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Browsing by Author "Berthier, Marion"

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  • Management of Resistant Cases of Feline Diabetes Mellitus Associated with Hyperadrenocorticism or Hypersomatotropism: Focus on Transsphenoidal Hypophysectomy as a Therapeutic Option
    Publication . Berthier, Marion; Bento, Maria Carolina Rocha de Medeiros
    This systematic review focuses on the management of resistant cases of feline diabetes mellitus (DM) associated with hyperadrenocorticism (HAC) or hypersomatotropism (HS), highlighting transsphenoidal hypophysectomy (TSH) as a therapeutic option. While insulin therapy and dietary adjustments are effective for most diabetic cats, HAC and HS can induce insulin resistance. HAC, though rare, increases cortisol production, impairing insulin sensitivity, while HS, more common, results in excessive growth hormone (GH) and insulin-like growth factor 1 (IGF-1), also contributing to insulin resistance. Transsphenoidal hypophysectomy directly targets the pituitary gland, addressing the root cause in both HS and pituitary dependent HAC. The TSH procedure requires preoperative imaging, careful planning, and postoperative hormone replacement and glucose monitoring. Despite its complexity and risks, TSH is an effective approach for achieving endocrine remission in both HAC and HS, often leading to a reduction or even cessation of insulin requirements and improved quality of life. In cats with HS treated with TSH, a high percentage can achieve diabetic remission and normalization of IGF-1 levels, with good long-term prognosis. For cats with HAC, TSH presents a targeted alternative to bilateral adrenalectomy with potentially fewer long-term complications.
    2025-06-30Master thesis Restricted access Show more