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Lopes DJ, De Jesus L, Rivas BB, De Oliveira MC, Furtado PV, Cattaruzzi D, Poppl ÁG. Safety and efficacy assessment of a synthetic porcine recombinant corticotrophin for the ACTH stimulation test in healthy cats. Domest Anim Endocrinol 2024; 89:106880. [PMID: 39163657 DOI: 10.1016/j.domaniend.2024.106880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 08/10/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024]
Abstract
Porcine adrenocorticotrophic hormone (ACTH) has been considered valid for the ACTH stimulation test (ACTHST) in humans and dogs; however, its safety and efficacy for use in cats are unknown. Also, the equivalence between 5 µg/kg and 125 µg/cat dose of synthetic corticotropin (1-24 ACTH - cosyntropin/tetracosactide) is assumed for ACTHST in cats. This study evaluated the safety and effectiveness of different porcine recombinant ACTH doses for the ACTHST in healthy cats and its equivalence with tetracosactide. The study was divided into two arms. The first evaluated safety and equivalence of intravenous 1 µg/kg, 5 µg/kg, or 125 µg/cat porcine ACTH in seven healthy cats for the ACTHST evaluating basal and post-ACTH androstenedione, aldosterone, cortisol, and progesterone concentrations. In the second arm, the equivalence of the 125 µg/cat porcine ACTH dose was evaluated compared to results obtained using 125 µg/cat of tetracosactide in ten healthy cats regarding cortisol responses. In all tests, several cat-friendly strategies were adopted, and the ACTHST protocol involved basal and 60-minute post-ACTH blood sampling and intravenous ACTH injection. No adverse reactions were documented, and no tested cat showed any complications during the study. No porcine ACTH tested dose significantly increased androstenedione secretion. In contrast, all tested doses were able to increase progesterone concentration significantly (P < 0.05), and Δ-progesterone in response to 5 µg/kg or 125 µg/cat was considered equivalent (P > 0.99). The 125 µg/cat dose promoted greater responses for both cortisol and aldosterone, characterized by Δ-cortisol (P = 0.009) and Δ-aldosterone (P = 0.004). Despite equivalent Δ-cortisol results in response to 5 µg/kg or 125 µg/cat (P = 0.18); post-ACTH results of cortisol in response to 5 µg/kg only approximate statistical significance when compared with basal (P = 0.07). Porcine ACTH and tetracosactide significantly increased post-ACTH cortisol concentration (P < 0.0001) while the Δ-cortisol was slightly greater in response to the porcine ACTH (P = 0.006). These results suggest porcine ACTH could be an alternative source of corticotropin for the ACTHST in cats; however, maximum corticoadrenal stimulation seemed more reliable in response to a 125 µg/cat regarding cortisol and aldosterone.
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Affiliation(s)
- Daniela J Lopes
- Veterinary Sciences Post-Graduation Program (PPGCV), Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Luciana De Jesus
- Veterinary Sciences Post-Graduation Program (PPGCV), Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Barbara B Rivas
- Veterinary Sciences Post-Graduation Program (PPGCV), Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Milena C De Oliveira
- Veterinary Sciences Post-Graduation Program (PPGCV), Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Priscila V Furtado
- Hormone Laboratory, Provet - Medicina Veterinária Diagnóstica, São Paulo, Brazil
| | - Debora Cattaruzzi
- Hormone Laboratory, Provet - Medicina Veterinária Diagnóstica, São Paulo, Brazil
| | - Álan G Poppl
- Veterinary Sciences Post-Graduation Program (PPGCV), Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Animal Medicine Departament, Veterinary Faculty, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.
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Erger CG, Gerras AL, Conley AJ, Gilor C, Burns DeMarle K, Refsal KR, Fleming JM, Sledge DG, Langlois DK. Case report: Androgen-secreting adrenocortical tumors in eight cats. Front Vet Sci 2023; 10:1158142. [PMID: 37383353 PMCID: PMC10293747 DOI: 10.3389/fvets.2023.1158142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/15/2023] [Indexed: 06/30/2023] Open
Abstract
Urine marking, aggression, and other behavioral concerns are common reasons for cat owners to seek veterinary care. Empiric treatment for lower urinary tract disease or primary behavior disorders are commonly pursued, especially in those cases with normal routine laboratory evaluations. Herein, we report the clinicopathologic findings in eight sexually altered cats that were diagnosed with androgen-secreting adrenocortical tumors. Nearly all cats (n = 7) initially were evaluated for inappropriate urination and pungent urine, with additional behavioral concerns including aggression (n = 3) and excess vocalization (n = 4) commonly reported. Penile barbs (n = 5) were identified in all five male cats, and an enlarged clitoris was observed in one female cat. Testing of serum androgen concentrations revealed abnormally high androstenedione (n = 1) or testosterone (n = 7) concentrations. In the five cases with available adrenal tissue, histopathologic evaluation identified either an adrenocortical adenoma (n = 3) or adrenocortical carcinoma (n = 2). Hormonal abnormalities resolved and clinical signs improved in the four cats that underwent surgical adrenalectomy, with each of these cats surviving >1 year. However, clinical signs were minimally impacted with medical treatments, including one cat in which trilostane treatment failed to improve clinical signs or testosterone concentrations. This collection of cases underscores the importance of a detailed physical examination as well as the consideration of endocrine disturbances in cats undergoing evaluation for inappropriate urination or aggression. Furthermore, this report adds to the growing body of evidence that sex-hormone secreting adrenal tumors in cats may be an under-recognized syndrome.
