A case of behavioral changes in a castrated male cat due to a functional adrenocortical adenoma producing testosterone and androstenedione

Abstract

Case summary This case report describes a 9-year-old neutered male cat with a functional adrenal tumor showing aggression toward other cats in the household, excessive meowing and urine spraying. The diagnosis was made based on the clinical signs, an enlarged right adrenal gland on ultrasound, penile spines and elevated sex hormones on an adrenocorticotropic hormone stimulation test. The cat was submitted to celiotomy and adrenalectomy. Histopathological examination confirmed the adrenocortical adenoma. Three months after surgery the penile spines disappeared and urine spraying, as well as excessive meowing, had greatly decreased; however, aggressive behavior took much longer to stop and required behavior therapy. Relevance and novel information Functional adrenal tumors producing only sex hormones and behavioral changes are uncommon. The cat reported herein started showing behavioral changes before spines appeared on the penis, and structural alterations in the adrenal gland at the abdominal ultrasonography were detected. Considering all the possible implications resulting from severe behavior problems such as cat–cat aggression, from a permanent separation of the cats to relinquishment, a detailed investigation of underlying medical mechanisms in these animals is crucial from the start. Examinations may need to be repeated later in the course.

Case report: Androgen-secreting adrenocortical tumors in eight cats

“…Surgical adrenalectomy is generally recommended for the treatment of adrenal tumors without overt evidence of metastatic disease ( 16 ). Indeed, the four cats that underwent adrenalectomy experienced improvement or resolution of clinical signs and long-term survival, which is consistent with clinical outcomes described in several previous case reports ( 26 – 30 ). However, adrenalectomy is invasive, expensive and unlikely to be pursued in all cases.…”

“…Interestingly, testosterone secreting adrenocortical tumors in humans are most common in children and women ( 45 – 48 ), and all cats in our case series were neutered. Similarly, cats in previous reports of androgen-secreting adrenal tumors were neutered ( 26 – 30 ). This observation raises concern that the absence of androgen secretion from gonadal tissue could be a risk factor for the future development of androgen-secreting adrenal tumors.…”

“…Aldosterone-secreting adrenal tumors are well-described in cats and are thought to be the most common form of corticosteroid-secreting adrenal tumor in this species (16). However, reports of sex-hormone secreting adrenal tumors are increasing in frequency in recent years (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Most of studies describe hyperprogesteronism with secondary diabetes mellitus (17-25), with only seven cases of androgen-secreting adrenal tumors described (26)(27)(28)(29)(30).…”

“…However, reports of sex-hormone secreting adrenal tumors are increasing in frequency in recent years (17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Most of studies describe hyperprogesteronism with secondary diabetes mellitus (17-25), with only seven cases of androgen-secreting adrenal tumors described (26)(27)(28)(29)(30). The primary objectives of this study were to describe the clinicopathologic features and management of 8 cats with androgen-secreting adrenal tumors, all of which were initially evaluated for behavioral concerns.…”