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From the guidelines: Feline hyperaldosteronism

Vet holding cat.

Considered a rare disease, feline primary hyperaldosteronism (PHA) is most commonly caused by a unilateral adrenocortical adenoma, a benign tumor on one of the adrenal glands.

AAHA Staff

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Cats with PHA are typically middle-aged to older cats. Because the cats are considered mature to senior, owners often perceive clinical signs of PHA to be normal aging changes. These signs include reluctance to jump, abnormal gait (plantigrade stance), lethargy, or cervical ventroflexion (drooping neck).

PHA is one of the many diseases discussed in the 2023 AAHA Selected Endocrinopathies of Dogs and Cats Guidelines. The guidelines contain many resources, including tips and tables related to the diagnosis and treatment of various endocrinopathies such as PHA. The table below is one such resource, and outlines the presentation, therapeutic recommendations, diagnostic red flags, and take-home messages for practice team members.

2023 AAHA Selected Endocrinopathies of Dogs and Cats Guidelines

2023 AAHA Selected Endocrinopathies of Dogs and Cats Guidelines

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Key Factors in Managing Feline Primary Hyperaldosteronism

Presentation
  • Hypokalemia, frequently under 3 mEq/L, which may not respond well to supplementation.
  • Systemic hypertension that may be difficult to control.
  • Serum sodium concentrations are usually normal.
  • Plasma aldosterone levels are elevated.
  • Abdominal ultrasound or other imaging may show adrenal mass.
Therapeutic Recommendations
  • Control hypertension.
  • Supplement potassium.
  • Use aldosterone receptor blocker.
  • Consider surgical removal of the adrenal tumor.
Diagnostic Red Flags for Hyperaldosteronism
  • Hypokalemia with no obvious cause, which may not respond well to supplementation.
  • Hypophosphatemia +/- metabolic alkalosis despite azotemia.
  • Hypertension that is difficult to control with standard doses of medications.
  • Hypertension without concurrent cardiac or thyroid disease.
Take-Home Messages for Practice Team Members
  • Signs of PHA can be subtle in the early stages.
  • Blood pressure measurement should be a standard of care for adult cats at least annually, and any time a middle-age to older cat presents with nonspecific clinical signs.

PHA, primary hyperaldosteronism.

AAHA’s veterinary practice guidelines offer the latest clinical and nonclinical guidance on a wide range of topics. From the Guidelines presents bite-sized nuggets of wisdom from these guidelines for the practice team to consider.

 Photo credit: © Bill Oxford via E+/Getty Images Plus

Disclaimer: Trends content is meant to inform, educate, and inspire by providing an array of diverse viewpoints. Any content published should not be viewed as an official stance, position, or endorsement by the American Animal Hospital Association (AAHA) or its Board of Directors. 

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Official publication of The American Animal Hospital Association