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Cook AK, Behrend E. SGLT2 inhibitor use in the management of feline diabetes mellitus. J Vet Pharmacol Ther 2024. [PMID: 38954371 DOI: 10.1111/jvp.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/07/2024] [Accepted: 06/10/2024] [Indexed: 07/04/2024]
Abstract
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are routinely used in the management of human type 2 diabetes and have been shown to effectively mitigate hyperglycemia and reduce the risks of cardiovascular and renal compromise. Two SGLT2 inhibitors, namely bexagliflozin and velagliflozin, were recently FDA approved for the treatment of uncomplicated feline diabetes mellitus. These oral hypoglycemic agents are a suitable option for many newly diagnosed cats, with rapid improvements in glycemic control and clinical signs. Suitable candidates must have some residual β-cell function, as some endogenous insulin production is required to prevent ketosis. Appropriate patient selection and monitoring are necessary, and practitioners should be aware of serious complications such as euglycemic diabetic ketoacidosis.
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Affiliation(s)
- Audrey K Cook
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - Ellen Behrend
- Veterinary Information Network, Davis, California, USA
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2
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Larrán B, Loste A, Borobia M, Miranda M, López-Alonso M, Herrero-Latorre C, Marca MC, Orjales I. Trace element status in canine endocrine diseases. Res Vet Sci 2024; 174:105309. [PMID: 38781816 DOI: 10.1016/j.rvsc.2024.105309] [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: 01/25/2024] [Revised: 05/16/2024] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
A balanced trace element status is essential for the optimal functioning of all organisms. However, their concentrations are often altered in diverse medical conditions. This study investigated the trace element profiles in plasma samples of dogs with endocrine diseases and used chemometric techniques to explore their associations with biochemical data. Thirteen elements (As, Cd, Co, Cr, Cu, Fe, Hg, Mn, Mo, Ni, Pb, Se and Zn) were measured in 40 dogs with hyperadrenocorticism (HAC), 29 dogs with diabetes mellitus (DM), 11 dogs with hypothyroidism (HT) and 30 control dogs using inductively coupled plasma mass spectrometry (ICP-MS). Statistically significant differences were observed for As, Cu, Mo, Se and Zn. In comparison with the control group, the HT patients had higher As and lower Se levels, while the HAC group had higher concentrations of Mo. All three disease groups had higher Cu and Zn concentrations than the control group, with the DM group having higher Cu concentrations and the HAC group higher Zn concentrations than the other endocrinopathy groups. The chemometric analysis revealed distinctive association patterns for discriminating each pathology group and the control group. Moreover, the analysis revealed the following associations: Mo with glucose levels and Cu with fructosamine levels in the DM group, As with cortisol levels in the HAC group, and Se with TT4 levels and As with TSH levels in the HT group. The study findings provide valuable insights into the complex relationships between trace elements and endocrinopathies, elucidating the associations with biochemical markers in these diseases. Larger-scale studies are necessary to fully understand the observed relationships and explore the potential clinical applications.
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Affiliation(s)
- Belén Larrán
- Departamento de Patoloxía animal, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain; Hospital Veterinario Universitario Rof Codina, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Araceli Loste
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, 50013 Zaragoza, Spain; Servicio de Endocrinología, Hospital Veterinario de la Universidad de Zaragoza, 50013 Zaragoza, Spain; Instituto Agroalimentario de Aragón-IA2-, Universidad de Zaragoza, 50013 Zaragoza, Spain
| | - Marta Borobia
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, 50013 Zaragoza, Spain; Servicio de Endocrinología, Hospital Veterinario de la Universidad de Zaragoza, 50013 Zaragoza, Spain
| | - Marta Miranda
- Hospital Veterinario Universitario Rof Codina, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain; Departamento de Anatomía, Producción Animal e Ciencias Clínicas Veterinarias, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain.
| | - Marta López-Alonso
- Departamento de Patoloxía animal, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Carlos Herrero-Latorre
- Instituto de Investigación en Análises Químicas e Biolóxicas, Departamento de Química Analítica, Nutrición e Bromatoloxía, Facultade de Ciencias, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - M Carmen Marca
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, 50013 Zaragoza, Spain; Servicio de Endocrinología, Hospital Veterinario de la Universidad de Zaragoza, 50013 Zaragoza, Spain
| | - Inmaculada Orjales
- Hospital Veterinario Universitario Rof Codina, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain; Departamento de Anatomía, Producción Animal e Ciencias Clínicas Veterinarias, Facultade de Veterinaria, Campus Terra, Universidade de Santiago de Compostela, 27002 Lugo, Spain
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3
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Beyer ASL, Kaemmerer D, Sänger J, Lupp A. Expression of FAM159B in Humans, Rats, and Mice: A Cross-species Examination. J Histochem Cytochem 2024:221554241262368. [PMID: 38907656 DOI: 10.1369/00221554241262368] [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: 06/24/2024] Open
Abstract
Little is known about the adaptor protein FAM159B. To determine whether FAM159B expression findings in rats or mice can be extrapolated to humans, we compared FAM159B expression in healthy tissue samples from all three species using immunohistochemistry. Despite variations in expression intensity, similar FAM159B expression patterns were observed in most organs across species. The most prominent species difference was noted in pancreatic islets; while FAM159B expression was limited to single cells on the outer edges in mice and rats, it was detectable across entire islets in humans. Double-labeling immunohistochemistry revealed partial overlap of FAM159B expression with that of insulin, glucagon, and somatostatin in human islets. By contrast, FAM159B showed complete colocalization with only somatostatin in rats and mice. An additional analysis of FAM159B expression in lean and obese Zucker rats revealed larger islet areas due to increased β-cell mass in obese rats, which was accompanied by a smaller percentage of FAM159B-positive δ-cells per islet area. Beyond the known differences in islet architecture across species, our results point to larger dissimilarities in blood glucose regulation between rodents and humans than generally assumed. Moreover, findings regarding FAM159B expression (and function) cannot be directly transferred between rodents and humans.
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Affiliation(s)
| | - Daniel Kaemmerer
- Department of General and Visceral Surgery, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Jörg Sänger
- Laboratory of Pathology and Cytology Bad Berka, Bad Berka, Germany
| | - Amelie Lupp
- Institute of Pharmacology and Toxicology, Jena University Hospital, Jena, Germany
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Niessen SJM, Kooistra HS, Forcada Y, Bjørnvad CR, Albrecht B, Roessner F, Herberich E, Kroh C. Efficacy and safety of once daily oral administration of sodium-glucose cotransporter-2 inhibitor velagliflozin compared with twice daily insulin injection in diabetic cats. J Vet Intern Med 2024. [PMID: 38884190 DOI: 10.1111/jvim.17124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 05/14/2024] [Indexed: 06/18/2024] Open
Abstract
BACKGROUND Options for treatment of diabetes mellitus in cats are limited to insulin injections and monitoring for hypoglycemia. HYPOTHESIS Once daily sodium-glucose cotransporter-2 inhibitor velagliflozin PO is noninferior to insulin injections. ANIMALS Client-owned diabetic cats (127 safety; 116 efficacy assessment). METHODS Prospective, randomized (1 mg/kg velagliflozin), positive controlled (titrated Caninsulin), open label, noninferiority field trial, comparing number of cats with treatment success in ≥1 clinical variable and ≥1 glycemic variable (margin Δ: 15%) on Day 45; secondary endpoints included glycemic and clinical assessments during 91 days. RESULTS On Day 45, 29/54 (54%) velagliflozin-treated cats and 26/62 (42%) Caninsulin-treated cats showed treatment success, demonstrating noninferiority (difference -11.8%; upper 1-sided 97.5% confidence interval, -∞ to 6.3%). By Day 91, quality of life (QoL), polyuria, and polydipsia had improved in 81%, 54% and 61% (velagliflozin); on blood glucose (BG) curves, mean BG was <252 mg/dL in 42/54 (78%; velagliflozin) and 37/62 (60%; Caninsulin); minimum BG was <162 mg/dL in 41/54 (76%; velagliflozin) and 41/62 (66%; Caninsulin); serum fructosamine was <450 μmol/L in 41/54 (76%; velagliflozin) and 38/62 (61%; Caninsulin). Velagliflozin's most frequent adverse events were loose feces/diarrhea (n = 23/61, 38%), positive urine culture (n = 19/61, 31%), and nonclinical hypoglycemia (BG <63 mg/dL; n = 8/61, 13%); Caninsulin's: clinical and nonclinical hypoglycemia (n = 35/66, 53%), positive urine culture (n = 18/66, 27%), and loose feces/diarrhea (n = 10/66, 15%). Diabetic ketoacidosis occurred in 4/61 (7%; velagliflozin) and 0/66 (Caninsulin). CONCLUSIONS AND CLINICAL IMPORTANCE Once daily oral administration of velagliflozin was noninferior to insulin injections, showed good QoL and glycemia without clinical hypoglycemia.
