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Abstract

Case Description—A 9-year-old castrated male domestic shorthair cat was examined because of hypertension that persisted after resolution of the patient's hyperthyroidism. Bilateral hypertensive retinopathy, a systolic heart murmur, left ventricular hypertrophy, and tachycardia were present.

Clinical Findings—Biochemical analysis revealed mild hypokalemia, normonatremia, high serum creatine kinase activity, high serum aldosterone concentration, and low plasma renin activity consistent with hyperaldosteronism. Hypercalcemia with an associated high serum parathyroid hormone concentration and an exaggerated low-dose dexamethasone suppression test result were consistent with concurrent hyperparathyroidism and hyperadrenocorticism, respectively. Ultrasonographic examination revealed a markedly enlarged left adrenal gland, an abnormally small right adrenal gland, and 2 nodules in the right thyroid and parathyroid glands.

Treatment and Outcome—Laparoscopic left adrenalectomy was performed concurrently with right thyroidectomy and parathyroidectomy. Histologic evaluation revealed an adrenal cortical adenoma, thyroid adenoma, and parathyroid adenoma. The cat recovered from surgery without complications. The hypercalcemia and hypertension resolved after surgery. Follow-up echocardiography revealed improvement in the left ventricular hypertrophy. Ultrasonographic examinations performed up to 26 months after adrenalectomy showed no evidence of regrowth of the adrenal mass. The patient survived for 44 months after adrenalectomy with no signs of recurrent hyperaldosteronism or hyperadrenocorticism.

Clinical Relevance—Laparoscopic adrenalectomy may be a plausible method for the treatment of unilateral functional adrenal neoplasia in feline patients when diagnostic imaging has ruled out intravascular invasion and metastatic disease. In addition, in a feline patient with hyperthyroidism and hypertension, other endocrine glands should be investigated.

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in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE To evaluate the impact of oral megestrol acetate (MA) administration on adrenal function in male bottlenose dolphins (Tursiops truncatus).

DESIGN Serial cross-sectional study.

ANIMALS 8 adult male dolphins, all of which were receiving MA at various daily doses (range, 0 to 60 mg, PO) for the control of reproductive behavior.

PROCEDURES Blood samples were collected every 2 weeks for 1 year from dolphins trained to voluntarily provide them. Cortisol, ACTH, and other hormone concentrations were measured in serum or plasma via radioimmunoassay or ELISA. Fecal samples, also provided by dolphins voluntarily, were assayed for glucocorticoid metabolite concentrations. Effects of daily MA dose on hormone concentrations were evaluated.

RESULTS Daily MA doses as low as 10 mg strongly suppressed cortisol secretion in nearly all dolphins, and except for a single measurement, no dolphin had measurable serum concentrations at doses ≥ 20 mg. Variations in serum cortisol concentration were unrelated to season but were directly related to ACTH concentrations, suggesting primary effects upstream of the adrenal gland. Cessation of MA administration resulted in almost immediate restoration of measurable serum cortisol concentrations, although concentrations continued to rise in a few dolphins over the following weeks to months.

CONCLUSIONS AND CLINICAL RELEVANCE Caution should be exercised when administering MA to control reproductive behavior in male dolphins. Because the hypothalamic-pituitary-adrenal axis appeared to be sensitive to even small doses of MA in dolphins, duration of treatment may be the most critical consideration.

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in Journal of the American Veterinary Medical Association

Abstract

Supply chain issues disrupt veterinary care and cause downstream consequences that alter the practice of veterinary medicine. Antimicrobials are just 1 class of pharmaceuticals that have been impacted by supply chain issues over the last couple of years. Since February 2021, 2 sponsors/manufacturers of penicillin products have reported shortages in the active pharmaceutical ingredient. With the release of the 2021 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals by the FDA, a key finding was a 19% decrease in penicillin sales and distribution from 2020 to 2021. Herein, we provide our clinicians’ professional perspective regarding how drug shortages, specifically that of penicillin, might contribute to misconstrued patterns in antimicrobial use and what can be done by veterinarians and the FDA to minimize the impact of an antimicrobial drug shortage on animal health and well-being.

Full access
in Journal of the American Veterinary Medical Association