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Diabetes Mellitus and the Kidneys. Vet Clin North Am Small Anim Pract 2023; 53:565-580. [PMID: 36854633 DOI: 10.1016/j.cvsm.2023.01.006] [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
The pathomechanisms implicated in diabetic kidney disease in people are present in dogs and cats and, in theory, could lead to renal complications in companion animals with long-standing diabetes mellitus. However, these renal complications develop during a long period, and there is little to no clinical evidence that they could lead to chronic kidney disease in companion animals.
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2
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Sierawska O, Niedźwiedzka-Rystwej P. Adipokines as potential biomarkers for type 2 diabetes mellitus in cats. Front Immunol 2022; 13:950049. [PMID: 36248900 PMCID: PMC9561307 DOI: 10.3389/fimmu.2022.950049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is no longer only a disease of humans, but also of domestic animals, and it particularly affects cats. It is increasingly thought that because of its unique characteristics, T2DM may belong not only to the group of metabolic diseases but also to the group of autoimmune diseases. This is due to the involvement of the immune system in the inflammation that occurs with T2DM. Various pro- and anti-inflammatory substances are secreted, especially cytokines in patients with T2DM. Cytokines secreted by adipose tissue are called adipokines, and leptin, adiponectin, resistin, omentin, TNF-α, and IL-6 have been implicated in T2DM. In cats, approximately 90% of diabetic cases are T2DM. Risk factors include older age, male sex, Burmese breed, presence of obesity, and insulin resistance. Diagnosis of a cat requires repeated testing and is complicated compared to human diagnosis. Based on similarities in the pathogenesis of T2DM between humans and cats, adipokines previously proposed as biomarkers for human T2DM may also serve in the diagnosis of this disease in cats.
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Affiliation(s)
- Olga Sierawska
- Doctoral School, University of Szczecin, Szczecin, Poland
- Institute of Biology, University of Szczecin, Szczecin, Poland
- *Correspondence: Olga Sierawska,
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3
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Fleeman L, Gostelow R. Updates in Feline Diabetes Mellitus and Hypersomatotropism. Vet Clin North Am Small Anim Pract 2020; 50:1085-1105. [PMID: 32680669 DOI: 10.1016/j.cvsm.2020.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Flash glucose monitoring is a novel, noninvasive monitoring technique that is increasingly used in the management of small animal diabetes. This article provides guidance on the use of flash glucose monitoring in cats and demonstrates how this technique can be used in a range of feline diabetic cases, including those where management is proving challenging. Other aspects of complicated feline diabetic care are also discussed, including management of the sick diabetic cat, potassium depletion myopathy, and treatment options for cats with hypersomatotropism-associated diabetes mellitus. The use of insulin glargine 300 U/ml as a promising new long-acting insulin for diabetic cats is also discussed.
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Affiliation(s)
- Linda Fleeman
- Animal Diabetes Australia, 9-11 Miles Street, Mulgrave, Victoria 3170, Australia
| | - Ruth Gostelow
- Department of Clinical Science and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hertfordshire AL9 7TA, UK.
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4
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Spencer S, Wheeler‐Jones C, Elliott J. Aldosterone and the mineralocorticoid receptor in renal injury: A potential therapeutic target in feline chronic kidney disease. J Vet Pharmacol Ther 2020; 43:243-267. [PMID: 32128854 PMCID: PMC8614124 DOI: 10.1111/jvp.12848] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/20/2020] [Accepted: 02/09/2020] [Indexed: 12/24/2022]
Abstract
There is a growing body of experimental and clinical evidence supporting mineralocorticoid receptor (MR) activation as a powerful mediator of renal damage in laboratory animals and humans. Multiple pathophysiological mechanisms are proposed, with the strongest evidence supporting aldosterone-induced vasculopathy, exacerbation of oxidative stress and inflammation, and increased growth factor signalling promoting fibroblast proliferation and deranged extracellular matrix homeostasis. Further involvement of the MR is supported by extensive animal model experiments where MR antagonists (such as spironolactone and eplerenone) abrogate renal injury, including ischaemia-induced damage. Additionally, clinical trials have shown MR antagonists to be beneficial in human chronic kidney disease (CKD) in terms of reducing proteinuria and cardiovascular events, though current studies have not evaluated primary end points which allow conclusions to made about whether MR antagonists reduce mortality or slow CKD progression. Although differences between human and feline CKD exist, feline CKD shares many characteristics with human disease including tubulointerstitial fibrosis. This review evaluates the evidence for the role of the MR in renal injury and summarizes the literature concerning aldosterone in feline CKD. MR antagonists may represent a promising therapeutic strategy in feline CKD.
