Madden Emily, Deguara Briannan-Kym
Queensland Veterinary Specialists, Stafford, QLD, Australia.
JFMS Open Rep. 2025 Mar 29;11(1):20551169251319945. doi: 10.1177/20551169251319945. eCollection 2025 Jan-Jun.
A 4-year-old male castrated Ragdoll cat presented for generalised seizures. The cat displayed hyporexia, lethargy and hiding behaviour 24-48 h before presentation. The cat had a chronic history of daily vomiting and tachypnoea for 12 months. Severe hypoglycaemia was noted at 1.8 mmol/l (reference interval 4.11-8.84) on initial presentation. The hypoglycaemia persisted despite multiple glucose boluses, resulting in the cat being treated with a glucose and glucagon continuous rate infusion. The cat underwent extensive diagnostic evaluation during hospitalisation, consisting of serial venous blood gas assessment, haematology and biochemistry analysis, urinalysis, serum insulin assay, resting cortisol, adrenocorticotropic hormone (ACTH) stimulation test, abdominal and thoracic imaging, and airway culture. A resting cortisol level of <14 nmol/l was obtained on day 2 of hospitalisation with a follow-up ACTH-stimulation test reporting a baseline cortisol of <28 nmol/l and a 1 h post-ACTH cortisol of 7 nmol/l, supporting a diagnosis of hypoadrenocorticism. The cat was successfully treated with glucocorticoid therapy and discharged home 8 days after initial presentation.
There are limited cases of feline hypoadrenocorticism present in the literature, most of which describe cats with both glucocorticoid and mineralocorticoid deficiency. Only two previous case reports of feline atypical hypoadrenocorticism exist. Only one of these case reports describes hypoglycaemia with signs of neuroglycopaenia on initial presentation. To the author's knowledge, this is the first successfully treated case of atypical hypoadrenocorticism presenting with hypoglycaemic seizures in a cat, demonstrating successful long-term management.
一只4岁去势的布偶猫因全身性癫痫发作前来就诊。该猫在就诊前24 - 48小时出现食欲减退、嗜睡和躲藏行为。这只猫有12个月的每日呕吐和呼吸急促的慢性病史。初诊时发现严重低血糖，血糖水平为1.8 mmol/l（参考区间4.11 - 8.84）。尽管多次推注葡萄糖，低血糖仍持续存在，因此对该猫进行了葡萄糖和胰高血糖素持续静脉输注治疗。住院期间，该猫接受了广泛的诊断评估，包括连续静脉血气分析、血液学和生物化学分析、尿液分析、血清胰岛素测定、静息皮质醇、促肾上腺皮质激素（ACTH）刺激试验、腹部和胸部影像学检查以及气道培养。住院第2天测得静息皮质醇水平<14 nmol/l，后续ACTH刺激试验报告基线皮质醇<28 nmol/l，ACTH注射后1小时皮质醇为7 nmol/l，支持肾上腺皮质功能减退的诊断。该猫接受糖皮质激素治疗后成功治愈，并在初诊8天后出院回家。
文献中报道的猫肾上腺皮质功能减退病例有限，其中大多数描述的是同时缺乏糖皮质激素和盐皮质激素的猫。之前仅有两篇关于猫非典型肾上腺皮质功能减退的病例报告。这些病例报告中只有一篇描述了初诊时伴有低血糖神经低血糖症状。据作者所知，这是第一例成功治疗的猫非典型肾上腺皮质功能减退伴低血糖性癫痫发作的病例，展示了成功的长期管理。
