7-week-old kitten weak and stopped eating from low adrenal hormones

Abstract

A 7 wk old female spayed domestic shorthair was evaluated for 3 days of lethargy and anorexia 1 wk after ovariohysterectomy. On presentation, she was weak, dehydrated, and hypotensive. Blood work showed azotemia, hyponatremia, hyperkalemia, hyperphosphatemia, and hyperproteinemia. Ingestion of a nephrotoxic substance was unlikely, there was no evidence of infection on urinalysis, and an abdominal ultrasound showed normal renal architecture with no evidence of ureteral ligation. A diagnosis of hypoadrenocorticism was established based on low baseline cortisol and aldosterone concentrations and lack of response to synthetic adrenocorticotropic hormone administration. Treatment was initiated with IV fluid therapy, corticosteroids, and subcutaneous desoxycorticosterone pivalate. After 3 mo of treatment, the cat continued to do clinically well with a decreasing dose of glucocorticoids. Owing to owner concerns with frequent veterinary visits and medication cost, the decision was made to extend the mineralocorticoid dose interval while closely monitoring clinical status and electrolyte concentrations. The cat's electrolytes remained normal and medications were discontinued. Repeat baseline cortisol and aldosterone concentrations and response to adrenocorticotropic hormone administration 18 days after discontinuing all medication revealed that adrenal function had recovered. This is the first report of transient hypoadrenocorticism in this species.