Hypersomatotropism in 3 Cats without Concurrent Diabetes Mellitus

Fletcher, Jon M; Scudder, Christopher; Kiupel, Matti; Pipe-Martin, Hannah; Kenny, Patrick; Mantis, Panagiotis; Fenn, Joe; Smith, K C; Blair, Robert V; Granger, L. Abbigail; Niessen, Stijn

doi:10.1111/jvim.14360

Cited by 21 publications

(22 citation statements)

References 16 publications

(41 reference statements)

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“…A crucial difference between humans and cats with acromegalic cardiomyopathy is the proportion of individuals affected by DM. All cats with acromegaly in our study had DM, and only four cases of non-diabetic acromegalic cats have been reported in the literature thus far [ 32 – 33 ]. In contrast, DM is only reported in 15–35% of humans with HS [ 65 , 73 ].…”

Section: Discussionmentioning

confidence: 90%

“…Recent work indicates that 25–33% of diabetic cats have HS [ 26 , 27 ] which suggests that the disease is significantly more common in cats than in humans. Cats with HS most frequently present with signs consistent with of diabetes mellitus (DM) [ 26 – 31 ] although case reports of non-diabetic acromegalic cats also exist [ 32 , 33 ].…”

Section: Introductionmentioning

confidence: 99%

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Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

et al. 2018

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BackgroundIn humans, acromegaly due to a pituitary somatotrophic adenoma is a recognized cause of increased left ventricular (LV) mass. Acromegalic cardiomyopathy is incompletely understood, and represents a major cause of morbidity and mortality. We describe the clinical, echocardiographic and histopathologic features of naturally occurring feline acromegalic cardiomyopathy, an emerging disease among domestic cats.MethodsCats with confirmed hypersomatotropism (IGF-1>1000ng/ml and pituitary mass; n = 67) were prospectively recruited, as were two control groups: diabetics (IGF-1<800ng/ml; n = 24) and healthy cats without known endocrinopathy or cardiovascular disease (n = 16). Echocardiography was performed in all cases, including after hypersomatotropism treatment where applicable. Additionally, tissue samples from deceased cats with hypersomatotropism, hypertrophic cardiomyopathy and age-matched controls (n = 21 each) were collected and systematically histopathologically reviewed and compared.ResultsBy echocardiography, cats with hypersomatotropism had a greater maximum LV wall thickness (6.5mm, 4.1–10.1mm) than diabetic (5.9mm, 4.2–9.1mm; Mann Whitney, p<0.001) or control cats (5.2mm, 4.1–6.5mm; Mann Whitney, p<0.001). Left atrial diameter was also greater in cats with hypersomatotropism (16.6mm, 13.0–29.5mm) than in diabetic (15.4mm, 11.2–20.3mm; Mann Whitney, p<0.001) and control cats (14.0mm, 12.6–17.4mm; Mann Whitney, p<0.001). After hypophysectomy and normalization of IGF-1 concentration (n = 20), echocardiographic changes proved mostly reversible. As in humans, histopathology of the feline acromegalic heart was dominated by myocyte hypertrophy with interstitial fibrosis and minimal myofiber disarray.ConclusionsThese results demonstrate cats could be considered a naturally occurring model of acromegalic cardiomyopathy, and as such help elucidate mechanisms driving cardiovascular remodeling in this disease.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

et al. 2018

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“…Although we deemed it unlikely that the other 3 cats had acromegaly, it is theoretically possible. In a recent study, acromegaly was diagnosed in 3 cats without DM . Different IGF‐I immunoassays may not give the same concentration due to differences in type of calibration material, immunoreactivity, and extraction method for IGFBPs, which otherwise interfere in the assay .…”

Section: Discussionmentioning

confidence: 99%

Effect of insulin treatment on circulating insulin‐like growth factor I and IGF‐binding proteins in cats with diabetes mellitus

