Miceli Diego D, Zelarayán Gabriela S, García Jorge D, Fernández Viviana, Ferraris Sergio
Endocrinology Unit, Hospital School of Veterinary Medicine, University of Buenos Aires, Faculty of Veterinary Sciences, Buenos Aires, Argentina.
Laboratory of Molecular Endocrinology and Signal Transduction, Institute of Experimental Biology and Medicine - CONICET, Buenos Aires, Argentina.
JFMS Open Rep. 2021 Jul 13;7(2):20551169211029896. doi: 10.1177/20551169211029896. eCollection 2021 Jul-Dec.
A 7-year-old spayed female domestic shorthair cat weighing 5 kg was referred with polyuria, polydipsia, lethargy, abdominal distension and dermatologic abnormalities. Diabetes mellitus was diagnosed and treatment was started with a diet for diabetic cats and insulin glargine (1 IU q12h SC). Hyperadrenocorticism (HAC) was suspected and diagnosed based on clinical signs, increased urinary cortisol:creatinine ratio, lack of suppression on low-dose dexamethasone suppression test and abdominal ultrasonography demonstrating bilateral adrenal enlargement. Oral cabergoline (10 μg/kg every other day) was initiated. After the second administration of cabergoline, the cat suffered from clinical hypoglycemia and no longer required insulin. One month after insulin withdrawal, blood work and urine analysis results showed normoglycemia, a normal serum fructosamine concentration (244 μmol/l) and normal urine analysis without glycosuria. Diabetic remission persisted until its death 7 months later. In addition, cabergoline treatment was associated with improvement in clinical signs such as lethargy, seborrhea, alopecia and abdominal distension.
To our knowledge, this is the first reported case of the use of cabergoline in a cat with HAC, as well as the first reported case of diabetic remission in a cat with HAC after cabergoline treatment. Cabergoline could be an alternative treatment for diabetic cats with pituitary-dependent HAC. Further work should focus on different protocols with greater number of cases.
一只7岁已绝育的雌性家养短毛猫,体重5千克,因多尿、多饮、嗜睡、腹部膨隆和皮肤异常前来就诊。诊断为糖尿病,开始采用糖尿病猫专用饮食及甘精胰岛素(1单位,皮下注射,每12小时一次)进行治疗。怀疑患有肾上腺皮质功能亢进症(HAC),并根据临床症状、尿皮质醇:肌酐比值升高、低剂量地塞米松抑制试验无抑制反应以及腹部超声显示双侧肾上腺增大而确诊。开始口服卡麦角林(每隔一天10微克/千克)。第二次给予卡麦角林后,这只猫出现临床低血糖,不再需要胰岛素。停用胰岛素1个月后,血液检查和尿液分析结果显示血糖正常、血清果糖胺浓度正常(244微摩尔/升)且尿液分析正常,无糖尿。糖尿病缓解一直持续到7个月后其死亡。此外,卡麦角林治疗使嗜睡、皮脂溢、脱毛和腹部膨隆等临床症状有所改善。
据我们所知,这是第一例报告使用卡麦角林治疗猫HAC的病例,也是第一例报告卡麦角林治疗后猫HAC出现糖尿病缓解的病例。卡麦角林可能是治疗垂体依赖性HAC糖尿病猫的一种替代疗法。进一步的工作应侧重于针对更多病例的不同方案。