Clinicians at the Queen Mother Hospital for Animals at the Royal Veterinary College have become the first team in the UK to successfully treat acromegaly in a cat with hypophysectomy surgery.
According to the RVC, this make it the first centre in the UK, and only the fourth in the world, to offer this procedure. The patient groups that might benefit from this RVC-exclusive procedure include cats and dogs with non-functional pituitary tumors, cats and dogs with hyperadrenocorticism (Cushing's disease) and cats with acromegaly or hypersomatotropism.
The RVC says removing the pituitary gland and the associated tumour which causes acromegaly or hyperadrenocorticism is the gold standard treatment in humans suffering from these diseases since it offers the greatest chance of a complete cure for the disease.
Prior to the RVC offering surgical treatment, the only treatment options available for acromegalic cats in the UK were radiation therapy or simply treatment of the resulting diabetes mellitus. The latter can prove extremely difficult and frustrating and the former unpredictable, unreliable and/or ineffective. Even when a complete response to the radiation therapy eventually occurs, hormonal abnormalities usually persist.
Dr Stijn Niessen, leading the hypophysectomy team at the Royal Veterinary College, said: "I'm extremely proud to be able to offer this unique surgery for the first time in the UK at the RVC. As a relatively new and innovative procedure in veterinary medicine there are risks involved, as is recognised with every form of neurosurgery of this level. However, despite these risks, this surgery does offer owners a chance for the best possible result for their pet using a single procedure. Hypophysectomy therefore represents the most elegant treatment method currently available enabling complete removal of the brain tumor and normalisation of damaging excessive hormone levels that are causing hormonal diseases like acromegaly and hyperadrenocorticism.
"Especially when a pituitary tumor is diagnosed late, the alternative treatment method of radiation therapy might well take too long to take effect and devastating neurological signs might occur due to the pressure of the pituitary tumor on the surrounding brain. In such cases, hypophysectomy can make an instant difference in relieving that pressure. However, in general, we would advocate the procedure to be considered as soon as possible following diagnosis, thereby preventing the animal's body from becoming more and more negatively affected by the excessive hormone levels associated with pituitary diseases like acromegaly and hyperadrenocorticism."
Dr. Niessen, a European Veterinary Specialist in Internal Medicine with research interests in diabetes and endocrinology and world-expert in acromegaly, will be selecting the patients suitable for the new treatment, preparing them for surgery and managing the aftercare programme. The longer-term aftercare programme will include hormone replacement treatment administered through eye-drops (usually temporarily) and tablets (permanent) to manage the hormone production lost through removal of the pituitary gland.
The surgery itself will be performed by Patrick Kenny, a European and American Specialist in Veterinary Neurology and Neurosurgery.
The RVC says the surgery would not be possible without the multidisciplinary approach at the Queen Mother Hospital for Animals, which includes the Internal Medicine, Neurology and Neurosurgery, Diagnostic Imaging, Anaesthesia and Emergency and Critical Care teams as well as a team of highly qualified nurses.
To support ongoing research in this field, the Royal Veterinary College is offering free blood tests for all diabetic dogs and cats which include fructosamine evaluation and screening tests for the presence of acromegaly in cats. Cats that record high hormone levels indicative of acromegaly will qualify to undergo a free CT scan for confirmation. If acromegaly is confirmed, all possible treatment options will be discussed with the client, including the hypophysectomy procedure. To request a free blood test for a patient please visit: www.rvc.ac.uk/cic
Veterinary surgeons currently managing a cat or dog with a pituitary tumor who are considering referral of this case can also contact Dr Stijn Niessen for further information at the QMHA on 01707 666365 or at qmhreception@rvc.ac.uk
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