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Affiliation(s)
- Stijn J M Niessen
- Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands
- Royal Veterinary College, University of London, Hertfordshire, United Kingdom
| | - Hans S Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Yaiza Forcada
- Veterinary Specialist Consultations & VIN Europe, Hilversum, The Netherlands
- Royal Veterinary College, University of London, Hertfordshire, United Kingdom
| | | | - Balazs Albrecht
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
| | | | - Esther Herberich
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
| | - Carla Kroh
- Boehringer Ingelheim Vetmedica GmbH, Ingelheim am Rhein, Germany
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Tardo AM, Fleeman LM, Fracassi F, Berg AS, Guarino AL, Gilor C. A dose titration protocol for once-daily insulin glargine 300 U/mL for the treatment of diabetes mellitus in dogs. J Vet Intern Med 2024. [PMID: 38831362 DOI: 10.1111/jvim.17106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/01/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND In purpose-bred dogs, insulin glargine 300 U/mL (IGla300) has long duration of action, peakless time-action profile, and low potency, making it suitable for use as a basal insulin. HYPOTHESIS To evaluate IGla300 in client-owned diabetic dogs monitored using a flash glucose monitoring system (FGMS). ANIMALS Ninety-five client-owned diabetic dogs, newly diagnosed or previously treated with other insulin formulations, with or without concurrent diseases. METHODS Prospective multi-institutional study. Clinical signs and standardized assessment of FGMS data, using treatment and monitoring guidelines established a priori, guided dose adjustments and categorization into levels of glycemic control. RESULTS The initial IGla300 dose was 0.5 U/Kg q24h for newly diagnosed dogs and (median dose [range]) 0.8 U/Kg (0.2-2.5) q24h for all dogs. Glycemic control was classified as good or excellent in 87/95 (92%) dogs. The IGla300 was administered q24h (1.9 U/kg [0.2-5.2]) and q12h (1.9 U/kg/day [0.6-5.0]) in 56/95 (59%) and 39/95 (41%) dogs, respectively. Meal-time bolus injections were added in 5 dogs (0.5 U/kg/injection [0.3-1.0]). Clinical hypoglycemia occurred in 6/95 (6%) dogs. Dogs without concurrent diseases were more likely to receive IGla300 q24h than dogs with concurrent diseases (72% vs 50%, respectively; P = .04). CONCLUSIONS AND CLINICAL IMPORTANCE Insulin glargine 300 U/mL can be considered a suitable therapeutic option for once-daily administration in diabetic dogs. Clinicians should be aware of the low potency and wide dose range of IGla300. In some dogs, twice-daily administration with or without meal-time bolus injections may be necessary to achieve glycemic control. Monitoring with FGMS is essential for dose titration of IGla300.
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Affiliation(s)
- Antonio Maria Tardo
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | | | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Alisa Saule Berg
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
| | - Aria L Guarino
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
- BluePearl Pet Hospital, Rockville, Maryland, USA
| | - Chen Gilor
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA
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Jaffey JA, Kreisler R, Graves TK, Al-Nakkash L, Backus RC, Allison L. Ex Vivo Immune Function and Modulatory Effects of Calcitriol in Dogs with Naturally Occurring Diabetes Mellitus. Vet Sci 2024; 11:193. [PMID: 38787165 PMCID: PMC11125998 DOI: 10.3390/vetsci11050193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/10/2024] [Accepted: 04/21/2024] [Indexed: 05/25/2024] Open
Abstract
Human patients with type 1 diabetes mellitus (T1DM) are susceptible to several long-term complications that are related to glycemic control and immune dysregulation. Immune function remains relatively unexplored in dogs with naturally occurring diabetes mellitus (NODM). Calcitriol improves various aspects of immune function in a variety of species, but its effect in diabetic dogs remains unexplored. Therefore, the objectives of this study were to (i) evaluate immune function in dogs with NODM and determine if differences exist based on the level of clinical control and (ii) assess the immunomodulatory effects of calcitriol. Twenty diabetic dogs (clinically controlled, n = ten, not controlled, n = ten) and 20 non-diabetic, healthy control dogs were included in this prospective, case-control study. Whole blood was incubated with calcitriol (10-7 M) or negative control, after which the samples were divided for phagocytosis and leukocyte cytokine response experiments. The phagocytosis of opsonized Escherichia coli (E. coli) was evaluated with flow cytometry. The samples for leukocyte cytokine response evaluations were stimulated with lipopolysaccharide (LPS), lipoteichoic acid (LTA), or phosphate buffer solution (PBS; negative control), and tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-8, and IL-10 were measured in supernatant using a canine-specific multiplex bead-based assay. The leukocytes from diabetic dogs produced higher concentrations of IL-10 (p = 0.01), IL-6 (p < 0.0001), and IL-8 (p < 0.0001) than the control dogs while controlling for the intervention and stimulant. Calcitriol decreased the supernatant concentrations of TNF-α (p < 0.001) and IL-8 (p = 0.04) with concomitant increases in IL-6 (p = 0.005). Diabetic dogs had a lower percentage of leukocytes undergoing phagocytosis (p < 0.0001) but a higher number of bacteria phagocytized per cell (p = 0.001) when compared to the control dogs. Calcitriol had no effect on phagocytic capacity. Lastly, the status of clinical control in diabetic dogs did not yield differences in immune function. These results support that dogs with NODM exhibit immune dysregulation and warrant additional investigation.
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Affiliation(s)
- Jared A. Jaffey
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ 85308, USA; (T.K.G.); (L.A.)
| | - Rachael Kreisler
- Department of Pathology and Population Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ 85308, USA;
| | - Thomas K. Graves
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ 85308, USA; (T.K.G.); (L.A.)
| | - Layla Al-Nakkash
- Department of Physiology, Midwestern University, College of Graduate Studies, Glendale, AZ 85308, USA;
| | - Robert C. Backus
- Department of Veterinary Medicine and Surgery, University of Missouri, College of Veterinary Medicine, Columbia, MO 65211, USA;
| | - Lauren Allison
- Department of Specialty Medicine, Midwestern University, College of Veterinary Medicine, Glendale, AZ 85308, USA; (T.K.G.); (L.A.)
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Strage EM, Ley C, Westermark GT, Tengholm A. Insulin release from isolated cat islets of Langerhans. Domest Anim Endocrinol 2024; 87:106836. [PMID: 38141375 DOI: 10.1016/j.domaniend.2023.106836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 12/18/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
Feline diabetes mellitus is a common endocrine disease with increasing prevalence. It shows similarities with human type 2 diabetes and is characterized by insulin resistance and deficient insulin secretion. Moreover, cats and humans belong to the very few species that form amyloid depositions in the pancreatic islets. However, little is known about cat islet function and no studies have addressed insulin secretion from isolated islets ex vivo. The aim of this study was to establish a protocol for isolation of islets of Langerhans from pancreata of cats euthanized due to disease, and to evaluate insulin secretion responses to various physiological and pharmacological stimuli. Collagenase digestion of pancreatic tissue from 13 non-diabetic cats and two cats with diabetic ketoacidosis yielded individual islets surrounded by a layer of exocrine tissue that was reduced after two days in culture. Histological examination showed islet amyloid in pancreatic biopsies from most non-diabetic and in one diabetic cat. Islets from non-diabetic cats cultured at 5.5 mM glucose responded with increased insulin secretion to 16.7 mM glucose, 30 mM K+ and 20 µM of the sulfonylurea glipizide (2-3 times basal secretion at 3 mM glucose). The glucagon-like peptide-1 receptor agonist exendin-4 (100 nM) had no effect under basal conditions but potentiated glucose-triggered insulin release. Only one of nine islet batches from diabetic cats released detectable amounts of insulin, which was enhanced by exendin-4. Culture of islets from non-diabetic cats at 25 mM glucose impaired secretion both in response to glucose and K+ depolarization. In conclusion, we describe a procedure for isolation of islets from cat pancreas biopsies and demonstrate that isolated cat islets secrete insulin in response to glucose and antidiabetic drugs. The study provides a basis for future ex vivo studies of islet function relevant to the understanding of the pathophysiology and treatment of feline diabetes.
