{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T18:21:05Z","timestamp":1781288465347,"version":"3.54.1"},"reference-count":108,"publisher":"American Animal Hospital Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Medical management is currently the most common treatment for pituitary-dependent hyperadrenocorticism and hypersomatotropism\/acromegaly in veterinary medicine. Medical management does not provide a cure for either disease process, and rarely is pituitary imaging a part of initial diagnostics. Early pituitary imaging in animals with clinically functional pituitary tumors provides a baseline assessment, allows monitoring of tumor changes, and permits radiation and surgical planning. Surgery is the only treatment for pituitary tumors that has curative intent and allows for a definitive diagnosis. Surgical removal of pituitary tumors via transsphenoidal hypophysectomy is an effective treatment for clinical pituitary tumors in patients exhibiting endocrine abnormalities associated with pituitary-dependent hyperadrenocorticism and hypersomatotropism. Surgery, however, is rarely pursued until patients have failed medical management, and often not until they are showing neurologic signs, making surgical success challenging. It is well documented that dogs surgically treated when the pituitary mass is small have a lower mortality, a lower recurrence rate, and a longer survival than those with larger pituitary masses. Providing owners with the option of early pituitary imaging in addition to medical, surgical, and radiation treatment options should be the standard of care for animals diagnosed with pituitary-dependent hyperadrenocorticism or hypersomatotropism.<\/jats:p>","DOI":"10.5326\/jaaha-ms-7009","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T14:10:02Z","timestamp":1610719802000},"page":"73-80","source":"Crossref","is-referenced-by-count":5,"title":["Pituitary Surgery: Changing the Paradigm in Veterinary Medicine in the United States"],"prefix":"10.5326","volume":"57","author":[{"given":"Rachel","family":"Rivenburg","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina Jo","family":"Owen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda G.","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie V.","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3280","reference":[{"key":"i1547-3317-57-2-73-b1","series-title":"Canine and feline endocrinology","first-page":"377","article-title":"Canine hyperadernocorticism","year":"2015","unstructured":"Behrend\n              EN.\n            \n          \n          Canine hyperadernocorticism.\n\t\t\t\t\tIn:FeldmanEC,NelsonRW,ReuschCE,,\n\t\t\t\t\teds.Canine and feline endocrinology.\n\t\t\t\t\t4th ed.\n\t\t\t\t\tSt. Louis:\n\t\t\t\t\tElsevier Saunders;\n\t\t\t\t\t2015:\n\t\t\t\t\t377\u2013\n\t\t\t\t\t451."},{"key":"i1547-3317-57-2-73-b2","series-title":"Textbook of veterinary internal medicine","first-page":"1840","article-title":"Hypercortisolism in cats (feline Cushing\u2019s syndrome)","year":"2010","unstructured":"Graves\n              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Assoc1996;\n\t\t\t\t\t208:\n\t\t\t\t\t1268\u2013\n\t\t\t\t\t73."},{"key":"i1547-3317-57-2-73-b41","series-title":"Domest Anim Endocrinol","first-page":"32","article-title":"Trilostane-induced inhibition of cortisol secretion results in reduced negative feedback at the hypothalamic-pituitary axis","volume":"36","year":"2009","unstructured":"Teshima\n              T,\n            \n            \n              Hara\n              Y,\n            \n            \n              Takekoshi\n              S,\n            \n          \n          .\n\t\t\t\t\tTrilostane-induced inhibition of cortisol secretion results in reduced negative feedback at the hypothalamic-pituitary axis.\n\t\t\t\t\tDomest Anim Endocrinol2009;\n\t\t\t\t\t36:\n\t\t\t\t\t32\u2013\n\t\t\t\t\t44."},{"key":"i1547-3317-57-2-73-b42","series-title":"Mol Cell Endocrinol","first-page":"81","article-title":"Imaging of the pituitary gland in dogs with pituitary-dependent 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         Nelson\n              RW.\n            \n          \n          Acromegaly and hyperadrenocorticism in cats: a clinical perspective.