Progressive loss of sensitivity of the A cell to insulin in geese made diabetic by subtotal pancreatectomy

Glucose Homeostasis and Derangement in Birds

Birds (class Aves) have 1.5 to 2 times higher blood glucose concentrations than mammals of comparable sizes. The reasons for this have been studied and are believed to be multifactorial. There is low expression of insulin receptors, decreased sensitivity of the pancreatic β-cells to glucose, an absent or dysfunctional glucose transporter type 4 pathway, and increased blood glucagon concentrations. Glucagon and somatostatin appear to play a greater role than insulin in glucose homeostasis in birds. Severe hyperglycemia in birds can be attributed to diabetes mellitus, necessitating therapy to prevent short-term and long-term deleterious effects.

Diabetes Mellitus With Concurrent Cerebellar Degeneration and Necrosis in a Domestic Goose ( Anser anser domesticus)

A 5-year-old sexually intact male Toulouse goose ( Anser anser domesticus) was presented for ataxia, polyuria, and polydipsia. The goose was cachectic and exhibited head tremors. Results of plasma biochemical analysis and point-of-care glucometry revealed persistent hyperglycemia. Despite supportive care and oral glipizide, the goose died within 48 hours of presentation. Necropsy revealed severe pancreatic atrophy and fibrosis with regionally extensive cerebellar encephalomalacia and generalized Purkinje cell degeneration and necrosis. On a wet basis, hepatic zinc concentration was determined to be twice the reference interval by atomic absorption spectroscopy. Based on these findings, the pancreatic insufficiency with secondary diabetes mellitus was attributed to chronic zinc toxicosis. Despite birds' relative resistance to high blood glucose concentrations, prolonged hyperglycemia is suspected to have caused selective Purkinje cell degeneration and necrosis by glial activation, mitochondrial dysfunction, and glutamate toxicity, which resulted in the clinically observed motor deficits. This is consistent with experimental diabetic rat models. This case highlights the need for further investigation of the complex pathophysiology of diabetes mellitus in birds.

The avian pancreas in health and disease

The avian endocrine pancreas shares some similarities with mammals but also some clinically relevant differences in anatomy and physiology. Diabetes mellitus, an uncommon disease of pet birds, is a challenging condition because of lack of knowledge of the exact pathophysiology and responses to insulin therapy. This article reviews the anatomy and physiology of the avian pancreas and describes the etiology, diagnosis, and treatment of diabetes mellitus in pet birds.

Diabetes mellitus concurrent with hepatic haemosiderosis in two macaws (Ara severa, Ara militaris)

Diabetes mellitus was diagnosed in a 5-year-old male chestnut-fronted macaw (Ara severa) and an 8-year-old female Military macaw (Ara militaris) based on persistent hyperglycaemia and glucosuria. Hepatic biopsies showed marked hepatic haemosiderosis, while pancreatic biopsies showed no inflammatory lesions. Repeatable and titratable responses to bovine or porcine protamine zinc insulin were recorded in both patients, who were followed up for more than 2 years. In addition, iron-elimination therapy was initiated by chelation or phlebotomy, and the birds' diet was changed to low-iron content pellets. Both birds responded favourably to this therapy, showing a decreased demand for extrinsic insulin. Follow-up biopsies demonstrated marked reduction in hepatic haemosiderin. Plasma fructosamine and beta-hydroxybutyric acid levels were measured periodically in both birds and compared with euglycaemic psittacines. Both tests appeared useful for monitoring treatment success. The potential association between diabetes mellitus and excessive iron storage in birds should be further investigated.