Pituitary Apoplexy in a Cat With Presumed Acute Diabetes Insipidus

To describe and discuss the unusual clinical presentation, novel imaging findings, and management of a cat with pituitary apoplexy and associated intraventricular hemorrhage.

A 13-year-old neutered male domestic shorthair cat presented with semi-comatose mentation and marked polyuria. The menace response and pupillary light and vestibuloocular reflexes were absent, while the corneal reflex was maintained. The cat also had sinus bradycardia, hypoventilation, and hypothermia, indicating a multifocal brain lesion. The urine was hyposthenuric (urine specific gravity 1.003), and with increasing hypernatremia, central diabetes insipidus was suspected. After approximately 2 h in the hospital, there was mild improvement in neurological deficits and vital parameters. Computed tomography revealed a pituitary tumor with intralesional and extensive extralesional parenchymal and intraventricular hemorrhage. The cat was euthanized at the owner's request due to the uncertainty of treatment duration and outcome.

This is the first reported case of suspected central diabetes insipidus in a dog or cat with PA and intraventricular hemorrhage; novel clinical and imaging findings are presented.