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猫经口皮质激素治疗后发生医源性肾上腺萎缩在超声检查中无法可靠识别。

Iatrogenic adrenal atrophy following oral corticotherapy is not reliably identified ultrasonographically in cats.

机构信息

Department of Clinical Sciences (Giron, Conversy, Finck), Faculty of Veterinary Medicine (Beauchamp), Université de Montréal, 3200 Rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2.

出版信息

Can Vet J. 2023 Aug;64(8):773-780.

PMID:37529393
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10352046/
Abstract

BACKGROUND

In dogs, corticosteroid administration is known to decrease adrenal gland height when measured ultrasonographically. However, comparable information is lacking in cats.

OBJECTIVES

i) Validate that the adrenal height of our control population without corticosteroid administration was similar to previous data, ii) determine effects of dose and duration of oral corticosteroid therapy on adrenal height, and iii) determine an adrenal size threshold to differentiate cats receiving corticosteroids or not.

ANIMALS AND PROCEDURES

Adult cats (N = 308) that received abdominal ultrasonographic examination(s) were retrospectively recruited and allocated into 2 groups: those with and without oral corticosteroid use. Cats receiving corticosteroids were subdivided into 6 subgroups by dose (supraphysiologic, anti-inflammatory, or immunosuppressive) and duration of therapy (≤ 1 mo or > 1 mo).

RESULTS

Adrenal height in cats without corticosteroid therapy was comparable to previous studies. An anti-inflammatory corticosteroid dose for > 1 mo caused a 21.4% decrease in adrenal height (mean difference of 0.8 mm; = 0.009). However, no difference in adrenal height was noted in the other subgroups ( > 0.21), and no useful adrenal height threshold was established.

CONCLUSION AND CLINICAL RELEVANCE

Feline iatrogenic adrenal atrophy may be difficult to establish with ultrasonography, as only cats receiving anti-inflammatory corticosteroid doses for > 1 mo had a modest (< 1 mm) decrease in adrenal height.

摘要

背景

在狗中,已知给予皮质类固醇会导致超声测量时肾上腺高度降低。然而,猫的相关信息尚缺乏。

目的

i)验证未给予皮质类固醇的本研究对照组猫的肾上腺高度与既往数据相似,ii)确定皮质类固醇剂量和治疗时间对肾上腺高度的影响,以及 iii)确定一个肾上腺大小阈值来区分接受或不接受皮质类固醇的猫。

动物和程序

接受过腹部超声检查的成年猫(N=308)被回顾性招募并分为 2 组:接受或未接受口服皮质类固醇治疗的猫。接受皮质类固醇的猫根据剂量(超生理、抗炎或免疫抑制)和治疗时间(≤1 个月或>1 个月)进一步分为 6 个亚组。

结果

未接受皮质类固醇治疗的猫的肾上腺高度与既往研究相似。抗炎皮质类固醇剂量>1 个月导致肾上腺高度降低 21.4%(平均差异 0.8 毫米;P=0.009)。然而,其他亚组(P>0.21)的肾上腺高度无差异,也未建立有用的肾上腺高度阈值。

结论和临床相关性

超声可能难以确定猫的医源性肾上腺萎缩,因为只有接受抗炎皮质类固醇剂量>1 个月的猫的肾上腺高度才会适度(<1 毫米)降低。

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本文引用的文献

1
Feline abdominal ultrasonography: what's normal? what's abnormal? The adrenal glands.猫科动物腹部超声检查:什么是正常的?什么是异常的?肾上腺。
J Feline Med Surg. 2021 Jan;23(1):33-49. doi: 10.1177/1098612X20979509.
2
Ultrasonographic evaluation of adrenal gland size in two body weight categories of healthy adult cats.超声评估两种体重类别健康成年猫的肾上腺大小。
J Feline Med Surg. 2021 Aug;23(8):804-808. doi: 10.1177/1098612X20974962. Epub 2020 Nov 25.
3
Ultrasonographic evaluation of adrenal gland size compared to body weight in normal dogs.正常犬肾上腺大小与体重的超声评估。
Vet Radiol Ultrasound. 2015 May-Jun;56(3):317-26. doi: 10.1111/vru.12236. Epub 2014 Dec 15.
4
Abdominal ultrasonographic findings in acromegalic cats.肢端肥大症猫的腹部超声检查结果
J Feline Med Surg. 2015 Aug;17(8):698-703. doi: 10.1177/1098612X14556847. Epub 2014 Nov 6.
5
Ultrasonographical examination of feline adrenal glands: intra- and inter-observer variability.猫肾上腺的超声检查:观察者内和观察者间的变异性
J Feline Med Surg. 2014 Dec;16(12):937-42. doi: 10.1177/1098612X14522049. Epub 2014 Feb 11.
6
Ultrasonographic appearance of adrenal glands in healthy and sick cats.健康与患病猫肾上腺的超声表现
J Feline Med Surg. 2013 Jun;15(6):445-57. doi: 10.1177/1098612X12469523. Epub 2012 Dec 12.
7
Ultrasonographic measurements of adrenal glands in cats with hyperthyroidism.甲状腺功能亢进猫肾上腺的超声测量
Vet Radiol Ultrasound. 2012 Mar-Apr;53(2):210-6. doi: 10.1111/j.1740-8261.2011.01888.x.
8
Effect of glucocorticoid administration on adrenal gland size and sonographic appearance in beagle dogs.
Vet Radiol Ultrasound. 2012 Mar-Apr;53(2):204-9. doi: 10.1111/j.1740-8261.2011.01884.x.
9
Glucocorticoids in the cat.猫体内的糖皮质激素
Vet Dermatol. 2008 Dec;19(6):340-7. doi: 10.1111/j.1365-3164.2008.00717.x.
10
Ultrasonographic evaluation of the size of the adrenal glands of 24 diseased cats without endocrinopathies.对24只无内分泌疾病的患病猫肾上腺大小的超声检查评估。
Vet Rec. 2007 May 12;160(19):658-60. doi: 10.1136/vr.160.19.658.