Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes
Abstract Background Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs. Objectives To document presenting complaints, examination findings, endocrinopathies, magnetic resonance ima...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-05-01
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| Series: | Journal of Veterinary Internal Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/jvim.16703 |
| _version_ | 1797816180515274752 |
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| author | Christian W. Woelfel Christopher L. Mariani Michael W. Nolan Erin K. Keenihan Sophia P. Topulos Peter J. Early Karen R. Muñana Sarah E. Musulin Natasha J. Olby |
| author_facet | Christian W. Woelfel Christopher L. Mariani Michael W. Nolan Erin K. Keenihan Sophia P. Topulos Peter J. Early Karen R. Muñana Sarah E. Musulin Natasha J. Olby |
| author_sort | Christian W. Woelfel |
| collection | DOAJ |
| description | Abstract Background Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs. Objectives To document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitary apoplexy. Animals Twenty‐six client‐owned dogs with acute onset of neurological dysfunction. Methods Retrospective case series. Dogs were diagnosed with pituitary apoplexy if MRI or histopathology documented an intrasellar or suprasellar mass with evidence of hemorrhage or infarction in conjunction with acute neurological dysfunction. Clinical information was obtained from medical records and imaging reports. Results Common presenting complaints included altered mentation (16/26, 62%) and gastrointestinal dysfunction (14/26, 54%). Gait or posture changes (22/26, 85%), mentation changes (18/26, 69%), cranial neuropathies (17/26, 65%), cervical or head hyperpathia (12/26, 46%), and hyperthermia (8/26, 31%) were the most frequent exam findings. Ten dogs (38%) lacked evidence of an endocrinopathy before presentation. Common MRI findings included T1‐weighted hypo‐ to isointensity of the hemorrhagic lesion (21/25, 84%), peripheral enhancement of the pituitary mass lesion (15/25, 60%), brain herniation (14/25, 56%), and obstructive hydrocephalus (13/25, 52%). Fifteen dogs (58%) survived to hospital discharge. Seven of these dogs received medical management alone (median survival 143 days; range, 7‐641 days) and 8 received medications and radiation therapy (median survival 973 days; range, 41‐1719 days). Conclusions and Clinical Importance Dogs with pituitary apoplexy present with a variety of acute signs of neurological disease and inconsistent endocrine dysfunction. Dogs that survive to discharge can have a favorable outcome. |
| first_indexed | 2024-03-13T08:33:56Z |
| format | Article |
| id | doaj.art-63e4e9eb3e75416698d939b4a6092b0a |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-03-13T08:33:56Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-63e4e9eb3e75416698d939b4a6092b0a2023-05-31T01:33:58ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762023-05-013731119112810.1111/jvim.16703Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomesChristian W. Woelfel0Christopher L. Mariani1Michael W. Nolan2Erin K. Keenihan3Sophia P. Topulos4Peter J. Early5Karen R. Muñana6Sarah E. Musulin7Natasha J. Olby8Veterinary Hospital, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USAVeterinary Hospital, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USAVeterinary Hospital, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USADepartment of Clinical Sciences, College of Veterinary Medicine North Carolina State University Raleigh North Carolina USAAbstract Background Pituitary apoplexy refers to hemorrhage or infarction within the pituitary gland resulting in acute neurological abnormalities. This condition is poorly described in dogs. Objectives To document presenting complaints, examination findings, endocrinopathies, magnetic resonance imaging (MRI), treatments, and outcomes of dogs with pituitary apoplexy. Animals Twenty‐six client‐owned dogs with acute onset of neurological dysfunction. Methods Retrospective case series. Dogs were diagnosed with pituitary apoplexy if MRI or histopathology documented an intrasellar or suprasellar mass with evidence of hemorrhage or infarction in conjunction with acute neurological dysfunction. Clinical information was obtained from medical records and imaging reports. Results Common presenting complaints included altered mentation (16/26, 62%) and gastrointestinal dysfunction (14/26, 54%). Gait or posture changes (22/26, 85%), mentation changes (18/26, 69%), cranial neuropathies (17/26, 65%), cervical or head hyperpathia (12/26, 46%), and hyperthermia (8/26, 31%) were the most frequent exam findings. Ten dogs (38%) lacked evidence of an endocrinopathy before presentation. Common MRI findings included T1‐weighted hypo‐ to isointensity of the hemorrhagic lesion (21/25, 84%), peripheral enhancement of the pituitary mass lesion (15/25, 60%), brain herniation (14/25, 56%), and obstructive hydrocephalus (13/25, 52%). Fifteen dogs (58%) survived to hospital discharge. Seven of these dogs received medical management alone (median survival 143 days; range, 7‐641 days) and 8 received medications and radiation therapy (median survival 973 days; range, 41‐1719 days). Conclusions and Clinical Importance Dogs with pituitary apoplexy present with a variety of acute signs of neurological disease and inconsistent endocrine dysfunction. Dogs that survive to discharge can have a favorable outcome.https://doi.org/10.1111/jvim.16703adenomacarcinomaendocrionopathyhemorrhagemagnetic resonance imagingsuprasellar |
| spellingShingle | Christian W. Woelfel Christopher L. Mariani Michael W. Nolan Erin K. Keenihan Sophia P. Topulos Peter J. Early Karen R. Muñana Sarah E. Musulin Natasha J. Olby Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes Journal of Veterinary Internal Medicine adenoma carcinoma endocrionopathy hemorrhage magnetic resonance imaging suprasellar |
| title | Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes |
| title_full | Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes |
| title_fullStr | Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes |
| title_full_unstemmed | Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes |
| title_short | Presumed pituitary apoplexy in 26 dogs: Clinical findings, treatments, and outcomes |
| title_sort | presumed pituitary apoplexy in 26 dogs clinical findings treatments and outcomes |
| topic | adenoma carcinoma endocrionopathy hemorrhage magnetic resonance imaging suprasellar |
| url | https://doi.org/10.1111/jvim.16703 |
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