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Mott J, Dolan JK, Gilor C, Gilor S. Establishment of a feline glycated hemoglobin reference interval for a novel dried-blood-spot assay and the effects of anemia on assay results. Vet Clin Pathol 2023; 52:531-539. [PMID: 37408106 DOI: 10.1111/vcp.13257] [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: 08/28/2022] [Revised: 03/07/2023] [Accepted: 03/25/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Glycated hemoglobin A1c (HbA1c) reflects long-term (months) glycemic control and has been previously investigated as a monitoring and diagnostic tool in diabetic cats. However, a standardized, reliable, and globally available test and reference intervals (RIs) have not been established. A novel dried-blood-spot card system (A1Care, Baycom Diagnostics) allows for easy collection and evaluation of HbA1c levels in feline patients. OBJECTIVE We aimed to establish an RI for HbA1c values in healthy adult cats using the A1Care (Baycom Diagnostics) dried-blood-spot card system. METHODS Forty-one healthy client-owned adult cats were enrolled in this study. The RI for HbA1c was calculated according to the recommendation of the American Society for Veterinary Clinical Pathology. RESULTS The A1Care HbA1c RI for cats was determined to be 1.9%-3.1%. In healthy cats, A1Care HbA1c values were positively correlated with age (Spearman rho = 0.4 [95% CI 0.1 to 0.6], P = 0.01). In 50% of anemic cats, the A1Care HbA1c value was above 3.1%. There was a weak negative correlation between the A1Care HbA1c value and PCV (Spearman rho = -0.4 [95% CI -0.6 to -0.1]). CONCLUSIONS This study established an RI for HbA1c in healthy adult cats similar to previously reported RIs. Future clinical studies are necessary to substantiate that this RI can differentiate diabetic from nondiabetic cats. Further long-term clinical studies will be valuable to determine if HbA1c values can be used as a screening test for prediabetes in cats.
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Affiliation(s)
- Jocelyn Mott
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Jacqueline K Dolan
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Chen Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Shir Gilor
- Department of Comparative, Diagnostic and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Validation, reference intervals and overlap performance of a new commercially available automated capillary electrophoresis assay for the determination of the major fraction of glycated haemoglobin (HbA1c) in dogs. Vet J 2018; 234:48-54. [DOI: 10.1016/j.tvjl.2018.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/08/2018] [Accepted: 02/11/2018] [Indexed: 11/22/2022]
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3
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Wiedmeyer CE, DeClue AE. Glucose Monitoring in Diabetic Dogs and Cats: Adapting New Technology for Home and Hospital Care. Clin Lab Med 2011; 31:41-50. [DOI: 10.1016/j.cll.2010.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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4
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Antidiabetic and antioxidative effects of hydro-methanolic extract of sepals of Salmalia malabarica in streptozotocin induced diabetic rats. J Appl Biomed 2010. [DOI: 10.2478/v10136-009-0004-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
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Behrend EN. Update on Drugs Used to Treat Endocrine Diseases in Small Animals. Vet Clin North Am Small Anim Pract 2006; 36:1087-105, vii. [PMID: 16984828 DOI: 10.1016/j.cvsm.2006.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Drug therapy for the endocrine system is implemented to replace a hormone deficiency or to prevent or reduce the formation or effects of excess hormone. Treatment of endocrine disorders covers diseases of the pituitary, adrenal, parathyroid, and thyroid glands as well as the endocrine pancreas. This article focuses on new therapies currently available for specific diseases. Administration of trilostane for treatment of hyperadrenocorticism and use of insulin glargine, protamine zinc insulin (PZI), and porcine Lente insulin for diabetes mellitus are discussed. In addition, transdermal methimazole therapy for treatment of feline hyperthyroidism and administration of progestins for pituitary dwarfism are considered.
