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Kayser E, Finet SE, de Godoy MRC. The role of carbohydrates in canine and feline nutrition. Anim Front 2024; 14:28-37. [PMID: 38910951 PMCID: PMC11188962 DOI: 10.1093/af/vfae017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Affiliation(s)
- Emanuela Kayser
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Shannon E Finet
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Maria R C de Godoy
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Yoo S, Jung SC, Kwak K, Kim JS. The Role of Prebiotics in Modulating Gut Microbiota: Implications for Human Health. Int J Mol Sci 2024; 25:4834. [PMID: 38732060 PMCID: PMC11084426 DOI: 10.3390/ijms25094834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
The human gut microbiota, an intricate ecosystem within the gastrointestinal tract, plays a pivotal role in health and disease. Prebiotics, non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/or activity of beneficial microorganisms, have emerged as a key modulator of this complex microbial community. This review article explores the evolution of the prebiotic concept, delineates various types of prebiotics, including fructans, galactooligosaccharides, xylooligosaccharides, chitooligosaccharides, lactulose, resistant starch, and polyphenols, and elucidates their impact on the gut microbiota composition. We delve into the mechanisms through which prebiotics exert their effects, particularly focusing on producing short-chain fatty acids and modulating the gut microbiota towards a health-promoting composition. The implications of prebiotics on human health are extensively reviewed, focusing on conditions such as obesity, inflammatory bowel disease, immune function, and mental health. The review further discusses the emerging concept of synbiotics-combinations of prebiotics and probiotics that synergistically enhance gut health-and highlights the market potential of prebiotics in response to a growing demand for functional foods. By consolidating current knowledge and identifying areas for future research, this review aims to enhance understanding of prebiotics' role in health and disease, underscoring their importance in maintaining a healthy gut microbiome and overall well-being.
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Affiliation(s)
- Suyeon Yoo
- Department of Nano-Bioengineering, Incheon National University, Incheon 22012, Republic of Korea
| | - Suk-Chae Jung
- Department of Bioengineering, University of Illinois Urbana-Champaign, Urbana, IL 61801, USA
| | - Kihyuck Kwak
- Department of Microbiology and Immunology, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Brain Korea 21 PLUS Project for Medical Sciences, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jun-Seob Kim
- Department of Nano-Bioengineering, Incheon National University, Incheon 22012, Republic of Korea
- Institute for New Drug Development, College of Life Science and Bioengineering, Incheon National University, Incheon 22012, Republic of Korea
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Gottlieb S, Rand JS, Anderson ST. Frequency of diabetic remission, predictors of remission and survival in cats using a low-cost, moderate-intensity, home-monitoring protocol and twice-daily glargine. J Feline Med Surg 2024; 26:1098612X241232546. [PMID: 38661475 PMCID: PMC11103314 DOI: 10.1177/1098612x241232546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
OBJECTIVES The aim of the present study was to retrospectively assess remission rates and survival in diabetic cats managed using a moderate-intensity, low-cost protocol of home blood glucose measurements and insulin adjustment by clients of a cat-only practice, and to determine if predictors of remission, relapse or survival could be identified. METHODS The records of a cat-only practice were used to identify 174 cats with newly diagnosed diabetes managed using only pre-insulin home blood glucose measurements for insulin dose adjustments based on a protocol provided to clients aimed at maintaining pre-insulin blood glucose in the range of 6.5-11.9 mmol/l (117-214 mg/dl). Cats were excluded for the following reasons: insufficient follow-up in the records; a lack of owner compliance was recorded; they were receiving ongoing corticosteroids for the management of other conditions; they were euthanased at the time of diagnosis; or they were diagnosed with acromegaly or hyperadrenocorticism. RESULTS Using only pre-insulin blood glucose measurements at home to adjust the insulin dose to maintain glucose in the range of 6.5-11.9 mmol/l, 47% of cats achieved remission, but 40% of those cats relapsed. A minority (16%) of cats were hospitalised for hypoglycaemia. The survival time was significantly longer in cats in remission and Burmese cats. CONCLUSIONS AND RELEVANCE The cost and time burden of treating diabetic cats may cause some clients to choose euthanasia over treatment. While the highest rates of diabetic remission have been reported in studies of newly diagnosed cats treated with intensive long-acting insulin protocols and low carbohydrate diets, these protocols may not be suitable for all clients. Nearly 50% of cats with newly diagnosed diabetes achieved remission with this low-cost, moderate-intensity, insulin dosing protocol. As remission was significantly associated with survival time, discussing factors in treatment to optimise remission is important, but it is also important to offer clients a spectrum of options. No cats that started treatment in this study were euthanased because the owner did not wish to continue the diabetes treatment.
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Affiliation(s)
- Susan Gottlieb
- The Cat Clinic, Brisbane, QLD, Australia
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Jacquie S Rand
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
- Australian Pet Welfare Foundation, Kenmore, QLD, Australia
| | - Stephen T Anderson
- School of Biomedical Sciences, The University of Queensland, St Lucia, QLD, Australia
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Godfrey H, Morrow S, Abood SK, Verbrugghe A. Identifying the target population and preventive strategies to combat feline obesity. J Feline Med Surg 2024; 26:1098612X241228042. [PMID: 38415669 PMCID: PMC10911305 DOI: 10.1177/1098612x241228042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Feline obesity continues to be a priority health and welfare issue. Most research surrounding obesity currently focuses on obesity treatment. However, treatment for feline obesity is slow, often unsuccessful and not without consequences. Identifying high-risk populations for obesity onset is crucial for developing and implementing preventive strategies. This review identifies post-gonadectomy kittens aged 5-12 months as the primary target population for obesity prevention in domestic cats and highlights dietary and feeding management strategies to be implemented for obesity prevention.
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Affiliation(s)
- Hannah Godfrey
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Shawna Morrow
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Sarah K Abood
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Adronie Verbrugghe
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Pathophysiology of Prediabetes, Diabetes, and Diabetic Remission in Cats. Vet Clin North Am Small Anim Pract 2023; 53:511-529. [PMID: 36898862 DOI: 10.1016/j.cvsm.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Diabetes mellitus (DM) has a heterogenous cause, and the exact pathogenesis differs between patients. Most diabetic cats have a cause similar to human type 2 DM but, in some, DM is associated with underlying conditions, such as hypersomatotropism, hyperadrenocorticism, or administration of diabetogenic drugs. Predisposing factors for feline DM include obesity, reduced physical activity, male sex, and increasing age. Gluco(lipo)toxicity and genetic predisposition also likely play roles in pathogenesis. Prediabetes cannot be accurately diagnosed in cats at the current time. Diabetic cats can enter remission, but relapses are common, as these cats might have ongoing, abnormal glucose homeostasis.
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Nutritional Management of Cats and Dogs with Diabetes Mellitus. Vet Clin North Am Small Anim Pract 2023; 53:657-674. [PMID: 36858905 DOI: 10.1016/j.cvsm.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
This article reviews the nutritional assessment and management of diabetic dogs and cats. It discusses how to determine appropriate nutritional goals for individual patients, including comorbid patients with diabetes. Considerations for macronutrient and micronutrient modifications will be reviewed.
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Rothlin‐Zachrisson N, Öhlund M, Röcklinsberg H, Ström Holst B. Survival, remission, and quality of life in diabetic cats. J Vet Intern Med 2023; 37:58-69. [PMID: 36637031 PMCID: PMC9889602 DOI: 10.1111/jvim.16625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
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.
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Affiliation(s)
| | | | - Helena Röcklinsberg
- Department of Animal Environment and HealthSwedish University of Agricultural SciencesUppsalaSweden
| | - Bodil Ström Holst
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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Moreno AA, Parker VJ, Winston JA, Rudinsky AJ. Dietary fiber aids in the management of canine and feline gastrointestinal disease. J Am Vet Med Assoc 2022; 260:S33-S45. [DOI: 10.2460/javma.22.08.0351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Dietary fiber describes a diverse assortment of nondigestible carbohydrates that play a vital role in the health of animals and maintenance of gastrointestinal tract homeostasis. The main roles dietary fiber play in the gastrointestinal tract include physically altering the digesta, modulating appetite and satiety, regulating digestion, and acting as a microbial energy source through fermentation. These functions can have widespread systemic effects. Fiber is a vital component of nearly all commercial canine and feline diets. Key features of fiber types, such as fermentability, solubility, and viscosity, have been shown to have clinical implications as well as health benefits in dogs and cats. Practitioners should know how to evaluate a diet for fiber content and the current knowledge on fiber supplementation as it relates to common enteropathies including acute diarrhea, chronic diarrhea, constipation, and hairball management. Understanding the fundamentals of dietary fiber allows the practicing clinician to use fiber optimally as a management modality.