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Affiliation(s)
- Emma M Strage
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, P.O. Box 7054, Uppsala SE-750 07, Sweden.
| | - Cecilia Ley
- Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, P.O. Box 7028, Uppsala SE-750 07, Sweden; Department of Pathology and Wildlife Diseases, National Veterinary Institute (SVA), Uppsala SE-751 89, Sweden
| | - Gunilla T Westermark
- Department of Medical Cell Biology, Uppsala University, Biomedical Centre, P.O. Box 571, Uppsala SE-751 23, Sweden
| | - Anders Tengholm
- Department of Medical Cell Biology, Uppsala University, Biomedical Centre, P.O. Box 571, Uppsala SE-751 23, Sweden
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Urbanschitz T, Huber L, Tichy A, Burgener IA, Zeugswetter FK. Short-term glycemic variability in non-diabetic, non-obese dogs assessed by common glycemic variability indices. Res Vet Sci 2024; 169:105156. [PMID: 38340380 DOI: 10.1016/j.rvsc.2024.105156] [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: 11/13/2022] [Revised: 12/14/2023] [Accepted: 01/12/2024] [Indexed: 02/12/2024]
Abstract
Glycemic variability (GV) refers to swings in blood glucose levels and is an emerging measure of glycemic control in clinical practice. It is associated with micro- and macrovascular complications and poor clinical outcomes in diabetic humans. Although an integral part of patient assessment in human patients, it is to a large extent neglected in insulin-treated diabetic dogs. This prospective pilot study was performed to describe canine within-day GV in non-diabetic dogs with the aim to provide a basis for the interpretation of daily glucose profiles, and to promote GV as an accessible tool for future studies in veterinary medicine. Interstitial glucose concentrations of ten non-diabetic, non-obese beagles were continuously measured over a 48-h period using a flash glucose monitoring system. GV was assessed using the common indices MAGE (mean amplitude of glycemic excursion), GVP (Glycemic variability percentage) and CV (coefficient of variation). A total of 2260 sensor measurements were obtained, ranging from 3.7 mmol/L (67 mg/dL) to 8.5 mmol/L (153 mg/dL). Glucose profiles suggested a meal-dependent circadian rhythmicity with small but significant surges during the feeding periods. No differences in GV indices were observed between day and night periods (p > 0.05). The MAGE (mmol/L), GVP (%) and CV (%) were 0.86 (± 0.19), 7.37 (± 1.65), 6.72 (± 0.89) on day one, and 0.83 (± 0.18), 6.95 (± 1.52), 6.72 (± 1.53) on day two, respectively. The results of this study suggest that GV is low in non-diabetic dogs and that glucose concentrations are kept within narrow ranges.
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Affiliation(s)
- Tobias Urbanschitz
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Lukas Huber
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Alexander Tichy
- University of Veterinary Medicine Vienna Platform for Bioinformatics and Biostatistics Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Iwan Anton Burgener
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
| | - Florian Karl Zeugswetter
- University of Veterinary Medicine Vienna Department of Small Animals and Horses Division of Small Animal Internal Medicine Veterinaerplatz 1, 1210 Vienna, Austria.
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Scudder C, Church D. Feline Comorbidities: Hypersomatotropism-induced diabetes in cats. J Feline Med Surg 2024; 26:1098612X241226690. [PMID: 38323402 PMCID: PMC10911310 DOI: 10.1177/1098612x241226690] [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] [Indexed: 02/08/2024]
Abstract
PRACTICAL RELEVANCE Diabetes mellitus is the second-most common feline endocrinopathy, affecting an estimated 1/200 cats. While the underlying causes vary, around 15-25% of cats with diabetes mellitus develop the condition secondarily to progressive growth hormone (GH)-induced insulin resistance. This typically results in a form of diabetes that is challenging to manage, whereby the response to insulin is very variable or high doses are required to achieve even minimal diabetic control. CLINICAL CHALLENGES Although uncontrolled chronic excessive GH may result in phenotypic changes that raise suspicion for acromegaly, many cats with hypersomatotropism (HST) do not have these changes. In these situations, a clinician's index of suspicion may be increased by the presence of less dramatic changes such as marked polyphagia, stertor or uncontrolled diabetes mellitus. The current diagnostic test of choice is demonstration of a markedly increased serum insulin-like growth factor 1 (IGF1) concentration, but some affected cats will have only a marginal increase; additionally, chronic insulin administration in cats results in an increase in serum IGF1, making the diagnosis less clear cut and requiring additional confirmatory tests. EVIDENCE BASE Over the past two decades, HST has increasingly been recognised as an underlying cause of diabetes mellitus in cats. This review, which focuses on diagnosis and treatment, utilises data from observational studies, clinical trials and case series, as well as drawing on the experience of the authors in managing this condition.
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Affiliation(s)
- Christopher Scudder
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hertfordshire, UK
| | - David Church
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hertfordshire, UK
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Schermerhorn T. Treating inflammatory conditions such as periodontal disease can improve glycaemic control in diabetic dogs. Vet Rec 2024; 194:34-35. [PMID: 38180220 DOI: 10.1002/vetr.3822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Affiliation(s)
- Thomas Schermerhorn
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, USA
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11
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Gant P, Barfield D, Florey J. Comparison of insulin infusion protocols for management of canine and feline diabetic ketoacidosis. J Vet Emerg Crit Care (San Antonio) 2024; 34:23-30. [PMID: 37987148 DOI: 10.1111/vec.13354] [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: 12/30/2021] [Revised: 09/12/2022] [Accepted: 10/06/2022] [Indexed: 11/22/2023]
Abstract
OBJECTIVE Describe the use of fixed-rate intravenous insulin infusions (FRIs) in cats and dogs with diabetic ketoacidosis (DKA) and determine if this is associated with faster resolution of ketosis compared to variable-rate intravenous insulin infusions (VRIs). Secondary objectives were to evaluate complication rates, length of hospitalization (LOH), and survival to discharge (STD). DESIGN Randomized clinical trial (January 2019 to July 2020). SETTING University veterinary teaching hospital and private referral hospital. ANIMALS Dogs and cats with DKA and venous pH <7.3, blood glucose concentration >11 mmol/L (198 mg/dL), and β-hydroxybutyrate (BHB) concentration >3 mmol/L were eligible for inclusion. Patients were randomly assigned to receive either FRI or VRI. INTERVENTIONS Neutral (regular) insulin was administered IV as an FRI or VRI. For FRI, the rate was maintained at 0.01 IU/kg/h. For VRI, the dose was adjusted according to blood glucose concentration. MEASUREMENTS AND RESULTS Sixteen cats and 20 dogs were enrolled. Population characteristics, mean insulin infusion rate, time to resolution of ketosis (BHB <0.6 mmol/L), complications, LOH, and STD were evaluated. In cats, overall resolution of ketosis was low (9/16 [56.3%]), limiting comparison of protocols. In dogs, resolution of ketosis was high (19/20 dogs [95.0%]) but the time to resolution in the FRI group was not different than that in the VRI group (P = 0.89), despite a 25% higher average insulin infusion rate in the FRI group (P = 0.04). The incidence of complications was low and did not differ between protocols. In cats, LOH and STD did not differ between protocols. All cats that died (5/16) did so within 78 hours and none had resolution of ketosis. Dogs receiving FRI had a shorter LOH (P = 0.01) but STD did not differ between protocols. Six dogs (30.0%) did not survive to hospital discharge but all had resolution of ketosis. CONCLUSIONS FRIs can be used in veterinary species but may not hasten resolution of ketosis.