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Affiliation(s)
- Ellen N Behrend
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
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Wiedmeyer CE, Johnson PJ, Cohn LA, Meadows RL, Kerl ME, Tessman RK, Perlis J, DeClue AE. Evaluation of a continuous glucose monitoring system for use in veterinary medicine. Diabetes Technol Ther 2005; 7:885-95. [PMID: 16386094 DOI: 10.1089/dia.2005.7.885] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND With the emergence of continuous glucose monitoring systems being used to provide a detailed glucose picture in humans, a commercially available system (CGMS(R), Medtronic Minimed, Northridge, CA) was examined for use in veterinary species. METHODS Adult, clinically normal horses (n = 7), cats (n = 3), dogs (n = 4), and cows (n = 5) were studied. Cats (n = 4), dogs (n = 5), and one horse with diabetes were included in the study. Several of the normal horses, including the horse with diabetes, and one cow were subjected to an intravenous glucose tolerance test. The CGMS was attached to each animal, and the recorded interstitial glucose concentrations were compared with whole blood glucose concentrations as determined by a point-of-care glucose meter. Events such as insulin administration, feeding, travel, or administration of intravenous glucose were all noted and compared with results from the CGMS. RESULTS There was a positive correlation between interstitial and whole blood glucose concentrations for all the clinically normal species, those with diabetes mellitus, and those receiving intravenous glucose. Events such as feeding, glucose or insulin administration, and transport to the clinic were noted by the owner or clinician and could be identified on the graph and correlated with time of occurrence. CONCLUSIONS Our data indicate that the use of the CGMS is valid for use in the species examined. Use of this system alleviated the need for multiple blood samples and the stress associated with obtaining those samples. This system may provide greater monitoring capabilities in patients with diabetes and promote the diagnostic and research potential of serial glucose monitoring in veterinary species.
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Affiliation(s)
- Charles E Wiedmeyer
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, Missouri 65211, USA.
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Abstract
Feline diabetes is a multifactorial disease with genetic and environmental factors, including diet, excess body weight, and physical inactivity, involved in its pathogenesis. Although type 2 diabetes is most common in cats, most cats are insulin-dependent at the time of diagnosis. If good glycemic control can be achieved early after diagnosis, a substantial proportion of diabetic cats go into clinical remission. Diabetic remission may be facilitated by using a low-carbohydrate-high-protein diet combined with a long-acting insulin, such as glargine, administered twice daily. Rather than just controlling clinical signs, these new treatment modalities make curing feline diabetes a realistic goal for practitioners.
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Affiliation(s)
- Jacquie S Rand
- Centre for Companion Animal Health, School of Veterinary Science, The University of Queensland, Brisbane, Queensland 4072, Australia.
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Wiedmeyer CE, Johnson PJ, Cohn LA, Meadows RL. Evaluation of a continuous glucose monitoring system for use in dogs, cats, and horses. J Am Vet Med Assoc 2004; 223:987-92. [PMID: 14552487 DOI: 10.2460/javma.2003.223.987] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate a continuous glucose monitoring system (CGMS) for use in dogs, cats, and horses. DESIGN Prospective clinical study. Animals-7 horses, 3 cats, and 4 dogs that were clinically normal and 1 horse, 2 cats, and 3 dogs with diabetes mellitus. PROCEDURE Interstitial glucose concentrations were monitored and recorded every 5 minutes by use of a CGMS. Interstitial glucose concentrations were compared with whole blood glucose concentrations as determined by a point-of-care glucose meter. Interstitial glucose concentrations were also monitored in 2 clinically normal horses after oral and i.v. administration of glucose. RESULTS There was a positive correlation between interstitial and whole blood glucose concentrations for clinically normal dogs, cats, and horses and those with diabetes mellitus. Events such as feeding, glucose or insulin administration, restraint, and transport to the clinic were recorded by the owner or clinician and could be identified on the graph and associated with time of occurrence. CONCLUSIONS AND CLINICAL RELEVANCE Our data indicate that use of CGMS is valid for dogs, cats, and horses. This system alleviated the need for multiple blood samples and the stress associated with obtaining those samples. Because hospitalization was not required, information obtained from the CGMS provided a more accurate assessment of the animal's glucose concentrations for an extended period, compared with measurement of blood glucose concentrations. Use of the CGMS will promote the diagnostic and research potential of serial glucose monitoring.