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Affiliation(s)
- Adam A. Moreno
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- The Comparative Hepatobiliary and Intestinal Research Program, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Valerie J. Parker
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- The Comparative Hepatobiliary and Intestinal Research Program, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Jenessa A. Winston
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- The Comparative Hepatobiliary and Intestinal Research Program, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Adam J. Rudinsky
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
- The Comparative Hepatobiliary and Intestinal Research Program, College of Veterinary Medicine, The Ohio State University, Columbus, OH
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Berman CF, Lobetti RG, Zini E, Fosgate GT, Schoeman JP. Influence of high-protein and high-carbohydrate diets on serum lipid and fructosamine concentrations in healthy cats. J Feline Med Surg 2022; 24:759-769. [PMID: 34605307 PMCID: PMC10812288 DOI: 10.1177/1098612x211047062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether high-protein and high-carbohydrate diets exert differential effects on serum cholesterol, triglyceride and fructosamine concentrations in healthy cats. METHODS A randomised, crossover diet trial was performed in 35 healthy shelter cats. Following baseline health assessments, cats were randomised into groups receiving either a high-protein or high-carbohydrate diet for 4 weeks. The cats were then fed a washout diet for 4 weeks before being transitioned to whichever of the two studied diets they had not yet received. Fasting serum cholesterol, triglyceride and fructosamine concentrations were determined at the end of each 4-week diet period. RESULTS Cats on the high-carbohydrate diet had significantly lower serum cholesterol (P <0.001) concentrations compared with baseline measurements. Cats on the high-protein diet had significantly higher serum cholesterol (P <0.001) and triglyceride (P <0.001) concentrations, yet lower fructosamine (P <0.001) concentrations compared with baseline measurements. In contrast, overweight cats (body condition score [BCS] >5) had lower cholesterol (P = 0.007) and triglyceride (P = 0.032) concentrations on the high-protein diet than cats within other BCS groups. CONCLUSIONS AND RELEVANCE Diets higher in protein and lower in carbohydrates appear beneficial for short-term glucose control in healthy cats. A high-protein diet was associated with significantly elevated cholesterol and triglyceride concentrations in healthy cats, even though the increase was significantly less pronounced in cats with a BCS >5. This finding suggests that overweight cats process high-protein diets, cholesterol and triglycerides differently than leaner cats.
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Affiliation(s)
- Chad F Berman
- Bryanston Veterinary Hospital, Bryanston, Johannesburg, South Africa
- Department of Companion Animal Clinical Studies, University of Pretoria, Pretoria, South Africa
| | - Remo G Lobetti
- Bryanston Veterinary Hospital, Bryanston, Johannesburg, South Africa
| | - Eric Zini
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - Geoffrey T Fosgate
- Department of Production Animal Studies, University of Pretoria, Pretoria, South Africa
| | - Johan P Schoeman
- Department of Companion Animal Clinical Studies, University of Pretoria, Pretoria, South Africa
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Xenoulis PG, Fracassi F. Feline Comorbidities: Clinical perspective on diabetes mellitus and pancreatitis. J Feline Med Surg 2022; 24:651-661. [PMID: 35775305 PMCID: PMC11107984 DOI: 10.1177/1098612x221106355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Diabetes mellitus (DM) is one of the most common feline endocrine disorders. It has been shown by several studies that DM in cats frequently coexists with pancreatitis. CLINICAL CHALLENGES It has not been definitively established what the exact pathogenetic association between DM and pancreatitis is in the cat. However, the association between these two conditions is most likely bidirectional, with DM predisposing cats to pancreatitis and vice versa. Diagnosis of pancreatitis in cats with DM is crucial because concurrent pancreatitis commonly leads to difficulties in the management of DM. When pancreatitis is associated with diabetic ketoacidosis (DKA), therapeutic management is even more challenging. AIMS This review focuses on the concurrent presence of DM or DKA and pancreatitis in cats, mainly focusing on their clinical management. EVIDENCE BASE Information provided in this review is based on feline-specific clinical research when available. In addition, comparative and human research, as well as clinical experience, has been used to enrich knowledge in areas where feline-specific research is not yet available.
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Affiliation(s)
- Panagiotis G Xenoulis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
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Villaverde C, Chandler M. Commercial vs Homemade Cat Diets: What you need to know. J Feline Med Surg 2022; 24:415-428. [PMID: 35311418 PMCID: PMC11104037 DOI: 10.1177/1098612x221090389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 09/27/2021] [Indexed: 11/15/2022]
Abstract
PRACTICAL RELEVANCE A feeding plan recommendation for cats, both healthy and with disease, should include diet choice, amounts to feed and the feeding method. Diet choice can be complex owing to the abundance of products, sometimes with conflicting marketing messages, and the prevalence of information with no scientific basis. It is important to be aware of the specific challenges of both commercial and homemade diets. Moreover, a nutritional assessment is a prerequisite when recommending a diet to ensure that it is safe, appropriate for the cat's life stage and nutritious for long-term feeding. COMMERCIAL VS HOMEMADE DIETS There are a variety of commercial diets available, allowing considerable customisation. These products are regulated and can be tested to determine nutritional adequacy and safety, although as the industry is partly self-regulated, choice of manufacturer is important. Properly formulated homemade diets can be customised to the patient and are a good option when no commercial product that meets the patient's needs exists. Homemade diets can be an owner preference. A serious limitation is the lack of testing, potentially affecting safety and also resulting in a reliance on database information to determine nutritional adequacy. Generic homemade diet recipes (eg, sourced from the internet) have additional risks of deficiencies and imbalances, and are not recommended. Homemade diets should be devised by a veterinary nutrition specialist with consideration of both patient and owner factors. CLINICAL CHALLENGES Dietary misinformation, which is all too readily available on the internet, may result in owners making questionable feeding choices for their pets. A homemade diet may be requested by owners based on the perception that there are poor ingredients in commercial foods. The veterinary healthcare team needs to have good evidence-based information to present to owners about diet choice. EVIDENCE BASE Several decades of research on feline nutrition forms the basis for nutritional requirements and dietary recommendations. There are varying degrees of evidence regarding requirements for each nutrient, and a lack of data on the effects of different types of processing on nutrient needs.
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Laflamme DP, Backus RC, Forrester SD, Hoenig M. Evidence does not support the controversy regarding carbohydrates in feline diets. J Am Vet Med Assoc 2022; 260:506-513. [DOI: 10.2460/javma.21.06.0291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Robert C. Backus
- 2Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO
| | | | - Margarethe Hoenig
- 4Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, IL
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Abstract
PRACTICAL RELEVANCE Up to 40% of the domestic feline population is overweight or obese. Obesity in cats leads to insulin resistance via multiple mechanisms, with each excess kilogram of body weight resulting in a 30% decline in insulin sensitivity. Obese, insulin-resistant cats with concurrent beta-cell dysfunction are at risk of progression to overt diabetes mellitus. APPROACH TO MANAGEMENT In cats that develop diabetes, appropriate treatment includes dietary modification to achieve ideal body condition (for reduction of insulin resistance), and optimization of diet composition and insulin therapy (for glycemic control and the chance of diabetic remission). Initially, as many obese cats that become diabetic will have lost a significant amount of weight and muscle mass by the time of presentation, some degree of diabetic control should be attempted with insulin before initiating any caloric restriction. Once body weight has stabilized, if further weight loss is needed, a diet with ≤ 12-15% carbohydrate metabolizable energy (ME) and >40% protein ME should be fed at 80% of resting energy requirement for ideal weight, with the goal of 0.5-1% weight loss per week. Other approaches may be necessary in some cats that need either substantial caloric restriction or do not find low carbohydrate diets palatable. Long-acting insulins are preferred as initial choices and oral antidiabetic drugs can be used in combination with diet if owners are unable or unwilling to give insulin injections. Glucagon-like peptide-1 (GLP-1) agonists have recently been investigated for use as adjunctive treatment in diabetic cats and sodium-glucose cotransporter-2 (SGLT2) inhibitors are currently being evaluated in clinical trials. EVIDENCE BASE The information in this review is drawn from: epidemiological studies on obesity prevalence; prospective longitudinal studies of development of insulin resistance with obesity; randomized controlled studies; and expert opinion regarding the effect of diet on diabetes management in cats.
