Efficacy of hypophysectomy for the treatment of hypersomatotropism-induced diabetes mellitus in 68 cats.
acromegaly
cat
diabetic
pituitary
remission
transsphenoidal
Journal
Journal of veterinary internal medicine
ISSN: 1939-1676
Titre abrégé: J Vet Intern Med
Pays: United States
ID NLM: 8708660
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
revised:
02
02
2021
received:
23
12
2019
accepted:
04
02
2021
pubmed:
25
2
2021
medline:
29
6
2021
entrez:
24
2
2021
Statut:
ppublish
Résumé
Hypersomatotropism (HST) is an increasingly recognized endocrinopathy in cats and is mostly described associated with diabetes mellitus (DM). To evaluate the efficacy and safety of transsphenoidal hypophysectomy in treating HST and DM in cats. Sixty-eight client-owned cats with HST and DM treated by transsphenoidal hypophysectomy. 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. 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). Transsphenoidal hypophysectomy is an effective treatment for cats with HST and DM, with a long-term outcome that compares favorably to existing options.
Sections du résumé
BACKGROUND
BACKGROUND
Hypersomatotropism (HST) is an increasingly recognized endocrinopathy in cats and is mostly described associated with diabetes mellitus (DM).
OBJECTIVES
OBJECTIVE
To evaluate the efficacy and safety of transsphenoidal hypophysectomy in treating HST and DM in cats.
ANIMALS
METHODS
Sixty-eight client-owned cats with HST and DM treated by transsphenoidal hypophysectomy.
METHODS
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
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
CONCLUSIONS
Transsphenoidal hypophysectomy is an effective treatment for cats with HST and DM, with a long-term outcome that compares favorably to existing options.
Identifiants
pubmed: 33624865
doi: 10.1111/jvim.16080
pmc: PMC7995378
doi:
Substances chimiques
Insulin
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
823-833Informations de copyright
© 2021 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC. on behalf of the American College of Veterinary Internal Medicine.
Références
J Clin Endocrinol Metab. 2014 Nov;99(11):3933-51
pubmed: 25356808
Vet Rec. 2007 Jun 30;160(26):902-7
pubmed: 17602106
Neurosurgery. 2010 Nov;67(5):1205-12
pubmed: 20871457
Vet Comp Oncol. 2006 Dec;4(4):209-17
pubmed: 19754805
Vet Clin North Am Small Anim Pract. 2013 Mar;43(2):319-50
pubmed: 23522175
J Vet Intern Med. 2005 Sep-Oct;19(5):687-94
pubmed: 16231713
Can Vet J. 1993 Nov;34(11):682-5
pubmed: 17424325
J Feline Med Surg. 2017 Aug;19(8):888-896
pubmed: 27578200
J Vet Intern Med. 2016 Jul;30(4):973-82
pubmed: 27425382
PLoS One. 2015 May 29;10(5):e0127794
pubmed: 26023776
Vet Surg. 1998 May-Jun;27(3):246-61
pubmed: 9605236
J Vet Intern Med. 2009 Mar-Apr;23(2):243-9
pubmed: 19192146
J Small Anim Pract. 2006 Jul;47(7):392-5
pubmed: 16842276
J Vet Intern Med. 2017 Mar;31(2):355-364
pubmed: 28145031
Vet Surg. 2001 Jan-Feb;30(1):72-86
pubmed: 11172463
J Vet Intern Med. 2015 Jul-Aug;29(4):1074-80
pubmed: 25945588
J Vet Intern Med. 2015 Jan;29(1):14-20
pubmed: 25619512
Vet Radiol Ultrasound. 2005 Jan-Feb;46(1):33-8
pubmed: 15693556
J Vet Intern Med. 2006 Sep-Oct;20(5):1151-4
pubmed: 17063708
J Endocr Soc. 2018 Oct 16;3(1):181-200
pubmed: 30620005
J Vet Intern Med. 2007 Sep-Oct;21(5):899-905
pubmed: 17939541
Vet Surg. 2014 May;43(4):369-79
pubmed: 24467302
J Vet Intern Med. 2009 Sep-Oct;23(5):1038-44
pubmed: 19572910
J Vet Intern Med. 2016 Jul;30(4):989-95
pubmed: 27425149
J Vet Intern Med. 2021 Mar;35(2):823-833
pubmed: 33624865
Int J Obes Relat Metab Disord. 1999 Mar;23(3):260-71
pubmed: 10193871
J Feline Med Surg. 2014 Feb;16(2):99-108
pubmed: 23847300
J Feline Med Surg. 2010 May;12(5):406-10
pubmed: 20417901
J Vet Intern Med. 2018 Jul;32(4):1383-1391
pubmed: 29782043