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O'Kell AL, Davison LJ. Etiology and Pathophysiology of Diabetes Mellitus in Dogs. Vet Clin North Am Small Anim Pract 2023; 53:493-510. [PMID: 36854636 DOI: 10.1016/j.cvsm.2023.01.004] [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: 02/27/2023]
Abstract
Canine diabetes results from a wide spectrum of clinical pathophysiological processes that cause a similar set of clinical signs. Various causes of insulin deficiency and beta cell loss, insulin resistance, or both characterize the disease, with genetics and environment playing a role. Understanding the genetic and molecular causes of beta cell loss will provide future opportunities for precision medicine, both from a therapeutic and preventative perspective. This review presents current knowledge of the etiology and pathophysiology of canine diabetes, including the importance of disease classification. Examples of potential targets for future precision medicine-based approaches to therapy are discussed.
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Affiliation(s)
- Allison L O'Kell
- Department of Small Animal Clinical Sciences, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32610, USA.
| | - Lucy J Davison
- Royal Veterinary College, Clinical Sciences and Services, Hawkshead Lane, Hertfordshire AL9 7TA, UK.
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O'Kell AL, Garrett TJ, Wasserfall C, Atkinson MA. Untargeted metabolomic analysis in non-fasted diabetic dogs by UHPLC-HRMS. Metabolomics 2019; 15:15. [PMID: 30830416 PMCID: PMC6461041 DOI: 10.1007/s11306-019-1477-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 01/16/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION We recently identified variances in serum metabolomic profiles between fasted diabetic and healthy dogs, some having similarities to those identified in human type 1 diabetes. OBJECTIVES Compare untargeted metabolomic profiles in the non-fasted state. METHODS Serum from non-fasted diabetic (n = 6) and healthy control (n = 6) dogs were analyzed by liquid chromatography-high resolution mass spectrometry. RESULTS Clear clustering of metabolites between groups were observed, with multiple perturbations identified that were similar to those previously observed in fasted diabetic dogs. CONCLUSION These findings further support the development of targeted assays capable of detecting metabolites that may be useful as biomarkers of canine diabetes.
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Affiliation(s)
- A L O'Kell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, The University of Florida, Box 100116, 2015 SW 16th Avenue, Gainesville, FL, 32608, USA.
| | - T J Garrett
- Department of Pathology, Immunology, and Laboratory Medicine, The University of Florida, 1395 Center Drive, Gainesville, FL, 32610, USA
| | - C Wasserfall
- Department of Pathology, Immunology, and Laboratory Medicine, The University of Florida Diabetes Institute, 1275 Center Drive, Gainesville, FL, 32610, USA
| | - M A Atkinson
- Departments of Pathology, Immunology and Laboratory Medicine, and Pediatrics, The University of Florida Diabetes Institute, 1275 Center Drive, Gainesville, FL, 32610, USA
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Morgan RK, Cortes Y, Murphy L. Pathophysiology and aetiology of hypoglycaemic crises. J Small Anim Pract 2018; 59:659-669. [PMID: 30102417 PMCID: PMC7166581 DOI: 10.1111/jsap.12911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/24/2018] [Accepted: 06/15/2018] [Indexed: 01/09/2023]
Abstract
Hypoglycaemia is a common, life-threatening complication that occurs as a component of a wide variety of disease processes. Despite its frequent occurrence, information concerning the aetiology, characteristics and outcomes of hypoglycaemic crises in veterinary medicine is limited. This review summarises the current understanding of the pathophysiology of hypoglycaemia, the body's counter-regulatory response, underlying aetiologies, diagnosis and treatment. Disease mechanisms are discussed and published evidence in veterinary literature regarding prognostic indicators, prevalence, diagnosis and treatment is examined for hypoglycaemia-related disease processes including insulinoma, glucose-lowering toxins and medications.