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Affiliation(s)
- Melissa Clark
- Gulf Coast Veterinary Specialists, 8042 Katy Freeway, Houston, TX 77024, USA
| | - Margarethe Hoenig
- College of Veterinary Medicine, University of Illinois, Urbana, IL 61802, USA
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Basavaiah R, Gurudutt PS. Prebiotic Carbohydrates for Therapeutics. Endocr Metab Immune Disord Drug Targets 2020; 21:230-245. [PMID: 32990546 DOI: 10.2174/1871530320666200929140522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 06/02/2020] [Accepted: 06/11/2020] [Indexed: 11/22/2022]
Abstract
The food industry is constantly shifting focus based on prebiotics as health-promoting substrates rather than just food supplements. A prebiotic is "a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gastrointestinal microflora that confers benefits upon host well-being and health." Prebiotics exert a plethora of health-promoting effects, which has lead to the establishment of multimillion food and pharma industries. The following are the health benefits attributed to prebiotics: mineral absorption, better immune response, increased resistance to bacterial infection, improved lipid metabolism, possible protection against cancer, relief from poor digestion of lactose, and reduction in the risk of diseases such as intestinal disease, non-insulin-dependent diabetes, obesity and allergy. Numerous studies in both animals and humans have demonstrated the health benefits of prebiotics.
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Affiliation(s)
- Renuka Basavaiah
- Department of Microbiology and Fermentation Technology, Central Food Technological Research Institute, Mysore - 570 020, Karnataka, CSIR, India
| | - Prapulla S Gurudutt
- Department of Microbiology and Fermentation Technology, Central Food Technological Research Institute, Mysore - 570 020, Karnataka, CSIR, India
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Laflamme DP. Understanding the Nutritional Needs of Healthy Cats and Those with Diet-Sensitive Conditions. Vet Clin North Am Small Anim Pract 2020; 50:905-924. [PMID: 32646606 DOI: 10.1016/j.cvsm.2020.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Diets for cats must provide complete nutrition and meet the needs of the individual patient. There is no single diet that is perfect for all cats, and veterinarians must consider the needs of the cat as well as the preferences of the owners when making dietary recommendations. This article focuses on the interface between animal factors and nutritional needs in cats and is divided into 3 sections. Section 1 addresses the dietary needs of healthy cats, including differences among life stages. Section 2 addresses common myths regarding feline nutrition. Section 3 addresses common nutrient-sensitive conditions in cats, including sarcopenia of aging.
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Affiliation(s)
- Dottie P Laflamme
- Veterinary Communications, 473 Grandma's Place, Floyd, VA 24091, USA.
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Albuquerque CSC, Bauman BL, Rzeznitzeck J, Caney SMA, Gunn-Moore DA. Priorities on treatment and monitoring of diabetic cats from the owners' points of view. J Feline Med Surg 2020; 22:506-513. [PMID: 31241424 PMCID: PMC10814342 DOI: 10.1177/1098612x19858154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The aims of this study were to evaluate: owners' perceptions and priorities on the treatment and monitoring of feline diabetes mellitus (DM); the perceived effectiveness of the communication between veterinarians and clients regarding disease management; and the impact DM has on the owners' everyday lives and human-pet bonds. METHODS An initial questionnaire, then an adapted second questionnaire, were available to owners of cats with DM on vetprofessionals.com . RESULTS A total of 748 questionnaires were completed. At diagnosis, fewer than half of veterinarians discussed how to recognise unstable diabetes (46%) or home blood glucose monitoring (HBGM) (40%). Owners were disappointed that the importance of diet on diabetic remission/stabilisation and HBGM were not discussed. Only 49% of respondents were supervised by a veterinarian/veterinary nurse while first drawing up insulin and injecting their cat. Websites/online forums that owners found themselves were most useful when learning about their cat's diabetes (76% agreed). Over a third of cats (39%) were not fed a 'diabetic' diet but, impressively, 71% of owners used HBGM. Initial concerns about costs, boarding, the effect on their daily life and potential negative impact on the human-pet bond reduced significantly after initiating treatment (P <0.0001). CONCLUSIONS AND RELEVANCE Caring for a diabetic cat requires significant owner commitment, plus support by the veterinary team for the owner and their cat. It is difficult to discuss all aspects of this complex disease with the owner in a single consultation; hence, it is important to involve the entire veterinary team in owner education and provide owners with informative material (eg, useful websites, printouts). Understanding owners' priorities, fears, and which monitoring methods have helped others, is paramount to achieve owner compliance and satisfaction, and so improve the health and welfare of diabetic cats. This study provides useful information on the management of feline DM, which can be instrumental in educating future owners.
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Affiliation(s)
- Carolina SC Albuquerque
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, UK
| | | | | | - Sarah MA Caney
- Vet Professionals, Midlothian Innovation Centre, Roslin, UK
| | - Danièlle A Gunn-Moore
- Royal (Dick) School of Veterinary Studies and The Roslin Institute, University of Edinburgh, Easter Bush Campus, Roslin, UK
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Pérez-López L, Boronat M, Melián C, Saavedra P, Brito-Casillas Y, Wägner AM. Assessment of the association between diabetes mellitus and chronic kidney disease in adult cats. J Vet Intern Med 2019; 33:1921-1925. [PMID: 31305000 PMCID: PMC6766521 DOI: 10.1111/jvim.15559] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 06/26/2019] [Indexed: 12/27/2022] Open
Abstract
Background Diabetes mellitus is the main cause of chronic kidney disease (CKD) in humans. The relationship between the 2 diseases in cats is unclear. Objective To assess the association between diabetes and CKD in a population of adult cats. Animals Five hundred sixty‐one cats that attended 2 veterinary centers in Gran Canaria, Spain, between 2014 and 2016. Methods Medical records were retrospectively reviewed. Cats aged 3 years or older, with sufficient data to define whether or not they had diabetes and CKD, were selected. Cats in critical condition, with dehydration or potential causes of prerenal azotemia and those treated with nephrotoxic drugs were excluded. Diagnosis of CKD was established when creatinine concentrations were >2 mg/dL, or serum creatinine 1.6‐2 mg/dL and urine specific gravity <1.035, or serum creatinine 1.6‐2 mg/dL and urine protein/creatinine ratio >0.4. Factors associated with CKD were identified through multivariate logistic regression analyses. Results Sixty‐seven (11.9%) cats had CKD and 16 (2.9%) cats had diabetes. Sixty cats without diabetes (11%) and 7 with diabetes (44%) had CKD. Among the latter, both conditions were diagnosed simultaneously in 6 cases, whereas diabetes preceded CKD in the other. Multivariate analysis showed that diabetes was significantly associated with CKD (odds ratio = 4.47; 95% confidence interval, 1.51‐13.28; P = .007). Other variables associated with CKD were age and mixed breed. Conclusions and Clinical Importance After adjusting for age, this study showed an association between diabetes and CKD in adult cats.
