Watson P J, Herrtage M E
Department of Clinical Veterinary Medicine, Cambridge.
J Small Anim Pract. 1998 Apr;39(4):175-84. doi: 10.1111/j.1748-5827.1998.tb03626.x.
The case records of six cats with hyperadrenocorticism presented to the Department of Clinical Veterinary Medicine, University of Cambridge, over an 11-year period were reviewed. Signalment and clinical signs were similar to previous reports but, in contrast to other reports, only three cats had diabetes mellitus on presentation. Abdominal radiographs revealed an adrenal mass in one case, obesity in all cases but no hepatomegaly. The adrenal glands were identified ultrasonographically in three out of six cases. Clinicopathological findings were non-specific. The diabetic cats had a significantly lower serum potassium concentration than the non-diabetic cats (P < 0.05). Results of adrenocorticotrophic hormone (ACTH) stimulation tests were supportive of a diagnosis of hyperadrenocorticism in the five cats in which they were performed. Five cats had pituitary-dependent hyperadrenocorticism (PDH) and one had an adrenal tumour. Differentiation between the two forms of hyperadrenocorticism was possible preoperatively in five out of six cats. Adrenal histopathology confirmed hyperplasia in four cats and adenocarcinoma in one cat. Three cats with PDH underwent bilateral adrenalectomy and two of these cats had low, flat ACTH stimulation tests postoperatively and survived for significant periods. The cat with an adrenal tumour underwent partial unilateral adrenalectomy, maintained a positive ACTH stimulation test postoperatively and was euthanased one week after surgery.
回顾了11年间送至剑桥大学临床兽医学系的6例肾上腺皮质功能亢进猫的病例记录。信号和临床症状与先前报告相似,但与其他报告不同的是,就诊时只有3只猫患有糖尿病。腹部X光片显示1例有肾上腺肿块,所有病例均有肥胖,但无肝肿大。6例中有3例通过超声检查发现了肾上腺。临床病理检查结果不具特异性。糖尿病猫的血清钾浓度显著低于非糖尿病猫(P < 0.05)。在进行促肾上腺皮质激素(ACTH)刺激试验的5只猫中,试验结果支持肾上腺皮质功能亢进的诊断。5只猫患有垂体依赖性肾上腺皮质功能亢进(PDH),1只患有肾上腺肿瘤。6只猫中有5只在术前能够区分两种形式的肾上腺皮质功能亢进。肾上腺组织病理学检查证实4只猫为增生,1只猫为腺癌。3只患有PDH的猫接受了双侧肾上腺切除术,其中2只术后ACTH刺激试验结果低平,存活了较长时间。患有肾上腺肿瘤的猫接受了部分单侧肾上腺切除术,术后ACTH刺激试验结果仍为阳性,术后一周实施了安乐死。