Abstract
Primary hyperaldosteronism (PHA) in cats occurs as a consequence of excessive hormone production by an adrenocortical tumor. Median survival time, association between tumor type and prognosis, and the likelihood that cats require continued medical therapy after surgery have not been systematically evaluated. To determine the median survival time of cats with PHA treated by unilateral adrenalectomy. To examine if tumor type, anesthesia time, or tumor location (left or right side) affect survival and if affected cats require continued postoperative treatment for persistent hypertension or hypokalemia. Ten client-owned cats. Retrospective study. Cats were diagnosed with PHA based on clinical signs, increased plasma aldosterone concentration, and advanced imaging. Cats underwent unilateral adrenalectomy. Survival time (days alive after surgery) was determined for each cat. Factors affecting median survival time were investigated, including histopathology, anesthesia time, and location (side) of the tumor. Eight of 10 cats survived to discharge from the hospital post adrenalectomy. Overall median survival was 1,297 days (range 2-1,582 days). The only significant factor affecting median survival time was anesthesia time >4 hours. Tumor type and location (side) did not significantly affect median survival time. No cats required continued medical treatment for PHA. Although PHA in cats is still considered an uncommon condition, it should be considered in middle to older aged cats with hypokalemic polymyopathy and systemic hypertension. Surgical correction by unilateral adrenalectomy is a viable approach to definitive treatment of PHA with no need for continued medical management.
Keywords
Adrenal tumor
Feline
Hypertension
Hypokalemia
MeSH Terms
Adrenal Cortex Neoplasms/metabolism,pathology,surgery,veterinary
Adrenalectomy/veterinary
Adrenocortical Adenoma/metabolism,pathology,surgery,veterinary
Adrenocortical Carcinoma/metabolism,pathology,surgery,veterinary
Aldosterone/metabolism
Animals
Cat Diseases/pathology,surgery
Cats
Histocytochemistry/veterinary
Hyperaldosteronism/pathology,surgery,veterinary
Kaplan-Meier Estimate
Retrospective Studies
Authors & Affiliations
6 authors, click to expand affiliations / ORCID
Lo A J
Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.
Holt D E
Brown D C
Schlicksup M D
Orsher R J
Agnello K A
References (33)
33 references, click to expand
-
Presidential address. I. Painting background. II. Primary aldosteronism, a new clinical syndrome.
J Lab Clin Med. 1955 Jan;45(1):3-17
PMID: 13233623
-
Laparoscopic adrenalectomy for management of a functional adrenal tumor in a cat.
J Am Vet Med Assoc. 2012 Aug 1;241(3):368-72
PMID: 22812475
-
Surgical management of adrenal gland tumors with and without associated tumor thrombi in dogs: 40 cases (1994-2001).
J Am Vet Med Assoc. 2003 Sep 1;223(5):654-62
PMID: 12959384
-
Feline anesthetic deaths in veterinary practice.
Top Companion Anim Med. 2010 Nov;25(4):189-94
PMID: 21147471
-
Use of abdominal ultrasonography in the diagnosis of primary hyperaldosteronism in a cat.
J Am Vet Med Assoc. 2000 Jul 15;217(2):213-5, 197
PMID: 10909461
-
Hyperaldosteronism in a cat with metastasised adrenocortical tumour.
Vet Q. 2001 Jan;23(1):38-43
PMID: 11206001
-
Feline endocrinopathies.
Vet Clin North Am Small Anim Pract. 2005 Jan;35(1):171-210, vii
PMID: 15627633
-
Risk factors for anaesthetic-related death in cats: results from the confidential enquiry into perioperative small animal fatalities (CEPSAF).
Br J Anaesth. 2007 Nov;99(5):617-23
PMID: 17881744
-
Successful surgical treatment of a cat with primary aldosteronism.
J Feline Med Surg. 1999 Jun;1(2):117-22
PMID: 11919025
-
Predictive factors and the effect of phenoxybenzamine on outcome in dogs undergoing adrenalectomy for pheochromocytoma.
