Hemodynamic effects of methylprednisolone acetate administration in cats

Trasida Ployngam Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108.

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Anthony H. Tobias Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108.

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Stephanie A. Smith Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108.

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Sheila M. F. Torres Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108.

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Sheri J. Ross Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, MN 55108.

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Abstract

Objective—To investigate the mechanisms by which corticosteroid administration may predispose cats to congestive heart failure (CHF).

Animals—12 cats receiving methylprednisolone acetate (MPA) for the treatment of dermatologic disorders.

Procedure—The study was conducted as a repeated-measures design. Various baseline variables were measured, after which MPA (5 mg/kg, IM) was administered. The same variables were then measured at 3 to 6 days and at 16 to 24 days after MPA administration. Evaluations included physical examination, systolic blood pressure measurement, hematologic analysis, serum biochemical analysis, thoracic radiography, echocardiography, and total body water and plasma volume determination.

Results—MPA resulted in a substantial increase in serum glucose concentration at 3 to 6 days after administration. Concurrently, RBC count, Hct, and hemoglobin concentration as well as serum concentrations of the major extracellular electrolytes, sodium and chloride, decreased. Plasma volume increased by 13.4% (> 40% in 3 cats), whereas total body water and body weight slightly decreased. All variables returned to baseline by 16 to 24 days after MPA administration.

Conclusions and Clinical Relevance—These data suggest that MPA administration in cats causes plasma volume expansion as a result of an intra to extracellular fluid shift secondary to glucocorticoid-mediated extracellular hyperglycemia. This mechanism is analogous to the plasma volume expansion that accompanies uncontrolled diabetes mellitus in humans. Any cardiovascular disorders that impair the normal compensatory mechanisms for increased plasma volume may predispose cats to CHF following MPA administration.

Abstract

Objective—To investigate the mechanisms by which corticosteroid administration may predispose cats to congestive heart failure (CHF).

Animals—12 cats receiving methylprednisolone acetate (MPA) for the treatment of dermatologic disorders.

Procedure—The study was conducted as a repeated-measures design. Various baseline variables were measured, after which MPA (5 mg/kg, IM) was administered. The same variables were then measured at 3 to 6 days and at 16 to 24 days after MPA administration. Evaluations included physical examination, systolic blood pressure measurement, hematologic analysis, serum biochemical analysis, thoracic radiography, echocardiography, and total body water and plasma volume determination.

Results—MPA resulted in a substantial increase in serum glucose concentration at 3 to 6 days after administration. Concurrently, RBC count, Hct, and hemoglobin concentration as well as serum concentrations of the major extracellular electrolytes, sodium and chloride, decreased. Plasma volume increased by 13.4% (> 40% in 3 cats), whereas total body water and body weight slightly decreased. All variables returned to baseline by 16 to 24 days after MPA administration.

Conclusions and Clinical Relevance—These data suggest that MPA administration in cats causes plasma volume expansion as a result of an intra to extracellular fluid shift secondary to glucocorticoid-mediated extracellular hyperglycemia. This mechanism is analogous to the plasma volume expansion that accompanies uncontrolled diabetes mellitus in humans. Any cardiovascular disorders that impair the normal compensatory mechanisms for increased plasma volume may predispose cats to CHF following MPA administration.

Contributor Notes

Dr. Smith's current address is the Department of Biochemistry, College of Medicine at Urbana-Champaign, University of Illinois, Urbana, IL 61801.

Supported by the Winn Feline Foundation, the University of Minnesota's College of Veterinary Medicine Companion Animal Fund, and the Anandamahidol Foundation.

Presented in part at the 2005 American College of Veterinary Internal Medicine Forum, Baltimore, June 2005.

The authors thank Kristin Hohnadel and Lori Koehler for technical assistance.

Dr. Tobias.
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