Hyperadrenocorticism in Cats: Welfare Management

Feline hyperadrenocorticism is rare but serious, causing welfare impacts similar to but distinct from the canine condition.

Key Facts

Hyperadrenocorticism in cats is rare — estimated at approximately 300 cases annually in the US
Unlike dogs, cats with hyperadrenocorticism often develop concurrent diabetes mellitus
Skin fragility syndrome — extremely thin, tear-prone skin — is a distinctive and painful feature of feline hyperadrenocorticism
Diagnosis requires ACTH stimulation testing or low-dose dexamethasone suppression testing with feline-specific interpretation
Trilostane treatment for cats requires careful dose adjustment — cats are more sensitive than dogs
Surgical adrenalectomy provides cure for adrenal-dependent disease but carries significant perioperative risk
Early diagnosis before skin fragility develops significantly improves welfare outcomes

Welfare Considerations

Feline hyperadrenocorticism welfare management requires recognizing the distinctive features that distinguish it from canine Cushing's. Skin fragility is the most welfare-significant manifestation — the skin tears with minimal trauma, creating painful wounds that heal slowly and become infected. Cats with skin fragility require extremely gentle handling and protective care to prevent further injury during diagnosis and treatment. The concurrent diabetes that commonly accompanies feline hyperadrenocorticism requires coordinated management. Treatment that controls cortisol excess allows skin integrity to restore and diabetes to potentially resolve, but the window between diagnosis and skin fragility development significantly affects welfare prognosis.

What You Can Do

Seek specialist referral for any cat showing skin fragility, concurrent diabetes, and appropriate signalment
Use the gentlest possible handling for cats with suspected hyperadrenocorticism to prevent skin tears
Discuss trilostane treatment with a veterinary internal medicine specialist for optimal dosing
Monitor response to treatment through clinical improvement and follow-up adrenal function testing
Provide wound care and infection prevention for existing skin tears during treatment initiation