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Affiliation(s)
- Laura Pérez-López
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain.,Veterinary Clinical Hospital of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Mauro Boronat
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
| | - Carlos Melián
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain.,Veterinary Clinical Hospital of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Pedro Saavedra
- Mathematics Department of the University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Yeray Brito-Casillas
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain
| | - Ana M Wägner
- Institute of Biomedical and Health Research (IUIBS), University of Las Palmas de Gran Canaria (ULPGC), Las Palmas de Gran Canaria, Spain.,Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria, Spain
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Diabetic cats have decreased gut microbial diversity and a lack of butyrate producing bacteria. Sci Rep 2019; 9:4822. [PMID: 30886210 PMCID: PMC6423039 DOI: 10.1038/s41598-019-41195-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 02/26/2019] [Indexed: 12/19/2022] Open
Abstract
Obesity and inactivity are major risk factors of feline diabetes mellitus (FDM) and human type II diabetes mellitus (T2DM). In recent years, changes in the gut microbiota have been suggested as a contributing factor to T2DM. Whether the gut microbiota (GM) composition plays a role in FDM remains unknown. The aim of the current study was firstly a cross-sectional comparison of the GM of diabetic cats, to that of lean, and of obese/overweight non-diabetic cats of a similar age. Specifically, fecal samples from 82 privately-owned cats from Denmark and Switzerland were sequenced using 16S rRNA gene amplicon metabarcoding. Secondly dietary intervention data was generated, by obtaining additional samples from a subset of cats after placing them on a high-protein diet for four weeks. The GM diversity of diabetic cats was lower than that of lean cats in the cross-sectional study, and lower compared to lean and to overweight/obese cats after diet intervention. Diabetic cats also exhibited fewer Anaerotruncus, Dialister, and unknown Ruminococcaceae than lean cats. Serum fructosamine levels correlated negatively with Prevotellaceae abundance and positively with Enterobacteriaceae abundance. In summary the intestinal microbiota of diabetic cats was characterized by decreased GM diversity and loss of butyrate producing bacterial genera.
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Gottlieb S, Rand J. Managing feline diabetes: current perspectives. VETERINARY MEDICINE (AUCKLAND, N.Z.) 2018; 9:33-42. [PMID: 30050865 PMCID: PMC6053045 DOI: 10.2147/vmrr.s125619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diabetes mellitus is a common endocrine disease in cats. While type 2 diabetes is the most common form seen in cats, other underlying causes may contribute to insulin resistance. Guidelines for diagnosis vary and often do not take into account prediabetic cats. The goals of treatment are to maximize the chance of remission, while minimizing the risks of hypoglycemia. This article presents a further overview of current treatment and monitoring recommendations for diabetic cats.
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Affiliation(s)
- Susan Gottlieb
- The Cat Clinic, Brisbane, QLD, Australia,
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia,
| | - Jacquie Rand
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia,
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20
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Gostelow R, Hazuchova K, Scudder C, Forcada Y, Church D, Niessen SJM. Prospective evaluation of a protocol for transitioning porcine lente insulin-treated diabetic cats to human recombinant protamine zinc insulin. J Feline Med Surg 2018; 20:114-121. [PMID: 29172917 PMCID: PMC11129256 DOI: 10.1177/1098612x17697482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives The objective was to evaluate a nadir-led protocol for transitioning porcine lente insulin suspension (PLIS)-treated diabetic cats onto human recombinant protamine zinc insulin (PZIR). Methods Recently diagnosed (<5 months) diabetic cats, treated with PLIS q12h for ⩾6 weeks, were recruited. Fructosamine, 24 h blood glucose curve (BGC), quality of life assessment (DIAQoL-pet score) and Diabetic Clinical Score (DCS) were assessed at enrolment (PLIS-treated) and 2, 4 and 12 weeks after transitioning to PZIR (starting dose 0.2-0.7 U/kg q12h). Short duration of insulin action was defined as <9 h. Linear mixed effects modelling assessed for change in fructosamine, mean blood glucose (MBG) during BGCs, DIAQoL-pet score, DCS and q12h insulin dose. McNemar's tests compared the proportion of cats with hypoglycaemia at week 0 (PLIS-treated) and week 4 (PZIR-treated). Results Twenty-two cats were recruited. Median PLIS dose at enrolment was 0.5 U/kg (interquartile range 0.3-0.7 U/kg) q12h, equalling median PZIR starting dose (0.5 U/kg; interquartile range 0.3-0.7 U/kg q12h). Transitioning was followed by significant decreases in fructosamine ( P = 0.00007), insulin dose ( P = 0.02), DCS ( P = 8.1 × 10-8) and DIAQoL-pet score ( P = 0.003), indicating improved quality of life. MBG did not alter significantly ( P = 0.1). Five cats (22.7%) achieved remission. Hypoglycaemia was recorded in 30/190 12 h BGCs (15.8%) and five cats experienced clinical hypoglycaemia. The proportion of cats with hypoglycaemia did not differ between PLIS (week 0) and PZIR (week 4) ( P = 1.0). Duration of action was analysed in 19 cats. Six cats (31.6%) showed short duration of action on PLIS, compared with two cats (10.5%) after 4 weeks on PZIR. All six cats with short PLIS duration showed duration of ⩾9 h on PZIR. Conclusions and relevance Used alongside a low-carbohydrate diet, transitioning to PZIR was associated with significantly improved clinical signs and quality of life, with some cats achieving remission. Transition to PZIR should be considered for cats with short duration of action on PLIS.
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Affiliation(s)
- Ruth Gostelow
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Katarina Hazuchova
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Christopher Scudder
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Yaiza Forcada
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - David Church
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Stijn JM Niessen
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
- Newcastle Medical School, Newcastle upon Tyne, UK
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Verbrugghe A, Hesta M. Cats and Carbohydrates: The Carnivore Fantasy? Vet Sci 2017; 4:vetsci4040055. [PMID: 29140289 PMCID: PMC5753635 DOI: 10.3390/vetsci4040055] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 10/30/2017] [Accepted: 11/08/2017] [Indexed: 01/02/2023] Open
Abstract
The domestic cat’s wild ancestors are obligate carnivores that consume prey containing only minimal amounts of carbohydrates. Evolutionary events adapted the cat’s metabolism and physiology to this diet strictly composed of animal tissues and led to unique digestive and metabolic peculiarities of carbohydrate metabolism. The domestic cat still closely resembles its wild ancestor. Although the carnivore connection of domestic cats is well recognised, little is known about the precise nutrient profile to which the digestive physiology and metabolism of the cat have adapted throughout evolution. Moreover, studies show that domestic cats balance macronutrient intake by selecting low-carbohydrate foods. The fact that cats evolved consuming low-carbohydrate prey has led to speculations that high-carbohydrate diets could be detrimental for a cat’s health. More specifically, it has been suggested that excess carbohydrates could lead to feline obesity and diabetes mellitus. Additionally, the chances for remission of diabetes mellitus are higher in cats that consume a low-carbohydrate diet. This literature review will summarise current carbohydrate knowledge pertaining to digestion, absorption and metabolism of carbohydrates, food selection and macronutrient balancing in healthy, obese and diabetic cats, as well as the role of carbohydrates in prevention and treatment of obesity and diabetes mellitus.
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Affiliation(s)
- Adronie Verbrugghe
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, 50 Stone Road E, Guelph N1G 2W1 ON, Canada.
| | - Myriam Hesta
- Laboratory of Animal Nutrition, Faculty of Veterinary Medicine, Ghent University, Heidestraat 19, Merelbeke B-9820, Belgium.
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Öhlund M, Egenvall A, Fall T, Hansson-Hamlin H, Röcklinsberg H, Holst BS. Environmental Risk Factors for Diabetes Mellitus in Cats. J Vet Intern Med 2016; 31:29-35. [PMID: 27906456 PMCID: PMC5259626 DOI: 10.1111/jvim.14618] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 08/29/2016] [Accepted: 11/01/2016] [Indexed: 12/12/2022] Open
Abstract
Background Diabetes in cats resembles type 2 diabetes in people. The etiology is not fully understood, but both genetic and environmental factors are believed to contribute. Objectives To assess the associations of environmental risk factors with diabetes in cats. Animals Cats with a diagnosis of diabetes (n = 396) insured by a Swedish insurance company during years 2009–2013, and a control group (n = 1,670) matched on birth year. Methods A web‐based questionnaire was used in a case–control study. An invitation to participate was sent to owners of 1,369 diabetic cats and 5,363 control cats. The survey contained questions related to the cat's breed, age, sex, neutering status, body condition, housing, access to the outdoors, activity level, diet, eating behavior, feeding routine, general health, stressful events, other pets in the household, medications, and vaccination status. Data were analyzed by multiple logistic regression. Results Response rate was 35% for the diabetic group and 32% for the control group. Indoor confinement, being a greedy eater, and being overweight were associated with an increased risk of diabetes. In cats assessed by owners as being normal weight, there was an association between eating predominantly dry food and an increased risk of diabetes (Odds ratio 3.8; 95% confidence intervals 1.3–11.2). Conclusions and Clinical Importance Dry food is commonly fed to cats worldwide. The association found between dry food and an increased risk of diabetes in cats assessed as normal weight by owners warrants further attention.
