Feline Hyperadrenocorticism

24 05 2011

Feline Hyperadrenocorticism

Is your cat prone to skin lacerations?  Does their skin appear to be easily damaged?  Skin fragility syndrome may be the first sign that your cat is suffering from an adrenal gland disorder known as hyperadrenocorticism.  In addition, the affected cat may concurrent insulin-resistant diabetes mellitus, an increase in appetite (polyphagia), have an insatiable thirst with a concurrent increase in urine production termed polydipsia and polyuria.  The affected pet may also appear obese, have abdominal enlargement and pant frequently.  These animals will often have recurrent infections especially of the urinary and respiratory tracts.

Hyperadrenocorticism is typically pituitary-dependent in the cat (due to a pituitary tumor).  Cats are typically affected around 10 years of age.  The range of onset is from 5 to 16 years old.

Serum chemistry changes include hypercholesterolemia (high cholesterol), hyperglycemia (high glucose levels), low blood urea nitrogen levels with a high serum alanine aminotransferase levels.  In contrast to the results seen in the dog, serum alkaline phosphatase levels are not elevated and the urine specific gravity is often at a concentrated level despite the polyuria and polydipsia.

The best screening tool would be a urinary cortisol/creatinine ratio in the cat.  A low-dose dexamethasone suppression test is the test of choice for confirmation.

In stark contrast to dogs who respond well to mitotane treatment, cats only respond to trilostane at 30 to 60 mg/cat/day.  Surgical treatment is an option but postoperative management is difficult for most individuals.

References:

Chiaramonte, D and D.S. Greco. “Adrenal Disorders in Cats”.  NAVC Clinician’s Brief.  April 2008. P. 42.

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