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Affiliation(s)
- R K Morgan
- Metropolitan Veterinary Associates, Norristown, Pennsylvania, USA
| | - Y Cortes
- Emergency Department, Oradell Animal Hospital, Paramus, New Jersey, USA
| | - L Murphy
- Veterinary Specialty Center of Delaware, New Castle, Delaware, USA
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O'Kell AL, Wasserfall C, Catchpole B, Davison LJ, Hess RS, Kushner JA, Atkinson MA. Comparative Pathogenesis of Autoimmune Diabetes in Humans, NOD Mice, and Canines: Has a Valuable Animal Model of Type 1 Diabetes Been Overlooked? Diabetes 2017; 66:1443-1452. [PMID: 28533295 PMCID: PMC5440022 DOI: 10.2337/db16-1551] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/15/2017] [Indexed: 12/13/2022]
Abstract
Despite decades of research in humans and mouse models of disease, substantial gaps remain in our understanding of pathogenic mechanisms underlying the development of type 1 diabetes. Furthermore, translation of therapies from preclinical efforts capable of delaying or halting β-cell destruction has been limited. Hence, a pressing need exists to identify alternative animal models that reflect human disease. Canine insulin deficiency diabetes is, in some cases, considered to follow autoimmune pathogenesis, similar to NOD mice and humans, characterized by hyperglycemia requiring lifelong exogenous insulin therapy. Also similar to human type 1 diabetes, the canonical canine disorder appears to be increasing in prevalence. Whereas islet architecture in rodents is distinctly different from humans, canine pancreatic endocrine cell distribution is more similar. Differences in breed susceptibility alongside associations with MHC and other canine immune response genes parallel that of different ethnic groups within the human population, a potential benefit over NOD mice. The impact of environment on disease development also favors canine over rodent models. Herein, we consider the potential for canine diabetes to provide valuable insights for human type 1 diabetes in terms of pancreatic histopathology, impairment of β-cell function and mass, islet inflammation (i.e., insulitis), and autoantibodies specific for β-cell antigens.
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Affiliation(s)
- Allison L O'Kell
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Clive Wasserfall
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Brian Catchpole
- Department of Pathology and Pathogen Biology, Royal Veterinary College, Hatfield, U.K
| | - Lucy J Davison
- Department of Veterinary Medicine, University of Cambridge, Cambridge, U.K., and Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K
| | - Rebecka S Hess
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jake A Kushner
- McNair Medical Institute and Department of Pediatric Diabetes and Endocrinology, Baylor College of Medicine, Texas Children's Hospital, Houston, TX
| | - Mark A Atkinson
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
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Strage EM, Lewitt MS, Hanson JM, Olsson U, Norrvik F, Lilliehöök I, Holst BS, Fall T. Relationship among insulin resistance, growth hormone, and insulin-like growth factor I concentrations in diestrous Swedish Elkhounds. J Vet Intern Med 2015; 28:419-28. [PMID: 24765678 PMCID: PMC4857978 DOI: 10.1111/jvim.12307] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background In the dog, the normal estrous cycle includes a prolonged luteal phase. Progesterone stimulates local canine mammary growth hormone (GH) production, which may act systemically and contribute to insulin resistance. Swedish Elkhounds are predisposed to progesterone‐related diabetes mellitus, and the relationship among insulin resistance, GH, and insulin‐like growth factor I (IGF‐I) is of particular interest. Objective To study insulin resistance in relation to GH and IGF‐I in nondiabetic Swedish Elkhounds during diestrus. We also assessed whether alterations in these hormones could predict diestrus‐linked diseases and all‐cause mortality. Animals Eighty‐four privately owned female intact Swedish Elkhounds >4 years of age. Methods Blood sampling and clinical examination during luteal phase, with a follow‐up questionnaire after 20 months. Insulin resistance was calculated by homeostasis model assessment (HOMA‐IR). Results In multivariable regression analysis, GH was positively associated with HOMA‐IR (P = .009). An increase in GH of 1 ng/mL was associated with a 12.7% increase in HOMA‐IR. Moreover, C‐peptide was positively associated with IGF‐I (P = .04), and an increase in C‐peptide of 0.1 ng/mL was associated with a 6.9% increase in IGF‐I. Structural equation modeling supported these results. Twenty‐three animals were found to have previously unrecognized mammary masses and had higher GH (P < .0001) and IGF‐I (P = .007) than dogs without mammary masses (n = 61). There was no association between high GH and IGF‐I concentrations at sampling and future mammary masses. Conclusion We showed that GH was strongly associated with insulin resistance in older Swedish Elkhounds during diestrus.
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Abstract
Diabetes mellitus is a common disease in dogs and cats. The most common form of diabetes in dogs resembles type 1 diabetes in humans. Studies suggest that genetics, an immune-mediated component, and environmental factors are involved in the development of diabetes in dogs. A variant of gestational diabetes also occurs in dogs. The most common form of diabetes in cats resembles type 2 diabetes in humans. A major risk factor in cats is obesity. Obese cats have altered expression of several insulin signaling genes and glucose transporters and are leptin resistant. Cats also form amyloid deposits within the islets of the pancreas and develop glucotoxicity when exposed to prolonged hyperglycemia. This review will briefly summarize our current knowledge about the etiology of diabetes in dogs and cats and illustrate the similarities among dogs, cats, and humans.