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Affiliation(s)
- M Öhlund
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - A Egenvall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - T Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - H Hansson-Hamlin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - H Röcklinsberg
- Department of Animal Environment and Health, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - B S Holst
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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Lewitt MS, Strage E, Church D. An individual approach to feline diabetes care: a case report and literature review. Acta Vet Scand 2016; 58:63. [PMID: 27766967 PMCID: PMC5073813 DOI: 10.1186/s13028-016-0245-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Achieving insulin independence is emerging as a realistic therapeutic goal in the management of feline diabetes mellitus. Case presentation The management of an 11-year-old spayed female Burmese cat presenting with diabetes mellitus after corticosteroid administration is described. Remission was achieved after the frequency of insulin administration was increased to four times a day, and supported by intensive home blood glucose monitoring and a high protein, low carbohydrate diet. Conclusion Owners are important collaborators in feline diabetes care and, with intensive home monitoring, more frequent insulin treatment may lead to remission without hypoglycemia. More frequent insulin injections than recommended in the literature may be necessary to achieve glycemic control and used as an alternative to a longer-acting insulin.
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Singh R, Rand JS, Coradini M, Morton JM. Effect of acarbose on postprandial blood glucose concentrations in healthy cats fed low and high carbohydrate diets. J Feline Med Surg 2015; 17:848-57. [PMID: 25344379 PMCID: PMC11112197 DOI: 10.1177/1098612x14556559] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
OBJECTIVES Feeding a low carbohydrate diet is recommended for diabetic cats; however, some cats may require diets containing moderate-to-high carbohydrate and may benefit from the use of therapeutic agents to improve glycemic control. The aim of the study was to determine the effect of the α-glucosidase inhibitor acarbose on postprandial plasma glucose concentration when combined with commercially available feline diets high and low in carbohydrate. METHODS Twelve healthy, adult, non-obese, neutered cats were enrolled. Plasma glucose concentrations were assessed over 24 h after feeding high and low carbohydrate diets, with and without acarbose, during single and multiple meal tests, in a crossover study. Commercially available feline diets were used, which were high and low in carbohydrate (providing 51% and 7% of metabolizable energy, respectively). RESULTS In cats fed the high carbohydrate diet as a single meal, mean 24 h glucose concentrations were lower when acarbose was administered. Mean glucose concentrations were lower in the first 12 h when acarbose was given once daily, whereas no significant difference was observed in mean results from 12-24 h. Acarbose had little effect in cats eating multiple meals. Compared with consumption of the high carbohydrate diet with acarbose, lower mean 24 h and peak glucose concentrations were achieved by feeding the low carbohydrate diet alone. CONCLUSIONS AND RELEVANCE In healthy cats meal-fed diets of similar composition to the diets used in this study, acarbose has minimal effect when a low carbohydrate diet is fed but reduces postprandial glucose concentrations over 24 h when a high carbohydrate diet is fed. However, mean glucose concentrations over 24 h are still higher when a high carbohydrate diet with acarbose is fed relative to the low carbohydrate diet without acarbose. Future studies in diabetic cats are warranted to confirm these findings.
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Affiliation(s)
- Ranee Singh
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Jacquie S Rand
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Marcia Coradini
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - John M Morton
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia Current address: Jemora Pty Ltd, PO Box 2277, Geelong, VIC, Australia
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Thompson A, Lathan P, Fleeman L. Update on insulin treatment for dogs and cats: insulin dosing pens and more. VETERINARY MEDICINE-RESEARCH AND REPORTS 2015; 6:129-142. [PMID: 30101100 PMCID: PMC6067590 DOI: 10.2147/vmrr.s39984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient’s requirements. Intermediate-acting insulin is usually the first choice for dogs, and longer-acting insulin is the first choice for cats. Once the insulin type is chosen, the best method of insulin administration should be considered. Traditionally, insulin vials and syringes have been used, but insulin pen devices have recently entered the veterinary market. Pens have different handling requirements when compared with standard insulin vials including: storage out of the refrigerator for some insulin preparations once pen cartridges are in use; priming of the pen to ensure a full dose of insulin is administered; and holding the pen device in place for several seconds during the injection. Many different types of pen devices are available, with features such as half-unit dosing, large dials for visually impaired people, and memory that can display the last time and dose of insulin administered. Insulin pens come in both reusable and disposable options. Pens have several benefits over syringes, including improved dose accuracy, especially for low insulin doses.
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Affiliation(s)
- Ann Thompson
- School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia
| | - Patty Lathan
- College of Veterinary Medicine Mississippi State University, Starkville, MS, USA
| | - Linda Fleeman
- Animal Diabetes Australia, Melbourne, VIC, Australia,
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Owens TJ, Larsen JA, Farcas AK, Nelson RW, Kass PH, Fascetti AJ. Total dietary fiber composition of diets used for management of obesity and diabetes mellitus in cats. J Am Vet Med Assoc 2015; 245:99-105. [PMID: 24941393 DOI: 10.2460/javma.245.1.99] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine total dietary fiber (TDF) composition of feline diets used for management of obesity and diabetes mellitus. DESIGN Cross-sectional survey. SAMPLE Dry veterinary (n = 10), canned veterinary (12), and canned over-the-counter (3) feline diets. PROCEDURES Percentage of TDF as insoluble dietary fiber (IDF), high-molecular-weight soluble dietary fiber (HMWSDF), and low-molecular-weight soluble dietary fiber (LMWSDF) was determined. RESULTS Median measured TDF concentration was greater than reported maximum crude fiber content in dry and canned diets. Median TDF (dry-matter) concentration in dry and canned diets was 12.2% (range, 8.11% to 27.16%) and 13.8% (range, 4.7% to 27.9%), respectively. Dry and canned diets, and diets with and without a source of oligosaccharides in the ingredient list, were not different in energy density or concentrations of TDF, IDF, HMWSDF, or LMWSDF. Similarly, loaf-type (n = 11) and gravy-type (4) canned diets differed only in LMWSDF concentration. Disparities in TDF concentrations among products existed despite a lack of differences among groups. Limited differences in TDF concentration and dietary fiber composition were detected when diets were compared on the basis of carbohydrate concentration. Diets labeled for management of obesity were higher in TDF concentration and lower in energy density than diets for management of diabetes mellitus. CONCLUSIONS AND CLINICAL RELEVANCE Diets provided a range of TDF concentrations with variable concentrations of IDF, HMWSDF, and LMWSDF. Crude fiber concentration was not a reliable indicator of TDF concentration or dietary fiber composition. Because carbohydrate content is calculated as a difference, results suggested that use of crude fiber content would cause overestimation of both carbohydrate and energy content of diets.
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Affiliation(s)
- Tammy J Owens
- Veterinary Medical Teaching Hospital, University of California-Davis, Davis, CA 95616
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The effects of differing proportions of dietary macronutrients on the digestibility and post-prandial endocrine responses in domestic cats ( Felis catus). JOURNAL OF APPLIED ANIMAL NUTRITION 2015. [DOI: 10.1017/jan.2015.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe aim of this study was to compare the effects of feeding two diets with different macronutrient proportions (high protein, low carbohydrate and low protein, high carbohydrate) on the digestibility and post-prandial endocrine responses of cats fed at maintenance levels, and to evaluate the effectiveness of the marginal ear vein prick technique for the measurement of blood glucose levels in feline studies. Two diets were fed to 16 adult domestic short-haired cats for a period of three weeks (eight cats per diet). Following a seven-day dietary adaptation period, the apparent macronutrient digestibility of the two diets was determined (days 8-19) using the total faecal collection method. The faeces were freeze dried, ground and analysed for dry matter, crude protein, crude fat and gross energy and then apparent digestibility was calculated. On days 20 and 21, the post-prandial glucose responses of the cats fed a single meal of one of the two diets were measured in serial blood samples collected using the marginal ear vein prick technique.Results showed that the high protein, low carbohydrate diet had higher (p < 0.05) apparent digestibility of dry matter, crude protein, crude fat and energy, lower (p < 0.01) daily faecal output and smaller fluctuations in blood glucose concentrations. Despite the two groups of cats having similar calorific intakes, the cats fed the high protein diet lost weight over the study period, whereas those fed the high carbohydrate, low protein diet gained weight. The marginal ear vein prick technique proved to be an effective alternative to catheterisation for blood glucose determination. The high protein diet tested in the current study, in addition to being more aligned to the cat's natural carnivorous diet, may be beneficial for weight management and blood glucose control in cats.
