Page 16 - Eclipse - Autumn/Winter 2022
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Ten years of hypophysectomy
he UK’s first successful feline The approach was pioneered at the RVC cats with acromegaly and diabetes
hypophysectomy surgery in 2012 by Neurology and Neurosurgery mellitus is typically cost prohibitive
was performed at the RVC 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 RVC, the maintain effectively. The RVC team
acromegaly and diabetes mellitus. team has developed a great deal of recently successfully performed
Since then, the RVC 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 RVC team have placed great emphasis typically recover very quickly post-
specialists has enabled RVC 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 RVC 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 RVC 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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