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Primary hyperaldosteronism in a domestic ferret with an adrenocortical adenoma

Marion Desmarchelier DMV1, Stéphane Lair DMV, DVSc, DACZM2, Marilyn Dunn DMV, MVSc, DACVIM3, and Isabelle Langlois DMV, DABVP4
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  • 1 Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 7C6, Canada.
  • | 2 Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 7C6, Canada.
  • | 3 Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 7C6, Canada.
  • | 4 Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St Hyacinthe, QC J2S 7C6, Canada.

Abstract

Case Description—A 6-year-old spayed female domestic ferret was evaluated because of lethargy, alopecia, pruritus, and an abdominal mass.

Clinical Findings—On initial examination, nonregenerative anemia, mild azotemia, and a large left adrenal gland mass were identified. However, deterioration of the ferret's general condition prevented excision of the mass, and dyspnea, weakness, hypertension, and severe hypokalemia developed. Plasma aldosterone concentration was > 3,329 pmol/L, confirming a provisional diagnosis of hyperaldosteronism. High concentrations of sex hormones were also observed, but baseline cortisol concentration was within reference limits.

Treatment and Outcome—Medical treatment included oral administration of spironolactone, potassium gluconate, leuprolide acetate, amlodipine, and benazepril. Inhalation of albuterol proved effective in reducing the dyspnea. In the following weeks, serum potassium concentration returned to within reference limits and hypertension decreased, but dyspnea persisted. Two months after initial examination, the ferret became anorectic and was euthanized. Histologic examination revealed a large left adrenal gland adenoma, progressive chronic nephropathy, severe pulmonary edema, and focal fibrosis in the left ventricle. Immunohistochemical staining of the adrenal gland mass revealed aldosterone within neoplastic adrenocortical cells.

Clinical Relevance—Findings suggested that primary hyperaldosteronism should be considered as a possible cause in ferrets with hypokalemia, hypertension, and an adrenal gland mass. Early detection of aldosterone-secreting masses might allow for removal of the tumor before irreversible complications occur.

Abstract

Case Description—A 6-year-old spayed female domestic ferret was evaluated because of lethargy, alopecia, pruritus, and an abdominal mass.

Clinical Findings—On initial examination, nonregenerative anemia, mild azotemia, and a large left adrenal gland mass were identified. However, deterioration of the ferret's general condition prevented excision of the mass, and dyspnea, weakness, hypertension, and severe hypokalemia developed. Plasma aldosterone concentration was > 3,329 pmol/L, confirming a provisional diagnosis of hyperaldosteronism. High concentrations of sex hormones were also observed, but baseline cortisol concentration was within reference limits.

Treatment and Outcome—Medical treatment included oral administration of spironolactone, potassium gluconate, leuprolide acetate, amlodipine, and benazepril. Inhalation of albuterol proved effective in reducing the dyspnea. In the following weeks, serum potassium concentration returned to within reference limits and hypertension decreased, but dyspnea persisted. Two months after initial examination, the ferret became anorectic and was euthanized. Histologic examination revealed a large left adrenal gland adenoma, progressive chronic nephropathy, severe pulmonary edema, and focal fibrosis in the left ventricle. Immunohistochemical staining of the adrenal gland mass revealed aldosterone within neoplastic adrenocortical cells.

Clinical Relevance—Findings suggested that primary hyperaldosteronism should be considered as a possible cause in ferrets with hypokalemia, hypertension, and an adrenal gland mass. Early detection of aldosterone-secreting masses might allow for removal of the tumor before irreversible complications occur.

Contributor Notes

Address correspondence to Dr. Lair.