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Sparkes AH, Cannon M, Church D, Fleeman L, Harvey A, Hoenig M, Peterson ME, Reusch CE, Taylor S, Rosenberg D. ISFM consensus guidelines on the practical management of diabetes mellitus in cats. J Feline Med Surg 2015; 17:235-50. [PMID: 25701862 PMCID: PMC11148891 DOI: 10.1177/1098612x15571880] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
PRACTICAL RELEVANCE Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. CLINICAL CHALLENGES Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently--unless hypoglycaemia is encountered. EVIDENCE BASE The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.
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Affiliation(s)
| | | | - David Church
- Professor, Small Animal Medicine and Surgery Group, The Royal Veterinary College, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - Linda Fleeman
- Animal Diabetes Australia, Rowville Veterinary Clinic, Rowville, VIC 3178, Australia
| | - Andrea Harvey
- Small Animal Specialist Hospital, North Ryde, NSW 2113, Australia
| | - Margarethe Hoenig
- Professor, Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana-Champaign, Illinois, USA
| | - Mark E Peterson
- Animal Endocrine Clinic, 21 West 100th Street, New York, NY 10025, USA
| | - Claudia E Reusch
- Professor & Director, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | | | - Dan Rosenberg
- Micen Vet Centre, 58 Rue Auguste Perret, Parc Technologique, Europarc, 9400 Créteil, France
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Abstract
Dietary macronutrients include protein, fat, and carbohydrates. Current nutritional recommendations establish minimums but not maximums for protein and fat but not for carbohydrates; thus, commercial feline maintenance diets have a wide range of macronutrient distribution depending on manufacturer, ingredients, and processing. There is growing interest and discussion, however, in defining the ideal macronutrient composition of feline diets to maximize longevity and health. Current recommendations should be tailored to each patient based on age, body condition, presence of muscle mass atrophy, and the presence of disease.
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Affiliation(s)
- Cecilia Villaverde
- Departament de Ciència Animal i dels Aliments (Animal and Food Science Department), Universitat Autònoma de Barcelona, Edifici V, Campus UAB, Bellaterra 08193, Spain.
| | - Andrea J Fascetti
- Department of Molecular Biosciences, University of California Davis, One Shields Avenue, Davis, CA 95616-8741, USA
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30
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Gottlieb S, Rand JS, Marshall R, Morton J. Glycemic status and predictors of relapse for diabetic cats in remission. J Vet Intern Med 2014; 29:184-92. [PMID: 25418027 PMCID: PMC4858081 DOI: 10.1111/jvim.12509] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 08/23/2014] [Accepted: 10/23/2014] [Indexed: 11/30/2022] Open
Abstract
Background It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance. Objective To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse. Animals A total of 21 cats in diabetic remission and 28 healthy control cats. Methods At a median of 107 days after remission, screening blood glucose concentration was measured on entry to the clinic. After a 24‐hour fast in hospital, fasting blood glucose, fructosamine and feline pancreatic lipase concentrations were measured, and 3 hours later, a simplified IV glucose tolerance test (1 g glucose/kg) performed. Twenty cats were monitored for relapse for at least 9 months. Results Of the 21 cats in remission, 19% (4/21) had impaired fasting glucose concentration and 76% (16/21) had impaired glucose tolerance. Of cats followed up for 9 months after testing, 30% (6/20) had relapsed and required insulin treatment. Fasting blood glucose concentration ≥7.5 mmol/L (≥135 mg/dL) (odds ratio [OR] = 12.8) and severely impaired glucose tolerance (≥5 hours to return to <6.5 mmol/L or <117 mg/dL; OR = 15.2) were significantly associated with relapse. Blood glucose concentration >14 mmol/L; 252 mg/dL at 3 hours was significantly associated with relapse (OR = 10.1). Conclusion and Clinical Importance Most cats in diabetic remission have impaired glucose tolerance and a minority have impaired fasting glucose concentration and should be considered prediabetic. More severe glucose intolerance and impaired fasting glucose concentration are predictors of relapse. Ongoing glucose monitoring of diabetic cats in remission is recommended.
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Affiliation(s)
- S Gottlieb
- The Cat Clinic, Brisbane, Qld, Australia
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Bloom CA, Rand J. Feline diabetes mellitus: clinical use of long-acting glargine and detemir. J Feline Med Surg 2014; 16:205-15. [PMID: 24563492 DOI: 10.1177/1098612x14523187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PRACTICAL RELEVANCE Diabetes mellitus is a common endocrine disorder in feline practice, affecting approximately 1 in 200 cats. The majority of diabetic cats have type 2 diabetes mellitus, which results from a combination of peripheral insulin resistance and a progressive reduction in insulin production. CLINICAL CHALLENGES While usually easy to diagnose, management of diabetes mellitus presents a number of challenges for practitioners and clients alike. Practitioners must decide on diet, insulin type and dose, monitoring method and intensity, and concomitant therapy, which will vary based on individual patient and client needs, and geographic location. Practitioners may also encounter patients with diabetic ketoacidosis or other diabetic complications, and patients with multiple concurrent diseases. Clients may be challenged by the substantial time and financial commitment involved in owning a diabetic cat. AUDIENCE Understanding the pathophysiology, optimal treatment protocols and current goals of diabetes management will benefit practitioners managing diabetic cats. This article reviews the most current management plans for feline diabetics. It places particular emphasis on best practice for achieving diabetic remission, which is an attainable goal in the majority of newly diagnosed diabetic cats. EVIDENCE BASE The information in this article is drawn from the recent human and veterinary literature, including prospective and retrospective studies. The body of prospective clinical data on the use of newer, long-acting insulins (glargine and especially detemir) in cats is limited, but growing.
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Affiliation(s)
- Carly Anne Bloom
- The Animal Medical Center, 510 East 62nd Street, New York, NY, 10065, USA
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Hafner M, Dietiker-Moretti S, Kaufmann K, Mueller C, Lutz TA, Reusch CE, Zini E. Intensive intravenous infusion of insulin in diabetic cats. J Vet Intern Med 2014; 28:1753-9. [PMID: 25312554 PMCID: PMC4895636 DOI: 10.1111/jvim.12449] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 07/15/2014] [Accepted: 08/04/2014] [Indexed: 11/28/2022] Open
Abstract
Background Remission occurs in 10–50% of cats with diabetes mellitus (DM). It is assumed that intensive treatment improves β‐cell function and increases remission rates. Hypothesis Initial intravenous infusion of insulin that achieves tight glycemic control decreases subsequent insulin requirements and increases remission rate in diabetic cats. Animals Thirty cats with newly diagnosed DM. Methods Prospective study. Cats were randomly assigned to one of 2 groups. Cats in group 1 (n = 15) received intravenous infusion of insulin with the goal of maintaining blood glucose concentrations at 90–180 mg/dL, for 6 days. Cats in group 2 (n = 15) received subcutaneous injections of insulin glargine (cats ≤4 kg: 0.5–1.0 IU, q12h; >4 kg 1.5–2.0 IU, q12h), for 6 days. Thereafter, all cats were treated with subcutaneous injections of insulin glargine and followed up for 6 months. Cats were considered in remission when euglycemia occurred for ≥4 weeks without the administration of insulin. Nonparametric tests were used for statistical analysis. Results In groups 1 and 2, remission was achieved in 10/15 and in 7/14 cats (P = .46), and good metabolic control was achieved in 3/5 and in 1/7 cats (P = .22), respectively. Overall, good metabolic control or remission occurred in 13/15 cats of group 1 and in 8/14 cats of group 2. In group 1, the median insulin dosage given during the 6‐month follow‐up was significantly lower than in group 2 (group 1: 0.32 IU/kg/day, group 2: 0.51 IU/kg/day; P = .013). Conclusions and Clinical Importance Initial intravenous infusion of insulin for tight glycemic control in cats with DM decreases insulin requirements during the subsequent 6 months.
