Peer-reviewed veterinary case report
Feline hyperadrenocorticism diagnosis and treatment update
By Boland, Lara A & Barrs, Vanessa R·Published in Journal of feline medicine and surgery·2017·Sydney School of Veterinary Science, Australia·View original on PubMed →
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Original publication title: Peculiarities of feline hyperadrenocorticism: Update on diagnosis and treatment.
- Species:
- cat
Plain-English summary
A 10-year-old cat was diagnosed with hyperadrenocorticism (HAC), a condition that can cause symptoms like extreme skin fragility and infections due to high cortisol levels. This cat also had diabetes, which is common in HAC cases. Treatment options include surgery to remove the adrenal gland or the pituitary gland, but some medications like mitotane may not work well. Trilostane is the preferred medication, although more research is needed on how it works in cats. The cat's treatment plan aimed to manage symptoms and improve its quality of life.
People also search for: cat hyperadrenocorticism treatment · feline diabetes management · cat skin problems treatment
Abstract
Practical relevance: Hyperadrenocorticism (HAC) is a relatively uncommon endocrinopathy of older cats, with a mean age at diagnosis of 10 years. In addition to pituitary-dependent and adrenal-dependent hypercortisolism, clinical signs of HAC can result from adrenal sex steroid-producing tumours. Clinical challenges: While HAC in cats has many similarities to canine HAC, there are key differences in presentation, diagnosis and response to therapy. Most, but not all, cats with HAC have concurrent diabetes mellitus, which is often insulin resistant. Up to a third of cats with HAC have extreme skin fragility and are at high risk of debilitating iatrogenic skin tears during diagnostic or therapeutic interventions. Infections of the skin and nail beds, and urinary, respiratory and gastrointestinal tract, secondary to cortisol-induced immune suppression, are also common. Cats respond differently to dogs to adrenal function tests including adrenocorticotropic hormone (ACTH) stimulation and dexamethasone suppression tests; a 10-fold higher dose of dexamethasone is recommended in cats to screen for HAC. Curative treatment options include adrenalectomy or transsphenoidal hypophysectomy. Radiation or medical treatment may improve clinical signs. The response to mitotane therapy is poor. While trilostane is the medical treatment of choice based on retrospective studies, investigations into the pharmacokinetics of this drug in cats are lacking. Global importance: Feline HAC occurs worldwide and is not associated with any purebreed predisposition. Although uncommon, adrenal sex steroid-producing tumours have a higher prevalence in cats than in dogs. Evidence base: The information in this review is drawn from over 180 reported cases of feline HAC. Reports investigating clinical presentation, clinicopathological findings and treatment outcomes are observational, retrospective multiple case series (EBM grade III) or single case reports (EBM grade IV). While most endocrine testing studies for diagnosis are cohort controlled analytical studies (EBM grade III), prospective, randomised, placebo-controlled studies have been performed (EBM grade I).
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/28838299/