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I agree with Andrew Lyon that pyridostigmine and neostigmine are both acetylcholineesterase inhibitors and therefore will lead to increased cholinergic activity at sympathetic and parasympathetic ganglionic sites. The adrenal medulla is a large sympathetic ganglia supplied by preganglionic sympathetic cholinergic fibers and therefore any increase in acetylcholine at this site will lead to increased sympathoadrenal discharge. Hence the finding of raised catecholamines levels observed in this patient which had to be genuine and not false. --- Andrew Lyon <[log in to unmask]> wrote: > > > Piridostigmin and neostigmin are both > acetylcholinesterase > inhibitors however I am not aware of any clinical > studies on urinary cat > levels during treatment. Is it possible that the > levels > you are detecting are real (not false) and that the > physiological effects > of the cats are masked by the inhibitors? Andrew > >