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Affiliation(s)
- Caylen G. Erger
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Allison L. Gerras
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
| | - Alan J. Conley
- Department of Population Health & Reproduction, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States
| | - Chen Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Karah Burns DeMarle
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, United States
| | - Kent R. Refsal
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, Lansing, MI, United States
| | | | - Dodd G. Sledge
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, Lansing, MI, United States
| | - Daniel K. Langlois
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States
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Prego MT, Dias MJ, Mestrinho L, Englar R, Grinwis G, Galac S, Leal RO. Diagnosis, treatment and outcome of pheochromocytoma in a cat. J Small Anim Pract 2023; 64:415-420. [PMID: 36977649 DOI: 10.1111/jsap.13601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/18/2022] [Accepted: 01/24/2023] [Indexed: 03/30/2023]
Abstract
Pheochromocytoma in cats is a rare clinical condition characterised by the development of a secretory endocrine tumour that arises from the adrenal medulla. An 8-year-old castrated male, domestic shorthair cat was referred for further investigation of a 4-month history of progressive weight loss with normal appetite, polyuria/polydipsia, generalised weakness, and severe hypertension. Sonography and computed tomography of the abdomen disclosed a mass arising from the left adrenal gland. The contralateral adrenal gland was normal in size and shape. Results from a low dose dexamethasone suppression test and measurements of plasma aldosterone concentration and plasma renin activity ruled out a cortisol-secreting tumour and aldosteronoma. The clinical presentation made a sex-steroid secreting tumour unlikely. Increased plasma metanephrine and normetanephrine concentrations prioritised the differential diagnosis of pheochromocytoma. The cat underwent adrenalectomy of the left gland and histopathological diagnosis with immunohistochemical markers confirmed the diagnosis.
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Affiliation(s)
- M T Prego
- Veterinary Teaching Hospital/Faculty of Veterinary Medicine, University of de Lisbon, Lisbon, Portugal
| | - M J Dias
- Veterinary Teaching Hospital/Faculty of Veterinary Medicine, University of de Lisbon, Lisbon, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - L Mestrinho
- Veterinary Teaching Hospital/Faculty of Veterinary Medicine, University of de Lisbon, Lisbon, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - R Englar
- College of Veterinary Medicine, University of Arizona, 1580 E Hanley Blvd, Oro Valley, Arizona, 85737, USA
| | - G Grinwis
- Veterinair Pathologisch Diagnostisch Centrum - Department of Biomolecular Health Sciences, Utrecht University, Utrecht, The Netherlands
| | - S Galac
- Department of Clinical Sciences, Utrecht University, Utrecht, The Netherlands
| | - R O Leal
- Veterinary Teaching Hospital/Faculty of Veterinary Medicine, University of de Lisbon, Lisbon, Portugal
- CIISA - Centre for Interdisciplinary Research in Animal Health - Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
- Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
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Bugbee A, Rucinsky R, Cazabon S, Kvitko-White H, Lathan P, Nichelason A, Rudolph L. 2023 AAHA Selected Endocrinopathies of Dogs and Cats Guidelines. J Am Anim Hosp Assoc 2023; 59:113-135. [PMID: 37167252 DOI: 10.5326/jaaha-ms-7368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Canine and feline endocrinopathies reflect an endocrine gland disease or dysfunction with resulting hormonal abnormali ties that can variably affect the patient's wellbeing, quality of life, and life expectancy. These guidelines provide consensus recommendations for diagnosis and treatment of four canine and feline endocrinopathies commonly encountered in clini cal practice: canine hypothyroidism, canine hypercortisolism (Cushing's syndrome), canine hypoadrenocorticism (Addi son's disease), and feline hyperthyroidism. To aid the general practitioner in navigating these common diseases, a stepwise diagnosis and treatment algorithm and relevant background information is provided for managing each of these diseases. The guidelines also describe, in lesser detail, the diagnosis and treatment of three relatively less common endo crinopathies of cats: feline hyperaldosteronism, feline hypothyroidism, and feline hyperadrenocorticism. Additionally, the guidelines present tips on effective veterinary team utilization and client communication when discussing endocrine cases.
