Diagnosis of diabetes mellitus in cats and dogs

Anesthetic Considerations in Dogs and Cats with Diabetes Mellitus

Understanding the effects of diabetes and hyperglycemia on hydration, acid-base status, and immune function is paramount to safely anesthetizing diabetic cats and dogs. Preoperative stabilization of glucose concentrations, hydration, and electrolyte imbalances is key to minimizing morbidity and mortality. Blood glucose monitoring perioperatively will help guide insulin and dextrose administration. Specific anesthetic considerations, and peri-anesthetic management of animals with diabetes mellitus, including anesthetic drugs and recommended insulin protocols are discussed.

Fibroblast growth factor-21 (FGF21) analogs as possible treatment options for diabetes mellitus in veterinary patients

Fibroblast growth factors (FGFs) are involved in numerous metabolic processes. The endocrine subfamily of FGFs, consisting of FGF19, FGF21, and FGF23, might have beneficial effects in the treatment of diabetes mellitus (DM) and/or obesity. The analog with the greatest potential, FGF21, lowers blood glucose levels, improves insulin sensitivity, and induces weight loss in several animal models. In this review we summarize recent (pre)clinical findings with FGF21 analogs in animal models and men. Furthermore, possible applications of FGF21 analogs for pets with DM will be discussed. As currently, information about the use of FGF21 analogs in pet animals is scarce.

Complete Blood Counts and Blood Smear Analyses in 312 Diabetic Dogs (2007-2017)

Diabetes mellitus is a common endocrinopathy in dogs that has been associated with various biochemical changes and comorbid diseases, but hematologic abnormalities have been rarely reported. The aim of this retrospective study was to evaluate complete blood count and blood smear alterations and to describe their relationship with, and incidence of comorbid diseases in, diabetic dogs. Three-hundred twelve diabetic dogs, 286 dogs diagnosed with systemic, nondiabetic illnesses, and 506 healthy dogs were identified during the study period. Groups were compared using contingency tables and logistic regression. Associations between statistically significant complete blood count and blood smear alterations and comorbidities were evaluated using multivariable analysis. High-grade codocytosis and anisocytosis were identified more frequently in diabetic dogs, whereas high-grade reactive lymphocytosis and keratocytosis were identified less frequently (P < .001). Diabetic dogs with high-grade codocytosis had lower red blood cell, hemoglobin, hematocrit and higher white blood cell counts (P < .001). Diabetic ketoacidosis was diagnosed more frequently in diabetic dogs with high-grade codocytosis when compared with those with low-grade codocytosis (P < .001) or when compared with any other cell morphologic alterations. This study suggests that blood smear analysis should be a routine part of the evaluation of diabetic dogs.

Dosing obese cats based on body weight spuriously affects some measures of glucose tolerance

The primary objective was to investigate whether dosing glucose by body weight results in spurious effects on measures of glucose tolerance in obese cats because volume of distribution does not increase linearly with body weight. Healthy research cats (n = 16; 6 castrated males, 10 spayed females) were used. A retrospective study was performed using glucose concentration data from glucose tolerance and insulin sensitivity tests before and after cats were fed ad libitum for 9 to 12 mo to promote weight gain. The higher dose of glucose (0.5 vs 0.3 g/kg body weight) in the glucose tolerance tests increased 2-min glucose concentrations (P < 0.001), and there was a positive correlation between 2-min and 2-h glucose (r = 0.65, P = 0.006). Two-min (P = 0.016 and 0.019, respectively), and 2-h (P = 0.057 and 0.003, respectively) glucose concentrations, and glucose half-life (T1/2; P = 0.034 and <0.001 respectively) were positively associated with body weight and body condition score. Glucose dose should be decreased by 0.05 g for every kg above ideal body weight. Alternatively, for every unit of body condition score above 5 on a 9-point scale, observed 2-h glucose concentration should be adjusted down by 0.1 mmol/L. Dosing glucose based on body weight spuriously increases glucose concentrations at 2 h in obese cats and could lead to cats being incorrectly classified as having impaired glucose tolerance. This has important implications for clinical studies assessing the effect of interventions on glucose tolerance when lean and obese cats are compared.

Diagnosis of prediabetes in cats: glucose concentration cut points for impaired fasting glucose and impaired glucose tolerance