\n\t\t\t\t\tJ Feline Med Surg2000;\n\t\t\t\t\t2:\n\t\t\t\t\t153\u2013\n\t\t\t\t\t8."},{"key":"i1547-3317-57-2-73-b46","series-title":"J Vet Intern Med","first-page":"355","article-title":"Pasireotide long-acting release treatment for diabetic cats with underlying hypersomatotropism","volume":"31","year":"2017","unstructured":"Gostelow\n              R,\n            \n            \n              Scudder\n              C,\n            \n            \n              Keyte\n              S,\n            \n          \n          .\n\t\t\t\t\tPasireotide long-acting release treatment for diabetic cats with underlying hypersomatotropism.\n\t\t\t\t\tJ Vet Intern Med2017;\n\t\t\t\t\t31:\n\t\t\t\t\t355\u2013\n\t\t\t\t\t64."},{"key":"i1547-3317-57-2-73-b47","series-title":"Can Vet J","first-page":"316","article-title":"Radiation therapy for pituitary tumors in the dog and cat","volume":"48","year":"2007","unstructured":"Mayer\n              MN\n            \n            \n              Treuil\n              PL.\n            \n          \n          Radiation therapy for pituitary tumors in the dog and cat.\n\t\t\t\t\tCan Vet J2007;\n\t\t\t\t\t48:\n\t\t\t\t\t316\u2013\n\t\t\t\t\t8."},{"key":"i1547-3317-57-2-73-b48","series-title":"J Endocrinol","first-page":"387","article-title":"Correlation between impairment of glucocorticoid feedback and the size of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism","volume":"152","year":"1997","unstructured":"Kooistra\n              HS,\n            \n            \n              Voorhout\n              G,\n            \n            \n              Mol\n              JA,\n            \n          \n          .\n\t\t\t\t\tCorrelation between impairment of glucocorticoid feedback and the size of the pituitary gland in dogs with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tJ Endocrinol1997;\n\t\t\t\t\t152:\n\t\t\t\t\t387\u2013\n\t\t\t\t\t94."},{"key":"i1547-3317-57-2-73-b49","series-title":"J Small Anim Pract","first-page":"240","article-title":"A magnetic resonance imaging-based classification system for indication of trans-sphenoidal hypophysectomy in canine pituitary-dependent hypercortisolism","volume":"57","year":"2016","unstructured":"Sato\n              A,\n            \n            \n              Teshima\n              T,\n            \n            \n              Ishino\n              H,\n            \n          \n          .\n\t\t\t\t\tA magnetic resonance imaging-based classification system for indication of trans-sphenoidal hypophysectomy in canine pituitary-dependent hypercortisolism.\n\t\t\t\t\tJ Small Anim Pract2016;\n\t\t\t\t\t57:\n\t\t\t\t\t240\u2013\n\t\t\t\t\t6."},{"key":"i1547-3317-57-2-73-b50","series-title":"PLoS One","first-page":"e0194342","article-title":"Time spent with cats is never wasted: lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease","volume":"13","year":"2018","unstructured":"Borgeat\n              K,\n            \n            \n              Niessen\n              SJM,\n            \n            \n              Wilkie\n              L,\n            \n          \n          .\n\t\t\t\t\tTime spent with cats is never wasted: lessons learned from feline acromegalic cardiomyopathy, a naturally occurring animal model of the human disease.\n\t\t\t\t\tPLoS One2018;\n\t\t\t\t\t13:\n\t\t\t\t\te0194342."},{"key":"i1547-3317-57-2-73-b51","series-title":"Vet Pathol","first-page":"889","article-title":"Immunohistochemical evaluation of canine pituitary adenomas obtained by transsphenoidal hypophysectomy","volume":"55","year":"2018","unstructured":"Miller\n              MA,\n            \n            \n              Owen\n              TJ,\n            \n            \n              Bruyette\n              DS,\n            \n          \n        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One","first-page":"e0127794","article-title":"Studying cat (Felis catus) diabetes: beware of the acromegalic imposter","volume":"10","year":"2015","unstructured":"Niessen\n              SJ,\n            \n            \n              Forcada\n              Y,\n            \n            \n              Mantis\n              P,\n            \n          \n          .\n\t\t\t\t\tStudying cat (Felis catus) diabetes: beware of the acromegalic imposter.