Efficacy of hypophysectomy for the treatment of hypersomatotropism-induced diabetes mellitus in 68 cats.

Autor: Fenn J; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK., Kenny PJ; Small Animal Specialist Hospital, North Ryde, New South Wales, Australia., Scudder CJ; Southfields Veterinary Specialists, Laindon Essex, UK.; Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK., Hazuchova K; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK., Gostelow R; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK., Fowkes RC; Department of Comparative Biomedical Sciences, Royal Veterinary College, London, UK., Forcada Y; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.; The VetCT Telemedicine Hospital, VetCT, St. John's Innovation Centre, Cambridge, UK., Church DB; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK., Niessen SJM; Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.; The VetCT Telemedicine Hospital, VetCT, St. John's Innovation Centre, Cambridge, UK.
Jazyk: angličtina
Zdroj: Journal of veterinary internal medicine [J Vet Intern Med] 2021 Mar; Vol. 35 (2), pp. 823-833. Date of Electronic Publication: 2021 Feb 24.
DOI: 10.1111/jvim.16080
Abstrakt: Background: Hypersomatotropism (HST) is an increasingly recognized endocrinopathy in cats and is mostly described associated with diabetes mellitus (DM).
Objectives: To evaluate the efficacy and safety of transsphenoidal hypophysectomy in treating HST and DM in cats.
Animals: Sixty-eight client-owned cats with HST and DM treated by transsphenoidal hypophysectomy.
Methods: Retrospective cohort study. Medical records were reviewed for glycemic control and serum insulin-like growth factor-1 (IGF-1) concentrations. Postoperative complications, death within 4 weeks, and proportion achieving diabetic remission were recorded. Survival times and DM-free intervals were calculated.
Results: Fifty-eight cats (85.3%) were alive 4 weeks postoperatively with 10 (15%) postoperative deaths. Complications included hypoglycemia (n = 9), electrolyte imbalance (n = 9), and transient congestive heart failure (n = 5). Fifty-five cats (95% of 58 surviving cats [81% of all cats undergoing surgery]) had improved control of diabetes. Diabetic remission occurred in 41 cats (71% of 58 surviving cats [60% of all cats]) with insulin administration discontinued after a median of 9 days (range, 2-120). Postoperative 4-week serum IGF-1 concentration nadir was significantly lower in cats achieving diabetic remission (median 20 ng/mL [15-708] than those that did not (324 ng/mL [15-1955]; P = .03). All cats received long-term levothyroxine and hydrocortisone PO, alongside desmopressin (conjunctival) in 38 of 53 cats (72%). Recurrence of DM occurred in 5 of 41 cats (12%) after a median of 248 days (range, 84-1232). Median survival time of all cats was 853 days (range, 1-1740).
Conclusions and Clinical Importance: Transsphenoidal hypophysectomy is an effective treatment for cats with HST and DM, with a long-term outcome that compares favorably to existing options.
(© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.)
Databáze: MEDLINE
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