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Affiliation(s)
- M Hafner
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Systematic review of feline diabetic remission: separating fact from opinion. Vet J 2014; 202:208-21. [PMID: 25312717 DOI: 10.1016/j.tvjl.2014.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 07/22/2014] [Accepted: 08/15/2014] [Indexed: 12/30/2022]
Abstract
It is increasingly recognised that diabetic remission is possible in the cat. This systematic review, following Cochrane Collaboration (CC) guidelines, critically appraises the level of evidence on factors influencing remission rate and factors predicting remission. A systematic online, bibliographic search and reference list examination was conducted. A level of evidence was assigned to each identified article by five internists using the Newcastle-Ottawa Scale for follow-up, cohort, case-series and case-control studies, the CC's risk of bias tool for trials and the Cochrane Effective Practice and Organisation of Care Group risk of bias criteria for before and after trials. Twenty-two studies were included in the review, assessing influence of pharmaceutical intervention (n = 14) and diet (n = 4), as well as diagnostic tests (n = 9) and feline patient characteristics (n = 5) as predictors of remission. The current level of evidence was found to be moderate to poor. Common sources of bias included lack of randomisation and blinding among trials, and many studies were affected by small sample size. Failure to provide criteria for the diagnosis of diabetes, or diabetic remission, and poor control of confounding factors were frequent causes of poor study design. Addressing these factors would significantly strengthen future research and ultimately allow meta-analyses to provide an excellent level of evidence. No single factor predicts remission and successful remission has been documented with a variety of insulin types and protocols. Dietary carbohydrate reduction might be beneficial, but requires further study. A lack of well-designed trials prevents reliable remission rate comparison. Factors associated with remission resemble those in human medicine and support the hypothesis that reversal of glucotoxicity is a major underlying mechanism for feline diabetic remission.
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Aptekmann KP, Armstrong J, Coradini M, Rand J. Owner Experiences in Treating Dogs and Cats Diagnosed With Diabetes Mellitus in the United StatesS. J Am Anim Hosp Assoc 2014; 50:247-53. [DOI: 10.5326/jaaha-ms-6101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to report owner experiences and satisfaction in treating a pet with diabetes mellitus using a descriptive report from an Internet-based survey. Descriptive analysis of results was performed, χ2 tests were used to detect differences in responses between dog and cat owners, and correlations were assessed using the nonparametric Spearman rank correlation. A total of 834 owners participated in the survey. More diabetic dogs (97%) than cats (82%) were treated with insulin injections. Insulin was administered twice daily in 87% of dogs and 73% of cats. Porcine lente and neutral protamine Hagedorn were the most commonly administered insulins in dogs. In cats, glargine and protamine zinc insulin were the most commonly used insulins. Most pets were not fed a prescribed diabetes diet. More cat (66%) than dog (50%) owners were satisfied with the diabetic control achieved. Cat owners were more likely to use home blood glucose monitoring. Treatment was considered expensive by the majority of owners. Few published reports follow diabetic pets after diagnosis or report owner satisfaction. The results of this study provide useful information that may help veterinarians better educate owners and set expectations regarding diabetes treatment and quality of life for diabetic pets.
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Affiliation(s)
- Karina P. Aptekmann
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Jane Armstrong
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Marcia Coradini
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Jacquie Rand
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
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Peterson ME, Eirmann L. Dietary Management of Feline Endocrine Disease. Vet Clin North Am Small Anim Pract 2014; 44:775-88, vi-vii. [DOI: 10.1016/j.cvsm.2014.03.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Nack R, DeClue AE. In cats with newly diagnosed diabetes mellitus, use of a near-euglycemic management paradigm improves remission rate over a traditional paradigm. Vet Q 2014; 34:132-6. [DOI: 10.1080/01652176.2014.924057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Karampinas PK, Evangelopoulos DS, Vlamis J, Nikolopoulos K, Korres DS. Confronting hip resurfacing and big femoral head replacement gait analysis. Orthop Rev (Pavia) 2014; 6:5221. [PMID: 24744841 PMCID: PMC3980157 DOI: 10.4081/or.2014.5221] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Accepted: 02/10/2014] [Indexed: 11/23/2022] Open
Abstract
Improved hip kinematics and bone preservation have been reported after resurfacing total hip replacement (THRS). On the other hand, hip kinematics with standard total hip replacement (THR) is optimized with large diameter femoral heads (BFH-THR). The purpose of this study is to evaluate the functional outcomes of THRS and BFH-THR and correlate these results to bone preservation or the large femoral heads. Thirty-one patients were included in the study. Gait speed, postural balance, proprioception and overall performance. Our results demonstrated a non-statistically significant improvement in gait, postural balance and proprioception in the THRS confronting to BFH-THR group. THRS provide identical outcomes to traditional BFH-THR. The THRS choice as bone preserving procedure in younger patients is still to be evaluated.
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Affiliation(s)
- Panagiotis K Karampinas
- Third Department of Orthopaedic Surgery, University of Athens, KAT Hospital , Athens, Greece
| | | | - John Vlamis
- Third Department of Orthopaedic Surgery, University of Athens, KAT Hospital , Athens, Greece
| | | | - Dimitrios S Korres
- Third Department of Orthopaedic Surgery, University of Athens, KAT Hospital , Athens, Greece
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An Overview of the Recent Developments on Fructooligosaccharide Production and Applications. FOOD BIOPROCESS TECH 2013. [DOI: 10.1007/s11947-013-1221-6] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Leal RO, Gil S, Brito MT, McGahie D, Niza MM, Tavares L. The use of oral recombinant feline interferon omega in two cats with type II diabetes mellitus and concurrent feline chronic gingivostomatitis syndrome. Ir Vet J 2013; 66:19. [PMID: 24153100 PMCID: PMC3816157 DOI: 10.1186/2046-0481-66-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Accepted: 10/02/2013] [Indexed: 11/29/2022] Open
Abstract
Feline Chronic Gingivostomatitis Syndrome (FCGS) is a common disease in clinical practice. Among the therapeutic options available, long-acting corticosteroids are frequently used due to their anti-inflammatory and immunosuppressive properties. Although they may improve the clinical symptoms, they can lead to a progressive form of the disease that becomes refractory to treatment. Furthermore, their direct relationship with type II diabetes mellitus (DM) is well known. Consequently, these drugs are controversial and not recommended for routine management of FCGS. Recombinant feline interferon-omega (rFeIFN-ω) is an immunomodulatory compound. Recently, its daily oral administration has been shown to be successful in treating refractory cases of FCGS. This case study describes two clinical cases of type II DM complicated by FCGS. Both animals were calicivirus positive and they had been previously treated with long-acting corticosteroids, which may have been the major cause of DM. The two cats were treated with glargine insulin (Lantus, starting dose 1 IU/cat twice daily (BID)), achieving remission 10 and 18 weeks later respectively. Considering the difficulty with control of FCGS in these animals, an oral daily dose of rFeIFN-ω was started as an alternative to long-acting corticosteroids. In both cats oral clinical signs gradually improved and 60 days after the start of therapy the owners reported a significant relief of pain during mastication. According to the authors’ knowledge, this is the first case report that describes the successful use of rFeIFN-ω in the management of FCGS in type II diabetic cats, in which long-acting corticosteroids are contraindicated.
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Affiliation(s)
- Rodolfo O Leal
- Centro de Investigação Interdisciplinar em Sanidade Animal (CIISA), Faculdade de Medicina Veterinária, Technical University of Lisbon (TULisbon), Av, Universidade Técnica, 1300-477 Lisbon, Portugal.
