Page 16 - Eclipse - Autumn/Winter 2022

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Page 16 - Eclipse - Autumn/Winter 2022
P. 16

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        Ten years of hypophysectomy




              he UK’s first successful feline   The approach was pioneered at the ºÚÁÏÉç   cats with acromegaly and diabetes
              hypophysectomy surgery        in 2012 by Neurology and Neurosurgery   mellitus is typically cost prohibitive
              was performed at the ºÚÁÏÉç in   specialist, Patrick Kenny. Over the six   and can be challenging for owners to
        TApril 2012, to treat a cat with    years since Patrick left the ºÚÁÏÉç, the   maintain effectively. The ºÚÁÏÉç team
        acromegaly and diabetes mellitus.   team has developed a great deal of   recently successfully performed
        Since then, the ºÚÁÏÉç team has treated   experience with the technique and have   hypophysectomy for the first time
        120 cats and 25 dogs with pituitary   seen a range of challenging cases.   to treat a rare case of a dog with
        tumours, providing treatment for pets                                  acromegaly, marking another landmark.
        and owners for which there have     Although it is technically challenging,
        traditionally been limited options.  surgical hypophysectomy is now    Hypophysectomy is also an excellent
                                            considered the optimal treatment option   treatment option for pituitary-dependent
        Over the past decade, collaboration   for feline acromegaly. Over the past 10   Cushing’s syndrome, most often seen
        between neurosurgeons, critical care,   years of performing the procedure, the   in dogs with pituitary tumours. Dogs
        internal medicine and anaesthesia   ºÚÁÏÉç team have placed great emphasis   typically recover very quickly post-
        specialists has enabled ºÚÁÏÉç         on using their experience to maximise   operatively and are often discharged
        Small Animal Referrals to deliver   patient safety and outcome, with the   within five days. Resolution of the clinical
        hypophysectomy treatment regularly and   mortality rate falling from around 15%   signs of Cushing’s is typically dramatic
        remain a global leader in this area.   initially to 6% for the last 50 cats treated.   and dogs demonstrate an excellent
                                                                               quality of life post-operatively. The team
        Hypophysectomy is most frequently   In cats with acromegaly and diabetes
        performed at the ºÚÁÏÉç in patients    mellitus, hypophysectomy is associated   has also treated a handful of cats with
        suffering from acromegaly and pituitary-  with a 70% rate of surviving cats   pituitary-dependent Cushing’s syndrome.
        dependent Cushing’s syndrome, caused   achieving complete diabetic remission   Although other options are available
        by hormone-producing pituitary tumours.   post-operatively, with significant   for treatment of pituitary dependent
                                            improvements in insulin responsiveness   Cushing’s syndrome, including life-long
        Transsphenoidal hypophysectomy      seen in the vast majority of the other   trilostane therapy and radiotherapy,
        involves the removal of a tumour    30% of patients. Cats typically stay at   hypophysectomy confers advantages
        affecting the pituitary gland from the   the Queen Mother Hospital for Animals   over these options, including the
        base of the brain through the soft palate   for a week to 10 days post-operatively   removal of the growing tumour and
        in the mouth. Access to this area of   while the team stabilises their diabetes.  potential for complete cessation of
        the brain is technically difficult and the                             hormone production.
        team at the ºÚÁÏÉç is helped by cutting-  Hypophysectomy only involves one
        edge diagnostic imaging and surgical   general anaesthetic procedure,
        equipment, such as the Brainsight   providing an advantage over radiation
        neuro-navigation system head frame.   therapy. Medical management of













         Bramble pre-operative               Bramble six months post operative

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