Multiple pituitary hormone deficiencies in a kitten: Hyposomatotropism, hypothyroidism, central diabetes insipidus and hypogonadism.

In humans, post-traumatic hypopituitarism (PTHP) is a common complication of traumatic brain injury, with the most frequently reported hormonal deficiencies resulting in hyposomatotropism and hypogonadism, followed by hypothyroidism, hypocortisolism, and central diabetes insipidus. To date, PTHP has rarely been reported in cats, and the reported cases often describe a single hormone deficiency. This report details an approximately 7-month-old cat with a history of suspected traumatic brain injury at 5 wk of age, that presented with growth retardation (1.53 kg) and polyuria-polydipsia. Thyroid panel, thyrotropin-releasing hormone stimulation test, thyroid scan with Technetium-99, repeat measurement of serum IGF-1, resting cortisol, endogenous ACTH concentration, and ACTH stimulation testing were performed. The cat was diagnosed with presumptive PTHP leading to hyposomatotropism, hypothyroidism, central diabetes insipidus, and hypogonadism. In this case, treatment of the hypothyroidism and central diabetes insipidus were successful. Hyposomatotropism and hypogonadism were not treated. Although reported feline PTHP cases have described a single hormone deficiency, this report details a cat with presumptive PTHP leading to hyposomatotropism, hypothyroidism, central diabetes insipidus, and hypogonadism. Attention should be paid to the potential for the development of PTHP in cats secondary to traumatic brain injury. Key clinical message: Post-traumatic hypopituitarism in cats can lead to multiple hormone deficiencies, leading to hyposomatotropism, hypothyroidism, central diabetes insipidus, and hypogonadism.

Insuffisances hormonales hypophysaires multiples chez un chaton : hyposomatotropisme, hypothyroïdie, diabète insipide central et hypogonadisme. En médecine humaine, l'hypopituitarisme post-traumatisme crânien (HPPT) est une complication fréquente après un trauma crânien. Les insuffisances hormonales les plus fréquemment rapportées sont l'hyposomatotropisme et l'hypogonadisme, suivis de l'hypothyroïdie, de l'hypocortisolisme et du diabète insipide central. À ce jour, l'HPPT a rarement été décrit chez le chat, et les cas publiés décrivent bien souvent une déficience hormonale unique. Dans le cas présent, un chat âgé d'environ 7 mois, avec un antécédent de trauma crânien suspecté à l'âge de 5 semaines, a été présenté avec un retard de croissance (1,53 kg) et un syndrome polyurie-polydipsique. Les examens d'endocrinologie complémentaires incluaient le dosage des hormones thyroïdiennes, la stimulation de l'hypophyse par la thyrolibérine, une scintigraphie thyroïdienne (Technetium-99), le dosage de l'IGF-1, du cortisol basal, de la concentration d'ACTH endogène, et un test de stimulation à l'ACTH. Le chat a été diagnostiqué de manière présomptive avec un HPPT causant de multiples insuffisances hormonales hypophysaires : hyposomatotropisme, hypothyroïdie, diabète insipide central et hypogonadisme. Chez ce chat, le traitement de l'hypothyroïdie et du diabète insipide central a été réussi. L'hyposomatotropisme et l'hypogonadisme n'ont pas été traités. Alors que les rapports de cas publiés sur l'HPPT félin décrivent souvent une seule déficience hormonale, ce chat a été diagnostiqué avec de multiples insuffisances hormonales hypophysaires. Les cliniciens doivent rester attentifs au développement potentiel d'un hypopituitarisme après un trauma crânien.Message clinique clé :L'hypopituitarisme post-traumatique chez le chat peut entraîner de multiples déficiences hormonales, entraînant un hyposomatotropisme, une hypothyroïdie, un diabète insipide central et un hypogonadisme.(Traduit par les auteurs).

Head trauma as a possible cause of central diabetes insipidus in a cat.

A 13-month-old female domestic shorthair cat presented with a 10-month history of polyuria and polydipsia that began after having been hit by a car. Neurological examination revealed visual deficits and an absent bilateral menace response. Hematological and serum biochemical analyses were within reference values, but hyposthenuria was identified. Failure to concentrate urine during the water deprivation test followed by an increase in urine specific gravity after administration of synthetic antidiuretic hormone (ADH) suggested a diagnosis of central diabetes insipidus. Subcutaneous or oral administration of synthetic ADH was effective in central diabetes insipidus treatment during the 19-month follow-up.