\n\t\t\t\t\tPLoS One2015;\n\t\t\t\t\t10:\n\t\t\t\t\te0127794."},{"key":"i1547-3317-57-2-73-b9","series-title":"Vet Surg","first-page":"246","article-title":"Results of transsphenoidal hypophysectomy in 52 dogs with pituitary-dependent hyperadrenocorticism","volume":"27","year":"1998","unstructured":"Meij\n              BP,\n            \n            \n              Voorhout\n              G,\n            \n            \n              van den Ingh\n              TS,\n            \n          \n          .\n\t\t\t\t\tResults of transsphenoidal 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Med","first-page":"1271","article-title":"Treatment of feline hypersomatotropism. Efficacy, morbiditiy and mortality of hypophysectomy","volume":"29","year":"2015","unstructured":"Kenny\n              P,\n            \n            \n              Scudder\n              C,\n            \n            \n              Keyte\n              S,\n            \n          \n          .\n\t\t\t\t\tTreatment of feline hypersomatotropism. Efficacy, morbiditiy and mortality of hypophysectomy.\n\t\t\t\t\tJ Vet Intern Med2015;\n\t\t\t\t\t29:\n\t\t\t\t\t1271."},{"key":"i1547-3317-57-2-73-b12","article-title":"Feline hypophysectomy for the treatment of hypersomatotropism: a review and update","unstructured":"Fenn\n              J.\n            \n          \n          Feline hypophysectomy for the treatment of hypersomatotropism: a review and update.\n\t\t\t\t\tIn:Proceedings of the American College of Veterinary Internal Medicine Forum;\n\t\t\t\t\tJune 14\u201316, 2018;\n\t\t\t\t\tSeattle, WA."},{"key":"i1547-3317-57-2-73-b13","series-title":"Vet Clin North Am Small Anim Pract","first-page":"129","article-title":"Transsphenoidal surgery for pituitary tumors and other sellar masses","volume":"48","year":"2018","unstructured":"Owen\n              TJ,\n            \n            \n              Martin\n              LG,\n            \n            \n              Chen\n              AV.\n            \n          \n          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pituitary-dependent hypercortisolism","volume":"118","year":"2018","unstructured":"Sawada\n              H,\n            \n            \n              Mori\n              A,\n            \n            \n              Lee\n              P,\n            \n          \n          .\n\t\t\t\t\tPituitary size alteration and adverse effects of radiation therapy performed in 9 dogs with pituitary-dependent hypercortisolism.\n\t\t\t\t\tRes Vet Sci2018;\n\t\t\t\t\t118:\n\t\t\t\t\t19\u2013\n\t\t\t\t\t26."},{"key":"i1547-3317-57-2-73-b16","series-title":"Vet Clin North Am Small Anim Pract","first-page":"273","article-title":"Management of canine pituitary-dependent hyperadrenocorticism with l-deprenyl (Anipryl)","volume":"27","year":"1997","unstructured":"Bruyette\n              DS,\n            \n            \n              Ruehl\n              WW,\n            \n            \n              Entriken\n              T,\n            \n          \n          .\n\t\t\t\t\tManagement of canine pituitary-dependent hyperadrenocorticism with l-deprenyl (Anipryl).\n\t\t\t\t\tVet Clin North Am Small Anim Pract1997;\n\t\t\t\t\t27:\n\t\t\t\t\t273\u2013\n\t\t\t\t\t86."},{"key":"i1547-3317-57-2-73-b17","series-title":"Top Companion Anim Med","first-page":"25","article-title":"Medical management of pituitary-dependent hyperadrenocorticism: mitotane versus trilostane","volume":"27","year":"2012","unstructured":"Reine\n              NJ.\n            \n          \n          Medical management of pituitary-dependent hyperadrenocorticism: mitotane versus trilostane.\n\t\t\t\t\tTop Companion Anim Med2012;\n\t\t\t\t\t27:\n\t\t\t\t\t25\u2013\n\t\t\t\t\t30."},{"key":"i1547-3317-57-2-73-b18","series-title":"J Am Vet Med Assoc","first-page":"1896","article-title":"Use of ketoconazole to treat dogs with pituitary-dependent hyperadrenocorticism: 48 cases (1994\u20132007)","volume":"233","year":"2008","unstructured":"Lien\n              YH\n            \n            \n              Huang\n              HP.\n            \n          \n          Use of ketoconazole to treat dogs with pituitary-dependent hyperadrenocorticism: 48 cases (1994\u20132007).\n\t\t\t\t\tJ Am Vet Med Assoc2008;\n\t\t\t\t\t233:\n\t\t\t\t\t1896\u2013\n\t\t\t\t\t901."