Hypocortisolaemia with gastrointestinal haemorrhage in a young cat

Abstract An 8‐month‐old, female, spayed domestic shorthair presented with a 1‐week history of lethargy and anorexia. On admission, the cat had severe hypoglycaemia, and hypovolaemic and distributive shock were suspected. Mucosal defects identified by ultrasonography were suggestive of gastrointestinal ulceration. Rapidly progressive anaemia was suspected to be caused by ongoing blood loss. Serum cortisol of less than 6 nmol/L prompted investigation of adrenal function, and an adrenocorticotropic hormone stimulation test was suggestive of hypoadrenocorticism. Treatment involved corticosteroid therapy, supportive care and multiple blood transfusions due to clinically significant anaemia. Despite treatment, the cat developed severe metabolic derangements and died following cardiopulmonary arrest. This case demonstrates the potential for severe gastrointestinal haemorrhage in cats with hypocortisolaemia. Early identification and management of adrenal insufficiency is likely to have a significant impact on survival.