Replying to Natalie Niven 09/09/2024 - 22:52
Hi Natalie,
Yes, hypophysectomy is the surgical removal of the pituitary gland. It’s a less common treatment option but can be considered in cases of pituitary-dependent hyperadrenocorticism, especially if the owner is looking for a more definitive treatment compared to long-term medical management. By removing the source of excess ACTH production, it eliminates the need for lifelong medication like trilostane.
You’re right, though—there are significant considerations with this surgery. Removing the pituitary gland can lead to deficiencies in other hormones, particularly those regulated by the anterior pituitary, such as thyroid-stimulating hormone (TSH) and growth hormone. Patients would often require lifelong hormone replacement therapy, like levothyroxine and desmopressin, for these other deficiencies. That’s definitely a big downside compared to the relatively simpler trilostane treatment we use in dogs.
The main advantage over trilostane is that surgery offers the possibility of a “cure” for hyperadrenocorticism, which can be appealing in cases where the cat has concurrent issues, like Norman’s diabetes. Stabilizing the Cushing’s syndrome could improve his insulin sensitivity and overall diabetic control, possibly reducing the need for complex insulin management.
Of course, it’s a highly specialized surgery with significant risks and is usually only performed in certain centers with the expertise, which is why it’s less common. But for the right case, it can be a good option to consider. I think the RVC are the only ones doing it in the UK currently… but I might be wrong on that!
Scott 🙂
