Peer-reviewed veterinary case report
Adrenal function in cats with cholestatic liver disease
By Buckley, Faith I et al.·Published in Journal of veterinary diagnostic investigation : official publication of the American Association of Veterinary Laboratory Diagnosticians, Inc·2017·Department of Clinical Sciences, United States·View original on PubMed →
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Original publication title: Adrenal function in cats with cholestatic liver disease.
- Species:
- cat
Plain-English summary
A group of cats with liver disease that causes bile buildup (cholestatic liver disease) were studied to understand their adrenal function, which is important for their recovery after anesthesia. The researchers found that these cats had higher levels of cortisol, a stress hormone, both before and after a test that stimulates adrenal function. However, cats that showed a smaller increase in cortisol after the test were more likely to not survive beyond 30 days after discharge. This suggests that monitoring cortisol levels could help predict which cats might have a harder time recovering from liver disease.
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Abstract
Cats with cholestatic liver disease experience significant morbidity and mortality when they undergo invasive procedures under anesthesia. Although inadequate adrenal response might account for these outcomes, adrenal function in cats with cholestatic liver disease has not been documented, to our knowledge. The goal of our study was to describe adrenal function in these cats. Twenty-seven cats with a serum bilirubin >230 µmol/L (3 mg/dL) and serum alanine aminotransferase >2 times the upper limit of normal had pre- and 60-min post-adrenocorticotropic hormone (ACTH) cortisol analysis after administration of 5 µg/kg cosyntropin intravenously. The change in cortisol concentrations (delta cortisol) was calculated. Pre- and post-ACTH cortisol concentrations were compared to reference values. Pre-ACTH, post-ACTH, and delta cortisol values were compared between cats surviving to discharge or for 30 d postdischarge. Mean pre-ACTH cortisol levels (205 ± 113 nmol/L [7.4 ± 4.2 µg/dL]) and post-ACTH cortisol levels (440 ± 113 nmol/L [15.9 ± 4.1 g/dL]) in cholestatic cats were significantly greater than reference values in clinically normal cats. There was no association of pre- or post-ACTH cortisol with survival. Cats with a delta cortisol <179 nmol/L (6.5 µg/dL) were more likely to be non-survivors at 30 d post-discharge ( p = 0.037) than cats with delta cortisol >179 nmol/L (6.5 µg/dL). Results indicate that cats with cholestasis have high basal and ACTH-stimulated cortisol values. A delta cortisol <179 nmol/L (6.5 µg/dL) defines a population of cats that have decreased 30-d survival.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/27852811/