J Vet Intern Med. 2008 Nov-Dec;22(6):1333-9
PMID: 18783351
-
Hyperaldosteronism in cats.
Semin Vet Med Surg Small Anim. 1994 Aug;9(3):153-7
PMID: 7938936
-
Adrenalectomy in dogs with adrenal gland tumors: 52 cases (2002-2008).
J Am Vet Med Assoc. 2011 Jul 15;239(2):216-21
PMID: 21756177
-
Feline adrenal disorders.
Clin Tech Small Anim Pract. 2007 Feb;22(1):26-31
PMID: 17542194
-
Predictors of successful outcome after adrenalectomy for primary aldosteronism.
Int Surg. 2012 Apr-Jun;97(2):104-11
PMID: 23102075
-
What is your diagnosis? Abdominal mass aspirate in a cat with an increased Na:K ratio.
Vet Clin Pathol. 2009 Mar;38(1):69-72
PMID: 19228358
-
Primary hyperaldosteronism in the cat: a series of 13 cases.
J Feline Med Surg. 2005 Jun;7(3):173-82
PMID: 15922224
-
Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats.
J Vet Intern Med. 2007 May-Jun;21(3):542-58
PMID: 17552466
-
Hyperaldosteronism and hyperprogesteronism in a cat with an adrenal cortical carcinoma.
J Vet Intern Med. 2005 May-Jun;19(3):355-8
PMID: 15954552
-
Feline primary hyperaldosteronism.
Vet Clin North Am Small Anim Pract. 2010 Mar;40(2):353-9
PMID: 20219494
-
Adrenalectomy and caval thrombectomy in a cat with primary hyperaldosteronism.
J Am Anim Hosp Assoc. 2007 Jul-Aug;43(4):209-14
PMID: 17615401
-
Perioperative mortality in small animal anaesthesia.
Vet J. 2009 Nov;182(2):152-61
PMID: 18658000
-
Primary hyperaldosteronism in two cats.
J Am Anim Hosp Assoc. 1999 Sep-Oct;35(5):411-6
PMID: 10493417
-
Adrenal pheochromocytoma with contralateral adrenocortical adenoma in a cat.
J Am Anim Hosp Assoc. 2010 Jan-Feb;46(1):36-42
PMID: 20045835
-
Primary aldosteronism: renaissance of a syndrome.
Clin Endocrinol (Oxf). 2007 May;66(5):607-18
PMID: 17492946
-
Contrast-enhanced computed tomography as a preoperative indicator of vascular invasion from adrenal masses in dogs.
Vet Radiol Ultrasound. 2009 Nov-Dec;50(6):625-9
PMID: 19999346
-
Aldosteronomas--state of the art.
Surg Clin North Am. 2009 Oct;89(5):1241-53
PMID: 19836495
-
Outcomes of laparoscopic adrenalectomy for hyperaldosteronism.
ANZ J Surg. 2007 Sep;77(9):768-73
PMID: 17685956
-
Management of hypokalaemia and hyperkalaemia.
J Feline Med Surg. 2001 Dec;3(4):181-3
PMID: 11795955
-
Primary hyperaldosteronism: expanding the diagnostic net.
J Feline Med Surg. 2011 Sep;13(9):641-50
PMID: 21872791
-
Ultrasonographic identification of vascular invasion by adrenal tumors in dogs.
Vet Radiol Ultrasound. 2012 Jul-Aug;53(4):442-5
PMID: 22583157
-
Elective and emergency surgical management of adrenal gland tumors: 60 cases (1999-2006).
J Am Anim Hosp Assoc. 2011 Nov-Dec;47(6):428-35
PMID: 22058350
-
Adrenal disorders in cats.
Vet Clin North Am Small Anim Pract. 1997 Mar;27(2):321-47
PMID: 9076911
-
Hyperaldosteronism and hyperprogesteronism in a cat.
J Feline Med Surg. 2009 Sep;11(9):758-62
PMID: 19712894