Acute adrenal haemorrhage in two cats with aldosterone-secreting adenocarcinomas

Kirkwood, Nicolle; Boland, Lara; Brunel, Laurencie; Wardman, Alison; Barrs, Vanessa R.

doi:10.1177/2055116919840828

Cited by 4 publications

(5 citation statements)

References 15 publications

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“…In one of these cats, a large haematoma, which presented as a 5 cm diameter heterogeneous area adjacent to the tumour, and haemorrhage into the retroperitoneal space were identified on ultrasound. 68 In the third cat, the tumour type was not specified and the imaging findings pertaining to this case were not described. 22…”

Section: Recognition Diagnosis and Management Of Cats With Hac And Cmentioning

confidence: 98%

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

Griffin

2021

Journal of Feline Medicine and Surgery

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Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Equipment: Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

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Section: Recognition Diagnosis and Management Of Cats With Hac And Cmentioning

confidence: 98%

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

Griffin

2021

Journal of Feline Medicine and Surgery

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“…The second system altered was urinary system. Likewise, [13] shows urinary system failure. However, lack correlation between blood pressure and renal failure indicates that other etiologies could be the cause, as hypokalemia, or increase of aldosterone or angiotensinogen II levels [5].…”

Section: Discussionmentioning

confidence: 99%

Primary Hyperaldosteronism in Cats: A Systematic Review

Ruvira¹,

Marín-Garcia²,

Mejia³

et al. 2023

Preprint

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Background: The main of this study was to realize a systematic review of clinical features and prognosis factors associated to diagnosis and prognosis of primary hyperaldosteronism in cats. Methods: Clinical cases with hyperaldosteronism confirmed with histopathological analysis have been included. Studies without information about clinical confirmation, type of carcinoma or affected system were excluded. A total of nine studies with seventeen patients with primary hyperaldosteronisms were used for this systematic review. Results: All cats included presented hypertension, renal failure (34.48%), ocular problems (27,59%), cardiovascular alterations (24.14%) and nervous system defects (13.79%). High levels of blood pressure and serum levels of aldosterone are related to adenocarcinoma, whereas the potassium levels were lower than cats with adenoma or bilateral hyperplasia. Conclusions: In primary feline hyperaldosteronism, patients with adenocarcinoma show higher levels of aldosterone, higher blood pressure and lower potassium levels than patients with adenoma or nodular hyperplasia. Adrenocortical adenocarcinomas are more frequent in older cats than young, and these patients present several clinical signs, mainly renal failure, and ocular complications. Regardless of aldosterone levels, a favorable prognosis is associated with adrenalectomy.

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“…1,2 To our knowledge, a total of 50 feline cases with hyperaldosteronism treated by adrenalectomy have been described in the veterinary literature. [3][4][5][6][7][8][9][10][11] Perioperative mortality after adrenalectomy in cats ranges from 20% to 40%. 4,6,7 The most frequent peri operative complication is moderate/severe haemor rhage.…”

Section: Introductionmentioning

confidence: 99%

“… 1 , 2 To our knowledge, a total of 50 feline cases with hyperaldosteronism treated by adrenalectomy have been described in the veterinary literature. 3 – 11…”

Section: Introductionmentioning

confidence: 99%

Surgical findings and outcomes after unilateral adrenalectomy for primary hyperaldosteronism in cats: a multi-institutional retrospective study

Magno

Foglia

Rossanese

et al. 2023

Journal of Feline Medicine and Surgery

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Case series summary Twenty-nine cats from different institutions with confirmed or highly suspected primary hyperaldosteronism treated by unilateral adrenalectomy were retrospectively included in this study. The most frequent clinical signs were lethargy (n = 20; 69%) and neck ventroflexion (n = 17; 59%). Hypokalaemia was present in all cats, creatinine kinase was elevated in 15 and hyperaldosteronism was documented in 24. Hypertension was frequently encountered (n = 24; 89%). Preoperative treatment included potassium supplementation (n = 19; 66%), spironolactone (n = 16; 55%) and amlodipine (n = 11; 38%). There were 13 adrenal masses on the right side, 15 on the left and, in one cat, no side was reported. The median adrenal mass size was 2 × 1.5 cm (range 1–4.6 × 0.4–3.8); vascular invasion was present in five cats, involving the caudal vena cava in four cats and the renal vein in one. Median duration of surgery was 57 mins. One major intraoperative complication (3%) was reported and consisted of haemorrhage during the removal of a neoplastic thrombus from the caudal vena cava. In 4/29 cats (14%), minor postoperative complications occurred and were treated medically. One fatal complication (3%) was observed, likely due to disseminated intravascular coagulation. The median duration of hospitalisation was 4 days; 97% of cats survived to discharge. The potassium level normalised in 24 cats within 3 months of surgery; hypertension resolved in 21/23 cats. Follow-up was available for 25 cats with a median survival of 1082 days. Death in the long-term follow-up was mainly related to worsening of comorbidities. Relevance and novel information Adrenalectomy appears to be a safe and effective treatment with a high rate of survival and a low rate of major complications. Long-term medical treatment was not required.

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Acute adrenal haemorrhage in two cats with aldosterone-secreting adenocarcinomas

Cited by 4 publications

References 15 publications

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

Primary Hyperaldosteronism in Cats: A Systematic Review

Surgical findings and outcomes after unilateral adrenalectomy for primary hyperaldosteronism in cats: a multi-institutional retrospective study

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