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Affiliation(s)
- Richard W Nelson
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California, Davis, California 95616, USAClinic for Small Animal Internal MedicineVetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Claudia E Reusch
- Department of Medicine and EpidemiologySchool of Veterinary Medicine, University of California, Davis, California 95616, USAClinic for Small Animal Internal MedicineVetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Ahlgren KM, Fall T, Landegren N, Grimelius L, von Euler H, Sundberg K, Lindblad-Toh K, Lobell A, Hedhammar Å, Andersson G, Hansson-Hamlin H, Lernmark Å, Kämpe O. Lack of evidence for a role of islet autoimmunity in the aetiology of canine diabetes mellitus. PLoS One 2014; 9:e105473. [PMID: 25153886 PMCID: PMC4143278 DOI: 10.1371/journal.pone.0105473] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 07/21/2014] [Indexed: 12/31/2022] Open
Abstract
Aims/Hypothesis Diabetes mellitus is one of the most common endocrine disorders in dogs and is commonly proposed to be of autoimmune origin. Although the clinical presentation of human type 1 diabetes (T1D) and canine diabetes are similar, the aetiologies may differ. The aim of this study was to investigate if autoimmune aetiology resembling human T1D is as prevalent in dogs as previously reported. Methods Sera from 121 diabetic dogs representing 40 different breeds were tested for islet cell antibodies (ICA) and GAD65 autoantibodies (GADA) and compared with sera from 133 healthy dogs. ICA was detected by indirect immunofluorescence using both canine and human frozen sections. GADA was detected by in vitro transcription and translation (ITT) of human and canine GAD65, followed by immune precipitation. Sections of pancreata from five diabetic dogs and two control dogs were examined histopathologically including immunostaining for insulin, glucagon, somatostatin and pancreas polypeptide. Results None of the canine sera analysed tested positive for ICA on sections of frozen canine or human ICA pancreas. However, serum from one diabetic dog was weakly positive in the canine GADA assay and serum from one healthy dog was weakly positive in the human GADA assay. Histopathology showed marked degenerative changes in endocrine islets, including vacuolisation and variable loss of immune-staining for insulin. No sign of inflammation was noted. Conclusions/Interpretations Contrary to previous observations, based on results from tests for humoral autoreactivity towards islet proteins using four different assays, and histopathological examinations, we do not find any support for an islet autoimmune aetiology in canine diabetes mellitus.
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Affiliation(s)
- Kerstin M. Ahlgren
- Department of Medical Sciences, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Tove Fall
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
- * E-mail:
| | - Nils Landegren
- Department of Medical Sciences, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Lars Grimelius
- Department of Immunology, Genetics and Pathology, Uppsala University, Sweden
| | - Henrik von Euler
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Katarina Sundberg
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Kerstin Lindblad-Toh
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, United States of America
- Science for Life Laboratory, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Anna Lobell
- Department of Medical Sciences, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Åke Hedhammar
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Göran Andersson
- Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Helene Hansson-Hamlin
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Åke Lernmark
- Diabetes and Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Olle Kämpe
- Department of Medical Sciences, Science for Life Laboratory, Uppsala University, Uppsala, Sweden
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Hoenig M. Carbohydrate Metabolism and Pathogenesis of Diabetes Mellitus in Dogs and Cats. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2014; 121:377-412. [DOI: 10.1016/b978-0-12-800101-1.00012-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Zeugswetter FK, Schornsteiner E, Haimel G, Schwendenwein I. Metabolic and hormonal responses to subcutaneous glucagon in healthy beagles. J Vet Emerg Crit Care (San Antonio) 2012; 22:558-63. [DOI: 10.1111/j.1476-4431.2012.00793.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Florian K. Zeugswetter
- From the Department of Companion Animals and Horses; Clinic for Small Animals and Infectious Diseases; University of Veterinary Medicine Vienna; Vienna
| | - Elisa Schornsteiner
- From the Department of Companion Animals and Horses; Clinic for Small Animals and Infectious Diseases; University of Veterinary Medicine Vienna; Vienna
| | - Georg Haimel
- From the Department of Companion Animals and Horses; Clinic for Small Animals and Infectious Diseases; University of Veterinary Medicine Vienna; Vienna
| | - Ilse Schwendenwein
- Department of Pathobiology; Central Laboratory, University of Veterinary Medicine Vienna; Vienna; Austria
