Peer-reviewed veterinary case report
Cat with kidney cancer and high renin-angiotensin-aldosterone system
By Evans, Jeremy et al.·Published in Journal of veterinary internal medicine·2022·Department of Small Animal Clinical Sciences, United States·View original on PubMed →
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Original publication title: Suspected primary hyperreninism in a cat with malignant renal sarcoma and global renin-angiotensin-aldosterone system upregulation.
- Species:
- cat
Plain-English summary
A 14-year-old male domestic medium-hair cat was brought in for vomiting, diarrhea, and not eating after being diagnosed with congestive heart failure. Tests showed low potassium levels, high blood pressure, and heart muscle thickening, along with a mass on the right kidney that turned out to be cancer. The cat was treated with medications to manage blood pressure and fluid retention. Further tests revealed unusually high levels of a hormone called renin, suggesting a rare condition called primary hyperreninism, possibly linked to the kidney tumor. Unfortunately, the cat's condition was serious, and the unusual findings highlight the complexity of diagnosing such cases in cats.
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Abstract
A 14-year-old male castrated domestic medium-hair cat with diabetes mellitus was evaluated for vomiting, diarrhea, and anorexia. Two weeks before presentation, the cat had been diagnosed with congestive heart failure and started on furosemide. Initial diagnostic testing identified hypokalemia, systemic hypertension, and hypertrophic cardiomyopathy phenotype, and plasma aldosterone concentration was moderately increased. Abdominal ultrasound examination disclosed bilateral adrenomegaly and a right renal mass, and cytology of a needle aspirate of the mass was consistent with malignant neoplasia. The cat was treated with amlodipine and spironolactone. Because of the unusual presentation for hyperaldosteronism, a comprehensive profile of renin-angiotensin-aldosterone system (RAAS) peptides was performed. Results from multiple timepoints indicated persistently and markedly increased plasma renin activity and generalized RAAS upregulation. In addition to the lack of adrenal tumor, the markedly increased plasma renin activity was atypical for primary hyperaldosteronism. These clinical findings are suggestive of primary hyperreninism, a condition previously unreported in cats. The concurrent presence of a renal neoplasm suggests the possibility of a renin-secreting tumor.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/34859924/