Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy.
| Autor: | Meij BP; Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, Utrecht, The Netherlands. B.P.Meij@uu.nl, Auriemma E, Grinwis G, Buijtels JJ, Kooistra HS |
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| Jazyk: | angličtina |
| Zdroj: | Journal of feline medicine and surgery [J Feline Med Surg] 2010 May; Vol. 12 (5), pp. 406-10. |
| DOI: | 10.1016/j.jfms.2010.03.014 |
| Abstrakt: | 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. (Copyright 2010 Elsevier Ltd. All rights reserved.) |
| Databáze: | MEDLINE |
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