I have been here at the veterinary
school for the last two weeks learning and doing research on transsphenoidal
hypophysectomy in dogs and cats for the treatment of pituitary tumors. Dr.
Bjorn Meij has hosted me in the Clinical Sciences Department and we have been
doing this pituitary surgery for dogs with Cushing’s disease (pituitary hyperadrenocorticism
or PDH). In humans, the preferred treatment for pituitary macroadenomas and
Cushing’s disease is hypophysectomy.
In animals, conventional medical
treatment is directed at the secondary effects of pituitary dependent
hyperadrenocorticism primarily by adrenocortical destruction through
chemotherapy (lysodren and trilostane). These treatment options have been long
utilized because of the ease of treatment and the lack of surgical expertise in
transsphenoidal hypophysectomy. Most people find medical treatment less than
ideal due to complications with the drugs, difficulty in maintaining steady
state and constant/expensive monitoring for disease management.
Dr. Meij has been performing
hypophysectomies in dogs and cats with PDH for the last 15 years with great
success. Utilizing advanced neurosurgical instrumentation and neuroimaging, he
has reduced his complication rates and increased the disease-free period to
more than 3 ½ years.
My goal for studying with Dr.
Meij is to bring this surgery back to the states and offer it for animals with
PDH. I will be working with my colleagues at the
University of
Pennsylvania
to refine our technique and hopefully begin offering this procedure.
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