Main hormone secreting adrenal tumors in dogs and cats
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Main hormone secreting adrenal tumors in dogs and cats Verónica Requerey Jiménez - Facultat de Veterinària de la UAB – June 30th 2016 Bibliographic study of the three most common adrenal tumors in dogs and cats (hyperadrenocorticism, pheochromocytoma, hyperaldosteronism), approaching the subject from the pathophysiology to recent studies about diagnosis and treatment. Adrenal primary tumors represent 1-2% of all canine tumors, being less common in cats, representing only 0.2%. Thanks to the greater availability of imaging techniques like ultrasounds, computed tomography (CT) and magnetic resonance imaging (MRI), the diagnosis of adrenal diseases has improved. Despite this, adrenal diseases remain emerging illnesses often diagnosed as incidental findings or in necropsy room . Hyperadrenocorticism Pheochromocytoma Hyperaldosteronism •PU/PD,polyphagia, panting,abdominal enlargement,endocrine alopecia. •Increased AP , ALT, cholesterol and hypertension •Asymptomatic or lethargy, weight loss, anorexia, panting, PU/PD, tachypnea,tachycardia. • Hypertension. •Weakness, neck ventroflexion , PU/PD. •Hypertension, hypokalemia. Abdominal Ultrasound Adrenal mass lymphoma These three diseases sometimes show non-specific clinical signs making it confusing and complicated to reach an adrenal disease diagnose. Because of that, it could be included in the diagnostic protocol of these cases, an ultrasound examination of adrenal glands. This way, adrenal damage could be discarded and misdiagnosis or empirical treatments could be avoided. The implementation of blood pressure mesure in physical examinations could be useful in the suspicion of a cortical or medular tumor that rises systholic pressure. Publication of veterinary clinical cases and the advances in human medicine can be also useful and guide to new lines of investigation and improve our diagnosis and treatments. Low-Dose dexamethasone suppression test or ACTH stimulation test Positive Negative Radiography Plasma-free metanephrine and free normetanephrine measurement Negative Positive Pheochromocytoma Adrenal HAC Sex hormones Removable tumor Adrenalectomy Unresectable tumor Trilostane Nonfunctional tumor Granuloma, abscess, myelolipomas, hematomas Removable tumor Adrenalectomy Unresectable tumor Phenoxybenzamine Metastases Aldosterone: Renin Ratio Negative Positive Secondary Hyperaldosteronism Nonfunctional tumor granuloma, abscess, myelolipomas, hematomas Primary Hyperaldosteronism Removable tumor Unresectable tumor Potassium gluconate, Adrenalectomy Spironolactone Amplodipine,
