- Veterinary View Box
- Posts
- What differential do you have in a castrated male cat with high testosterone?
What differential do you have in a castrated male cat with high testosterone?
Frontiers in veterinary science 2023
Obi Veterinary Education
April 16, 2025
Caylen G. Erger, Allison L. Gerras, Alan J. Conley et al.
Background
The study investigates androgen-secreting adrenocortical tumors (ASTs) in eight neutered cats, a condition linked to behavioral abnormalities such as inappropriate urination and aggression. While sex-hormone-secreting adrenal tumors are rare, their incidence may be underrecognized. The authors aim to describe the clinical, diagnostic, and management features of these cases.
Methods
This retrospective case series includes eight cats evaluated between 2014 and 2022 across seven veterinary clinics. Data were collected on clinical history, physical examinations, serum androgen concentrations, imaging findings, and treatment outcomes. Adrenalectomy specimens were histologically analyzed, and immunohistochemical assessments were performed in selected cases.
Results
1) Clinical Signs:
-Behavioral complaints included periuria (n=7), malodorous urine (n=7), aggression (n=3), and vocalization (n=4).
-Physical findings included penile barbs in males (n=5) and an enlarged clitoris in one female.
2) Diagnostics:
-Elevated testosterone (n=7) or androstenedione (n=1) concentrations confirmed androgen excess.
-Imaging revealed unilateral adrenal tumors in six cases and histopathology identified three adenomas and two carcinomas.
3) Treatments:
-Surgical adrenalectomy (n=4) resolved clinical signs and normalized androgen levels in all cases, with long-term survival (>1 year) in three cats.
-Medical treatments, including trilostane, failed to significantly improve signs in non-surgical cases.
Limitations
The study's retrospective design limits its ability to establish causality.
Small sample size restricts generalizability.
Lack of comprehensive hormonal and genetic testing reduces the depth of mechanistic insights.
Conclusions
Androgen-secreting adrenal tumors should be considered in neutered cats presenting with behavioral changes resistant to empirical treatments. Surgical adrenalectomy provides favorable outcomes, while medical management remains ineffective. Enhanced recognition of clinical and diagnostic features may improve case identification and management.
Images of the penis in a 7-year-old neutered male domestic shorthair cat (case 1) that underwent surgical adrenalectomy for a androstenedione-secreting adrenal tumor. Serum androstenedione concentration prior to surgery was 3.2 nmol/L (RI 0.35–2.1 nmol/L), which decreased to 0.35 nmol/L 3 weeks after surgery. (A) Penile barbs are apparent immediately prior to surgery. (B) The penile barbs had substantially regressed 2 weeks post-adrenalectomy.
How did we do? |
Disclaimer: The summary generated in this email was created by an AI large language model. Therefore errors may occur. Reading the article is the best way to understand the scholarly work. The figure presented here remains the property of the publisher or author and subject to the applicable copyright agreement. It is reproduced here as an educational work. If you have any questions or concerns about the work presented here, reply to this email.