Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy.

Abstract

UNLABELLED:

PATIENT AND SURGICAL TREATMENT: An 11-year-old, castrated male cat was referred for insulin-resistant diabetes mellitus. It had a ravenous appetite, increased body weight, polyuria/polydipsia and a dull hair coat. The cat was receiving 25 IU insulin four times daily but blood glucose concentrations remained elevated. Plasma concentrations of growth hormone (GH) (51 microg/l, reference range 0.8-7.2 microg/l) and insulin-like growth factor 1 (IGF-1) (3871 microg/l, reference range 39-590 microg/l) were highly elevated, whereas those of alpha-melanocyte-stimulating hormone, adrenocorticotropic hormone and cortisol were normal. Computed tomography revealed a thick palatum molle and an enlarged pituitary gland, indicating a pituitary neoplasm. Microsurgical transsphenoidal hypophysectomy was performed and microscopic examination of the surgical specimen revealed an acidophilic, infiltrative pituitary adenoma that showed positive immunostaining for GH.

OUTCOME:

The clinical signs resolved and 3 weeks after surgery the cat no longer required insulin administration. One year after hypophysectomy the plasma concentrations of GH and IGF-1 were 2.4 microg/l and 113 microg/l, respectively.

PRACTICAL RELEVANCE:

This is the first report detailing transsphenoidal hypophysectomy as a feasible and effective treatment for feline acromegaly due to a pituitary somatotroph adenoma. Moreover, in this patient, concurrent insulin-resistant diabetes mellitus resolved completely. The surgery is discussed in the context of human and other feline therapies for acromegaly.

• Authors: Björn P Meij, Edoardo Auriemma, Guy Grinwis, Jenny J C W M Buijtels, Hans S Kooistra
• Journal: Journal of feline medicine and surgery (J Feline Med Surg) Vol. 12 Issue 5 Pg. 406-10 (May 2010) ISSN: 1532-2750 [Electronic] England
• PMID: 20417901 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright 2010 Elsevier Ltd. All rights reserved.

Chemical References

• Blood Glucose
• Insulin-Like Growth Factor I
• Growth Hormone

Topics

• Acromegaly (blood, surgery, veterinary)
• Adenocarcinoma (blood, complications, surgery, veterinary)
• Adrenocortical Hyperfunction (blood, complications, surgery, veterinary)
• Animals
• Blood Glucose (metabolism)
• Cat Diseases (blood, surgery)
• Cats
• Diabetes Mellitus (blood, surgery, veterinary)
• Growth Hormone (blood)
• Hypophysectomy (veterinary)
• Insulin-Like Growth Factor I (metabolism)
• Male
• Sphenoid Bone
• Treatment Outcome