Feline laparoscopic adrenalectomy

Laparoscopic adrenalectomy (LA) has been described now in several studies for management of canine adrenal neoplasia with generally good results and low conversion rates. In cats adrenalectomy is rarely required as adrenal neoplasia is a rare finding. Cats are principally affected by aldosterone-secreting adrenal tumors, a syndrome which is typically characterized by hyperaldosteronemia, hypokalemia, and hypertension. The clinical signs associated with the condition commonly include hypokalemic polymyopathy (cervical ventroflexion and weakness can be present) and systemic hypertension. Surgical resection of these tumors is the preferred treatment and the authors group published details of the first cat treated by LA in 2012. While most feline adrenal neoplasms are aldosterone secreting some can have either cortisol or progesterone-secreting masses, which can cause extreme body wall fragility. Since we published the initial report the authors group have treated a further 8 cats with adrenal masses and from this small cohort we have found that in some cases that feline LA has some important differences from its canine counterpart, making the procedure potentially more challenging in cats than in dogs.

Whenever feline adrenalectomy is considered, be it by an open or laparoscopic approach, appropriate case work-up and endocrinological assessment is vital to success. Advanced imaging is strongly encouraged in cats to assess the location and margins of the tumor and to aid the surgeon in deciding whether a laparoscopic approach is appropriate. Thankfully most cats have non-invasive masses that are relatively small although tumor invasion into the vasculature has been described and in these cases open adrenalectomy is the preferred technique.  [...]