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Affiliation(s)
- Sarah Spencer
- Comparative Biomedical SciencesThe Royal Veterinary CollegeLondonUK
| | | | - Jonathan Elliott
- Comparative Biomedical SciencesThe Royal Veterinary CollegeLondonUK
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5
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Pérez-López L, Boronat M, Melián C, Brito-Casillas Y, Wägner AM. Animal Models and Renal Biomarkers of Diabetic Nephropathy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1307:521-551. [PMID: 32329028 DOI: 10.1007/5584_2020_527] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Diabetes mellitus (DM) is the first cause of end stage chronic kidney disease (CKD). Animal models of the disease can shed light on the pathogenesis of the diabetic nephropathy (DN) and novel and earlier biomarkers of the condition may help to improve diagnosis and prognosis. This review summarizes the most important features of animal models used in the study of DN and updates the most recent progress in biomarker research.
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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
| | - 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
- Department of Animal Pathology, Veterinary Faculty, University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Arucas, Las Palmas, 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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6
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Gal A, Burton SE, Weidgraaf K, Singh P, Lopez-Villalobos N, Jacob A, Malabu U, Burchell R. The effect of the sodium-glucose cotransporter type-2 inhibitor dapagliflozin on glomerular filtration rate in healthy cats. Domest Anim Endocrinol 2020; 70:106376. [PMID: 31585313 DOI: 10.1016/j.domaniend.2019.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 11/29/2022]
Abstract
Sodium-glucose cotransporter type-2 inhibitors (SGLT2is) reduce glomerular hyperfiltration in diabetic people with early diabetic nephropathy. The objective of this report was to assess changes in glomerular filtration rate in healthy cats after treatment with a SGLT2i. Eight healthy research adult castrated male cats were used in a randomized, controlled, cross-over study design. We induced isolated renal tubular glucosuria by dosing cats with the SGLT2i dapagliflozin. The cats received by mouth 10 mg dapagliflozin or control every 24 h in each of the 4, 5-d trial periods that were separated by a 7-d washout period. We assessed glomerular filtration rate (iohexol clearance method), serum urea, creatinine, symmetric dimethylarginine, and 24-h sodium and chloride urinary excretion on the fifth day of each trial period. We analyzed the data with a mixed linear model that included the fixed effects of treatment (treated and control) and trial period, and the random effect of the cat. Compared with controls, cats treated with dapagliflozin had a significant increase in mean (±SE) glomerular filtration rate (3.1 ± 0.2 vs 2.5 ± 0.2 mL/kg/min; P = 0.01), whereas there were no significant differences in serum urea, creatinine and symmetric dimethylarginine, and 24-h urine sodium and chloride excretion. We propose that dapagliflozin-mediated delivery of sodium and glucose distal from the proximal convoluted tubule induced compensatory increased sodium absorption at the thick ascending loop of Henle that resulted in decreased sodium delivery to the distal tubule leading to tubuloglomerular feedback-mediated glomerular hyperfiltration. Future studies should determine if SGLT2is' renoprotective effect in people can be enhanced with the addition of a Na+-K+-Cl- diuretic and whether dapagliflozin will be useful in mitigating proteinuria and hypertension that follow glomerular hyperfiltration in diabetic companion animals in a similar mechanism as in people.
