Nelson R W, Feldman E C, Smith M C
Department of Small Animal Clinics, School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.
J Am Vet Med Assoc. 1988 Jul 15;193(2):245-50.
Hyperadrenocorticism was diagnosed in 7 cats with concurrent diabetes mellitus. Four cats had pituitary adenoma with bilateral adrenocortical hyperplasia, 1 cat had pituitary carcinoma with bilateral adrenocortical hyperplasia, 1 cat had adrenocortical carcinoma, and 1 cat had adrenocortical adenoma of the left adrenal gland. One year later, adrenocortical adenoma involving the right adrenal gland also was diagnosed in this cat. Clinical signs included polyuria and polydipsia (n = 7), development of pot-bellied appearance (n = 5), dermatologic alterations (n = 5), lethargy (n = 3), weight loss (n = 3), dyspnea/panting (n = 2), and recurrent bacterial infections (n = 2). In 6 cats, the diagnosis of hyperadrenocorticism was established before death on the basis of results of the ACTH stimulation test (n = 3) and the dexamethasone screening test (n = 5). Pituitary-dependent hyperadrenocorticism was differentiated from adrenocortical neoplasia on the basis of results of the dexamethasone suppression test (n = 4), endogenous ACTH concentration (n = 3), results of abdominal radiography and ultrasonography (n = 3), and exploratory celiotomy (n = 1). Four cats died or were euthanatized without treatment attempts. Treatment with mitotane followed by 60Co teletherapy was ineffective in one cat with pituitary adenoma. One cat with pituitary carcinoma died one week after bilateral adrenalectomy. Bilateral adrenocortical adenomas were removed surgically in the affected cat.
7只并发糖尿病的猫被诊断为肾上腺皮质功能亢进。4只猫患有垂体腺瘤伴双侧肾上腺皮质增生,1只猫患有垂体癌伴双侧肾上腺皮质增生,1只猫患有肾上腺皮质癌,1只猫患有左肾上腺皮质腺瘤。1年后,这只猫也被诊断出右肾上腺有肾上腺皮质腺瘤。临床症状包括多尿和多饮(n = 7)、出现大腹便便的外观(n = 5)、皮肤改变(n = 5)、嗜睡(n = 3)、体重减轻(n = 3)、呼吸困难/气喘(n = 2)和反复细菌感染(n = 2)。在6只猫中,根据促肾上腺皮质激素(ACTH)刺激试验结果(n = 3)和地塞米松筛查试验结果(n = 5),在死亡前确诊为肾上腺皮质功能亢进。根据地塞米松抑制试验结果(n = 4)、内源性ACTH浓度(n = 3)、腹部X线摄影和超声检查结果(n = 3)以及剖腹探查结果(n = 1),将垂体依赖性肾上腺皮质功能亢进与肾上腺皮质肿瘤区分开来。4只猫未经治疗尝试即死亡或被安乐死。一只患有垂体腺瘤的猫接受米托坦治疗后再进行60钴远距离治疗无效。一只患有垂体癌的猫在双侧肾上腺切除术后一周死亡。对患病猫进行手术切除双侧肾上腺皮质腺瘤。