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Farrow HA, Rand JS, Morton JM, O'Leary CA, Sunvold GD. Effect of dietary carbohydrate, fat, and protein on postprandial glycemia and energy intake in cats. J Vet Intern Med 2013; 27:1121-35. [PMID: 23869495 DOI: 10.1111/jvim.12139] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Revised: 03/13/2013] [Accepted: 05/29/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Reducing carbohydrate intake is recommended in diabetic cats and might also be useful in some healthy cats to decrease diabetes risk. OBJECTIVE To compare postprandial glucose and insulin concentrations and energy intakes between cats fed diets high in protein, fat, or carbohydrate. ANIMALS Twenty-four lean cats with normal glucose tolerance. METHODS In a prospective randomized study, each of 3 matched groups (n = 8) received a different test diet for 5 weeks. Diets were high in either protein (46% of metabolizable energy [ME]), fat (47% ME), or carbohydrate (47% ME). Glucose and insulin were measured during glucose tolerance, ad libitum, and meal-feeding tests. RESULTS During ad libitum feeding, cats fed the high-carbohydrate diet consumed 25% and 18% more carbohydrate than cats fed diets high in fat and protein, respectively, and energy intake was highest when the high-fat and high-protein diets were fed. Regardless of the feeding pattern, cats fed the high-carbohydrate diet had 10-31% higher peak and mean glucose compared with both other diets; peak glucose in some cats reached 10.4 mmol/L (188 mg/dL) in cats fed 47% ME carbohydrate and 9.0 mmol/L (162 mg/dL) in cats fed 23% ME. CONCLUSIONS AND CLINICAL IMPORTANCE High-carbohydrate diets increase postprandial glycemia in healthy cats compared with diets high in fat or protein, although energy intake is lower. Avoidance of high- and moderate-carbohydrate diets can be advantageous in cats at risk of diabetes. Maintenance energy requirements should be fed to prevent weight gain when switching to lower carbohydrate diets.
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Affiliation(s)
- H A Farrow
- School of Veterinary Science, The University of Queensland, Brisbane, Qld, Australia
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Factors associated with clinical remission in cats with diabetes mellitus. ACTA VET BRNO 2013. [DOI: 10.2754/avb201281040421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Type 2 diabetes mellitus is a common endocrine disease in cats. The aim of this study was to investigate factors that are associated with clinical remission in diabetic cats, and those that might influence survival time. Medical records of 29 cats with diabetes mellitus were evaluated retrospectively. Data collected from each record included breed, age, and sex, types of diet before and after admission, degree of weight loss, duration of clinical signs before admission, elevation of alanine aminotransferase activity and ketonuria at the time of admission, concurrent pancreatitis or renal failure, glipizide administration, insulin supplement, and survival time. The diet after establishing diagnosis (restriction to non-carbohydrate canned food) was the only factor that was significantly associated with achieving clinical remission (P < 0.001). Survival time of cats was positively associated (P = 0.004) with clinical remission status and the type of diet after admission (P = 0.04) and negatively associated with the presence of chronic renal failure (P = 0.04). This was the first report of feline diabetes mellitus from Taiwan.
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Roomp K, Rand JS. Management of Diabetic Cats with Long-acting Insulin. Vet Clin North Am Small Anim Pract 2013; 43:251-66. [DOI: 10.1016/j.cvsm.2012.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mimura K, Mori A, Lee P, Ueda K, Oda H, Saeki K, Arai T, Sako T. Impact of commercially available diabetic prescription diets on short-term postprandial serum glucose, insulin, triglyceride and free fatty acid concentrations of obese cats. J Vet Med Sci 2013; 75:929-37. [PMID: 23449461 DOI: 10.1292/jvms.12-0310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Diet therapy is an important treatment component available for obese cats. In this study, the impact of four commercially available prescription diet regimens (1 for general use and 3 aimed at treating obesity and diabetes mellitus (DM)) on short-term postprandial serum glucose, insulin, triglyceride and nonesterified fatty acid (NEFA) concentrations was investigated with five obese cats. The diet regimens used were as follows: C/D dry (general use: moderate protein, moderate fat, high carbohydrate and low fiber), M/D dry (DM: high protein, high fat, low carbohydrate and high fiber), W/D dry (DM: high protein, low fat, high carbohydrate and high fiber) and Diabetic dry (DM: high protein, low fat, low carbohydrate and high fiber). A significant reduction (10-13%) in postprandial glucose (area under the curve; AUC) was observed with the M/D and Diabetic diets, which both contained lower concentrations of carbohydrates than the C/D diet. An accompanying significant reduction (30-36%) in postprandial insulin AUC was also observed with the three DM diets, which all had higher amounts of fiber, as compared with the C/D diet. Lastly, a significant increase (32-65%) in postprandial NEFA AUC was observed with the M/D and Diabetic diets as compared with the C/D diet. Therefore, dietary amounts of carbohydrates and fiber, as opposed to protein content or dietary fat, appear to have a very significant impact on postprandial glycemia and subsequent insulin requirement levels in obese cats. In addition, dietary amounts of carbohydrates may also impact lipid metabolism in obese cats.
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Affiliation(s)
- Kana Mimura
- Department of Veterinary Nursing and Technology, School of Veterinary Science, Nippon Veterinary and Life Science University, 1-7-1 Kyonancho, Musashino, Tokyo 180-8602, Japan
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Zoran DL, Rand JS. The Role of Diet in the Prevention and Management of Feline Diabetes. Vet Clin North Am Small Anim Pract 2013; 43:233-43. [DOI: 10.1016/j.cvsm.2012.11.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Smith JR, Vrono Z, Rapoport GS, Turek MM, Creevy KE. A survey of Southeastern United States veterinarians' preferences for managing cats with diabetes mellitus. J Feline Med Surg 2012; 14:716-22. [PMID: 22661022 PMCID: PMC11104109 DOI: 10.1177/1098612x12450169] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
This study evaluated primary practitioners' perceptions of managing feline diabetics. Surveys distributed during local continuing education events achieved a response rate of 46% (90/195). A mean of 74% feline diabetics required chronic insulin; 26% were transient diabetics. Choice of insulin was most influenced by duration of action: human recombinant protamine zinc insulin was ranked first (42%) and glargine second (27%). Dietary management was always/usually recommended by 97% respondents, with prescription or proprietary low-carbohydrate, high-protein diets recommended in 93% responses. More recent graduates (P=0.0419), those who worked in larger practices (P=0.0315), and those who saw more transient diabetics (P=0.0288) were more likely to recommend dietary change. In-house blood glucose curves (BGCs) were the most popular method of assessing glycemic control, while at-home BGCs were least popular, although their use correlated positively with annual diabetic caseload (r=0.43, P=0.0239). Owners mishandling insulin was cited as the most common cause of poor glycemic control, while clinical signs of acromegaly were rarely recognized.
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Affiliation(s)
- Jo R Smith
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602, USA.
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Verbrugghe A, Hesta M, Daminet S, Janssens GPJ. Nutritional modulation of insulin resistance in the true carnivorous cat: a review. Crit Rev Food Sci Nutr 2012; 52:172-82. [PMID: 22059962 DOI: 10.1080/10408398.2010.499763] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Cats are strict carnivores that rely on nutrients in animal tissues to meet their specific and unique nutritional requirements. In their natural habitat, cats consume prey high in protein with moderate amounts of fat and minimal carbohydrates in contrast to commercial diets, which are sometimes moderate to high in carbohydrates. This change in diet has been accompanied by a shift from an outdoor environment to an indoor lifestyle and decreased physical activity, because cats no longer need to hunt to obtain food. This transformation of the lifestyle of cats is thought to be responsible for the recent increase in incidence of obesity, insulin resistance, and diabetes mellitus in domestic cats. At first, an overview of the evolutionary physiological adaptations of carbohydrate digestion in the feline digestive tract and of the hepatic carbohydrate and protein metabolism reflecting the true carnivorous nature of cats is given. Secondly, this literature review deals with nutritional modulation of insulin sensitivity, focusing on dietary macronutrients, carbohydrate sources, and dietary fiber for prevention and treatment of insulin resistance.
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