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Affiliation(s)
- Charles E Wiedmeyer
- Veterinary Medical Diagnostic Laboratory, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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Nelson R, Spann D, Elliott D, Brondos A, Vulliet R. Evaluation of the Oral Antihyperglycemic Drug Metformin in Normal and Diabetic Cats. J Vet Intern Med 2004. [DOI: 10.1111/j.1939-1676.2004.tb00130.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Up to one quarter of diabetic cats can be well controlled with oral hypoglycemic drugs, although at least 75% require insulin therapy. Most available insulins provide good clinical control but only moderate glycemic control. Because mild to moderate hyperglycemia is well tolerated by cats receiving insulin but hypoglycemia can be life threatening, conservative insulin dosing is recommended. Clinical signs and water intake indicate whether a dose adjustment is required, but serial blood glucose measurements are usually needed to determine the direction of the adjustment. Starting doses of 0.3 to 0.5 IU/kg administered twice daily (rounded down to the nearest whole unit) are usually safe. Dose adjustments should not exceed 1 IU per cat every 2 to 4 weeks unless clinical hypoglycemia has occurred. Cats with clinical hypoglycemia need to be reassessed to see if they are in remission. If not, a 50% to 75% reduction in dose is advised. Approximately 30% of cats go into diabetic remission 1 to 4 months after an adequate treatment protocol is instituted.
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Affiliation(s)
- J S Rand
- Companion Animal Centre for Diabetes and Obesity, Companion Animal Sciences, School of Veterinary Science, University of Queensland, Queensland, Australia.
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Nelson RW, Scott-Moncrieff JC, Feldman EC, DeVries-Concannon SE, Kass PH, Davenport DJ, Kiernan CT, Neal LA. Effect of dietary insoluble fiber on control of glycemia in cats with naturally acquired diabetes mellitus. J Am Vet Med Assoc 2000; 216:1082-8. [PMID: 10754667 DOI: 10.2460/javma.2000.216.1082] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of dietary insoluble fiber on control of glycemia in cats with naturally acquired diabetes mellitus. DESIGN Randomized controlled crossover trial. ANIMALS 16 cats with naturally acquired diabetes mellitus. PROCEDURE Cats were fed a diet high in insoluble fiber (HF) containing 12% cellulose (dry-matter basis) or a diet low in insoluble fiber (LF) for 24 weeks; they were fed the other diet for the subsequent 24 weeks. Caloric intake and insulin treatment were adjusted to maintain stable body weight and control of glycemia, respectively. Cats were allowed an adaptation period of 6 weeks after initiation of a diet, after which control of glycemia was evaluated at 6-week intervals for 18 weeks. Variables assessed included serum glucose concentration measured during the preprandial state, blood glycated hemoglobin concentration, serum glucose concentration measured at 2-hour intervals for 12 hours beginning at the time of the morning insulin injection, 12-hour mean serum glucose concentration, and mean fluctuation in serum glucose concentration from the 12-hour mean serum glucose concentration. RESULTS Mean daily caloric intake, body weight, or daily insulin dosage did not differ significantly between cats when fed HF and LF diets. Mean preprandial serum glucose concentration, most post-prandial serum glucose concentrations, and the 12-hour mean serum glucose concentration were significantly lower when cats consumed the HF diet, compared with values when cats consumed the LF diet. CONCLUSIONS AND CLINICAL RELEVANCE These results support feeding a commercially available diet containing approximately 12% insoluble fiber (dry-matter basis) to cats with naturally acquired diabetes mellitus.