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Affiliation(s)
- Andrew Bugbee
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Renee Rucinsky
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Sarah Cazabon
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Heather Kvitko-White
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Patty Lathan
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Amy Nichelason
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Liza Rudolph
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
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Miceli DD, García JD, Rey Amunategui JP, Pompili GA, Rial LA, Más J, Molina EM, Pignataro OP. Prevalence of hypersomatotropism and hyperthyroidism in cats with diabetes mellitus from referral centers in Buenos Aires (2020-2022). J Feline Med Surg 2023; 25:1098612X221148565. [PMID: 36779783 PMCID: PMC10812081 DOI: 10.1177/1098612x221148565] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
OBJECTIVES The aim of this study was to estimate the prevalence of hypersomatotropism (HST) and hyperthyroidism in cats with diabetes mellitus (DM) from referral centers in Buenos Aires, Argentina. METHODS This was a prospective study. Systematic screening of serum insulin-like growth factor 1 (IGF-1) and total thyroxine was performed in all cats diagnosed with DM at referral centers in Buenos Aires between February 2020 and February 2022. RESULTS In total, 154 diabetic cats were evaluated (99 males and 55 females; median age 12 years [range 3-21]; mean body weight 5 kg [range 2-12]). Altogether, there were 115 (75%) domestic shorthairs and one domestic longhair; the remaining 38 cats were purebred (mainly Siamese, n = 25 [16%]). Twenty (12.9%) cats had IGF-1 concentrations >1000 ng/ml, and three (1.9%) had IGF-1 concentrations between 800 and 1000 ng/ml along with pituitary enlargement on CT, resulting in a 14.9% HST prevalence rate in diabetic cats. Intracranial imaging was performed in all cats with HST; median pituitary dorsoventral height was 5.8 mm (range 3.1-9.5). Fourteen of 23 (61%) cats had phenotypic changes consistent with acromegaly at the time of diagnosis of HST. Four of 154 (2.5%) cats had concurrent hyperthyroidism. CONCLUSIONS AND RELEVANCE To date, this is the first study outside of Europe to have evaluated the prevalence of HST and hyperthyroidism in cats with DM. In Buenos Aires referral centers, feline HST is the most common concurrent endocrinopathy in cats with DM but with a lower prevalence than has previously been reported. Hyperthyroidism is a rare concurrent endocrinopathy in diabetic cats from referral centers in Buenos Aires.
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Affiliation(s)
- Diego D Miceli
- Laboratory of Molecular Endocrinology and Signal Transduction, Institute of Experimental Biology and Medicine – CONICET, Buenos Aires, Argentina
- Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
| | - Jorge D García
- Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | | | - Gustavo A Pompili
- Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | - Laura A Rial
- Department of Animal Welfare and Ethology, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | - Javier Más
- Diagnotest Laboratory, Buenos Aires, Argentina
| | - Estela M Molina
- Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | - Omar P Pignataro
- Laboratory of Molecular Endocrinology and Signal Transduction, Institute of Experimental Biology and Medicine – CONICET, Buenos Aires, Argentina
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Leal KM, Rocha MB, Varela FV, Rodrigues L, Furtado PV, da Costa FVA, Pöppl ÁG. Is methylprednisolone acetate-related insulin resistance preventable in cats? Top Companion Anim Med 2022; 49:100648. [PMID: 35202848 DOI: 10.1016/j.tcam.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
Methylprednisolone acetate (MPA) is often prescribed to cats despite being recognized eventually as diabetogenic. To assess MPA-related insulin resistance and evaluate the efficacy of metformin or an obesity and diabetes mellitus (O&D) adjuvant diet as protective factors, a randomized clinical trial was conducted with 28 owned cats undergoing glucocorticoid therapy. A single MPA dose of 20 mg intramuscularly was administered to each cat. Controls (n=10) received only MPA. In the diet group (n=9), replacement of their habitual diet by ad-libitum feeding of a feline commercial O&D diet (Equilíbrio O&D, Total Alimentos ADM) was made. In the metformin group (n=9), metformin chlorhydrate 25mg/cat PO/q24h was administered for 30 days. All patients were clinically evaluated at baseline (T0), day 15 (T15), and day 30 (T30) and blood draw for complete blood count, serum biochemistry, and determination of insulin concentrations. Fasting Insulin Sensitivity Index (SI), Amended Insulin to Glucose Ratio (AIGR), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and Homeostatic Model Assessment of beta-cell function (HOMA-B) were calculated based on fasting glycemia and insulinemia. All groups showed significantly higher levels (p < 0.05) of neutrophils, albumin, glucose, cholesterol, triglycerides, and serum insulin at T15. Patients in the metformin group showed also higher SI, AIGR, and HOMA-IR results at T15. Also, at T15, reduced levels (p < 0.05) of eosinophils, lymphocytes, and creatinine were documented in all groups. An MPA single dose induced changes in insulin sensitivity in cats; however, neither metformin nor O&D feeding used in this study was effective as protective factors against MPA-related insulin resistance.
