Do sick cats have big adrenal glands?

Ultrasonographically Detected Adrenomegaly in Clinically Ill Cats: A Retrospective Study

Oliveira et al

Background:
Feline adrenomegaly, a condition marked by the enlargement of one or both adrenal glands, is poorly documented in non-endocrinopathic contexts. This study aimed to assess the prevalence of ultrasonographically detected adrenomegaly in clinically ill cats, characterize its clinical relevance, and explore associated diseases.

Methods:
A retrospective cross-sectional study reviewed 983 abdominal ultrasonography (AUS) reports from a veterinary teaching hospital between October 2018 and February 2021. Adrenomegaly was defined as adrenal glands exceeding a dorsoventral axis of 4.8 mm. Data on cat signalment, clinical context, and associated diagnoses were collected. Comparative analyses were conducted between left and right adrenal glands using ultrasonographic measurements.

Results:

Prevalence: Adrenomegaly was detected in 7% (68/983) of cases.
Signalment: European/Domestic Short-Hair neutered males and cats aged ≥10 years were overrepresented.
Findings: Adrenomegaly was incidental in 91% of cases and bilateral in 53%. Unilateral enlargement (47%) was more frequent on the left side. Left adrenals were larger and oval-shaped, whereas right adrenals were predominantly bipolar.
Associated Diagnoses: Chronic kidney disease (CKD, 37%) was most common, followed by endocrinopathies (29%), including hyperthyroidism and diabetes mellitus. Neoplasia, inflammatory diseases, and infections were less frequent.
Endocrine Investigation: Adrenomegaly was not functionally explored in 82% of cases. Only 18% underwent further endocrine tests, limiting diagnostic specificity.

Limitations:
The retrospective design, variability in ultrasound equipment, and inconsistent endocrine and histopathological evaluations reduced diagnostic accuracy. Many cases lacked detailed follow-up, and findings could reflect incidental stress-related changes rather than pathology.

Conclusions:
Adrenomegaly is a prevalent ultrasonographic finding in clinically ill cats, frequently unrelated to adrenal pathology. CKD and hyperthyroidism were the most common comorbidities. Further studies with comprehensive endocrine and histopathological analyses are needed to clarify its clinical significance and differentiation from functional disorders.

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