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Affiliation(s)
- Poppy Gant
- Department of Emergency and Critical Care, Willows Referral Service, Solihull, UK
| | - Dominic Barfield
- Section of Emergency and Critical Care, Department of Clinical Science and Services, Royal Veterinary College, London, UK
| | - Jessica Florey
- Department of Internal Medicine, Dick White Referrals, Cambridgeshire, UK
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Berg AS, Jacob ME, Mamo LB, Pluta DH, Lunn KF. Refrigerated multi-dose insulin vials remain sterile through 6 months of use. J Small Anim Pract 2023; 64:776-780. [PMID: 37559404 DOI: 10.1111/jsap.13664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/30/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To evaluate sterility in refrigerated multi-dose insulin vials through 6 months of routine aspiration. MATERIALS AND METHODS Twelve vials of insulin, six of insulin glargine U100 (Lantus®, 10 mL multi-dose vial, Sanofi, Bridgewater, NJ) containing the preservative metacresol, and six of protamine zinc insulin U40 (ProZinc®, 10 mL multi-dose vial, Boehringer Ingelheim, Duluth, GA) containing the preservative phenol, were refrigerated and aspirated twice daily for 6 months, using a new insulin syringe each time. Three vials of each insulin type were wiped with a single-use alcohol swab before sampling. Three times weekly, aspirated samples were inoculated in Tryptic Soy Broth enrichment media and incubated for evidence of microbial growth. Positive broth was cultured and speciated. Endpoints were microbial vial contamination (defined as three consecutive positive cultures of the same organism) and completion of the six-month study period. RESULTS Microbial contamination was not identified in any vial throughout the study period. A total of 454 aspirated samples were cultured, one of which exhibited non-repeatable growth of Staphylococcus epidermidis. This vial was prematurely lost to breakage after 59 culture samples (29 after the positive growth). CLINICAL SIGNIFICANCE Refrigerated phenol- and metacresol-containing multi-dose insulin products carry minimal risk for iatrogenic infection through 6 months of use, regardless of alcohol swab preparation.
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Affiliation(s)
- A S Berg
- North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - M E Jacob
- North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - L B Mamo
- North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - D H Pluta
- North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
| | - K F Lunn
- North Carolina State University, 1060 William Moore Drive, Raleigh, NC, 27607, USA
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Strey S, Mischke R, Rieder J. [Polyendocrine syndromes in dogs]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:313-325. [PMID: 37956663 DOI: 10.1055/a-2183-0654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The autoimmune polyendocrine syndrome (APS) refers to a combination of autoimmune endocrine disorders. It is rarely described in dogs. The most common combinations are hypoadrenocorticism and hypothyroidism, followed by diabetes mellitus, and less often hypoparathyroidism and orchitis. The diagnosis of the APS is based on the diagnosis of each endocrinopathy, as is the therapy, which involves the substitution of deficient hormones. If a patient was previously stable under treatment and is showing further signs (e.g. polyuria, polydipsia, or weight loss), the development of additional endocrinopathies like hypoadrenocorticism or diabetes mellitus should be considered. The diagnosis of the initially diagnosed endocrinopathy should also be critically questioned. This article summarizes some cases of our own animal hospital and selected cases published in the available literature.
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Affiliation(s)
- Sina Strey
- Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover
| | - Reinhard Mischke
- Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover
| | - Johanna Rieder
- Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover
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Kim J, Chae Y, Lee D, Koo Y, Cha S, Yun T, Yang MP, Kang BT, Kim H. Association between Hyperglycemia and Canine Serum Pancreatic Lipase Immunoreactivity Concentration in Diabetic Dogs. J Am Anim Hosp Assoc 2023; 59:241-248. [PMID: 37708476 DOI: 10.5326/jaaha-ms-7365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2023] [Indexed: 09/16/2023]
Abstract
It has been reported that hypertriglyceridemia can partially mediate between diabetes mellitus (DM) and pancreatitis in dogs, implying that another mediator, such as chronic hyperglycemia, might exist. Therefore, this study aimed to evaluate the relationship between hyperglycemia and serum canine pancreatic lipase immunoreactivity (cPLI) concentration in diabetic dogs. This retrospective cohort study included 26 client-owned diabetic dogs, divided according to their serum fructosamine levels (<500 μmol/L = well-controlled DM group; ≥500 μmol/L = untreated or poorly controlled DM group). Five of the 26 DM dogs (19.2%) had serum cPLI concentrations consistent with pancreatitis, among which two showed ultrasonographic evidence of pancreatitis without clinical signs. The serum cPLI concentrations (median [interquartile range]) were significantly higher in the untreated or poorly controlled group (520 μg/L [179.76-1000 μg/L]) than in the well-controlled group (77 μg/L [32.22-244.6 μg/L], P = 0.0147). The serum fructosamine concentration was positively correlated with the serum cPLI concentration (r = 0.4816; P = 0.0127). Multivariate analysis revealed serum triglyceride and fructosamine concentrations were associated with the serum cPLI concentration. In conclusion, this study suggests that chronic hyperglycemia may induce pancreatic inflammation in diabetic dogs; however, the clinical significance of increased cPLI concentration is unknown.
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Affiliation(s)
- Joonseok Kim
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Yeon Chae
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Dohee Lee
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Yoonhoi Koo
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Sijin Cha
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Taesik Yun
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Mhan-Pyo Yang
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Byeong-Teck Kang
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
| | - Hakhyun Kim
- From the Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk, South Korea
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15
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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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Kwong TC, Chau ECT, Mak MCH, Choy CT, Chan LT, Pang CK, Zhou J, Poon PHC, Guan Y, Tsui SKW, Chan SW, Leung GPH, Tai WCS, Kwan YW. Characterization of the Gut Microbiome in Healthy Dogs and Dogs with Diabetes Mellitus. Animals (Basel) 2023; 13:2479. [PMID: 37570288 PMCID: PMC10417117 DOI: 10.3390/ani13152479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/17/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
With a close pathogenetic resemblance to human diabetes, canine Diabetes Mellitus, a chronic metabolic disease featuring abnormally high blood sugar levels, is increasing in prevalence worldwide. Unlike humans, canine glycemic control requires life-long insulin injections and dietary control in most cases, thereby jeopardizing diabetic dogs' quality of life and increasing the difficulty of disease control. While many research studies have focused on elucidating the relationship between the canine gut microbiome and diseases, there is currently no research on the subject of diabetes mellitus in dogs. We hypothesized that the gut microbiome of canines with diabetes mellitus is different from that of healthy controls. Thus, we performed targeted 16S rRNA sequencing and comprehensive bioinformatic analysis to compare the gut microbiome profiles of 16 diabetic dogs with those of 32 healthy dogs. Clostridioides difficile, Phocaeicola plebeius, Lacrimispora indolis, and Butyricicoccus pullicaecorum were found to be enriched in diabetic dogs. A distinct shift towards carbohydrate degradation metabolic pathways was found to be differentially abundant in the diabetic subjects. Alteration of the co-occurrence network was also evident in the diabetic group. In conclusion, our study suggests that the gut microbial landscape differs in diabetic canines at the genera, species, functional, and network levels. These findings have significant implications for disease management, and thus warrant further research.
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Affiliation(s)
- Tsz Ching Kwong
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Eddie Chung Ting Chau
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Mark Chi Ho Mak
- Non-Profit Making Veterinary Services Society Limited, Hong Kong, China;
| | - Chi Tung Choy
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China; (C.T.C.); (J.Z.)
| | - Lee Tung Chan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Chun Keung Pang
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Junwei Zhou
- Microbiome Research Centre, BioMed Laboratory Company Limited, Hong Kong, China; (C.T.C.); (J.Z.)
| | - Phoebe Hoi Ching Poon
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Yuqiong Guan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Stephen Kwok Wing Tsui
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
| | - Shun Wan Chan
- Department of Food and Health Sciences, Faculty of Science and Technology, Technological and Higher Education Institute of Hong Kong, Hong Kong, China;
| | - George Pak Heng Leung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China;
| | - William Chi Shing Tai
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Hong Kong, China;
| | - Yiu Wa Kwan
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China; (E.C.T.C.); (L.T.C.); (C.K.P.); (P.H.C.P.); (Y.G.); (S.K.W.T.)
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17
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Wrightson R, Albertini M, Pirrone F, McPeake K, Piotti P. The Relationship between Signs of Medical Conditions and Cognitive Decline in Senior Dogs. Animals (Basel) 2023; 13:2203. [PMID: 37443999 DOI: 10.3390/ani13132203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Canine cognitive dysfunction syndrome (CCDS) is a progressive age-related neurodegenerative disorder in dogs. Minimal research has been performed to investigate how clinical signs may be impacted by other medical conditions. A cross-sectional study was performed using the Canine Cognitive Assessment Scale (CCAS) to evaluate cognitive impairment as reported by owners. Owner-reported health-related measures included behaviour changes, the body condition score, and veterinary diagnoses of disease. The responses from 804 dogs in the last 25% of their expected lifespan were analysed. Factors were identified in the owner-reported behavioural signs of disease representing pathologies in four body systems: musculoskeletal-neurological, digestive, metabolic, and dermatological, with the items comprising these factors also compiled into a cumulative measure of health. The results showed a strong correlation between the CCAS score and both the musculoskeletal-neurological factor and the overall cumulative measure of health. Moderate correlations between the CCAS score and the digestive factor and metabolic factor were also observed. The correlation between the dermatological factor and the CCAS score was weak. This study highlights the need to screen dogs for concurrent diseases when using scales to assess cognitive impairment and to monitor dogs who have health conditions, particularly those that are painful, for the onset of cognitive impairment.