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Key Words
- AAFP, American Association of Feline Practitioners
- AIGR, amended insulin to glucose ratio
- CV, coefficient of variation
- ESVE, European Society of Veterinary Endocrinology
- FDM, feline diabetes mellitus
- GLP-1, glucagon-like peptide-1
- HOMA-B, homeostatic model assessment of beta-cell function
- HOMA-IR, homeostatic model assessment of insulin resistance
- LOD, limit of detection
- MPA, methylprednisolone acetate
- O&D, obesity and diabetes
- RIA, radioimmunoassay
- SI, Fasting insulin sensitivity index
- adjuvant feeding
- diabetes mellitus
- glucocorticoid therapy
- insulinaemia
- metformin
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Affiliation(s)
- Karine Marchioro Leal
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Veterinary Hospital UniRitter, Laureate International Universities, 2001 Manoel Elias Av., Mário Quintana, Porto Alegre, RS, 91240-260, Brazil
| | - Mariana Barcelos Rocha
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Fernanda Venzon Varela
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Luana Rodrigues
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Priscila Viau Furtado
- Hormonal Laboratory, Faculty of Veterinary Medicine and Zootecny, University of São Paulo (USP), 87 Orlando Marques de Paiva Av., Butantã, São Paulo, SP, 05508-270, Brazil
| | - Fernanda Vieira Amorim da Costa
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Department of Animal Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Álan Gomes Pöppl
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Department of Animal Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil.
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YAYOSHI N, HAMAMOTO Y, ODA H, HAGA A, KOYAMA K, SAKO T, MORI A. Successful treatment of feline hyperadrenocorticism with pituitary macroadenoma using radiation therapy: a case study. J Vet Med Sci 2022; 84:898-904. [PMID: 35527017 PMCID: PMC9353102 DOI: 10.1292/jvms.22-0021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 10-year-old castrated male cat showing behavioral (irritation, prowling, and tumbling) and cutaneous abnormalities such as dermal fragility was diagnosed as hyperadrenocorticism with
pituitary macroadenoma, concurrent with insulin dependent diabetes mellitus. Pituitary enlargement (18.0 mm) was observed during magnetic resonance imaging. High endogenous
adrenocorticotropic hormone levels (>2,500 pg/ml) were also observed. Although trilostane treatment (5–10 mg/head, daily) was commenced, the clinical signs did not disappear. Insulin and
trilostane treatment were discontinued on day 86 after first day of radiation therapy (4 Gy/12 fractions). After radiation therapy, a decreased pituitary tumor size (10.7 mm) was observed on
day 301; neurological and dermatological signs exhibited remission. Radiation therapy is the treatment of choice for feline hyperadrenocorticism with pituitary macroadenoma with neurological
signs.
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Affiliation(s)
- Naoko YAYOSHI
- School of Veterinary Science, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Yuji HAMAMOTO
- School of Veterinary Science, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Hitomi ODA
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Aiko HAGA
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Kaoru KOYAMA
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Toshinori SAKO
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
| | - Akihiro MORI
- School of Veterinary Nursing and Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University
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Pilot MA, Bell C, O’Dair H, Glenn EJ, Bailey S, Langley-Hobbs SJ. Chronic paronychia in cats with patellar fracture and dental anomaly syndrome. J Feline Med Surg 2021; 23:1200-1212. [PMID: 33759602 PMCID: PMC10812158 DOI: 10.1177/1098612x21998612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
CASE SERIES SUMMARY The aim of this case series was to describe the clinical features and treatment of paronychia in cats diagnosed with patellar fracture and dental anomaly syndrome (PADS). Clinical records, photographs, microbiology, cytology and histopathology reports were collected, and follow-up was obtained. Five cats with paronychia were included. All five cats had multiple digits of multiple limbs affected and eventually underwent amputation of the third phalanx of one or multiple digits. A total of 36 digits were affected, 17% (n = 6/36) resolved with medical management and 83% (n = 30/36) were eventually treated successfully by amputation. The cats had treatment with numerous courses of antibiotics (range 7-20; mean 11 courses) over periods of time ranging from 10 to 67 months (mean 32 months). RELEVANCE AND NOVEL INFORMATION Chronic paronychia may be an additional clinical feature of PADS and the probable mechanism involves poor integrity of osteopetrotic bone, loss of normal nailbed anatomy and secondary osteomyelitis of the distal phalanx. Medical management with antibiotics, anti-inflammatory therapy and steroid treatment may improve the clinical signs in the short term; however, in severe instances, amputation of the third phalanx of the affected digit seems to be necessary to resolve repeated recurrences and discomfort. Additional information on the long-term outcome is required. In any cat with atraumatic patellar fractures and/or retained deciduous teeth, paronychia may require surgical management if medical management is unsuccessful.
