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Feline hyperaldosteronism
/content/chapter/10.22233/9781905319893.chap19
Feline hyperaldosteronism
- Authors: Andrea M. Harvey and Kent R. Refsal
- From: BSAVA Manual of Canine and Feline Endocrinology
- Item: Chapter 19, pp 204 - 214
- DOI: 10.22233/9781905319893.19
- Copyright: © 2012 British Small Animal Veterinary Association
- Publication Date: January 2012
Abstract
Feline hyperaldosteronism results from increased secretion of aldosterone from the adrenal glands and may be primary or secondary. This chapter focuses on physiology of the RAAS, aetiology, clinical features, diagnosis, treatment and prognosis.
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Figures
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19.1
Regulation of aldosterone release © 2012 British Small Animal Veterinary Association
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19.1
Regulation of aldosterone release
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19.2
Simplified diagram of adrenal steroid biosynthesis. © 2012 British Small Animal Veterinary Association
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19.2
Simplified diagram of adrenal steroid biosynthesis.
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19.3
Typical ventroflexion of the neck in ahypokalaemic cat. (Courtesy of Ellie Mardell and Andy Sparkes) © 2012 British Small Animal Veterinary Association
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19.3
Typical ventroflexion of the neck in ahypokalaemic cat. (Courtesy of Ellie Mardell and Andy Sparkes)
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19.4
Bilateral iridal haemorrhage in a cat with systemic hypertension. (Courtesy of Tim Knott, Rowe Veterinary Group) © 2012 British Small Animal Veterinary Association
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19.4
Bilateral iridal haemorrhage in a cat with systemic hypertension. (Courtesy of Tim Knott, Rowe Veterinary Group)
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19.5
Bilateral retinal detachment in a cat with systemic hypertension. This cat presented with sudden onset blindness. (Courtesy of Tim Knott, Rowe Veterinary Group) © 2012 British Small Animal Veterinary Association
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19.5
Bilateral retinal detachment in a cat with systemic hypertension. This cat presented with sudden onset blindness. (Courtesy of Tim Knott, Rowe Veterinary Group)
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19.6
Hypertensive retinopathy can have a variable appearance, such as (a) retinal oedema with patchy areas of retinal haemorrhage or (b) more diffuse retinal haemorrhage. (Courtesy of Jim Carter, University of Bristol) © 2012 British Small Animal Veterinary Association
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19.6
Hypertensive retinopathy can have a variable appearance, such as (a) retinal oedema with patchy areas of retinal haemorrhage or (b) more diffuse retinal haemorrhage. (Courtesy of Jim Carter, University of Bristol)
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19.7
Both these cats were diagnosed with concurrent hyperaldosteronism and hyperprogesteronism, due to unilateral adrenal carcinomas. (a) This cat’s primary presenting problems were progressive symmetrical alopecia, seborrhoea oleosa, abdominal distension and,more recently, diabetes mellitus, polyphagia, failure of hair regrowth and hindlimb weakness. (b) Note the very thin skin and prominent cutaneous blood vessels commonly seen in cases of hyperprogesteronism. (Courtesy of Langford Veterinary Services) © 2012 British Small Animal Veterinary Association
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19.7
Both these cats were diagnosed with concurrent hyperaldosteronism and hyperprogesteronism, due to unilateral adrenal carcinomas. (a) This cat’s primary presenting problems were progressive symmetrical alopecia, seborrhoea oleosa, abdominal distension and,more recently, diabetes mellitus, polyphagia, failure of hair regrowth and hindlimb weakness. (b) Note the very thin skin and prominent cutaneous blood vessels commonly seen in cases of hyperprogesteronism. (Courtesy of Langford Veterinary Services)
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19.10
Ultrasonogram illustrating the typical WaUv hypoechoic appearance of an adrenal mass of the left adrenal gland. This mass was an adrenal adenoma. A unilateral adrenalectomy was successful in managing this case. The normal appearance of the right adrenal gland can also be seen. (Courtesy of Langford Veterinary Services) © 2012 British Small Animal Veterinary Association
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19.10
Ultrasonogram illustrating the typical WaUv hypoechoic appearance of an adrenal mass of the left adrenal gland. This mass was an adrenal adenoma. A unilateral adrenalectomy was successful in managing this case. The normal appearance of the right adrenal gland can also be seen. (Courtesy of Langford Veterinary Services)
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19.11
T2-weighted coronal MRI scan of the abdomen from the same case as
Figure 19.10
, demonstrating the significantly enlarged left adrenal gland, in comparison to the right.demonstrating the significantly enlarged left adrenal gland, in comparison to the right. It can be seen that there is no evidence of invasion of the caudal vena cava in this case. (Courtesy of Langford Veterinary Services) © 2012 British Small Animal Veterinary Association
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19.11
T2-weighted coronal MRI scan of the abdomen from the same case as
Figure 19.10
, demonstrating the significantly enlarged left adrenal gland, in comparison to the right.demonstrating the significantly enlarged left adrenal gland, in comparison to the right. It can be seen that there is no evidence of invasion of the caudal vena cava in this case. (Courtesy of Langford Veterinary Services)
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19.12
Algorithm demonstrating the diagnostic pathway of hyperaldosteronism. PHA = primary hyperaldosteronism; SHA = secondary hyperaldosteronism; PRA = plasma renin activity; MFTs = mineralocorticoid function tests. (Reproduced and adapted from
Refsal and Harvey (2010)
with the permission of Saunders Elsevier) © 2012 British Small Animal Veterinary Association
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19.12
Algorithm demonstrating the diagnostic pathway of hyperaldosteronism. PHA = primary hyperaldosteronism; SHA = secondary hyperaldosteronism; PRA = plasma renin activity; MFTs = mineralocorticoid function tests. (Reproduced and adapted from
Refsal and Harvey (2010)
with the permission of Saunders Elsevier)
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19.13
Algorithm demonstrating the diagnostic pathway of hyperaldosteronism when PRA/MFTs not available. PHA = primary hyperaldosteronism; SHA = secondary hyperaldosteronism; PRA = plasma renin activity; MFTs = mineralocorticoid function tests.(Reproduced and adapted from
Refsal and Harvey (2010)
with the permission of Saunders Elsevier) © 2012 British Small Animal Veterinary Association
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19.13
Algorithm demonstrating the diagnostic pathway of hyperaldosteronism when PRA/MFTs not available. PHA = primary hyperaldosteronism; SHA = secondary hyperaldosteronism; PRA = plasma renin activity; MFTs = mineralocorticoid function tests.(Reproduced and adapted from
Refsal and Harvey (2010)
with the permission of Saunders Elsevier)
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19.14
Intraoperative view of an aldosterone-secretingadrenal adenoma. Note the white cauliflower-like appearance of the adrenal tumour. Adrenalectomywas successful in this patient with no surgicalcomplications. The cat was clinically well with no medicalmanagement 12 months postoperatively. (Courtesy ofLaura Owen, University of Cambridge) © 2012 British Small Animal Veterinary Association
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19.14
Intraoperative view of an aldosterone-secretingadrenal adenoma. Note the white cauliflower-like appearance of the adrenal tumour. Adrenalectomywas successful in this patient with no surgicalcomplications. The cat was clinically well with no medicalmanagement 12 months postoperatively. (Courtesy ofLaura Owen, University of Cambridge)