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Affiliation(s)
- A Gal
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - S E Burton
- School of Biological Sciences, Victoria University of Wellington, Wellington, New Zealand
| | - K Weidgraaf
- School of Agriculture and Environment, Massey University, Palmerston North, New Zealand
| | - P Singh
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - N Lopez-Villalobos
- School of Agriculture and Environment, Massey University, Palmerston North, New Zealand
| | - A Jacob
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| | - U Malabu
- School of Medicine, James Cook University, Townsville, Queensland, Australia
| | - R Burchell
- School of Veterinary Science, James Cook University, Townsville, Queensland, Australia
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7
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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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8
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Kassab BM, Hussein HH, Mahmoud OM, Abdel-Alrahman G. Effects of insulin and metformin on fetal kidney development of streptozotocin-induced gestational diabetic albino rats. Anat Cell Biol 2019; 52:161-175. [PMID: 31338233 PMCID: PMC6624335 DOI: 10.5115/acb.2019.52.2.161] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 12/12/2018] [Accepted: 12/14/2018] [Indexed: 02/06/2023] Open
Abstract
Gestational diabetes mellitus is one of common medical complications of pregnancy. Hyperglycemia in utero impairs renal development and produces renal anomalies. Metformin has antioxidant properties and better glycemic control. Aim: assessment insulin and metformin effects on renal development of streptozotocin-induced gestational diabetic albino rats. Sixty virgin female albino rats were used. Once pregnancy confirmed, animals were randomly assigned into control, metformin, diabetic, diabetic plus insulin, diabetic plus metformin and diabetic plus insulin and metformin treated groups. Rats were sacrificed on the 20th day of gestation; fetuses were extracted and weighted. Fetal kidneys were extracted prepared for light, morphometric and electron microscopic examination. Diabetic followed by diabetic plus metformin treated groups revealed retardation of glomerular development in the cortical and Juxtaglomerular zones with a significant increase in the early immature glomerular stages and immature to mature glomerular ratio compared to other groups. Diabetic group also showed morphometric changes, shrunken and empty glomeruli, vacuolar degeneration and hemorrhage. Diabetic plus metformin group showed minimal improvement while diabetic plus insulin and diabetic plus insulin and metformin groups showed developmental, histopathological and morphometric improvement with best results in the combination group. Gestational diabetes mellitus (GDM) possess deleterious effects on fetal kidney development. Insulin improves the glycemic state and decreases GDM effects on fetal kidneys. Metformin produces mild protection while the combination of insulin and metformin produces the best glycemic control and protect fetal kidneys.
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Affiliation(s)
- Ban M Kassab
- Department of Anatomy, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Hoda H Hussein
- Department of Anatomy, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Omayma M Mahmoud
- Department of Anatomy, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Gamal Abdel-Alrahman
- Department of Anatomy, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
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9
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Novel treatment strategies for chronic kidney disease: insights from the animal kingdom. Nat Rev Nephrol 2018; 14:265-284. [PMID: 29332935 DOI: 10.1038/nrneph.2017.169] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress. Biomimetic studies suggest that the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) offers protection in extreme environmental conditions and promotes longevity in the animal kingdom. Similarly, during months of fasting, immobilization and anuria, hibernating bears are protected from muscle wasting, azotaemia, thrombotic complications, organ damage and osteoporosis - features that are often associated with CKD. Improved understanding of the susceptibility and protective mechanisms of these animals and others could provide insights into novel strategies to prevent and treat several human diseases, such as CKD and ageing-associated complications. An integrated collaboration between nephrologists and experts from other fields, such as veterinarians, zoologists, biologists, anthropologists and ecologists, could introduce a novel approach for improving human health and help nephrologists to find novel treatment strategies for CKD.