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Affiliation(s)
- Mariette A Pilot
- Langford Small Animal Hospital, Langford House, University of Bristol, Bristol, UK
| | - Cynthia Bell
- Specialty Oral Pathology for Animals, Geneseo, IL, USA
| | - Hilary O’Dair
- Langford Small Animal Hospital, Langford House, University of Bristol, Bristol, UK
| | | | - Steven Bailey
- Exclusively Cats Veterinary Hospital, Waterford, MI, USA
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Yu J, Lenord J, Lau M, Brunel L, Gray R, Donahoe SL, Boland L. Gynaecomastia in a male neutered cat with an adrenal tumour and associated hyperprogesteronism, hypercortisolism and hyperaldosteronism. JFMS Open Rep 2021; 7:20551169211045640. [PMID: 34616560 PMCID: PMC8488528 DOI: 10.1177/20551169211045640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Case summary A 7-year-old male neutered domestic longhair cat was presented with chronic progressive gynaecomastia, polydipsia, polyphagia, weight loss and poor fur regrowth. Sexualised behavioural changes were not reported and virilisation was not present on physical examination. Pertinent haematology, biochemistry and urinalysis findings at the time of referral included mild hypokalaemia. Left adrenomegaly and mild prostatomegaly were identified on a CT scan. Evaluation of adrenal hormones with a low-dose dexamethasone suppression test, serum progesterone, testosterone, oestradiol, plasma aldosterone, renin, plasma metanephrine and normetanephrine measurement supported a diagnosis of hyperprogesteronism, hyperaldosteronism and hypercortisolism. Adrenalectomy was performed and histopathology was consistent with an adrenocortical tumour. Clinical signs and hormone elevations resolved postoperatively. Relevance and novel information To our knowledge, this is the second report of gynaecomastia secondary to an adrenal tumour in a male neutered cat and the first associated with hyperprogesteronism.
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Affiliation(s)
- Jane Yu
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Jason Lenord
- Balmain Veterinary Hospital, Rozelle, NSW, Australia
| | - Michelle Lau
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Laurencie Brunel
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Rachael Gray
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Shannon L Donahoe
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Lara Boland
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
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10
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McClintock D, Austel M, Gogal RM, Banovic F. Oral dexamethasone sodium phosphate solution significantly reduces pruritus and clinical lesions in feline hypersensitivity dermatitis: an open-label study. Vet Dermatol 2021; 32:497-e137. [PMID: 34351657 DOI: 10.1111/vde.13006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND There are no liquid oral glucocorticoids labelled for management of pruritus and clinical lesions of feline hypersensitivity dermatitis (feline HD). HYPOTHESIS First, to demonstrate that dexamethasone sodium phosphate (DexSP, DexajectSP, Henry Schein; Dublin, OH, USA; 4 mg/mL), an intravenous glucocorticoid, can be absorbed by healthy cats when administered orally. Second, to demonstrate the efficacy of orally administered DexSP for reducing pruritus and clinical lesions in patients with feline HD. ANIMALS Seven healthy and 12 client-owned cats with HD. METHODS AND MATERIALS Healthy cats were administered a single dose of 0.2 mg/kg DexSP p.o. and serum concentrations were measured using enzyme-linked immunosorbent assay (ELISA). Feline HD patients were assessed with SCORing Feline Allergic Dermatitis (SCORFAD) and pruritus Visual Analog Scale (pVAS) at Visit 1 (V1) and after 20-31 days of receiving 0.2 mg/kg/day DexSP p.o. (V2). Complete blood cell counts, serum chemistry profile, and urinalysis were performed in 50% of feline HD patients at both visits. RESULTS Healthy cats had detectable serum concentrations of DexSP following oral administration; concentrations ranged from 0.7 to 92.3 ng/mL. Feline HD patients showed significant decreases in SCORFAD and pVAS scores from V1 to V2. CONCLUSIONS DexSP was absorbed when administered orally to healthy cats and 0.2 mg/kg/day DexSP is an efficacious dose to rapidly improve the pruritus and clinical lesions associated with feline HD.
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Affiliation(s)
- Dayle McClintock
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA, 30605, USA
| | - Michaela Austel
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA, 30605, USA
| | - Robert M Gogal
- Department of Veterinary Biosciences and Diagnostic Imaging, College of Veterinary Medicine, University of Georgia, 501 D.W. Brooks Drive, Athens, GA, 30602, USA
| | - Frane Banovic
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, 2200 College Station Road, Athens, GA, 30605, USA
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11
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Komiya T, Mori A, Nishii N, Oda H, Onozawa E, Seki S, Sako T. Relationship between anti-insulin antibody production and severe insulin resistance in a diabetic cat. J Vet Med Sci 2021; 83:661-665. [PMID: 33840723 PMCID: PMC8111345 DOI: 10.1292/jvms.20-0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A 5-year-old castrated male domestic shorthair cat was diagnosed with diabetic
ketoacidosis and severe insulin resistance. Although the conventional treatment for
diabetic ketoacidosis was provided, the cat required frequent hospitalization because of
severe dehydration and repeated diabetic ketoacidosis. We detected anti-insulin antibodies
for human in this cat. Serum insulin-binding IgG levels were markedly elevated compared
with those in healthy cats and other diabetic cats. We initiated prednisolone to suppress
the effects of anti-insulin antibodies. After initiation of prednisolone, the cat was
gradually recovered with increasing activity and appetite. Furthermore, satisfactory
glycemic control was achieved with combined subcutaneous injection of insulin detemir and
insulin degludec.
