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Small Animal Medicine > Feline Pituitary & Adrenal Diseases > Flashcards

Feline Pituitary & Adrenal Diseases Flashcards

1
Q

What are the 3 most common causes of insulin resistance in diabetic cats?

A
  1. hyperadrenocorticism - pituitary or adrenal
  2. acromegaly - pituitary
  3. hyperthyroidism
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2
Q

What is the most common signalment associated with hyperadrenocorticism in cats?

A

~10 y/o - no breed or sex predisposition known

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3
Q

What are the 4 most common clinical signs associated with hyperadrenocorticism in cats? What else is seen?

A
  1. PU/PD
  2. abdominal enlargement
  3. polyphagia
  4. skin atropy
  • muscle wasting, weight loss/gain
  • alopecia, skin fragility (can tear off)
  • unkempt hair coat
  • plantigrade stance
  • hepatomegaly
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4
Q

What are 3 common laboratory findings in cats with hyperadrenocorticism?

A
  1. hyperglycemia - DM common
  2. hypercholesterolemia
  3. increased ALT > ALP —> cats lack cALP
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5
Q

What is most commonly found on UA in cats with hyperadrenocorticism?

A
  • glucosuria
  • proteinuria
  • minimally concentrated USG
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6
Q

What testing is preferred for diagnosing hyperadrenocorticism in cats? What is typically avoided?

A

LDDST

ACTH stim - poor sensitivity in cats (only 1/3 are +)

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7
Q

What medical treatment is recommended in cats with hyperadrenocorticism? When in surgery recommended?

A

Trilostane

if ADH

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8
Q

How are pituitary macroadenomas causing Cushing’s in cats typically managed?

A
  • tumor control with radiation therapy
  • clinical control with Trilostane
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9
Q

How does presentation in cats with Cushing’s compare with dogs? Clinical pathology?

A
  • panting is rare in cats
  • alopecia is more mild and less common
  • skin can tear spontaneously

80% of cats will be diabetic (10% in dogs)

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10
Q

What is the most common cause of acromegaly?

A

GH-secreting macroadenoma

  • hyperplasia can rarely occur
  • also causes insulin resistance - 30-50% of cats
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11
Q

What signalment is most commonly associated with acromegaly?

A

older (10 y/o) neutered males

  • no breed predisposition
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12
Q

What are the 4 most common presentations in cats with acromegaly?

A
  1. insulin-resistant diabetes (30-50%)
  2. stridor
  3. heart failure
  4. neurologic signs - increased tumor size
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13
Q

What is the most common clinical sign associated with acromegaly? What is also seen?

A

weight gain

  • PU/PD
  • polyphagia
  • weight loss
  • stridor
  • stiffness
  • lameness
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14
Q

What is commonly seen on physical exam in cats with acromegaly?

A
  • abdominal organomegaly
  • broad facial features
  • clubbed paws
  • prognathia inferior
  • widening interdental spaces
  • enlarged tongue
  • murmur associated with cardiac hypertrophy
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15
Q

Acromegaly:

A

broad features tend to develop slowly and go unnoticed by owners

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16
Q

What 2 diagnostics are used in cats that possibly have acromegaly?

A
  1. IGF-1 levels - will be pronounced, possibly slightly elevated in poorly controlled diabetics (hard to measure GH)
  2. CT/MRI - confirms tumor
17
Q

What 2 non-medical treatments are available for cats with acromegaly?

A
  1. hypophysectomy to remove tumor
  2. radiation therapy - less invasive
18
Q

What 2 medical therapies are available for cats with acromegaly?

A
  1. Pasireotide - somatostatin analog that blocks GH production ($$$)
  2. Cabergoline - dopamine receptor agonist
19
Q

What are the 3 effects of hypersomatotropism?

A
  1. arthritis
  2. stridor
  3. heart failure
20
Q

How can the diabetes in cases of cats with acromegaly and insulin resistance be controlled?

A

higher doses of insulin —> sudden hypoglycemia possible

21
Q

What is the prognosis of acromegaly like?

A
  • short-term with definitive tx = guarded to poor
  • long-term = poor
  • survival = 4-60 months
22
Q

What are the 2 most common causes of primary hyperaldosteronism in cats? Why is it commonly under-diagnosed?

A
  1. adrenal tumor
  2. idiopathic hyperplasia

can look like CKD

23
Q

What is the most common signalment associated with feline hyperaldosteronism?

A

older (11 y/o) cats with no sex or breed predisposition

24
Q

What are 5 common clinical signs associated with feline hyperaldosteronism? What are some non-specific signs?

A
  1. cervical ventroflexion (hypokalemia)
  2. weakness/collapse (hypokalemia)
  3. dysphagia
  4. ataxia
  5. ocular hypertension and blindness

anorexia, restlessness, weight loss

25
Q

What is most commonly seen on physical exam in cats with hyperaldosteronism?

A
  • hypertension
  • bilateral retinal detachment
  • heart murmur
26
Q

What 3 things in clinical pathology are seen in cats with primary hyperaldosteronism?

A
  1. hypokalemia
  2. azotemia - increased BUN/creatinine
  3. increased CK - myopathy
27
Q

What 3 things are diagnostic of primary hyperaldosteronism in cats?

A
  1. hypokalemia
  2. elevated aldosterone on plasma aldosterone concentrations (extremely high)
  3. ultrasound showing adrenal tumors and bilateral enlargement
28
Q

What surgical treatment is recommended for primary hyperaldosteronism in cats?

A

unilateral adrenalectomy

29
Q

What 3 medical treatments are recommended in cats with primary hyperaldosteronism?

A
  1. Spironolactone (potassium-sparing!)
  2. Amlodipine for hypertension
  3. K supplementation with IV KCl or oral potassium gluconate

make sure to treat underlying disease!

Small Animal Medicine (52 decks)

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