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Adrenal function in cats with cholestatic liver disease.

Faith I Buckley1, Orla Mahony1, Cynthia R L Webster1

  • 1Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, Grafton, MA.

Journal of Veterinary Diagnostic Investigation : Official Publication of the American Association of Veterinary Laboratory Diagnosticians, Inc
|November 18, 2016
PubMed
Summary

Cats with liver disease show high cortisol levels, but a low cortisol response to ACTH predicts poor survival. This finding is crucial for managing cholestatic cats undergoing procedures.

Keywords:
Adrenocorticotropic hormonebilecatscortisolhyperbilirubinemiajaundice

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Area of Science:

  • Veterinary Medicine
  • Endocrinology
  • Hepatology

Background:

  • Cholestatic liver disease in cats is linked to poor outcomes during anesthesia and invasive procedures.
  • Adrenal function in these cats is not well-documented, despite potential implications for surgical risk.
  • Understanding adrenal response is key to improving patient management and outcomes.

Purpose of the Study:

  • To characterize adrenal function in cats suffering from cholestatic liver disease.
  • To investigate the relationship between adrenal function, specifically cortisol levels, and survival rates in these cats.
  • To identify potential biomarkers for predicting outcomes in cholestatic feline patients.

Main Methods:

  • Twenty-seven cats with confirmed cholestatic liver disease underwent pre- and post-adrenocorticotropic hormone (ACTH) stimulation tests.
  • Serum cortisol levels were measured before and 60 minutes after intravenous cosyntropin administration.
  • Cortisol changes (delta cortisol) were calculated and compared to reference ranges and survival data.

Main Results:

  • Cats with cholestasis exhibited significantly higher basal and ACTH-stimulated cortisol levels compared to healthy controls.
  • No correlation was found between pre- or post-ACTH cortisol levels and survival.
  • A delta cortisol below 179 nmol/L (6.5 µg/dL) was significantly associated with decreased 30-day survival.

Conclusions:

  • Cats with cholestatic liver disease have elevated baseline and stimulated cortisol levels.
  • A diminished cortisol response to ACTH (delta cortisol <179 nmol/L) identifies cats at higher risk of mortality.
  • This study highlights the importance of assessing adrenal function in cholestatic cats for prognostic purposes.