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

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. © 2013 by the American College of Veterinary Internal Medicine.