Central diabetes insipidus in a cat with central nervous system B cell lymphoma.

A 6-year-old male neutered cat presented with blindness, lethargy, polydipsia, hyposthenuria and severe hypernatraemia. Central diabetes insipidus was demonstrated by means of a low measured anti-diuretic hormone (ADH) concentration in the face of hypernatraemia, and clinical response to supplementation with desmopressin. Magnetic resonance imaging of the brain showed a discrete mass in the region of the hypothalamus. The cat was euthanased and post-mortem histological examination demonstrated B cell lymphoma involving the brain, optic nerves, urinary bladder wall and diaphragm. To the authors' knowledge, this case report is the first to describe central diabetes insipidus caused by central nervous system lymphoma in the cat.

Central diabetes insipidus after transsphenoidal surgery in dogs with Cushing's disease.

Transsphenoidal surgery (TSS) is an effective treatment for canine Cushing's disease, as well as human Cushing's disease. In humans, only the pituitary adenoma tissue is resected by TSS. However, in dogs, the whole pituitary including normal tissue is resected. Hence, central diabetes insipidus (CDI) may complicate the postoperative course in almost all dogs with Cushing's disease treated by TSS. However, it is difficult to assess the duration of the postoperative CDI, and whether it may be transient or permanent. In this study, postoperative CDI in 21 dogs with Cushing's disease and its predicted prognosis by preoperative parameters was investigated. In this study, CDI after TSS was classified as either transient or permanent based on the requirement for desmopressin. Preoperative circulating serum cortisol concentrations and pre- and post-operative plasma AVP concentrations were not significantly different between the transient CDI dogs and permanent CDI dogs. The duration of postoperative CDI was not correlated to the signal intensity ratio (posterior lobe of the pituitary/cerebral cortex), which is obtained from preoperative magnetic resonance imaging (MRI). However, the pituitary height/brain area (P/B) ratio of the permanent CDI dogs was significantly greater than that of the transient CDI dogs. In addition, there was a significant difference between the enlarged-pituitary (P/B ratio > 0.31) transient CDI dogs and the permanent CDI dogs. These results suggest that the incidence of postoperative permanent CDI is strongly influenced by the pituitary size.

Multiple endocrine diseases in cats: 15 cases (1997-2008).

The objective of this retrospective study was to characterize a population of cats from a tertiary care center diagnosed with multiple endocrine disorders, including the specific disorders and time intervals between diagnosis of each disorder. Medical records of 15 cats diagnosed with more than one endocrine disorder were reviewed. The majority of cats were domestic shorthairs, and the mean age at the time of diagnosis of the first disorder was 10.3 years. The most common combination of disorders was diabetes mellitus and hyperthyroidism. Two cats had concurrent diabetes mellitus and hyperadrenocorticism, one cat had concurrent central diabetes insipidus and diabetes mellitus. A mean of 25.7 months elapsed between diagnoses of the first and second endocrine disorder, but this was variable. This study suggests the occurrence of multiple endocrine disorders is uncommon in cats.

Central diabetes insipidus in five cats: clinical presentation, diagnosis and oral desmopressin therapy.

Five cases of central diabetes insipidus (CDI) in domestic shorthair cats are described. All cats were under 3 years of age at the onset of clinical signs, and outdoor or outdoor/indoor cats, in which a prior trauma was either present or possible. The history included polydipsia and polyuria, and physical examination abnormalities included urinary bladder distention and dehydration. All cats had hyposthenuria with a urine specific gravity between 1.003 and 1.006. The diagnosis was confirmed by an observed inability to concentrate urine during a water deprivation test or compatible serum osmolality, followed by an increase in urine concentration after desmopressin administration. All cats in this report were treated successfully with oral desmopressin. The dose (25-50 microg q8-12h) and the response to therapy were variable. Oral desmopressin administration may serve as an effective alternative route for cat owners who find the conjunctival or nasal application of the solution an inconvenient mode of therapy.