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Langhorn R, Kieler IN, Koch J, Christiansen LB, Jessen LR. Symmetric Dimethylarginine in Cats with Hypertrophic Cardiomyopathy and Diabetes Mellitus. J Vet Intern Med 2017; 32:57-63. [PMID: 29230874 PMCID: PMC5787200 DOI: 10.1111/jvim.14902] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 10/30/2017] [Accepted: 11/16/2017] [Indexed: 01/26/2023] Open
Abstract
Background Symmetric dimethylarginine (SDMA) has been increasingly used as a marker of early chronic kidney disease (CKD) in cats, but little is known about the influence of comorbidities on SDMA in this species. Hypothesis Hypertrophic cardiomyopathy (HCM) and diabetes mellitus (DM), independently of CKD, are associated with changes in serum SDMA. Animals Ninety‐four cats (17 with CKD, 40 with HCM, 17 with DM, and 20 healthy controls). Methods Case‐control study. Clinical examination, echocardiography, ECG, blood pressure, CBC, biochemistry, thyroxine, and SDMA measurement were performed. Urinalysis was performed in controls and cats with CKD and DM. Analysis of variance was used to compare overall differences in the log‐transformed SDMA data among groups. A random forest algorithm was applied to explore which clinical and other factors influenced serum SDMA. Results Median (range) serum SDMA for the renal group (positive control) was 19 (10–93) μg/dL, whereas for the control group (negative control), it was 10 (5–15) μg/dL. For the cardiac and diabetic groups, serum SDMA was 9 (4–24) μg/dL and 7 (3–11) μg/dL, respectively. The renal group had significantly higher SDMA concentrations and the diabetic group significantly lower SDMA concentrations compared to all other groups. Conclusions and Clinical Importance Serum SDMA concentrations in cats with HCM were not significantly different from those of healthy control cats. Cats with DM, however, had significantly lower SDMA concentrations than controls, a finding that needs further investigation and should be kept in mind when evaluating renal function of cats with this endocrinopathy.
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Affiliation(s)
- R Langhorn
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - I N Kieler
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J Koch
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L B Christiansen
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L R Jessen
- Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
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11
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Current Understanding of the Pathogenesis of Progressive Chronic Kidney Disease in Cats. Vet Clin North Am Small Anim Pract 2016; 46:1015-48. [PMID: 27461408 DOI: 10.1016/j.cvsm.2016.06.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In cats with chronic kidney disease (CKD), the most common histopathologic finding is tubulointerstitial inflammation and fibrosis. However, these changes reflect a nonspecific response of the kidney to any inciting injury. The risk of developing CKD is likely to reflect the composite effects of genetic predisposition, aging, and environmental and individual factors that affect renal function over the course of a cat's life. However, there is still little information available to determine exactly which individual risk factors predispose a cat to develop CKD. Although many cats diagnosed with CKD have stable disease for years, some cats show overtly progressive disease.
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12
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Brown CA, Elliott J, Schmiedt CW, Brown SA. Chronic Kidney Disease in Aged Cats: Clinical Features, Morphology, and Proposed Pathogeneses. Vet Pathol 2016; 53:309-26. [PMID: 26869151 DOI: 10.1177/0300985815622975] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chronic kidney disease (CKD) is the most common metabolic disease of domesticated cats, with most affected cats being geriatric (>12 years of age). The prevalence of CKD in cats exceeds that observed in dogs, and the frequency of the diagnosis of CKD in cats has increased in recent decades. Typical histologic features include interstitial inflammation, tubular atrophy, and fibrosis with secondary glomerulosclerosis. In contrast to people and dogs, primary glomerulopathies with marked proteinuria are remarkably rare findings in cats. Although a variety of primary renal diseases have been implicated, the disease is idiopathic in most cats. Tubulointerstitial changes, including fibrosis, are present in the early stages of feline CKD and become more severe in advanced disease. A variety of factors-including aging, ischemia, comorbid conditions, phosphorus overload, and routine vaccinations-have been implicated as factors that could contribute to the initiation of this disease in affected cats. Factors that are related to progression of established CKD, which occurs in some but not all cats, include dietary phosphorus intake, magnitude of proteinuria, and anemia. Renal fibrosis, a common histologic feature of aged feline kidneys, interferes with the normal relationship between peritubular capillaries and renal tubules. Experimentally, renal ischemia results in morphologic changes similar to those observed in spontaneous CKD. Renal hypoxia, perhaps episodic, may play a role in the initiation and progression of this disease.
