Clinical Assessment of Adrenal Disorders in Felines
Summary
Feline adrenal disorders encompass a spectrum of endocrine diseases arising from dysfunction within the adrenal cortex or its regulatory axis. The most frequently encountered condition is primary hyperaldosteronism, characterised by excessive aldosterone secretion leading to hypokalaemia, systemic hypertension and neuromuscular signs. Hyperadrenocorticism, though rare in cats, involves chronic cortisol overproduction resulting in polyuria, polydipsia, dermatological changes and secondary diabetes mellitus. Less commonly, androgen‐secreting adrenocortical tumours manifest through behavioural alterations, inappropriate urination and virilisation. A structured clinical assessment begins with a comprehensive history and physical examination to detect blood pressure abnormalities, muscle weakness and skin lesions. Baseline biochemical panels assess electrolyte imbalances and renal function, while specific hormone assays quantify cortisol, aldosterone or sex steroid concentrations. Dynamic endocrine function tests, such as low‐dose dexamethasone suppression and, more recently, angiotensin receptor‐based suppression tests, help distinguish autonomous adrenal activity from physiological responses. Imaging modalities, notably high‐resolution ultrasonography and cross‐sectional imaging, enable measurement of adrenal dimensions, detection of nodular changes and evaluation of contralateral gland status. Histopathology following surgical adrenalectomy remains the definitive diagnostic standard. Therapeutic options are tailored to disease category: mineralocorticoid antagonists and potassium supplementation for hyperaldosteronism; enzyme inhibitors such as trilostane for hyperadrenocorticism; and surgical excision for functional tumours. Early recognition and targeted management markedly improve quality of life, reduce cardiovascular risk and mitigate progression of endocrine comorbidities.
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Clinical Assessment of Adrenal Disorders in Felines publication trend
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Technical terms
Hyperadrenocorticism: A condition of excessive cortisol production by the adrenal cortex.
Primary hyperaldosteronism: Autonomous overproduction of aldosterone leading to hypokalaemia and hypertension.
Adrenomegaly: Enlargement of one or both adrenal glands detected via imaging.
Dexamethasone suppression test: A dynamic endocrine test measuring cortisol response to exogenous dexamethasone.
Telmisartan suppression test: An emerging diagnostic assay using an angiotensin receptor blocker to assess aldosterone regulation.
Adrenocorticotropic hormone (ACTH): A pituitary hormone that stimulates cortisol secretion from the adrenal cortex.
References
- Primary Hyperaldosteronism in Cats An Underdiagnosed Disorder. Veterinary Clinics of North America Small Animal Practice (2020).
- Case report: Androgen-secreting adrenocortical tumors in eight cats. Frontiers in Veterinary Science (2023).
- Evaluation of oral telmisartan administration as a suppression test for diagnosis of primary hyperaldosteronism in cats. Journal of Veterinary Internal Medicine (2023).
- Ultrasonographic Detected Adrenomegaly in Clinically Ill Cats: A Retrospective Study. Veterinary Sciences (2022).
- Trilostane Therapy for Treatment of Pituitary‐Dependent Hyperadrenocorticism in 5 Cats. Journal of Veterinary Internal Medicine (2004).
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