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Mared M, Catchpole B, Kämpe O, Fall T. Evaluation of circulating concentrations of glucose homeostasis biomarkers, progesterone, and growth hormone in healthy Elkhounds during anestrus and diestrus. Am J Vet Res 2012; 73:242-7. [DOI: 10.2460/ajvr.73.2.242] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fall T, Hedhammar A, Wallberg A, Fall N, Ahlgren KM, Hamlin HH, Lindblad-Toh K, Andersson G, Kämpe O. Diabetes mellitus in elkhounds is associated with diestrus and pregnancy. J Vet Intern Med 2011; 24:1322-8. [PMID: 21054539 DOI: 10.1111/j.1939-1676.2010.0630.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Female Elkhounds are shown to be at increased risk for diabetes mellitus, and occurrence of diabetes during pregnancy has been described in several cases. HYPOTHESIS Onset of diabetes mellitus in Elkhounds is associated with diestrus. ANIMALS Sixty-three Elkhounds with diabetes mellitus and 26 healthy controls. METHODS Medical records from 63 Elkhounds with diabetes were reviewed and owners were contacted for follow-up information. Blood samples from the day of diagnosis were available for 26 dogs. Glucose, fructosamine, C-peptide, growth hormone (GH), insulin-like growth factor-1, progesterone, and glutamate decarboxylase isoform 65-autoantibodies were analyzed and compared with 26 healthy dogs. Logistic models were used to evaluate the association of clinical variables with the probability of diabetes and with permanent diabetes mellitus after ovariohysterectomy (OHE). RESULTS All dogs in the study were intact females and 7 dogs (11%) were pregnant at diagnosis. The 1st clinical signs of diabetes mellitus occurred at a median of 30 days (interquartile range [IQR], 3-45) after estrus, and diagnosis was made at a median of 46 days (IQR, 27-62) after estrus. Diabetes was associated with higher concentrations of GH and lower concentrations of progesterone compared with controls matched for time after estrus. Forty-six percent of dogs that underwent OHE recovered from diabetes with a lower probability of remission in dogs with higher glucose concentrations (odds ratio [OR], 1.2; P=.03) at diagnosis and longer time (weeks) from diagnosis to surgery (OR, 1.5; P=.05). CONCLUSIONS Diabetes mellitus in Elkhounds develops mainly during diestrus and pregnancy. Immediate OHE improves the prognosis for remission of diabetes.
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Affiliation(s)
- T Fall
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, and Department of Medical Sciences, University Hospital, Uppsala, Sweden.
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Oberg J, Fall T, Lilliehöök I. Validation of a species-optimized enzyme-linked immunosorbent assay for determination of serum concentrations of insulin in dogs. Vet Clin Pathol 2011; 40:66-73. [PMID: 21299583 DOI: 10.1111/j.1939-165x.2011.00283.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Measurement of canine serum insulin has relied on methods developed to measure human insulin. A species-optimized test for measurement of serum insulin in dogs is now commercially available. OBJECTIVE The purpose of this study was to validate the canine ELISA for determination of serum insulin concentration in dogs. METHODS Precision was determined by evaluating intra- and interassay coefficient of variation (CV), and accuracy was determined by dilution and spike recovery studies. A method comparison study with samples from 34 clinically healthy dogs and 73 dogs examined for various illnesses and disorders ("patients") was performed using the canine ELISA and an ELISA for human insulin. Biologic relevance of the canine assay was evaluated by measuring insulin in samples collected from 8 healthy dogs after administration of glucagon. A stability study was preformed with 6 samples stored at 20°C, 4-8°C, and -20°C. RESULTS For the canine ELISA, intra- and interassay CVs were 4.3-7.8% and 4.4-7.7%, respectively. Mean recovery after dilution was 99% and recovery after spiking with porcine insulin was 116%. The canine and human ELISAs correlated well (r(2) =.94 for healthy dogs, r(2) =.88 for patient samples). After glucagon injection serum insulin concentrations increased significantly in 8 dogs. Insulin was stable for 30 days in 6 serum samples stored at -20°C and in most samples for 8 days at 4-8°C. Insulin was stable for <3 days at room temperature (20°C). CONCLUSIONS The new canine serum insulin ELISA had good precision and accuracy and correlated well with the previously used assay.
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Affiliation(s)
- Josefine Oberg
- Clinical Pathology Laboratory, University Animal Hospital, Uppsala, Sweden.
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Kovalik M, Thoday KL, Handel IG, de C. Bronsvoort BM, Evans H, van den Broek AHM, Mellanby RJ. Ciclosporin A therapy is associated with disturbances in glucose metabolism in dogs with atopic dermatitis. Vet Dermatol 2010; 22:173-80. [DOI: 10.1111/j.1365-3164.2010.00935.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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