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Affiliation(s)
- C A Brown
- Athens Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - C W Schmiedt
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - S A Brown
- Department of Physiology and Pharmacology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Zini E, Ferro S, Lunardi F, Zanetti R, Heller RS, Coppola LM, Guscetti F, Osto M, Lutz TA, Cavicchioli L, Reusch CE. Exocrine Pancreas in Cats With Diabetes Mellitus. Vet Pathol 2015; 53:145-52. [DOI: 10.1177/0300985815603434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Pancreatitis has been described in cats with diabetes mellitus, although the number of studies currently available is very limited. In addition, ketoacidosis has been hypothesized to be associated with pancreatitis in diabetic cats. The aims of the present study were to investigate whether diabetic cats have pancreatitis and to determine if pancreatitis is more frequent with ketoacidosis. Samples of pancreas were collected postmortem from 37 diabetic cats, including 15 with ketoacidosis, and 20 control cats matched for age, sex, breed, and body weight. Sections were stained with hematoxylin and eosin, double-labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/PCNA, and glucagon/Ki67, and single-labeled for Iba1. A previously proposed semiquantitative score was used to characterize pancreatitis, along with counts of inflammatory cells. Scores of pancreatitis and the number of neutrophils, macrophages, and lymphocytes in the exocrine pancreas did not differ between diabetic and control cats or between diabetic cats with and without ketoacidosis. Of note, PCNA-positive acinar cells were increased ( P = .002) in diabetic cats, particularly near islets ( P < .001). Ki67-positive acinar cells were increased only near islets ( P = .038). Ketoacidosis was not linked to proliferation. The results suggest that histopathologic evidence of pancreatitis may not be more frequent in diabetic cats and that ketoacidosis may not be associated with it at the time of death. Augmented PCNA-positive acinar cells might indicate increased proliferation due to chronic pancreatitis. The reason behind the prevalent proliferation of acinar cells surrounding pancreatic islets deserves further investigation.
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Affiliation(s)
- E. Zini
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Department of Animal Medicine, Production, and Health, University of Padova, Legnaro, Italy
- Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - S. Ferro
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
| | - F. Lunardi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - R. Zanetti
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
| | - R. S. Heller
- Department of Histology and Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - L. M. Coppola
- Department of Animal Medicine, Production, and Health, University of Padova, Legnaro, Italy
| | - F. Guscetti
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - M. Osto
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - T. A. Lutz
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Institute of Laboratory Animal Science, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - L. Cavicchioli
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
| | - C. E. Reusch
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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14
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Zini E, Lunardi F, Zanetti R, Heller RS, Coppola LM, Ferro S, Guscetti F, Osto M, Lutz TA, Reusch CE, Cavicchioli L. Endocrine Pancreas in Cats With Diabetes Mellitus. Vet Pathol 2015; 53:136-44. [DOI: 10.1177/0300985815591078] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Pancreatic amyloidosis and loss of α and β cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats ( P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups ( P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats ( n = 8 of 37; 21.6%) than control cats ( n = 1 of 20; 5.0%). The results confirm previous observations that loss of β cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with β-cell loss.
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Affiliation(s)
- E. Zini
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Department of Animal Medicine, Production, and Health, University of Padova, Legnaro, Italy
- Istituto Veterinario di Novara, Granozzo con Monticello, Italy
| | - F. Lunardi
- Department of Cardiac, Thoracic and Vascular Sciences, University of Padova, Padova, Italy
| | - R. Zanetti
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
| | - R. S. Heller
- Department of Histology and Imaging, Novo Nordisk A/S, Måløv, Denmark
| | - L. M. Coppola
- Department of Animal Medicine, Production, and Health, University of Padova, Legnaro, Italy
| | - S. Ferro
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
| | - F. Guscetti
- Institute of Veterinary Pathology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - M. Osto
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - T. A. Lutz
- Institute of Veterinary Physiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Institute of Laboratory Animal Science, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - C. E. Reusch
- Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - L. Cavicchioli
- Department of Comparative Biomedicine and Food Sciences, University of Padova, Legnaro, Italy
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Affiliation(s)
- T. M. Khan
- Clinical Sciences, Pfizer Global Innovative Pharma, Eastern Point Road, Groton CT, USA
| | - K. N. M. Khan
- Drug Safety R&D, Pfizer Worldwide R&D, Eastern Point Road, Groton CT, USA
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