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Affiliation(s)
- Rosalind Wrightson
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Mariangela Albertini
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Federica Pirrone
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
| | - Kevin McPeake
- The Royal (Dick) School of Veterinary Studies, Midlothian, Edinburgh EH25 9RG, UK
| | - Patrizia Piotti
- Department of Veterinary Medicine and Animal Science, University of Milan, 26900 Lodi, Italy
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18
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Bugbee A, Rucinsky R, Cazabon S, Kvitko-White H, Lathan P, Nichelason A, Rudolph L. 2023 AAHA Selected Endocrinopathies of Dogs and Cats Guidelines. J Am Anim Hosp Assoc 2023; 59:113-135. [PMID: 37167252 DOI: 10.5326/jaaha-ms-7368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Canine and feline endocrinopathies reflect an endocrine gland disease or dysfunction with resulting hormonal abnormali ties that can variably affect the patient's wellbeing, quality of life, and life expectancy. These guidelines provide consensus recommendations for diagnosis and treatment of four canine and feline endocrinopathies commonly encountered in clini cal practice: canine hypothyroidism, canine hypercortisolism (Cushing's syndrome), canine hypoadrenocorticism (Addi son's disease), and feline hyperthyroidism. To aid the general practitioner in navigating these common diseases, a stepwise diagnosis and treatment algorithm and relevant background information is provided for managing each of these diseases. The guidelines also describe, in lesser detail, the diagnosis and treatment of three relatively less common endo crinopathies of cats: feline hyperaldosteronism, feline hypothyroidism, and feline hyperadrenocorticism. Additionally, the guidelines present tips on effective veterinary team utilization and client communication when discussing endocrine cases.
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Affiliation(s)
- Andrew Bugbee
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Renee Rucinsky
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Sarah Cazabon
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Heather Kvitko-White
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Patty Lathan
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Amy Nichelason
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
| | - Liza Rudolph
- Department of Small Animal Medicine and Surgery, University of Georgia, Athens, Georgia (A.B.); Mid Atlantic Cat Hospital, Mid Atlantic Feline Thyroid Center, Queenstown, Maryland (R.R.); Boston Veterinary Clinic, Boston, Massachusetts (S.C.); KW Veterinary Consulting, LLC, Kansas City, Missouri (H.K.-W.); Mississippi State University, Mississippi State, Mississippi (P.L.); School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin (A.N.); Rowan College of South Jersey, Sewell, New Jersey (L.R.)
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Del Baldo F, Colajanni L, Corradini S, Palagiano P, Di Cunzolo A, Perissinotto L, Drudi I, Horspool L, Fracassi F. Owner preference for insulin delivery device and glycaemic control in diabetic dogs. J Small Anim Pract 2023; 64:255-264. [PMID: 36316285 DOI: 10.1111/jsap.13573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 04/12/2023]
Abstract
OBJECTIVES To assess treatment satisfaction and owner preference for two delivery devices (VetPen, MSD Animal Health, and U40 insulin syringes) and the effect on glycaemic control in diabetic dogs treated with porcine insulin zinc suspension. MATERIALS AND METHODS Randomised prospective cross-over study with two arms, each of 8 weeks. Twenty client-owned diabetic dogs on insulin treatment by U40 syringe were enrolled. Dogs were randomly assigned to receive insulin by syringe or pen injector for 2 months, followed by 2 months of the other injection method. Treatment satisfaction and owners' insulin delivery device preference were assessed using a questionnaire. Glycaemic control was assessed using a clinical score, serum fructosamine and glycated haemoglobin (HbA1c%) at the time of the enrolment (T0) and the end of each arm of treatment (T2 and T4). RESULTS Treatment satisfaction differed for the two types of the delivery device when the order that each device was used was taken into consideration. Owners who used the syringe first did not have a significant preference for an injection device. In contrast, owners who used the pen injector first expressed a significant preference for VetPen compared to syringes. No significant differences in the number of dogs of Groups 1 and 2 with good and poor glycaemic control at T2 and T4 were detected. CLINICAL SIGNIFICANCE Overall treatment satisfaction and preference for the two delivery methods were similar. However, VetPen was preferred by owners who were randomised to use this device first. Glycaemic control did not appear to be affected by the insulin delivery device used.
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Affiliation(s)
- F Del Baldo
- Department of Veterinary Medical Science, University of Bologna, Bologna, Italy
| | - L Colajanni
- Department of Veterinary Medical Science, University of Bologna, Bologna, Italy
| | - S Corradini
- Clinica Veterinaria dell'Orologio, Sasso Marconi, Italy
| | | | | | | | - I Drudi
- Department of Statistical Sciences, University of Bologna, Bologna, Italy
| | - L Horspool
- MSD Animal Health, Boxmeer, The Netherlands
| | - F Fracassi
- Department of Veterinary Medical Science, University of Bologna, Bologna, Italy
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20
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Kuzi S, Mazaki-Tovi M, Hershkovitz S, Yas E, Hess RS. Long-term field study of lispro and neutral protamine Hagedorn insulins treatment in dogs with diabetes mellitus. Vet Med Sci 2023; 9:704-711. [PMID: 36795089 PMCID: PMC10029897 DOI: 10.1002/vms3.1077] [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: 02/17/2023] Open
Abstract
BACKGROUND The long-term clinical and biofhemical effects of basal-bolus insulin treatment with lispro and NPH in dogs with diabetes mellitus are undocumented. OBJECTIVES To perform a prospective pilot field study of the long-term effects of lispro and NPH on clinical signs and serum fructosamine concentrations (SFC) in dogs with diabetes mellitus. METHODS Twelve dogs received combined lispro and NPH insulins treatment twice a day and were examined every 2 weeks for 2 months (visits 1-4), and every 4 weeks for up to 4 additional months (visits 5-8). Clinical signs and SFC were recorded at each visit. Polyuria and polydipsia (PU/PD) were scored as absent (0) or present (1). RESULTS Median (range) PU/PD scores of combined visits 5-8 (0, 0-1) were significantly lower than median scores of combined visits 1-4 (1, 0-1, p = 0.03) and at enrolment (1, 0-1, p = 0.045). Median (range) SFC of combined visits 5-8 (512 mmol/L, 401-974 mmol/L) was significantly lower than SFC of combined visits 1-4 (578 mmol/L, 302-996 mmol/L, p = 0.002) and at enrolment (662 mmol/L, 450-990 mmol/L, p = 0.03). Lispro insulin dose was significantly and negatively, albeit weakly, correlated with SFC concentration during visits 1 through 8 (r = -0.3, p = 0.013). Median duration of follow up was 6 months (range 0.5-6) and most dogs (8, 66.7%) were followed for 6 months. Four dogs withdrew from the study within 0.5-5 months because of documented or suspected hypoglycaemia, short NPH duration or sudden unexplained death. Hypoglycaemia was noted in 6 dogs. CONCLUSIONS Long-term lispro and NPH combination therapy may improve clinical and biochemical control of some diabetic dogs with comorbidities. Risk of hypoglycaemia should be addressed with close monitoring.
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Affiliation(s)
- Sharon Kuzi
- Department of Small Animals Internal Medicine, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Department of Small Animals Internal Medicine, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Shai Hershkovitz
- Department of Small Animals Internal Medicine, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Einat Yas
- Department of Small Animals Internal Medicine, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Rehovot, Israel
| | - Rebecka S Hess
- Department of Clinical Sciences & Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, Philadelphia
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21
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Costa RS, Jones T. Anesthetic Considerations in Dogs and Cats with Diabetes Mellitus. Vet Clin North Am Small Anim Pract 2023; 53:581-589. [PMID: 36854634 DOI: 10.1016/j.cvsm.2023.01.002] [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
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.
