Conn's syndrome / Hyperaldosteronism Diagnosis

missko

TCS Member
Thread starter
Young Cat
Joined
Jul 19, 2015
Messages
28
Purraise
22
Location
New York, NY
Hello friends, 2021 has not been a good year for our pet cats. On 9/17/2021, Samantha underwent a colon biopsy that resulted in a resection that is still healing and an FGESF diagnosis. On 10/20/2021, her fur brother, Watson, was diagnosed with Conn's Syndrome / hyperaldosteronism. Antonio65 Antonio65 , thank you for sharing so much information about your cat Lola's experience with this disease. What are the odds that both of my precious cats have such rare disorders? Perhaps its time to buy a lottery ticket given my knack with these long odds. But I digress...

Watson is a 13 year old, neutered DSH. The big man upstairs really broke the mold when He made Watson - Watson is truly a dog trapped in a cat's body. I've never met a cat who is so friendly, gentle and playful. He's been in the family since he was a kitten and had been fine until 2-3 years ago when his creatinine started creeping up. He's been on Hill's canned K/D kidney diet since then. His potassium levels were low, and we have been supplementing with potassium powder. We took him to an internal medicine vet at Gulf Coast Specialty Veterinary in Houston, TX. The vet offered to run and ultrasound for completeness to rule out urinary tract issues (Watson has been peeing outside the box).

the ultrasound revealed an adrenal mass on one side. It is growing against the vena cava. The vet ran an X-ray to check to spreading, thankfully it has not. The exam also revealed Watson has high blood pressure. The vet recommends surgery to remove the mass once the blood pressure is stable. He is now on spirolacatone and amlodipine.

the IM vets says adrenalectomy has a 20-40pct complication rate. I’ve read scary things about cats dying within the first 2 weeks of surgery.

Watson is a robust guy on the outside - no weakness, bright and alert. Inside he is showing his age: stage 2 ckd, high blood pressure, low potassium. I asked the vet if he is a good candidate for surgery. He didn’t answer my question directly. He recommends surgery because the gland will keep growing even with drugs to manage potassium and etc. the growing gland could rupture the vena cava and kill him. He didn’t handicap Watson’s likelihood of complication within the 20-40pct range.

after our experience with Samantha’s surgery, I’m more cautious and don’t want to rush into anything. what hospitals have deep experience with adrenal gland removal or vascular surgery? At gulf coast veterinary, the surgeon would be a soft tissue surgeon.

Thanks!
 

mrsgreenjeens

Every Life Should Have Nine Cats
Staff Member
Advisor
Joined
Aug 13, 2009
Messages
16,391
Purraise
7,130
Location
Arizona
I'm so sorry your cats are having such health issues.

As to the best place to go for the surgery, I would think your Vet would be the best resource to ask. They should be able to refer you to a surgeon who might be familiar with this, or who can at least do the surgery if they can't.
 

Antonio65

TCS Member
Top Cat
Joined
Feb 27, 2017
Messages
6,054
Purraise
9,677
Location
Orbassano - Italy
Hi missko missko , I'm so sorry to read about your Watson and his adrenal gland issues.
It seems you have read much about my Lola's history and adventure with the same disease.

Yes, the mass will keep growing up and will do damages if not removed. When my Lola was operated, the risk was that the vena cava could be damaged by the scalpel by mistake. That's why the vets told me that the chances of a positive outcome during the surgery was around 50%, that means that Lola had one chance out of two to die during the surgery.
The other option I had was to say no to the surgery and let Lola die anyway, for sure, so I took my chances, and things went fine during the surgery, but we had a terrible scare two days later when she went into a coma and she was going to die, but she woke up when I talked to her. The miracle I still treasure...

The weeks post surgery were fine, I only had to monitor her constantly every single day till the follow up visit a month later.

It is true, the Potassium will be low even with the supplement and spirolactone, and it will affect his life negatively. And it is highly possible that his high BP is linked to this issue. Lola had BP spikes as well, and she turned blind overnight, two months before the diagnosis of hyperaldosteronism.

I decided to put Lola under that surgery because she would have had a little chance to survive, versus no chances at all had I done nothing.

I couldn't help you on what clinic you can go to, let your vet guide you.
When my Lola had to be operated, we were referred to the, probably, best clinic in the country, where there were the best IM doctors and surgeons. The surgeon who operated my Lola came from another city, on purpose for this surgery, and he told me he had never done such a surgery before because it is a rare disease.
In order to perform the surgery, your Watson must be stable both with his BP and with his potassium. My Lola was deemed not a good candidate at the first attempt because her potassium wouldn't go over 3 even with a week of IV supplement, and she was sent back home (to die, according to the vets), where I supplemented her orally to the point she improved so much that she was in list for the surgery a few weeks later.

As for the odds to experience so many weird and rare disorders in our cats, well, I know how stressful it is. My two previous cats had so many weird and rare issues in their lives that my vets said I should have written a book.
Lola had CKD since she was 6 yo, but that CKD never got worse for the rest of her life. She had a nose carcinoma, one of the rarest forms of cancer in a cat, it's lethal and untreatable, but she was treated with the radiotherapy and survived (they told me it had never happened before!), she had this hyperaldosteronism (one of the rarest diseases in a cat), she got blind from a retina detachment, but she recovered her sight.
The other cat, Pallina, had HT, but in the not usual form of apathetic HT.

My current cats, one has Type B blood and has clotting issues. The other had neurological issues when she was a kitten, and no vet was able to understand what it was. Now she's fine... maybe...

It seems that strange cats come all to my address.

Best of luck to your Watson.
 

fionasmom

Moderator
Staff Member
Moderator
Joined
Jun 21, 2014
Messages
13,125
Purraise
17,368
Location
Los Angeles
I can really only offer moral support for you and Watson. I have had two dogs with Cushing's Disease, one still living six years into his treatment. In dog, most of the tumors are on the pituitary; less appear on the adrenal glands. Watson, despite being a dog in a cat's body, does not specifically have this; however, what he has is related to the endocrine system. There are overlapping diagnostics, like the ACTH stim test.

This doctor is a specialist in endocrinology. I am not sure where he is now, but he was at a specialty referral hospital in Los Angeles at one time.

Dr. Dave Bruyette – Endocrinology – VetVacation CE

This is an interview with him where he talks about treatment in cats.

The feline facets of Cushing's disease
Feline hyperaldosteronism: Recognition and diagnosis
 
Top