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- Cats get it too.....
Emma Roberts 1 | Ian K. Ramsey2 | Ruth Gostelow3 | Anna Latysheva4 |Luca Battaglia5 | Paolo Silvestrini6 | Ghita Benchekroun7 | Karen Brenner8 |Bérénice Conversy9 | Riccardo Ferriani10 | Andre Kortum11 |Lisa Stammeleer12 | Nele Van den Steen13 | Flavia Tavares14 | Julia Lieser15 |Angie Hibbert16 | Antoine Duclos 17 | Troy Bunn18 | Alisdair M Boag19 |Carolina Arenas20 | Kirsty Roe21 | Florian K. Zeugswetter 22 | Yi Cui23 |Imogen Schofield24 | Federico Fracassi
Background
Hypoadrenocorticism (Addison's disease) is a rare condition in cats characterized by adrenal insufficiency, leading to a deficiency in glucocorticoids, mineralocorticoids, or both. Unlike dogs, detailed studies on feline hypoadrenocorticism are scarce. This study aimed to describe clinical findings, laboratory abnormalities, treatment responses, and outcomes in a large cohort of cats with hypoadrenocorticism, including cases without classic electrolyte abnormalities.
Methods
This multicenter, retrospective observational study included 41 cats diagnosed with hypoadrenocorticism between 2000 and 2021. Diagnosis was based on ACTH stimulation tests and clinical presentations. Cats were categorized into two groups:
-Those with hyponatremia and/or hyperkalemia (HH, n=36).
-Those without these abnormalities (NHNH, n=5). Data collection included signalment, clinical signs, laboratory results, imaging findings, and treatment protocols. Statistical analysis assessed differences between the groups and outcomes.
Results
Signalment and Presentation:
-Median age at diagnosis: 5.7 years (range: 0.2–13.8 years).
-Common signs: lethargy (87.8%), anorexia (78%), weakness (61%), and vomiting (39%).
-Cats with HH were more likely to be hypothermic, dehydrated, and weak compared to NHNH cats.
Laboratory and Imaging Findings:
-73.2% of cats exhibited azotemia, while 31.7% had hypercalcemia.
-Exocrine pancreatic insufficiency (EPI) and cobalamin deficiency were diagnosed in 4/7 and 5/11 tested cats, respectively.
-Imaging occasionally revealed adrenal abnormalities, including atrophy or masses.
Treatment and Outcomes:
-Prednisolone and desoxycorticosterone pivalate (DOCP) were the most common therapies.
-85.4% of cats survived hospitalization, with a median survival time of 2,035 days for all-cause mortality.
-Cats in the NHNH group generally had favorable outcomes but were fewer in number, limiting statistical power.
Long-term Follow-Up:
-Cats that survived hospitalization had good long-term prognoses, though ongoing monitoring was advised for complications like EPI and cobalamin deficiency.
Limitations
This study’s retrospective design and non-standardized treatments may have introduced variability. The small number of NHNH cases limited comparative analyses. Additionally, incomplete follow-up data and diagnostic tests for some cases reduced the ability to draw broad conclusions.
Conclusions
Hypoadrenocorticism in cats can present with or without classic electrolyte disturbances, emphasizing the need for suspicion in atypical cases. The disease has a generally favorable prognosis with appropriate treatment. Associated conditions like EPI and cobalamin deficiency warrant attention during diagnosis and follow-up.
Kaplan-Meier survival curve of disease-specific mortality in cats diagnosed with hypoadrenocorticism, split by treatment (DOCP, FC, or sole prednisolone). Survival time represents the time from diagnosis in years until the time of death or euthanasia because of disease-specific mortality.
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