Pneumoperitoneum in two cats treated with trilostane for hypercortisolism

This report describes two cases of pneumoperitoneum in cats receiving treatment for hypercortisolism and diabetes mellitus. Both cats presented with abdominal distention and lethargy and diagnoses of pneumoperitoneum were radiographically confirmed. No clear underlying cause or other predisposing factors were documented and both cats were subsequently euthanased. One of the cats underwent necropsy, which confirmed a perforated gastric ulcer with no evidence of underlying neoplasia or other pathology. This case report may suggest a possible association between pneumoperitoneum and hypercortisolism and/or trilostane therapy in cats, which has not been documented previously and warrants further investigation.