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Affiliation(s)
- Renata S Costa
- Specialty Medicine, Midwestern University, 5715 West Utopia Road, Office 323-K, Glendale, AZ 85308, USA.
| | - Teela Jones
- Anesthesiologist, Summit Veterinary Referral Center, 2505 South 80th Street, Tacoma, WA 98409, USA
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22
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Del Baldo F, Fracassi F. Continuous Glucose Monitoring in Dogs and Cats: Application of New Technology to an Old Problem. Vet Clin North Am Small Anim Pract 2023; 53:591-613. [PMID: 36854635 DOI: 10.1016/j.cvsm.2023.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
In recent years, glucose monitoring has been revolutionized by the development of continuous glucose monitoring systems (CGMS), which are wearable non/minimally invasive devices that measure glucose concentration almost continuously for several consecutive d/wk. The Abbott FreeStyle Libre is the CGMS used most commonly. It has adequate clinical accuracy both in dogs and cats, even though the accuracy is lower in the hypoglycemic range. It allows an accurate identification of glycemic excursions occurring throughout the day as well as of glucose variations during consecutive days, enabling the clinician to make a more informed decision about the insulin dose and frequency of administration.
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Affiliation(s)
- Francesca Del Baldo
- Department of Veterinary Medical Science, University of Bologna, via Tolara di Sopra, 40066, Ozzano dell'Emilia, Bologna, Italy.
| | - Federico Fracassi
- Department of Veterinary Medical Science, University of Bologna, via Tolara di Sopra, 40066, Ozzano dell'Emilia, Bologna, Italy
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Suemanotham N, Phochantachinda S, Chatchaisak D, Sakcamduang W, Chansawhang A, Pitchakarn P, Chantong B. Antidiabetic effects of Andrographis paniculata supplementation on biochemical parameters, inflammatory responses, and oxidative stress in canine diabetes. Front Pharmacol 2023; 14:1077228. [PMID: 36865924 PMCID: PMC9971231 DOI: 10.3389/fphar.2023.1077228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 02/02/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction: Diabetes mellitus is a common endocrine disorder that causes hyperglycemia in dogs. Persistent hyperglycemia can induce inflammation and oxidative stress. This study aimed to investigate the effects of A. paniculata (Burm.f.) Nees (Acanthaceae) (A. paniculata) on blood glucose, inflammation, and oxidative stress in canine diabetes. A total of 41 client-owned dogs (23 diabetic and 18 clinically healthy) were included in this double-blind, placebo-controlled trial. Methods: The diabetic dogs were further divided into two treatments protocols: group 1 received A. paniculata extract capsules (50 mg/kg/day; n = 6) or received placebo for 90 days (n = 7); and group 2 received A. paniculata extract capsules (100 mg/kg/day; n = 6) or received a placebo for 180 days (n = 4). Blood and urine samples were collected every month. No significant differences in fasting blood glucose, fructosamine, interleukin-6, tumor necrosis factor-alpha, superoxide dismutase, and malondialdehyde levels were observed between the treatment and placebo groups (p > 0.05). Results and Discussion: The levels of alanine aminotransferase, alkaline phosphatase, blood urea nitrogen, and creatinine were stable in the treatment groups. The blood glucose levels and concentrations of inflammatory and oxidative stress markers in the client-owned diabetic dogs were not altered by A. paniculata supplementation. Furthermore, treatment with this extract did not have any adverse effects on the animals. Non-etheless, the effects of A. paniculata on canine diabetes must be appropriately evaluated using a proteomic approach and involving a wider variety of protein markers.
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Affiliation(s)
- Namphung Suemanotham
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand,Department of pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sataporn Phochantachinda
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Duangthip Chatchaisak
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Walasinee Sakcamduang
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Anchana Chansawhang
- The Center for Veterinary Diagnosis, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Pornsiri Pitchakarn
- Department of Biochemistry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Boonrat Chantong
- Department of Pre-Clinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand,*Correspondence: Boonrat Chantong,
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Rothlin‐Zachrisson N, Öhlund M, Röcklinsberg H, Ström Holst B. Survival, remission, and quality of life in diabetic cats. J Vet Intern Med 2023; 37:58-69. [PMID: 36637031 PMCID: PMC9889602 DOI: 10.1111/jvim.16625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Remission is documented in a substantial proportion of cats with diabetes. The effects of diabetes mellitus (DM) on the lives of cats and their owners should be considered when evaluating treatment success. OBJECTIVES To study outcome in cats with DM and the impact DM has on the life situation of cat and owner. ANIMALS Domestic and pedigree cats with a diagnosis of DM (n = 477) insured by a Swedish insurance company during 2009 to 2013. METHODS Retrospective cross-sectional study. A questionnaire was sent to 1369 owners of cats diagnosed with DM. The questions concerned the cat, treatment, owner perceptions of the disease and treatment and disease outcome. Data were analyzed using multiple linear and logistic regression, with outcomes set as survival for more than 4 weeks after diagnosis, survival time, achieving remission, remission without relapse and quality of life (QoL) for the cat. RESULTS The response rate was 35%, leaving 477 questionnaires for analysis. The remission rate among treated cats was 29% (118/405). Feeding a commercially available wet diet was associated with both remission (OR 3.16, 95% confidence interval 1.27-8.12) and remission without relapse (OR 14.8, 95% confidence interval 2.25-153.8). Remission was associated with a better QoL for the cat. CONCLUSIONS AND CLINICAL IMPORTANCE The association between feeding a commercially available wet diet and remission is important and strengthens the role of diet in treatment of DM in cats. Linking remission and a better QoL for the cat emphasizes remission as a goal in disease management.
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Affiliation(s)
| | | | - Helena Röcklinsberg
- Department of Animal Environment and HealthSwedish University of Agricultural SciencesUppsalaSweden
| | - Bodil Ström Holst
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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Corbee RJ, van Everdingen DL, Kooistra HS, Penning LC. Fibroblast growth factor-21 (FGF21) analogs as possible treatment options for diabetes mellitus in veterinary patients. Front Vet Sci 2023; 9:1086987. [PMID: 36699319 PMCID: PMC9868460 DOI: 10.3389/fvets.2022.1086987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/13/2022] [Indexed: 01/10/2023] Open
Abstract
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.
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Arlt SP, Ottka C, Lohi H, Hinderer J, Lüdeke J, Müller E, Weber C, Kohn B, Bartel A. Metabolomics during canine pregnancy and lactation. PLoS One 2023; 18:e0284570. [PMID: 37163464 PMCID: PMC10171673 DOI: 10.1371/journal.pone.0284570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/03/2023] [Indexed: 05/12/2023] Open
Abstract
During pregnancy and parturition, female dogs have to cope with various challenges such as providing nutrients for the growth of the fetuses, hormonal changes, whelping, nursing, milk production, and uterine involution. Metabolomic research has been used to characterize the influence of several factors on metabolism such as inter- and intra-individual factors, feeding, aging, inter-breed differences, drug action, behavior, exercise, genetic factors, neuter status, and pathologic processes. Aim of this study was to identify metabolites showing specific changes in blood serum at the different phases of pregnancy and lactation. In total, 27 privately owned female dogs of 21 different breeds were sampled at six time points: during heat, in early, mid and late pregnancy, at the suspected peak of lactation and after weaning. A validated and highly automated canine-specific NMR metabolomics technology was utilized to quantitate 123 measurands. It was evaluated which metabolite concentrations showed significant changes between the different time points. Metabolites were then grouped into five clusters based on concentration patterns and biochemical relationships between the metabolites: high in mid-pregnancy, low in mid-pregnancy, high in late pregnancy, high in lactation, and low in lactation. Several metabolites such as albumin, glycoprotein acetyls, fatty acids, lipoproteins, glucose, and some amino acids show similar patterns during pregnancy and lactation as shown in humans. The patterns of some other parameters such as branched-chain amino acids, alanine and histidine seem to differ between these species. For most metabolites, it is yet unstudied whether the observed changes arise from modified resorption from the intestines, modified production, or metabolism in the maternal or fetal tissues. Hence, further species-specific metabolomic research may support a broader understanding of the physiological changes caused by pregnancy that are likely to be key for the normal fetal growth and development. Our findings provide a baseline of normal metabolic changes during healthy canine pregnancy and parturition. Combined with future metabolomics findings, they may help monitor vital functions of pre-, intra-, and post-partum bitches and may allow early detection of illness.