},{"key":"i1547-3317-57-2-73-b19","series-title":"J Am Anim Hosp Assoc","first-page":"269","article-title":"Long-term efficacy of trilostane administered twice daily in dogs with pituitary-dependent hyperadrenocorticism","volume":"42","year":"2006","unstructured":"Alenza\n              DP,\n            \n            \n              Arenas\n              C,\n            \n            \n              Lopez\n              ML,\n            \n          \n          .\n\t\t\t\t\tLong-term efficacy of trilostane administered twice daily in dogs with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tJ Am Anim Hosp Assoc2006;\n\t\t\t\t\t42:\n\t\t\t\t\t269\u2013\n\t\t\t\t\t76."},{"key":"i1547-3317-57-2-73-b20","series-title":"Vet Radiol Ultrasound","first-page":"554","article-title":"Comparison of two coarse fractionated radiation protocols for the management of canine pituitary macrotumor: an observational study of 24 dogs","volume":"56","year":"2015","unstructured":"Marcinowska\n              A,\n            \n            \n              Warland\n              J,\n            \n            \n              Brearley\n              M,\n            \n          \n          .\n\t\t\t\t\tComparison of two coarse fractionated radiation protocols for the management of canine pituitary macrotumor: an observational study of 24 dogs.\n\t\t\t\t\tVet Radiol Ultrasound2015;\n\t\t\t\t\t56:\n\t\t\t\t\t554\u2013\n\t\t\t\t\t62."},{"key":"i1547-3317-57-2-73-b21","series-title":"J Vet Intern Med","first-page":"1383","article-title":"Stereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly","volume":"32","year":"2018","unstructured":"Wormhoudt\n              TL,\n            \n            \n              Boss\n              MK,\n            \n            \n              Lunn\n              K,\n            \n          \n          .\n\t\t\t\t\tStereotactic radiation therapy for the treatment of functional pituitary adenomas associated with feline acromegaly.\n\t\t\t\t\tJ Vet Intern Med2018;\n\t\t\t\t\t32:\n\t\t\t\t\t1383\u2013\n\t\t\t\t\t91."},{"key":"i1547-3317-57-2-73-b22","series-title":"J Am Vet Med Assoc","first-page":"374","article-title":"Efficacy of cobalt 60 radiotherapy in dogs with pituitary-dependent hyperadrenocorticism","volume":"212","year":"1998","unstructured":"Goossens\n              MM,\n            \n            \n              Feldman\n              EC,\n            \n            \n              Theon\n              AP,\n            \n          \n          .\n\t\t\t\t\tEfficacy of cobalt 60 radiotherapy in dogs with pituitary-dependent hyperadrenocorticism.\n\t\t\t\t\tJ Am Vet Med Assoc1998;\n\t\t\t\t\t212:\n\t\t\t\t\t374\u2013\n\t\t\t\t\t6."},{"key":"i1547-3317-57-2-73-b23","series-title":"Can Vet J","first-page":"481","article-title":"Effects of radiotherapy on pituitary corticotroph macrotumors in dogs: a retrospective study of 12 cases","volume":"48","year":"2007","unstructured":"de Fornel\n              P,\n            \n            \n              Delisle\n              F,\n            \n            \n              Devauchelle\n              P,\n            \n          \n          .\n\t\t\t\t\tEffects of radiotherapy on pituitary corticotroph macrotumors in dogs: a retrospective study of 12 cases.\n\t\t\t\t\tCan Vet J2007;\n\t\t\t\t\t48:\n\t\t\t\t\t481\u2013\n\t\t\t\t\t6."},{"key":"i1547-3317-57-2-73-b24","series-title":"J Am Vet Med Assoc","first-page":"374","article-title":"Cobalt 60 irradiation of pituitary gland tumors in three cats with acromegaly","volume":"213","year":"1998","unstructured":"Goossens\n              MM,\n            \n            \n              Feldman\n              EC,\n            \n            \n              Nelson\n              RW,\n            \n          \n          .\n\t\t\t\t\tCobalt 60 irradiation of pituitary gland tumors in three cats with acromegaly.\n\t\t\t\t\tJ Am Vet Med Assoc1998;\n\t\t\t\t\t213:\n\t\t\t\t\t374\u2013\n\t\t\t\t\t6."},{"key":"i1547-3317-57-2-73-b25","series-title":"Vet Comp Oncol","first-page":"209","article-title":"Coarse fractionated radiation therapy for pituitary tumours in cats: a retrospective study of 12 cases","volume":"4","year":"2006","unstructured":"Brearley\n              MJ,\n            \n            \n              Polton\n              GA,\n            \n            \n              Littler\n              RM,\n            \n          \n          .