Feline Hypercortisolism, Hypoadrenocorticism, and Hyperaldosteronism Flashcards
What is another term for Hyperaldosteronism?
Conns syndrome
What stimulates the release of Aldosterone, and where is aldosterone released from?
- Ang II, ↑ K+, corticotrophin
- Released from zona glomerulosa
Aldosterone is released from _______
A. Zona glomerulosa
B. Zona fasciculata
C. Zona reticularis
D. Adrenal medulla
A. Zona glomerulosa
What is the main action of aldosterone?
- Stimulates Na+ reabsorption and K+ and H+ excretion
- Upregulates endothelin, ACE, Ang II causing vasoconstriction
What are the main clinical signs in cats with Conns disease?
- Hypokalemia: Inappetance, weakness, cervical ventroflexion
- Hypertension: retinal detachment, ocular hemorrhage, kidney damage, cardiac hypertrophy
A cat is presenting with inappetance, weakness, and retinal detachment. How can Hyperaldosteronism be diagnosed?
- Check aldosterone levels (↑↑↑) and plasma renin activity (↓↓↓)
- AUS or CT to ID tumor
What is the treatment protocol for a patient with Hyperaldosteronism?
- 1st option is always medical management: Treat hypertension and hypokalemia
- Spironolactone
- Potassium supplementation
- Amlodipine
- Adrenalectomy if unilateral
What is the prognosis for cats with Conns disease?
(Hyperaldosteronism)
- 2-3 years regardless of surgery vs medical management, and regardless of neoplasia vs benign
What concurrent disease should always be investigated in a cat with hyperglycemia, PU/PD/PP, and uncontrolled diabetes mellitus?
HyperAdrenocorticism cats are almost always diabetic
A cat is presenting with thin skin, hair loss on the ventral abdomen, and calcinosis cutis. What are you suspect of?
A. Hyperaldosteronism
B. Hypercortisolism
C. Hypoadrenocortisolism
D. Congenital hypothyroidism
B. Hypercortisolism (HAC/Cushings)
What results would you expect from a ACTH stim test on a cat with Cushings disease?
(HAC)
- High normal baseline cortisol
- Supraelevated cortisol levels post ACTH
80% of cats with Hypercortisolism/Cushings have a mass localized to the ___________
Pituitary gland
(PDH most common in cats)
How do the adrenal glands appear on ultrasound in a cat with Hypercortisolism/Cushings?
- Cats usually have pituitary tumor (80%) secreting excess ACTH → bilateral hyperplasia of adrenal glands
- If adrenal tumor → 1 adrenal will be large, other will be atrophied
A cat with bilateral hyperplasia of the adrenal glands on ultrasound. Where is the tumor located?
pituitary tumor (80%) secreting excess ACTH → bilateral hyperplasia of adrenal glands → Cushings
What is the drug of choice for treating HAC in dogs and cats?
Trilostane