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Affiliation(s)
- Sebastian P Arlt
- Clinic of Reproductive Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Berlin, Germany
| | | | - Hannes Lohi
- PetBiomics Ltd, Helsinki, Finland
- Department of Veterinary Biosciences and Department of Medical and Clinical Genetics, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Janna Hinderer
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Berlin, Germany
| | - Julia Lüdeke
- Clinic for Animal Reproduction, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Berlin, Germany
| | | | | | - Barbara Kohn
- Clinic for Small Animals, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Berlin, Germany
| | - Alexander Bartel
- Institute for Veterinary Epidemiology and Biostatistics, Faculty of Veterinary Medicine, Freie Universitaet Berlin, Berlin, Germany
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Kuzi S, Mazaki-Tovi M, Ahmad WA, Ovadia Y, Aroch I. Clinical utility of serum fructosamine in long-term monitoring of diabetes mellitus in dogs. Vet Rec 2023; 192:e2236. [PMID: 36180819 DOI: 10.1002/vetr.2236] [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: 03/17/2022] [Revised: 08/29/2022] [Accepted: 09/07/2022] [Indexed: 01/24/2023]
Abstract
BACKGROUND Serum fructosamine (sFA) is used to assess glycaemic control in dogs with diabetes mellitus (DM). Nevertheless, its interpretation is hindered by several limitations. METHODS This retrospective study evaluates the long-term diagnostic performance of sFA for monitoring clinical control of DM. sFA, bodyweight, appetite, presence of polyuria/polydipsia and clinical scores (CS; well-controlled DM, CS-0; uncontrolled DM, CS-1) were recorded. RESULTS The study included 75 dogs (321 visits; median 3 visits/dog; range 1-19). Mean sFA was higher (p < 0.001) on visits with CS-1 (584 μmol/L; 95% confidence interval [95% CI] 561-608) than on visits with CS-0 (506 μmol/L; 95% CI 484-528). Increases in sFA increased the odds ratio for CS-1 (1.37; 95% CI 1.24-1.52, p < 0.001). sFA was moderately predictive of the CS (area under receiver operating characteristic curve = 0.75; 95% CI 0.70-0.80; p < 0.0001), with a 486 μmol/L cutoff yielding 80% sensitivity and 59% specificity. Mean sFA was lower (p = 0.005) when hypoglycaemic episodes were suspected (496 μmol/L; 95% CI 450-541) than in their absence (572 μmol/L; 95% CI 548-596). sFA is moderately accurate for classifying CS in diabetic dogs. Decreasing sFA over follow-ups indicates improved CS but might suggest occurrence of hypoglycaemic episodes. LIMITATIONS Retrospective design, variable treatments and comorbidities are limitations of this study. CONCLUSION sFA has a moderate clinical utility in the long-term monitoring of diabetic dogs, but may serve as a first-line, accessible diagnostic tool. Discordant CS and sFA evaluation, or decreased sFA, warrants additional monitoring (i.e., continuous glucose monitoring).
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Affiliation(s)
- Sharon Kuzi
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Michal Mazaki-Tovi
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Wiessam Abu Ahmad
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Yael Ovadia
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
| | - Itamar Aroch
- Koret School of Veterinary Medicine, The Hebrew University of Jerusalem, Rehovot, Israel
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Suemanotham N, Photcharatinnakorn P, Chantong B, Buranasinsup S, Phochantachinda S, Sakcamduang W, Reamtong O, Thiangtrongjit T, Chatchaisak D. Curcuminoid supplementation in canine diabetic mellitus and its complications using proteomic analysis. Front Vet Sci 2022; 9:1057972. [PMID: 36619946 PMCID: PMC9816143 DOI: 10.3389/fvets.2022.1057972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Inflammation and oxidative stress contribute to diabetes pathogenesis and consequences. Therapeutic approaches for canine diabetes remain a challenge. Curcumin has anti-inflammatory and anti-oxidative effects and is beneficial for humans with diabetes mellitus (DM); however, data on its impact on canine diabetes is limited. This study aimed to evaluate the potential for causing adverse effects, anti-inflammatory effects, anti-oxidative effects and proteomic patterns of curcuminoid supplementation on canine DM. Methods Altogether, 18 dogs were divided into two groups: DM (n = 6) and healthy (n = 12). Curcuminoid 250 mg was given to the DM group orally daily for 180 days. Blood and urine sample collection for hematological parameters, blood biochemistry, urinalysis, oxidative stress parameters, inflammatory markers and proteomics were performed every 6 weeks. Results and discussion Curcuminoid supplementation with standard therapy significantly decreased oxidative stress with the increased glutathione/oxidized glutathione ratio, but cytokine levels were unaffected. According to the proteomic analysis, curcuminoid altered the expression of alpha-2-HS-glycoprotein, transthyretin, apolipoprotein A-I and apolipoprotein A-IV, suggesting that curcuminoid improves insulin sensitivity and reduces cardiovascular complications. No negative impact on clinical symptoms, kidneys or liver markers was identified. This study proposed that curcuminoids might be used as a targeted antioxidant strategy as an adjunctive treatment to minimize diabetes complications in dogs.
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Affiliation(s)
- Namphung Suemanotham
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand,Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | | | - Boonrat Chantong
- Department of Pre-clinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Shutipen Buranasinsup
- Department of Pre-clinic and Applied Animal Science, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Sataporn Phochantachinda
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Walasinee Sakcamduang
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Onrapak Reamtong
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Tipparat Thiangtrongjit
- Department of Molecular Tropical Medicine and Genetics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Duangthip Chatchaisak
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand,*Correspondence: Duangthip Chatchaisak ✉
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Kornya M, Abrams-Ogg A, Comeau D, Caswell J. Juvenile hyperinsulinism in a Maine Coon kitten. JFMS Open Rep 2022; 8:20551169221136473. [DOI: 10.1177/20551169221136473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Case summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabolism (ie, storage diseases and urea cycle disorders), infection or iatrogenic hypoglycemia were negative. An inappropriately high serum insulin level was noted in the face of marked hypoglycemia. The insulin:glucose ratio was 0.44 (<0.3) and the amended insulin:glucose ratio was 1268 (<30). Thoracic radiography and abdominal ultrasonography did not identify a cause for this elevated insulin level. Stabilization with a low, but adequate, blood glucose occurred with corticosteroid therapy, with further significant improvement with the addition of diazoxide. Peripheral neuropathy developed several months later, and concerns for quality of life led to humane euthanasia approximately 1 year after the initial diagnosis. Insulin levels remained high at the time of euthanasia. Necropsy found no gross lesions, though microscopic degeneration of the sciatic nerve and subjectively mildly increased size and number of pancreatic islets was noted. These findings were consistent with a diagnosis of congenital hyperinsulinism. Relevance and novel information This is the first reported case of congenital hyperinsulinism in a cat and may parallel the diffuse form of hypoglycemic hyperinsulinism reported in humans and a single dog. It should be considered a differential diagnosis in kittens presenting for refractory hypoglycemia.
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Affiliation(s)
- Matthew Kornya
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | | | - Dominique Comeau
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
| | - Jeff Caswell
- Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Slead TS, Woolcock AD, Scott-Moncrieff JC, Messick JB, Moore GE. Complete Blood Counts and Blood Smear Analyses in 312 Diabetic Dogs (2007-2017). J Am Anim Hosp Assoc 2022; 58:180-188. [PMID: 35793489 DOI: 10.5326/jaaha-ms-7230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2021] [Indexed: 11/11/2022]
Abstract
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.
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Affiliation(s)
- Tanner S Slead
- From the Department of Veterinary Clinical Sciences, North Carolina State University, Raleigh, North Carolina (T.S.S.)
| | - Andrew D Woolcock
- From the Department of Veterinary Clinical Sciences (A.D.W., C.S.-M.), Purdue University, West Lafayette, Indiana
| | - J Catharine Scott-Moncrieff
- From the Department of Veterinary Clinical Sciences (A.D.W., C.S.-M.), Purdue University, West Lafayette, Indiana
| | - Joanne B Messick
- From the Department of Comparative Pathobiology (J.B.M.), Purdue University, West Lafayette, Indiana
| | - George E Moore
- From the Department of Veterinary Administration (G.E.M.), Purdue University, West Lafayette, Indiana
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Hulsebosch SE, Pires J, Bannasch MJ, Lancaster T, Delpero A, Ragupathy R, Murikipudi S, Zion T, Gilor C. Ultra-long-acting recombinant insulin for the treatment of diabetes mellitus in dogs. J Vet Intern Med 2022; 36:1211-1219. [PMID: 35621084 PMCID: PMC9308417 DOI: 10.1111/jvim.16449] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND For the treatment of diabetes mellitus (DM) in dogs, novel insulins with decreased injection frequency while maintaining safety and efficacy are desirable. Insulin fused with immunoglobulin-fragment-crystallizable (Fc) has an ultra-long plasma half-life because it recycles through cells, protected from proteolysis. HYPOTHESIS Glycemic control can be achieved in diabetic dogs with a recombinant fusion protein of a synthetic insulin and canine Fc (AKS-218d) administered subcutaneously once-weekly. ANIMALS Five client-owned dogs with naturally occurring DM. METHODS Prospective clinical trial in dogs with DM that were recruited from the UC Davis Veterinary Teaching Hospital and local veterinary clinics. Dogs previously controlled using intermediate-acting insulin q12h were transitioned to once-weekly injections of a preliminary construct identified as AKS-218d. The dose of AKS-218d was titrated weekly for 8 weeks based on clinical response and continuous interstitial glucose monitoring. Clinical signs, body weight, serum fructosamine concentrations, and mean interstitial glucose concentrations (IG) over the preceding week were compared between baseline (before AKS-218d) and during the last week of treatment. Data were compared using nonparametric paired tests. RESULTS Once-weekly AKS-218d, compared to baseline twice-daily insulin therapy, resulted in no significant changes in clinical signs, median (range) body weight (+0.4 kg [-0.5-1.1]; P = .6), fructosamine concentration (-75 mmol/L [-215 to +126]; P = .4), or mean IG (+81 mg/dL [-282 to +144]; P = .8). No adverse reactions were reported. CONCLUSION Control of clinical signs, body weight, and maintenance of glycemia was achieved with this once-weekly novel insulin construct in 4 of 5 dogs.