\n\t\t\t\t\tCoarse fractionated radiation therapy for pituitary tumours in cats: a retrospective study of 12 cases.\n\t\t\t\t\tVet Comp Oncol2006;\n\t\t\t\t\t4:\n\t\t\t\t\t209\u2013\n\t\t\t\t\t17."},{"key":"i1547-3317-57-2-73-b26","series-title":"J Vet Intern Med","first-page":"1038","article-title":"Linear-accelerator-based modified radiosurgical treatment of pituitary tumors in cats: 11 cases (1997\u20132008)","volume":"23","year":"2009","unstructured":"Sellon\n              RK,\n            \n            \n              Fidel\n              J,\n            \n            \n              Houston\n              R,\n            \n          \n          .\n\t\t\t\t\tLinear-accelerator-based modified radiosurgical treatment of pituitary tumors in cats: 11 cases (1997\u20132008).\n\t\t\t\t\tJ Vet Intern Med2009;\n\t\t\t\t\t23:\n\t\t\t\t\t1038\u2013\n\t\t\t\t\t44."},{"key":"i1547-3317-57-2-73-b27","series-title":"J Vet Intern Med","first-page":"1027","article-title":"Survival, neurologic response, and prognostic factors in dogs with pituitary masses treated with radiation therapy and untreated dogs","volume":"21","year":"2007","unstructured":"Kent\n              MS,\n            \n            \n              Bommarito\n              D,\n            \n            \n              Feldman\n              E,\n            \n          \n          .\n\t\t\t\t\tSurvival, neurologic response, and prognostic factors in dogs with pituitary masses treated with radiation therapy and untreated dogs.\n\t\t\t\t\tJ Vet Intern Med2007;\n\t\t\t\t\t21:\n\t\t\t\t\t1027\u2013\n\t\t\t\t\t33."},{"key":"i1547-3317-57-2-73-b28","series-title":"J Am Vet Med Assoc","first-page":"225","article-title":"Megavoltage irradiation of pituitary macrotumors in dogs with neurologic signs","volume":"213","year":"1998","unstructured":"Theon\n              AP,\n            \n            \n              Feldman\n              EC\n            \n          :\n\t\t\t\t\tMegavoltage irradiation of pituitary macrotumors in dogs with neurologic signs.\n\t\t\t\t\tJ Am Vet Med Assoc1998;\n\t\t\t\t\t213:\n\t\t\t\t\t225\u2013\n\t\t\t\t\t31."},{"key":"i1547-3317-57-2-73-b29","series-title":"Canine and feline endocrinology and reproduction","first-page":"252","article-title":"Canine hyperadrenocroticism (Cushing\u2019s syndrome)","year":"2004","unstructured":"Feldman\n              RW\n            \n            \n              Nelson\n              EC.\n            \n          \n          Canine hyperadrenocroticism (Cushing\u2019s syndrome).\n\t\t\t\t\tIn:FeldmanRW,NelsonEC,eds.Canine and feline endocrinology and reproduction.\n\t\t\t\t\t3rd ed.\n\t\t\t\t\tSt. Louis:\n\t\t\t\t\tElsevier Saunders;\n\t\t\t\t\t2004:\n\t\t\t\t\t252\u2013\n\t\t\t\t\t357."},{"key":"i1547-3317-57-2-73-b30","series-title":"Vet Q","first-page":"57","article-title":"Neurological abnormalities in 97 dogs with detectable pituitary masses","volume":"39","year":"2019","unstructured":"Menchetti\n              M,\n            \n            \n              De Risio\n              L,\n           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Anim Med2012;\n\t\t\t\t\t27:\n\t\t\t\t\t31\u2013\n\t\t\t\t\t5."},{"key":"i1547-3317-57-2-73-b33","series-title":"J Feline Med Surg","first-page":"15","article-title":"Feline acromegaly: an essential differential diagnosis for the difficult diabetic","volume":"12","year":"2010","unstructured":"Niessen\n              SJ.\n            \n          \n          Feline acromegaly: an essential differential diagnosis for the difficult diabetic.\n\t\t\t\t\tJ Feline Med Surg2010;\n\t\t\t\t\t12:\n\t\t\t\t\t15\u2013\n\t\t\t\t\t23."},{"key":"i1547-3317-57-2-73-b34","article-title":"Endocrinology conversion factors","unstructured":"Schenck\n              CA,\n            \n            \n              Nachreiner\n              R,\n            \n            \n              Refsal\n              K.\n            \n          \n          Endocrinology conversion factors.\n\t\t\t\t\thttps:\/\/cvm.msu.edu\/assets\/documents\/VDL\/Endocrinology-Conversion-Factors.pdf. 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