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Affiliation(s)
- R W Nelson
- Department of Medicine, School of Veterinary Medicine, University of California, Davis 95616, USA
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Martin G, Rand J. Current understanding of feline diabetes: part 2, treatment. J Feline Med Surg 2000; 2:3-17. [PMID: 11716587 PMCID: PMC10829197 DOI: 10.1053/jfms.2000.0057] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/1999] [Indexed: 11/11/2022]
Abstract
When treating diabetic cats, the primary aim is to control clinical signs without causing clinical hypoglycaemia. Secondary goals are to maximise the chances of attaining diabetic remission and to minimise the risk of complications due to chronic hyperglycaemia. A treatment plan that is convenient for the owner is important for compliance. Underweight or overweight diabetic cats should be fed with the aim of normalising bodyweight. Current evidence suggests that non-obese diabetic cats can be fed ad libitum. The oral hypoglycaemic drug glipizide is well established as a treatment for about a third of diabetic cats, which have residual beta cell function. Preliminary studies on other oral agents such as vanadium salts, metformin, and troglitazone indicate a potential use in some diabetic cats. Insulin treatment remains the treatment of choice for the majority of diabetic cats. Choice of insulin, dose rates and monitoring of treatment are discussed.
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Affiliation(s)
- G Martin
- Companion Animal Sciences, School of Veterinary Science and Animal Production, The University of Queensland, Australia 4072
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Abstract
Changes in glycosylated hemoglobin (GHb) concentrations, K values (% disappearance of glucose/min after an intravenous injection of 1 g/kg dextrose), and blood glucose concentrations were examined in eight cats before and during the induction of diabetes, and in four of these cats after they were placed on insulin treatment. There was a statistically significant separation of GHb, K values, and fasting blood glucose concentrations between healthy and diabetic cats. Changes in GHb correlated best with the K value and single weekly fasting glucose concentrations averaged over eight periods for each cat while diabetes was induced (R = 0.80 and 0.78, respectively); however, fasting blood glucose concentrations obtained on the day of the GHb measurement were also highly correlated (R = 0.69; P < 0.001). The correlation between GHb and single weekly glucose concentrations obtained in insulin-treated cats at the time of insulin peak action and averaged over an 8-wk time period for each cat was less but still significant (R = 0.53; P < 0.001). It is concluded that GHb measurements are a simple and reliable way to monitor changes in glucose control in the diabetic cat over a prolonged period.
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Affiliation(s)
- M Hoenig
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens 30602-7389, USA.
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Haberer B, Reusch CE. Glycated haemoglobin in various pathological conditions: investigations based on a new, fully automated method. J Small Anim Pract 1998; 39:510-7. [PMID: 9846312 DOI: 10.1111/j.1748-5827.1998.tb03696.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A new automated affinity chromatographic method for determining glycated haemoglobin (GHb) in dogs and cats was tested. The method appeared to be practical, quick and accurate. The reference range, calculated on the basis of 50 healthy dogs and 43 healthy cats, lay between 2.4 and 3.4 per cent in dogs and 2.0 and 2.9 per cent in cats. Concentrations were not influenced by age or gender. GHb levels obtained for 21 dogs and 18 cats with newly diagnosed diabetes mellitus were significantly higher than those of the control animals, ranging from 4.5 to 8.6 per cent (median 6.1) in dogs and from 2.7 to 6.0 per cent (median 3.8 per cent) in cats. The GHb levels in 31 normoglycaemic dogs with anaemia ranged from 2.3 to 4.3 per cent (median 3.3 per cent), and those of 22 normoglycaemic cats with anaemia from 2.6 to 3.9 per cent (median 3.2 per cent); both sets of levels were significantly elevated compared to control group values. GHb concentrations in animals with polycythaemia, azotaemia or liver disease showed no significant deviations from the control group; in individual cases they were slightly elevated compared to the reference range. The automated measuring method employed can be used to determine GHb in dogs and cats. Anaemic animals should generally be excluded from the GHb determination.
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Affiliation(s)
- B Haberer
- Clinic for Small Animal Internal Medicine, University of Munich, Germany
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