A 15 years short hair male cat was referred to our clinic for a poorly controlled diabetes mellitus which had been diagnosed 3 years before. The cat presented polyuria and polydipsia, weight loss and poor haircoat. Three seizures episodes were described in the last two months. Cutaneous changes were represented by extensive alopecia thin, fragile and easily wrinkled skin with crusted wounds, prominent vasculature and comedones. The hair loss involved the abdomen, the flank region and the proximal part of the extremities. Hyperkeratotic paws were present. These dermatologic findings had been developed in the last six months. Hyperglycemia, hyperlipaemia, high levels of serum ALT and fructosamine were the most evident biochemical evidences. Abdomen ultrasonography showed hepatomegaly with focal hypoechoic parenchimal lesions, enlarged gallbladder, extrahepatic bile ducts distensions. These findings suggested an hepatic neoplasia and a pancreatic involvment (extrahepatic bile ducts enlarged). Hypertrophic adrenal glands were also observed. Although not commonly reported, the Cushing’s Syndrome in the cat is usually described with concurrent diabetes mellitus. In order to provide that, we performed a high-dose dexamethasone suppression test. The suppression by more than 50% below baseline value following administration of a high dose of DXM suggested a pituitary dependent hyperadrenocorticism (PDH). However the owner refused any further therapy rather than insulin. The cat was euthanisized a month later. The post mortem examination showed: a pituitary basophil adenocarcinoma, a pancreatic islet cells adenocarcinoma and an hepatic carcinoma suggesting a multiple endocrine neoplasia. Adrenal cortex hyperplasia, cutaneous follicular and dermal atrophy was also assessed as the consequences of the Cushing’s Syndrome. In human, several combination of endocrine tumours are known to occur. They are refferred to as multiple endocrine neoplasias (MEN) and are related to a common gene defect, including inactivation of both alleles of a tumour suppressor gene. MEN 1 subgroup includes combinations of parathyroid and pituitary hyperplasia and/or neoplasia and pancreatic islet cells neoplasia. MEN syndromes are rare in veterinary medicine and mostly described in the dog. The case reported was clinically diagnosed as a Cushing’s Syndrome. Only the post-mortem examination could identify the multiple endocrine glands involvment and diagnose a MEN 1-like syndrome. Further studies are needed to identify a genetic defect such as described in human pathology.

A multiple endocrine neoplasia type 1-like syndrome in a cat / P. Scarpa, S. Colombo, S. Faverzani, P. Roccabianca. ((Intervento presentato al convegno WSAVA - FECAVA WORLD CONGRESS tenutosi a AMSTERDAM nel 2000.

A multiple endocrine neoplasia type 1-like syndrome in a cat

P. Scarpa;S. Faverzani;P. Roccabianca
2000

Abstract

A 15 years short hair male cat was referred to our clinic for a poorly controlled diabetes mellitus which had been diagnosed 3 years before. The cat presented polyuria and polydipsia, weight loss and poor haircoat. Three seizures episodes were described in the last two months. Cutaneous changes were represented by extensive alopecia thin, fragile and easily wrinkled skin with crusted wounds, prominent vasculature and comedones. The hair loss involved the abdomen, the flank region and the proximal part of the extremities. Hyperkeratotic paws were present. These dermatologic findings had been developed in the last six months. Hyperglycemia, hyperlipaemia, high levels of serum ALT and fructosamine were the most evident biochemical evidences. Abdomen ultrasonography showed hepatomegaly with focal hypoechoic parenchimal lesions, enlarged gallbladder, extrahepatic bile ducts distensions. These findings suggested an hepatic neoplasia and a pancreatic involvment (extrahepatic bile ducts enlarged). Hypertrophic adrenal glands were also observed. Although not commonly reported, the Cushing’s Syndrome in the cat is usually described with concurrent diabetes mellitus. In order to provide that, we performed a high-dose dexamethasone suppression test. The suppression by more than 50% below baseline value following administration of a high dose of DXM suggested a pituitary dependent hyperadrenocorticism (PDH). However the owner refused any further therapy rather than insulin. The cat was euthanisized a month later. The post mortem examination showed: a pituitary basophil adenocarcinoma, a pancreatic islet cells adenocarcinoma and an hepatic carcinoma suggesting a multiple endocrine neoplasia. Adrenal cortex hyperplasia, cutaneous follicular and dermal atrophy was also assessed as the consequences of the Cushing’s Syndrome. In human, several combination of endocrine tumours are known to occur. They are refferred to as multiple endocrine neoplasias (MEN) and are related to a common gene defect, including inactivation of both alleles of a tumour suppressor gene. MEN 1 subgroup includes combinations of parathyroid and pituitary hyperplasia and/or neoplasia and pancreatic islet cells neoplasia. MEN syndromes are rare in veterinary medicine and mostly described in the dog. The case reported was clinically diagnosed as a Cushing’s Syndrome. Only the post-mortem examination could identify the multiple endocrine glands involvment and diagnose a MEN 1-like syndrome. Further studies are needed to identify a genetic defect such as described in human pathology.
Settore VET/03 - Patologia Generale e Anatomia Patologica Veterinaria
Settore VET/08 - Clinica Medica Veterinaria
WORLD SMALL ANIMAL VETERINARY ASSOCIATION
FEDERATION OF EUROPEAN COMPANION ANIMAL VETERINARY ASSOCIATION
A multiple endocrine neoplasia type 1-like syndrome in a cat / P. Scarpa, S. Colombo, S. Faverzani, P. Roccabianca. ((Intervento presentato al convegno WSAVA - FECAVA WORLD CONGRESS tenutosi a AMSTERDAM nel 2000.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/185727
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