Trilostane therapy for treatment of spontaneous hyperadrenocorticism in cats: 15 cases (2004-2012)

J Vet Intern Med. 2013 Nov-Dec;27(6):1471-7. doi: 10.1111/jvim.12178. Epub 2013 Sep 6.

Abstract

Background: Medical treatment with trilostane improves clinical signs, causes unclear insulin requirement changes, and variable survival times in cats.

Objectives/hypothesis: To characterize the long-term efficacy of trilostane in treating cats with hyperadrenocorticism (HAC).

Animals: Fifteen client-owned cats with spontaneous HAC.

Methods: Multicenter descriptive retrospective study with a search performed on all medical records for cats diagnosed with spontaneous HAC.

Results: Clinical signs (13 of 15 cats) and ACTH stimulation testing results (13 of 15) improved with trilostane therapy. Diabetes mellitus was reported in 9/15 cases. Insulin requirements decreased by 36% within 2 months in 6/9 diabetic cats. Median survival time was 617 days for all cats (range 80-1,278 days). Complications included weight loss, urinary tract infections, chronic kidney disease, seizures, and recurrent pancreatitis. Hypocortisolemia was documented in 1 case. Cause of death occurred as a result of nonadrenal or nondiabetic illnesses (renal failure, seizures [caused by hypoglycemia or unknown]), or lymphoma.

Conclusions and clinical importance: Trilostane ameliorates clinical signs of HAC in cats, is tolerated well in the long term, and can lead to improved regulation of diabetes.

Keywords: Cushing's syndrome; Endocrinopathy; Feline; Steroid synthesis inhibitor.

Publication types

  • Multicenter Study

MeSH terms

  • Adrenocortical Hyperfunction / diagnostic imaging
  • Adrenocortical Hyperfunction / drug therapy
  • Adrenocortical Hyperfunction / physiopathology
  • Adrenocortical Hyperfunction / veterinary*
  • Animals
  • Body Weight / physiology
  • Cat Diseases / diagnostic imaging
  • Cat Diseases / drug therapy
  • Cat Diseases / physiopathology*
  • Cats
  • Diabetes Mellitus / physiopathology
  • Diabetes Mellitus / veterinary*
  • Dihydrotestosterone / analogs & derivatives*
  • Dihydrotestosterone / pharmacology
  • Dihydrotestosterone / therapeutic use
  • Enzyme Inhibitors / pharmacology*
  • Enzyme Inhibitors / therapeutic use
  • Female
  • Insulin / administration & dosage
  • Male
  • Retrospective Studies
  • Ultrasonography

Substances

  • Enzyme Inhibitors
  • Insulin
  • Dihydrotestosterone
  • trilostane