Jones Sarah A, Owens Scott L, Birchard Stephen J
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
Department of Internal Medicine, MedVet Indianapolis, Carmel, IN, USA.
JFMS Open Rep. 2019 Nov 14;5(2):2055116919885698. doi: 10.1177/2055116919885698. eCollection 2019 Jul-Dec.
An 11-year-old female, reportedly spayed, domestic shorthair cat was examined for a 4-month history of weight loss, aggression, urine spraying, malodorous urine and estrus-like behavior. Physical examination revealed thickened skin, a mildly prominent vulva and confirmed malodorous urine. On abdominal ultrasonography, a 6 mm hypoechoic nodule was found in the left cranial abdomen. An adrenocorticotropic hormone (ACTH) stimulation test with adrenal panel revealed elevated serum concentrations of androstenedione and testosterone pre- and post-cosyntropin stimulation, mildly decreased cortisol pre- and post-cosyntropin stimulation, and decreased resting aldosterone. Exploratory laparotomy was performed and a cystic, nodular mass was found in the region of the left ovary. The mass was surgically removed and submitted for histopathology; results were conclusive for an ovarian remnant with an intact corpus luteum and non-neoplastic parovarian cysts. Previously observed clinical signs resolved within two weeks of ovariectomy. A follow-up ACTH stimulation test with adrenal panel 6 weeks postoperatively revealed normalization of serum androstenedione, testosterone and cortisol concentrations. Four years postoperatively, at the time of writing, the cat remains free of clinical signs.
We are unaware of any previously reported cases of non-neoplastic ovarian remnants associated with clinically relevant hyperandrogenism. A non-neoplastic ovarian-dependent hyperandrogenism should be included as a differential diagnosis of spayed female cats showing aggression and urine spraying behavior.
一只11岁的雌性家猫,据报道已绝育,因体重减轻、攻击性、喷尿、尿液恶臭和类似发情行为的4个月病史前来就诊。体格检查发现皮肤增厚、阴户轻度突出,并确认尿液恶臭。腹部超声检查发现左颅腹有一个6毫米的低回声结节。促肾上腺皮质激素(ACTH)刺激试验及肾上腺指标检测显示,合成促肾上腺皮质激素刺激前后血清雄烯二酮和睾酮浓度升高,合成促肾上腺皮质激素刺激前后皮质醇轻度降低,静息醛固酮降低。进行了剖腹探查术,在左卵巢区域发现一个囊性结节性肿块。该肿块被手术切除并送去做组织病理学检查;结果确诊为带有完整黄体的卵巢残余物和非肿瘤性卵巢旁囊肿。卵巢切除术后两周内,之前观察到的临床症状消失。术后6周进行的ACTH刺激试验及肾上腺指标检测显示血清雄烯二酮、睾酮和皮质醇浓度恢复正常。术后四年,在撰写本文时,这只猫仍无临床症状。
我们未发现任何先前报道的与临床相关的高雄激素血症相关的非肿瘤性卵巢残余物病例。非肿瘤性卵巢依赖性高雄激素血症应作为表现出攻击和喷尿行为的绝育母猫的鉴别诊断之一。