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Affiliation(s)
- Takumi Komiya
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan.,Animal Emergency Center Fuchu, 1-17-1 Midoricho, Fuchu, Tokyo 183-0006, Japan
| | - Akihiro Mori
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
| | - Naohito Nishii
- Joint Department of Veterinary Medicine, Faculty of Applied Biological Sciences, Gifu University, 1-1 Yanagido, Gifu 501-1193, Japan
| | - Hitomi Oda
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
| | - Eri Onozawa
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
| | - Seri Seki
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
| | - Toshinori Sako
- School of Veterinary Nursing & Technology, Faculty of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
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12
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Miceli DD, Zelarayán GS, García JD, Fernández V, Ferraris S. Diabetes mellitus remission in a cat with hyperadrenocorticism after cabergoline treatment. JFMS Open Rep 2021; 7:20551169211029896. [PMID: 34345435 PMCID: PMC8283091 DOI: 10.1177/20551169211029896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Case summary A 7-year-old spayed female domestic shorthair cat weighing 5 kg was referred with polyuria, polydipsia, lethargy, abdominal distension and dermatologic abnormalities. Diabetes mellitus was diagnosed and treatment was started with a diet for diabetic cats and insulin glargine (1 IU q12h SC). Hyperadrenocorticism (HAC) was suspected and diagnosed based on clinical signs, increased urinary cortisol:creatinine ratio, lack of suppression on low-dose dexamethasone suppression test and abdominal ultrasonography demonstrating bilateral adrenal enlargement. Oral cabergoline (10 μg/kg every other day) was initiated. After the second administration of cabergoline, the cat suffered from clinical hypoglycemia and no longer required insulin. One month after insulin withdrawal, blood work and urine analysis results showed normoglycemia, a normal serum fructosamine concentration (244 μmol/l) and normal urine analysis without glycosuria. Diabetic remission persisted until its death 7 months later. In addition, cabergoline treatment was associated with improvement in clinical signs such as lethargy, seborrhea, alopecia and abdominal distension. Relevance and novel information To our knowledge, this is the first reported case of the use of cabergoline in a cat with HAC, as well as the first reported case of diabetic remission in a cat with HAC after cabergoline treatment. Cabergoline could be an alternative treatment for diabetic cats with pituitary-dependent HAC. Further work should focus on different protocols with greater number of cases.
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Affiliation(s)
- Diego D Miceli
- Endocrinology Unit, Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina.,Laboratory of Molecular Endocrinology and Signal Transduction, Institute of Experimental Biology and Medicine - CONICET, Buenos Aires, Argentina.,Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
| | | | - Jorge D García
- Endocrinology Unit, Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina
| | - Viviana Fernández
- Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
| | - Sergio Ferraris
- Veterinary Science Center, Maimonides University, Buenos Aires, Argentina
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13
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O'Sullivan LE, Kent M, Glass EN, Song RB, Warren JD, de Lahunta A, Miller A. Pathology in Practice. J Am Vet Med Assoc 2021; 258:857-860. [PMID: 33825532 DOI: 10.2460/javma.258.8.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Miller MA, Piotrowski SL, Donovan TA, Scott-Moncrieff JC, Owen TJ, McCue JP, DuSold DM, Ramos-Vara JA, Weng HY, Chen AV, Martin LG, Bruyette DS. Feline Pituitary Adenomas: Correlation of Histologic and Immunohistochemical Characteristics With Clinical Findings and Case Outcome. Vet Pathol 2021; 58:266-275. [PMID: 33280571 PMCID: PMC10722206 DOI: 10.1177/0300985820978309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Pituitary glands from 141 feline autopsy cases were reviewed histologically. Adenoma and hyperplasia were the most common lesions at 13 cases each. Pituitary adenoma was more likely than hyperplasia to be associated with clinical evidence of endocrinopathy or an intracranial mass (P < .001). A histochemical and immunohistochemical panel was applied to 44 autopsy- or hypophysectomy-derived pituitary adenomas in 43 cats from 2 diagnostic laboratories. Adenomas were differentiated from hyperplasia by the presence of disrupted reticulin fibers. One cat had a double (somatotroph and melanotroph) adenoma. Twenty somatotroph adenomas consisted of periodic acid-Schiff (PAS)-negative acidophils that expressed growth hormone; 16/20 had hypersomatotropism; 17/20 had diabetes mellitus. Eleven melanotroph adenomas consisted of PAS-positive basophils or chromophobes that expressed melanocyte-stimulating and adrenocorticotrophic hormones; 5/11 had hypercortisolism; 6/11 had diabetes mellitus. Eleven gonadotroph adenomas consisted of PAS-negative chromophobes that expressed follicle-stimulating and/or luteinizing hormones. Two thyrotroph adenomas consisted of PAS-negative basophils or chromophobes that expressed thyroid-stimulating hormone. Pituitary-dependent disease was not recognized in cats with gonadotroph or thyrotroph adenomas. The Ki-67 proliferation index in hypophysectomy specimens was lower in somatotroph than in melanotroph adenomas. Fourteen cats with hypophysectomy-treated somatotroph or melanotroph adenoma had an 899-day median survival time versus 173 days in 17 nonsurgical cases. After adjusting for age, adenoma size and type, hypophysectomized cats had an overall better survival time than nonsurgical cases (P = .029). The study results underscore the value of hypophysectomy and trophic hormone immunohistochemistry in the treatment and classification of feline pituitary adenomas.