Diabetes is typically diagnosed in cats once clinical signs are evident. Diagnostic criteria for prediabetes in cats have not been defined. The objective of the study was to establish methodology and cut points for fasting and 2-h blood glucose concentrations in healthy client-owned senior cats (≥8 yr) using ear/paw samples and a portable glucose meter calibrated for feline blood. Of the 78 cats, 27 were ideal (body condition score [BCS] 4 or 5 of 9), 31 overweight (BCS 6 or 7), and 20 obese (BCS 8 or 9); 19 were Burmese and 59 non-Burmese. After an 18-24-h fast and an ear/paw blood glucose measurement using a portable glucose meter, glucose (0.5 g/kg bodyweight) was administered intravenous and blood glucose measured at 2 min and 2 h. Cut points for fasting and 2-h glucose concentrations were defined as the upper limits of 95% reference intervals using cats with BCS 4 or 5. The upper cut point for fasting glucose was 6.5 mmol/L. Of the overweight and obese cats, 1 (BCS 7) was above this cut point indicating evidence of impaired fasting glucose. The cut point for 2-h glucose was 9.8 mmol/L. A total of 7 cats (4 with BCS 8 or 9 including 1 Burmese; 3 with BCS 6 or 7, non-Burmese) were above this cut point and thus had evidence of impaired glucose tolerance. In conclusion, the methodology and cutpoints for diagnosis of prediabetes are defined for use in healthy cats 8 yr and older with a range of BCSs.

A survey of owner attitudes and experiences in managing diabetic dogs

A survey of the experiences of owners of diabetic dogs was carried out by distributing questionnaires to veterinary clinics in São Paulo, Brazil. A total of 93 dog owners were surveyed over a 4 month period and descriptive statistical analysis, frequency distribution and correlations were performed. In most cases the clinical condition of the dogs had improved following treatment and owners were largely satisfied with veterinary intervention. Injection of neutral protamine hagedorm twice daily was the most commonly prescribed treatment and respondents found this procedure easy to perform, although it did pose some difficulties when the owners were away from their animals. Cost was considered an important factor at the initiation of treatment programs. The information gleaned from this survey, in providing useful insights into the attitudes and experiences of owners of diabetic animals, will contribute to improvements in the treatment and management of such patients.

Diabetes in people, cats, and dogs: biomedicine and manifold ontologies

If people express salient beliefs and values in caring for pets then it is worth considering that dogs and housecats are routinely treated using the biomedical armamentarium. To investigate animal-human connections in the treatment of dogs and housecats for diabetes, we conducted ethnographic interviews in Canada with 12 pet owners and six health professionals in conjunction with a review of documentation on diabetes in cats, dogs, and people. Treating dogs and housecats for diabetes, we conclude, pivots on recognition of these animals as sentient selves. At the same time, treating diabetes in dogs and housecats helps to produce a named disease as a physical thing. In treating a housecat or a dog for diabetes, pet owners breach one of the foundational distinctions of Western science: human and nonhuman bodies exhibit continuity in terms of physicality, but a fundamental discontinuity exists when it comes to interiority.

Mechanisms and outcomes of drug- and toxicant-induced liver toxicity in diabetes

Increase dincidences of hepatotoxicity have been observed in diabetic patients receiving drug therapies. Neither the mechanisms nor the predisposing factors underlying hepatotoxicity in diabetics are clearly understood. Animal studies designed to examine the mechanisms of diabetes-modulated hepatotoxicity have traditionally focused only on bioactivation/detoxification of drugs and toxicants. It is becoming clear that once injury is initiated, additional events determine the final outcome of liver injury. Foremost among them are two leading mechanisms: first, biochemical mechanisms that lead to progression or regression of injury; and second, whether or not timely and adequate liver tissue repair occurs to mitigate injury and restore liver function. The liver has a remarkable ability to repair and restore its structure and function after physical or chemical-induced damage. The dynamic interaction between biotransformation-based liver injury and compensatory tissue repair plays a pivotal role in determining the ultimate outcome of hepatotoxicity initiated by drugs or toxicants. In this review, mechanisms underlying altered hepatotoxicity in diabetes with emphasis on both altered bioactivation and liver tissue repair are discussed. Animal models of both marked sensitivity (diabetic rats) and equally marked protection (diabetic mice) from drug-induced hepatotoxicity are described. These examples represent a remarkable species difference. Availability of the rodent diabetic models offers a unique opportunity to uncover mechanisms of clinical interest in averting human diabetic sensitivity to drug-induced hepatotoxicities. While the rat diabetic models appear to be suitable, the diabetic mouse models might not be suitable in preclinical testing for potential hepatotoxic effects of drugs or toxicants, because regardless of type 1 or type2 diabetes, mice are resistant to acute drug-or toxicant-induced toxicities.

Home monitoring of the diabetic pet

Home monitoring of the diabetic pet is a challenging proposition for many pet owners. Diabetes, unlike many other diseases, requires that the client, not the veterinarian, treat the disease. It is crucial that veterinarians reinforce and educate clients that successful treatment of diabetes mellitus will depend solely on the client's actions throughout the course of the treatment. This article provides guidelines on educating clients in the home monitoring process. This commonsense approach covers elements of in-home monitoring, including general appearance, clinical signs, behavior changes, feeding schedules, and medication administration. Additionally, thorough explanation is provided for clients who wish to take a more active role in obtaining and monitoring blood and urine chemistry values. This information is provided to assist the veterinary technician and veterinarian in educating clients of their responsibility in treating this disease.