Updates in Feline Diabetes Mellitus and Hypersomatotropism

Uncommon dermatologic manifestation (paronychia) in a cat with diabetes mellitus

A 3.5-year-old male intact domestic short hair cat presented for a chronic wound and crusts over the claw and claw folds over several months. The cat was diagnosed with diabetes mellitus based on the presence of persistent hyperglycemia, glucosuria, and compatible clinical signs which consist of polyuria, polydipsia, polyphagia, and weight loss. Glipizide (Glucotrol XL, Pfizer, Indonesia) 2.5 mg orally twice daily was prescribed. By the seventeenth day, the patient's claws and skin around the paw had normalized and the abnormal claw sloughed off, revealing a normal claw underneath. Blood glucose, urinalysis and serum fructosamine were also normalized by the thirtieth day. The patient underwent diabetic remission, and the skin and claw lesions have remained in remission and not recurred since the treatment of the diabetes mellitus. This is the first report of a diabetic cat with dermatologic changes to the skin and claw regions. As the diabetes mellitus went into clinical remission, so too did the dermatologic manifestations, even without any specific dermatologic treatment.

Survival, remission, and quality of life in diabetic cats

BACKGROUND

Remission is documented in a substantial proportion of cats with diabetes. The effects of diabetes mellitus (DM) on the lives of cats and their owners should be considered when evaluating treatment success.

OBJECTIVES

To study outcome in cats with DM and the impact DM has on the life situation of cat and owner.

ANIMALS

Domestic and pedigree cats with a diagnosis of DM (n = 477) insured by a Swedish insurance company during 2009 to 2013.

METHODS

Retrospective cross-sectional study. A questionnaire was sent to 1369 owners of cats diagnosed with DM. The questions concerned the cat, treatment, owner perceptions of the disease and treatment and disease outcome. Data were analyzed using multiple linear and logistic regression, with outcomes set as survival for more than 4 weeks after diagnosis, survival time, achieving remission, remission without relapse and quality of life (QoL) for the cat.

RESULTS

The response rate was 35%, leaving 477 questionnaires for analysis. The remission rate among treated cats was 29% (118/405). Feeding a commercially available wet diet was associated with both remission (OR 3.16, 95% confidence interval 1.27-8.12) and remission without relapse (OR 14.8, 95% confidence interval 2.25-153.8). Remission was associated with a better QoL for the cat.

CONCLUSIONS AND CLINICAL IMPORTANCE

The association between feeding a commercially available wet diet and remission is important and strengthens the role of diet in treatment of DM in cats. Linking remission and a better QoL for the cat emphasizes remission as a goal in disease management.

Perception of veterinarians on monitoring diabetic cats with emphasis on the flash glucose monitoring system

ABSTRACT This study aimed to understand the perception of veterinarians regarding monitoring blood and interstitial glucose levels in cats with diabetes mellitus and/or diabetic ketoacidosis, with emphasis on the flash glucose monitoring system (FGMS) (FreeStyle Libre, Abbott, Brazil). This research consisted of two stages. In all, 516 response forms were obtained, and of these, 480 (93%) were considered valid. In total, 333 (69.4%) veterinarians did not use the FGMS, while 147 (30.6%) did. The cost of the FGMS (116, 78%) was the greatest deterrent to acceptability. Veterinarians who use the device consider it indispensable in the hospital monitoring of diabetic ketoacidosis and a facilitator in the accurate monitoring of measurements. In addition, the preferred location for application of the sensor is the cranial lateral wall of the chest and it is quite tolerable. Monitoring a diabetic cat requires commitment from the owner and the veterinary team to ensure feline-friendly management.

Case Report: Cytologic Description of Somatotroph Pituitary Adenoma in a Cat

This case report describes for the first time the cytologic characteristics of a hormonally secreting pituitary adenoma in a cat. An 8-year-old female spayed domestic long-haired cat was referred with a previous diagnosis of hypersomatotropism and secondary diabetes mellitus 7 months prior. Clinical signs included weight loss, polyphagia, polyuria, and polydipsia. Serum insulin-like growth factor-1 was 340 nmol/L (RI: 12-92), and CT scan revealed a hypophyseal mass, and a presumptive diagnosis of acromegaly was made. A transsphenoidal hypophysectomy was performed. A fragment of the pituitary gland was subjected to a squash preparation and cytology revealed a neuroendocrine neoplasm characterized by anisokaryosis and prominent nucleoli. Additional cytologic findings included cell cohesiveness, indistinct cytoplasmic borders, nuclear crowding, molding, and fragmentation. A diagnosis of adenoma was based on a lack of histopathologic or imaging evidence of invasion. A week later, during post-surgical hospitalization, the patient worsened and died. Histopathology from a necropsy procedure revealed fibrinosuppurative meningitis as a post-surgical complication. Pituitary adenomas might have an aggressive cytologic appearance, despite a lack of histopathologic invasion or dissemination.