Feline Endocrinopathies Flashcards

1
Q

You are presented with a diabetic cat that is showing signs of insulin resistance, which endocrine diseases are more likely to cause insulin resistance in a diabetic cat?

A

(Hyperadrenocorticism and acromegaly; also hyperthyroidism but not as commonly as the other two)

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2
Q

What are some of the more common clinical signs and PE findings associated with hyperadrenocorticism in cats?

A

(PU/PD, abdominal enlargement, polyphagia, skin atrophy; also but less commonly muscle wasting, weight loss, alopecia, skin fragility, unkempt haircoat, plantigrade stance, hepatomegaly, and weight gain)

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3
Q

(T/F) It is very common, 80% of cases, for hyperadrenocortic cats to also have diabetes mellitus.

A

(T)

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4
Q

Why do cats not have severe increases in ALP when they have hyperadrenocorticism like dogs do?

A

(Because cats do not have the cortisol isoenzyme that increase ALP in dogs, so ALP elevation is less common in cats with hyperadrenocorticism when compared to dogs)

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5
Q

What laboratory (blood work, UA) findings do you expect to find in a cat with hyperadrenocorticism?

A

(Diabetes mellitus/hyperglycemia, hypercholesterolemia, increased ALT and +/- ALP, glucosuria, proteinuria, and minimally concentrated USG)

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6
Q

Which Cushing’s test would you reach for in a cat you suspect has hyperadrenocorticism based on clinical findings?

A

(LDDST, ACTH stim has poor sensitivity in cats)

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7
Q

What organ has to be abnormal to cause feline acromegaly?

A

(The pituitary gland, either tumor or pituitary overgrowth leading to excess release of growth hormone)

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8
Q

How does feline acromegaly cause the following possible presentations:

  • Stridor
  • Heart failure
  • Neurological signs
A
  • Stridor (From narrowing of nasal cavities d/t facial bone growth d/t excess growth hormone)
  • Heart failure (From heart enlargement d/t excess growth hormone)
  • Neurological signs (From tumor growth)
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9
Q

Is weight gain or weight loss more common in a case of acromegaly in cats?

A

(Weight gain)

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10
Q

What might you find during a physical exam of a cat with acromegaly?

A

(Abdominal organomegaly, broad facial features, clubbed paws, prognathia inferior, widening interdental spaces, enlarged tongue, and heart murmur)

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11
Q

What can you test for in a cat’s blood to indicate they have acromegaly?

A

(IGF-1 levels, otherwise need CT/MRI to diagnose an enlarged pituitary)

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12
Q

What are the two preferred treatment options for feline acromegaly?

A

(Hypophysectomy or radiation therapy; medical therapy is not as effective as the other two options)

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13
Q

What are the two drug options for treatment of feline acromegaly and what do those drugs do?

A

(Pasireotide → somatostatin analog (has negative feedback on GH excretion); cabergoline → dopamine receptor agonist (has negative feedback on the pituitary in general))

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14
Q

What can occur with the common simultaneous diabetes mellitus in cases of acromegaly where you choose to not treat?

A

(It will become hard to control, you’ll need to use high doses of insulin, and there is a possibility of sudden hypoglycemia)

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15
Q

Why do cats with hyperaldosteronism have signs such as cervical ventroflexion, weakness/collapse, dysphagia, and ataxia?

A

(Bc they are hypokalemic)

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16
Q

Why are cats with hyperaldosteronism hypertensive?

A

(Bc they are retaining sodium and water)

17
Q

What other disease does hyperaldosteronism look a lot like (which has caused it to go underdiagnosed)?

A

(Looks a lot like CKD (hypokalemia, azotemia, increased CK), if you are treating a cat for CKD and they are not responding, consider testing for hyperaldosteronism)

18
Q

How do you diagnose hyperaldosteronism?

A

(Test plasma aldosterone concentration and/or perform US and look for an adrenal tumor or bilateral enlargement of the adrenals)

19
Q

What is the preferred treatment for primary hyperaldosteronism in cats?

A

(Unilateral adrenalectomy, can use spironolactone as an aldosterone antagonist, amlodipine, and potassium supplementation for medical)

20
Q

What are differentials for secondary hypertension?

A

(Renal disease (look for azotemia), hyperthyroidism (test T4), hyperaldosteronism (test aldosterone), and pheochromocytomas (rare))