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Affiliation(s)
| | - Stacey L. Piotrowski
- Purdue University, West Lafayette, IN, USA
- Comparative Biomedical Scientist Training Program, National Institutes of Health, Bethesda, MD, USA
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15
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Tardo AM, Reusch CE, Galac S, Fornetti S, Tirolo A, Golinelli S, Shehdula D, Fracassi F. Feline plasma adrenocorticotropic hormone: validation of a chemiluminescent assay and concentrations in cats with hypercortisolism, primary hypoadrenocorticism and other diseases. J Feline Med Surg 2021; 23:67-73. [PMID: 32478637 PMCID: PMC10741360 DOI: 10.1177/1098612x20925686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aims of this study were to validate a commercially available chemiluminescent assay for measurement of feline plasma adrenocorticotropic hormone concentration (ACTH), to determine the normal reference interval (RI) of plasma ACTH in healthy cats, to assess plasma ACTH in cats with naturally occurring hypercortisolism (HC), primary hypoadrenocorticism (PH) and other diseases (OD), and to evaluate the effect of aprotinin on plasma ACTH degradation. METHODS Forty healthy cats, 10 with HC, 11 with PH and 30 with OD, were included. The chemiluminescent enzyme immunometric assay was evaluated by measurement of intra-assay precision, interassay precision and linearity. The RI for plasma ACTH in healthy cats was established using robust methods. Plasma ACTH of samples collected with and without aprotinin, stored at 4°C and assayed over a 6-day period, was measured. RESULTS The intra-assay coefficients of variance (CVs) ranged from 2.7% to 4.3% and interassay CVs from 3.3% to 10.7%. Dilution studies showed excellent accuracy (R2 >0.99). The RI for plasma ACTH in healthy cats was 32-370 pg/ml. Plasma ACTH was not significantly different between healthy cats and the OD group. Cats with pituitary-dependent hypercortisolism (PDH) and PH had significantly higher plasma ACTH than the other groups. Plasma ACTH did not show significant differences when samples collected with and without aprotinin were compared. CONCLUSIONS AND RELEVANCE The Immulite chemiluminescent assay is a valid technique for measuring plasma ACTH in cats and the RI of plasma ACTH is quite wide. Owing to the low overlap between healthy or OD cats and cats with HC or PH, the measurement of plasma ACTH appears to be useful and should be included in the diagnostic work-up when HC or PH are suspected. Furthermore, the measurement of plasma ACTH may be an accurate test for differentiating PDH from adrenal-dependent hypercortisolism.
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Affiliation(s)
- Antonio M Tardo
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Claudia E Reusch
- Clinic for Small Animal Internal
Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sara Galac
- Department of Clinical Sciences, Faculty
of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Sofia Fornetti
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Alessandro Tirolo
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Stefania Golinelli
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Dardan Shehdula
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
| | - Federico Fracassi
- Department of Veterinary Medical
Sciences, University of Bologna, Ozzano dell’Emilia, Bologna, Italy
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16
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Sanders K, Galac S, Meij BP. Pituitary tumour types in dogs and cats. Vet J 2021; 270:105623. [PMID: 33641809 DOI: 10.1016/j.tvjl.2021.105623] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/18/2021] [Accepted: 01/19/2021] [Indexed: 12/25/2022]
Abstract
Pituitary tumours are common in dogs and are being increasingly recognized in cats. Pituitary tumours are usually classified as adenomas and should only be classified as carcinomas when there is evidence of metastatic spread of the tumour, which is rare. Despite the benign nature of most pituitary tumours, they can still compress or invade neighbouring tissues. Pituitary tumours can be functional (hormonally active) or non-functional (hormonally silent). The aim of this review was to provide an overview of the different pituitary tumour types in dogs and cats that have been reported in the literature. In dogs, the most common pituitary tumour type is the corticotroph adenoma, which can cause pituitary-dependent hypercortisolism. In cats, the most common pituitary tumour is the somatotroph adenoma, which can cause hypersomatotropism, and the second-most common is the corticotroph adenoma. A lactotroph adenoma has been described in one dog, while gonadotroph, thyrotroph and null cell adenomas have not been described in dogs or cats. Hormonally silent adenomas are likely underdiagnosed because they do not result in an endocrine syndrome. Tools used to classify pituitary tumours in humans, particularly immunohistochemistry for lineage-specific transcription factors, are likely to be useful to classify canine and feline pituitary tumours of unknown origin. Future studies are required to better understand the full range of pituitary adenoma pathology in dogs and cats and to determine whether certain adenoma subtypes behave more aggressively than others. Currently, the mechanisms that underlie pituitary tumorigenesis in dogs and cats are still largely unknown. A better understanding of the molecular background of these tumours could help to identify improved pituitary-targeted therapeutics.