Strage

Sundberg

Holst

et al. 2018

Veterinary Internal Medicne

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BackgroundInsulin‐like growth factor‐I (IGF‐I) is used to screen for acromegaly in diabetic cats. In humans, most circulating IGF‐I forms ternary complexes (TC) with IGF‐binding protein (IGFBP‐3) and an acid‐labile subunit. Compared to humans, the amount of TC in cats is more variable. Insulin‐like growth factor‐I concentrations are reported to increase during insulin treatment, more rapidly in cats achieving remission.ObjectivesTo investigate (i) factors associated with circulating IGF‐I concentrations, including IGFBP‐profiles (ii) effect of insulin treatment on IGF‐I concentrations and (iii) IGF‐I as prognostic marker of diabetes mellitus remission.AnimalsThirty‐one privately owned diabetic cats of which 24 were followed 1 year, and 13 healthy cats.MethodsProspective study. Serum insulin, IGF‐I, glucose, and fructosamine concentrations were measured. IGF‐binding forms were determined by chromatography in 14 diabetic and 13 healthy cats; and IGF‐I, IGF‐II, IGFBP‐3, and IGFBP‐5 by mass spectrometry in 3 cats achieving remission.ResultsInsulin‐like growth factor‐I median (interquartile range) before start of insulin treatment was 300 (160‐556) ng/mL. Insulin‐like growth factor‐I was positively associated with TC (P < .0001) and endogenous insulin (P = .005) and negatively associated with fructosamine (P < .0001). Median IGF‐I was higher 2‐4 weeks after start of insulin treatment compared with baseline (300 versus 670 ng/mL, P = .0001) and predicted future remission (P = .046). In cats that went into remission, the amount of TC and IGFBP‐3 increased, suggesting increase in IGF‐I is dependent on TC formation.ConclusionsInsulin treatment should be accounted for when interpreting IGF‐I in diabetic cats. Insulin‐like growth factor‐I 2‐4 weeks after initiation of insulin treatment shows promise as prognostic marker for remission in diabetic cats.

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“…3 Only recently have cases of acromegalic cats without DM been described. 9,10 These findings highlight the importance of not overlooking acromegaly as a possible differential diagnosis in cats with compatible clinical signs, even in the absence of DM. Increased knowledge of clinical presentation in these cats could improve the diagnosis of acromegaly, thus increasing the number of acromegalic cats diagnosed before DM development.…”

Section: Introductionmentioning

confidence: 91%

Sciatic neuropathy in an acromegalic cat without concurrent diabetes mellitus

Corsini

Bianchi

Volta

et al. 2020

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 17-year-old neutered male European Shorthair cat was presented owing to an inability to jump and respiratory stridor. The owner did not report any other clinical signs. On physical examination, the main findings were plantigrade stance, broad facial features and inspiratory stridor. Neurological examination revealed posterior paraparesis, hypotonia and right hindlimb muscle atrophy. Laboratory findings were unremarkable and glycaemia was normal. Serum insulin-like growth factor 1 concentration was elevated (>1000 ng/ml). A total body CT scan showed an enlarged pituitary gland, thickening of the nasal turbinates and an L7–S1 right foraminal stenosis. Electrodiagnostic testing confirmed the presence of a neuropathy affecting both sciatic nerves. The cat was treated with gabapentin only and was still alive and euglycaemic 16 months after the diagnosis. Relevance and novel information This case describes for the first time sciatic neuropathy, an occasional complication of acromegaly in people, as a possible clinical presentation in acromegalic cats without concurrent diabetes mellitus.

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Hypersomatotropism in 3 Cats without Concurrent Diabetes Mellitus

Cited by 21 publications

References 16 publications

Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

Time spent with cats is never wasted: Lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease

Effect of insulin treatment on circulating insulin‐like growth factor I and IGF‐binding proteins in cats with diabetes mellitus

Sciatic neuropathy in an acromegalic cat without concurrent diabetes mellitus

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