edu, 2018).
The disease can be caused due to the destruction of the beta cells of the pancreas by
autoimmune action, or when the cells of the body stops responding to insulin (known as
insulin resistance). The disease can be caused due to obesity, high blood pressure, genetic
predisposition or family history; ethnic background; injury to pancreas; autoimmune disease;
high levels of cholesterol in blood and pregnancy (gestational diabetes). Common symptoms
include: frequent urination; dry mouth; increased appetite and thirst; weight loss; weakness;
wounds take longer to heal; dry skin; neuropathy and infections. Treatment for diabetes
includes change in diet; administration of insulin and concurrent treatment of any associated
diseases (if any). The treatment is long term (Gilor et al., 2016; Öhlund et al., 2017;
Davidson, 2015).
surgery (removal of the gland);
medications (like anti thyroid medicine)
Daminet & Hill, 2017; Volckaert et al.,
2016)
Regular follow-ups are needed
for long term care (Peterson,
2015).
Whether common in
canine/feline/both
Common in feline Common in canine
Diabetes Mellitus:
Diabetes Mellitus is a metabolic disease in which the blood glucose levels becomes
elevated that consequently affects the metabolism in the body. The disease has 2 distinct
types: Type 1 and type 2. Type 1 diabetes mellitus is caused due to the underproduction of
insulin while type 2 diabetes is due to a resistance to the hormone by the cells and tissues of
the body (Vetmed.wsu.edu, 2018).
The disease can be caused due to the destruction of the beta cells of the pancreas by
autoimmune action, or when the cells of the body stops responding to insulin (known as
insulin resistance). The disease can be caused due to obesity, high blood pressure, genetic
predisposition or family history; ethnic background; injury to pancreas; autoimmune disease;
high levels of cholesterol in blood and pregnancy (gestational diabetes). Common symptoms
include: frequent urination; dry mouth; increased appetite and thirst; weight loss; weakness;
wounds take longer to heal; dry skin; neuropathy and infections. Treatment for diabetes
includes change in diet; administration of insulin and concurrent treatment of any associated
diseases (if any). The treatment is long term (Gilor et al., 2016; Öhlund et al., 2017;
Davidson, 2015).
8Veterinary Terminology
Diabetes mellitus is different from diabetes insipidus, which is a disease caused due to
a deficient secretion of the hormone Arginine Vasopressin or when the collecting tubules or
distal tubules of nephron are unable to respond to the hormone (Rossi & Ross, 2018).
Diabetes mellitus is different from diabetes insipidus, which is a disease caused due to
a deficient secretion of the hormone Arginine Vasopressin or when the collecting tubules or
distal tubules of nephron are unable to respond to the hormone (Rossi & Ross, 2018).
9Veterinary Terminology
References:
Adam, Z., Starý, K., Kubinyi, J., Zajíčková, K., Řehák, Z., Koukalová, R., ... & Čermáková,
Z. (2016). Hypercalcemia, symptoms, differential diagnostics and treatment, or
importance of calcium investigation. Vnitrni lekarstvi, 62(5), 370-383.
Adler, J. A., Drobatz, K. J., & Hess, R. S. (2007). Abnormalities of serum electrolyte
concentrations in dogs with hypoadrenocorticism. Journal of veterinary internal
medicine, 21(6), 1168-1173. DOI: 0.1111/j.1939-1676.2007.tb01933.x
Aspinall, V., & Cappello, M. (2015). Introduction to Veterinary Anatomy and Physiology
Textbook-E-Book. Elsevier Health Sciences. Available at:
https://books.google.co.in/books?
hl=en&lr=&id=Iti4BwAAQBAJ&oi=fnd&pg=PP1&dq=Introduction+to+Veterinary+
Anatomy+and+Physiology+Textbook-E-
Book&ots=8WmS4RIcio&sig=U1l2cH_24rFxj5l0fJlmpiLUn9E#v=onepage&q=Intro
duction%20to%20Veterinary%20Anatomy%20and%20Physiology%20Textbook-E-
Book&f=false
Barbosa, Y. D. S., Rodrigues, D. D. A., da Silva, N. C. B., Silva, F. L., da Silva, C. R. A., &
Sousa, J. M. (2016). Hyperadrenocorticism in a dog: case report. PUBVET, 10(6),
460-465.
Cunningham, J. G., & Klein, B. G. (2007). Veterinary physiology. Missouri: Saunders
Elsevier. Available at: http://sutlib2.sut.ac.th/sut_contents/H111503.pdf
D.umn.edu. (2018). Homeostatic Control Systems. D.umn.edu. Retrieved 15 March 2018,
from http://www.d.umn.edu/~jkeener/hlth2040-1-su2012/pwreadings/pdf/1-3.pdf
References:
Adam, Z., Starý, K., Kubinyi, J., Zajíčková, K., Řehák, Z., Koukalová, R., ... & Čermáková,
Z. (2016). Hypercalcemia, symptoms, differential diagnostics and treatment, or
importance of calcium investigation. Vnitrni lekarstvi, 62(5), 370-383.
Adler, J. A., Drobatz, K. J., & Hess, R. S. (2007). Abnormalities of serum electrolyte
concentrations in dogs with hypoadrenocorticism. Journal of veterinary internal
medicine, 21(6), 1168-1173. DOI: 0.1111/j.1939-1676.2007.tb01933.x
Aspinall, V., & Cappello, M. (2015). Introduction to Veterinary Anatomy and Physiology
Textbook-E-Book. Elsevier Health Sciences. Available at:
https://books.google.co.in/books?
hl=en&lr=&id=Iti4BwAAQBAJ&oi=fnd&pg=PP1&dq=Introduction+to+Veterinary+
Anatomy+and+Physiology+Textbook-E-
Book&ots=8WmS4RIcio&sig=U1l2cH_24rFxj5l0fJlmpiLUn9E#v=onepage&q=Intro
duction%20to%20Veterinary%20Anatomy%20and%20Physiology%20Textbook-E-
Book&f=false
Barbosa, Y. D. S., Rodrigues, D. D. A., da Silva, N. C. B., Silva, F. L., da Silva, C. R. A., &
Sousa, J. M. (2016). Hyperadrenocorticism in a dog: case report. PUBVET, 10(6),
460-465.
Cunningham, J. G., & Klein, B. G. (2007). Veterinary physiology. Missouri: Saunders
Elsevier. Available at: http://sutlib2.sut.ac.th/sut_contents/H111503.pdf
D.umn.edu. (2018). Homeostatic Control Systems. D.umn.edu. Retrieved 15 March 2018,
from http://www.d.umn.edu/~jkeener/hlth2040-1-su2012/pwreadings/pdf/1-3.pdf
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