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Affiliation(s)
- K Sanders
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands.
| | - S Galac
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
| | - B P Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands
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17
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Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
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Affiliation(s)
- Sally Griffin
- BVSc, Ce666rtAVP, DipECVDI, Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
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18
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Kirkwood N, Boland L, Brunel L, Wardman A, Barrs VR. Acute adrenal haemorrhage in two cats with aldosterone-secreting adenocarcinomas. JFMS Open Rep 2019; 5:2055116919840828. [PMID: 30992996 PMCID: PMC6449812 DOI: 10.1177/2055116919840828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Case summary Two 13-year-old domestic shorthair cats were diagnosed with unilateral right
adrenocortical carcinomas (ACCs) and primary hyperaldosteronism (PHA). Both
had polyuria, polydipsia and weight loss, and developed severe anaemia from
an episode of acute adrenal haemorrhage. In one case, this occurred during
hospitalisation and treatment of severe muscle weakness with cervical
ventroflexion, while the other cat had acute collapse at home. A diagnosis
of PHA was confirmed in both cases based on measurement of plasma
aldosterone and renin activity. In one case, basal progesterone was also
measured and was elevated. On ultrasonography and CT in one case,
haemorrhage into the right retroperitoneal space was identified. Unilateral
adrenalectomy was performed in both cases and there was no evidence of
venous tumoral invasion in either. On histopathology of the excised adrenal
glands both were ACCs with tumour necrosis, and one had extensive
intratumoral haemorrhage. Both cats were diagnosed with International Renal
Interest Society stage 2 or 3 chronic kidney disease postoperatively; one
survived for 18 months and the other was well 8 months postoperatively. Relevance and novel information Acute adrenal haemorrhage secondary to adrenal neoplasia has been reported in
only one other cat, in which tumour type and function were not specified.
Acute adrenal haemorrhage can occur as a consequence of tumour necrosis and
rupture and can cause severe hypovolaemia and anaemia in cats with primary
hyperaldosteronism.
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Affiliation(s)
- Nicolle Kirkwood
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Lara Boland
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Laurencie Brunel
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Alison Wardman
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
| | - Vanessa R Barrs
- Valentine Charlton Cat Centre, University Veterinary Teaching Hospital, Sydney School of Veterinary Science, Faculty of Science, University of Sydney, NSW, Australia
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19
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Effects of Low-level Brodifacoum Exposure on the Feline Immune Response. Sci Rep 2018; 8:8168. [PMID: 29802369 PMCID: PMC5970145 DOI: 10.1038/s41598-018-26558-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 05/11/2018] [Indexed: 12/15/2022] Open
Abstract
Anticoagulant rodenticides have been implicated as a potential inciting factor in the development of mange in wild felids, but a causative association between anticoagulant rodenticide exposure and immune suppression has not been established. Specific-pathogen-free domestic cats were exposed to brodifacoum over a 6-week period to determine whether chronic, low-level exposure altered the feline immune response. Cats were vaccinated with irrelevant antigens at different points during the course of the experiment to assess recall and direct immune responses. Measures of immune response included delayed-type hypersensitivity tests and cell proliferation assays. IgE and antigen-specific antibodies were quantified via ELISA assays, and cytokine induction following exposure to vaccine antigens was also analyzed. While cats had marked levels of brodifacoum present in blood during the study, no cats developed coagulopathies or hematologic abnormalities. Brodifacoum-exposed cats had transient, statistically significant decreases in the production of certain cytokines, but all other measures of immune function remained unaffected throughout the study period. This study indicates that cats may be more resistant to clinical effects of brodifacoum exposure than other species and suggests that the gross impacts of environmentally realistic brodifacoum exposure on humoral and cell-mediated immunity against foreign antigen exposures in domestic cats are minimal.
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20
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Vogelnest LJ. Skin as a marker of general feline health: Cutaneous manifestations of systemic disease. J Feline Med Surg 2017; 19:948-960. [PMID: 28838298 PMCID: PMC11128893 DOI: 10.1177/1098612x17723246] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Practical relevance: Although most skin lesions occur due to diseases primarily affecting the skin, some reflect important systemic diseases. Such lesions may relate directly to the systemic disease, or may occur due to secondary skin diseases that develop because of immunosuppression. Early recognition of skin changes as a marker of systemic disease will maximise patient outcomes. Clinical challenges: In older or clearly debilitated cats presenting with skin disease, the potential for underlying systemic disease is often readily apparent. Similarly, cats presenting with severe ulcerative or multifocal nodular skin lesions, or with concurrent signs of systemic illness, will more instinctively prompt systemic evaluation. More challenging is the cat presenting with alopecic, scaling, erythemic and/or mildly crusted skin disease, with or without pruritus; hypersensitivities and infectious dermatoses are the most common considerations, but occasionally systemic disease underlies the skin changes. Knowing when screening laboratory testing, body imaging or other systemic diagnostics are indicated is not always straightforward. Evidence base: This article reviews cutaneous presentations of systemic diseases reported in the veterinary literature, and discusses important differential diagnoses. The author draws on clinical experience, published data on disease prevalence and case evaluations, and expert opinions on approach to common systemic problems to provide guidance on when investigation for underlying systemic disease is most appropriate.
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Affiliation(s)
- Linda J Vogelnest
- Small Animal Specialist Hospital, Sydney, NSW, Australia, and Associate Lecturer, University of Sydney, NSW, Australia
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