Feline acromegaly: The keys to diagnosis
Growth hormone stimulates the production of insulin-like growth factors in several tissues throughout the body. Insulin-like growth factor-1 (IGF-1), which is produced in the liver, is thought to be the key factor that facilitates the anabolic effects of growth hormone that are responsible for the characteristic appearance of people, dogs, and cats with acromegaly.
Similar to its etiology in people, acromegaly in cats is the result of a functional adenoma of the pituitary gland that releases excessive growth hormone despite negative feedback.1ANATOMY AND PHYSIOLOGY
Growth hormone is produced in an anterior lobe of the pituitary gland, specifically by cells called somatotrophs. The regulation of growth hormone is complex, and many factors—both environmental and endogenous—are responsible for its control. The two most important regulators of growth hormone production and release are growth hormone-releasing hormone (GHRH) and somatostatin, which are produced in the hypothalamus. While growth hormone release is stimulated by GHRH, it is inhibited by somatostatin as well as by negative feedback from itself and IGF-1.1
Feline acromegaly is an uncommon disease, although it is thought to be underdiagnosed. It most commonly affects middle-aged and older, male castrated cats. In one study, 13 of 14 cats with acromegaly were males, with an average age of 10.2 years.2 This association may be biased, however, as most cats in which acromegaly is diagnosed are presented for complications associated with diabetes mellitus, which is also common in older, male castrated cats. Based on available data, no known breed association for feline acromegaly exists.
Physical changes associated with feline acromegaly include increased body weight, a broadened face, enlarged feet, protrusion of the mandible (prognathia inferior), increased interdental spacing, organomegaly, and a poor coat (Figures 1-3).
Neurologic disease associated with feline acromegaly is uncommon but can occur with large pituitary adenomas. Neurologic signs that have been observed with acromegaly include dullness, lethargy, abnormal behavior, circling, and blindness.
Because of an associated degenerative arthropathy and peripheral (diabetic) neuropathy, lameness has also been noted in cats with acromegaly.