Hyperadrenocorticism treated with metyrapone followed by bilateral adrenalectomy in a cat

A 6-year-old spayed female cat was evaluated for uncontrolled diabetes mell itus and poor hair coat. Clinicopathologic abnormalities included high seru m activity of liver enzymes, hyperglycemia, hypercholesterolemia, glucosuri a, and an exaggerated response to ACTH stimulation. Abdominal ultrasonograp hy revealed large adrenal glands. Hyperadrenocorticism was diagnosed. Treat ment for a facial abscess was instituted along with administration of metyr apone for hyperadrenocorticism. After stabilization, bilateral adrenalectom y was performed. The cat recovered without complications and has remained c linically normal for 5 months with treatment of desoxycorticosterone pivala te and prednisone. Treatment with metyrapone appeared to stabilize the cat metabolically and clinically prior to surgery.