Page 2769 - Cote clinical veterinary advisor dogs and cats 4th

1439.e4 Pheochromocytoma

Pheochromocytoma
VetBooks.ir

• Unexplained episodes of hypertension
• Unexplained end organ effects suggestive of hypertension
• Unexplained paroxysmal ventricular arrhythmia
• Unexplained loss of stamina

Abdominal ultrasound

Adrenal mass identified* Normal adrenal glands

Findings suggestive of HAC Nothing suggestive of HAC Consider other diagnosis
(e.g., PU/PD, potbelly, ALP ↑)

LDDS and/or ACTH Plasma or urine metanephrines
stimulation ± extended
hormone profile
No identifiable Referral to
metastasis (ideally veterinary surgical
based on CT, MRI,
(+) result; initiate (–) result (–) result; (+) result; start or PET/CT, likely specialist for
treatment consider other phenoxybenzamine available only consideration of
diagnosis (initial dose 0.25 at specialty center) adrenalectomy
mg/kg PO q 12h)

Apparent Continue
metastasis or phenoxybenzamine
owner constraints and supportive/
prohibit surgery palliative care

*Investigation may begin with incidentally discovered adrenal mass
PU/PD, Polyuria/polydipsia; HAC, hyperadrenocorticism; CT, computed tomography; MRI, magnetic resonance imaging; PET, positron
emission tomography.

www.ExpertConsult.com