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Affiliation(s)
- Sean E. Hulsebosch
- Department of Veterinary Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA
| | - Jully Pires
- Veterinary Medical Teaching HospitalUniversity of CaliforniaDavisCaliforniaUSA
| | - Michael J. Bannasch
- Veterinary Medical Teaching HospitalUniversity of CaliforniaDavisCaliforniaUSA
| | | | | | | | | | - Todd Zion
- Akston BiosciencesBeverlyMassachusettsUSA
| | - Chen Gilor
- Department of Veterinary Medicine and EpidemiologyUniversity of CaliforniaDavisCaliforniaUSA,Department of Small Animal Clinical SciencesUniversity of Florida, College of Veterinary MedicineGainesvilleFloridaUSA
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Xenoulis PG, Fracassi F. Feline Comorbidities: Clinical perspective on diabetes mellitus and pancreatitis. J Feline Med Surg 2022; 24:651-661. [PMID: 35775305 PMCID: PMC11107984 DOI: 10.1177/1098612x221106355] [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] [Indexed: 11/16/2022]
Abstract
PRACTICAL RELEVANCE Diabetes mellitus (DM) is one of the most common feline endocrine disorders. It has been shown by several studies that DM in cats frequently coexists with pancreatitis. CLINICAL CHALLENGES It has not been definitively established what the exact pathogenetic association between DM and pancreatitis is in the cat. However, the association between these two conditions is most likely bidirectional, with DM predisposing cats to pancreatitis and vice versa. Diagnosis of pancreatitis in cats with DM is crucial because concurrent pancreatitis commonly leads to difficulties in the management of DM. When pancreatitis is associated with diabetic ketoacidosis (DKA), therapeutic management is even more challenging. AIMS This review focuses on the concurrent presence of DM or DKA and pancreatitis in cats, mainly focusing on their clinical management. EVIDENCE BASE Information provided in this review is based on feline-specific clinical research when available. In addition, comparative and human research, as well as clinical experience, has been used to enrich knowledge in areas where feline-specific research is not yet available.
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Affiliation(s)
- Panagiotis G Xenoulis
- Clinic of Medicine, Faculty of Veterinary Science, University of Thessaly, Karditsa, Greece
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Italy
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Knies M, Teske E, Kooistra H. Evaluation of the FreeStyle Libre, a flash glucose monitoring system, in client-owned cats with diabetes mellitus. J Feline Med Surg 2022; 24:e223-e231. [PMID: 35762266 PMCID: PMC9315169 DOI: 10.1177/1098612x221104051] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives Home blood glucose monitoring using a portable blood glucose meter is
important in the management of feline diabetes mellitus, but taking blood
samples may be stressful for owners and cats. A flash glucose monitoring
system measuring interstitial glucose, such as the FreeStyle Libre,
overcomes some of these drawbacks. The aim of this study was to evaluate the
practical use and analytical and clinical accuracy of the FreeStyle Libre in
41 client-owned diabetic cats. Methods In this prospective study, interstitial glucose concentrations were measured
with the FreeStyle Libre and compared with blood glucose concentrations
measured with a portable blood glucose meter (AlphaTRAK) on days 1, 7 or 8
and 14 after application of the device. Cat behaviour during application,
location, skin reaction at the attachment site and owner satisfaction were
assessed. Accuracy was determined by fulfilment of ISO 15197:2013 criteria,
including Bland–Altman plotting and error grid analysis. Results Placing the device was easy, with 70% of cats showing no reaction. Most
sensors were placed on the thoracic wall. Skin reactions at the attachment
site were not present or mild in almost all cats. Owners were very satisfied
with the use of the FreeStyle Libre. Median functional life of the sensor
was 10 days (range 1–14). Good correlation was found between interstitial
and blood glucose measurements (rho[r] = 0.88, P
<0.0001). Fifty-three percent of interstitial glucose concentrations were
within a maximum deviation of 15% from blood glucose concentrations and
92.7% were within the safe risk zones 0 and 1 of the surveillance error
grid. Conclusions and relevance The flash glucose monitoring system was easy to use and owners of diabetic
cats were satisfied with its use. Although the device did not completely
fulfil ISO requirements, it is sufficiently accurate for glucose monitoring
in diabetic cats.
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Affiliation(s)
- Marieke Knies
- AniCura Veterinary Referral Centre Haaglanden, Rijswijk, The Netherlands.,Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Erik Teske
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Hans Kooistra
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
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Reduction in Glomerular and Renal Tubular Damage in Kidneys of Diabetic Rats Supplemented with Alpha-Lipoic Acid. ACTA VET-BEOGRAD 2022. [DOI: 10.2478/acve-2022-0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Chronic hyperglycemia caused by diabetes results in systemic damage to the body, and the kidney ends up being the target of tissue damage. The use of antioxidants such as alpha-lipoic acid (ALA) has been shown to improve clinical and biochemical parameters in diabetic patients as they help in the prevention of oxidative stress. The present study aimed to undertake a comparative evaluation of the renal morphology of normal and diabetes-induced Wistar rats supplemented with ALA. The experiment had 4 experimental groups (n=7): a control group and a diabetic group that were fed commercial food; an alpha-lipoic group and an alpha-lipoic diabetic group that received the ALA supplement. Diabetes was induced with a single intraperitoneal injection of alloxane monohydrate administered after fasting. After 60 days of the experiment, the kidneys were excised to study the histomorphometric and stereological parameters of the glomeruli and renal tubules and the immunohistochemical parameters with a podocyte count. In the evaluation, the ALA promoted improvement in all of the relevant parameters of the glomerular areas and attenuation of tubular lesions of diabetic animals (p<0.001). Supplementation with ALA also showed beneficial effects in diabetic animals, such as reducing hyperglycemia and the damage promoted by oxidative stress alongside promoting a protective effect on the renal parenchyma. The reduction of glomerular and tubular damage delayed the advance of diabetic nephropathy and its complications, preventing renal failure in diabetic groups.
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Ringstad NK, Lingaas F, Thoresen SI. Breed distributions for diabetes mellitus and hypothyroidism in Norwegian dogs. Canine Med Genet 2022; 9:9. [PMID: 35610669 PMCID: PMC9128090 DOI: 10.1186/s40575-022-00121-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes mellitus (DM) and hypothyroidism are common canine endocrinopathies. Both canine DM and primary hypothyroidism are assumed to originate from autoimmune destruction of the respective endocrine glands and have been associated with the major histocompatibility complex (MHC) gene region. This study aims to investigate breed distributions for DM and hypothyroidism in the Norwegian canine population by calculating odds ratios (OR) from two different comparator groups. METHODS Results from canine serum samples submitted from 2001 to 2018 to the Veterinary Clinical Pathology Laboratory (VCPL) at the Faculty of Veterinary Medicine, Norwegian University of Life Sciences for analysis of fructosamine and thyroid hormones in serum were used as cases in a retrospective bivariate analysis of canine breeds. The ORs were calculated as a measure of risk for the included breeds, where all the submitted blood samples to the VCPL and dogs registered in the Norwegian Kennel Club (NKK), the national organization for dog owners, were used as two comparator groups. RESULTS Significant differences in disease prevalence between breeds were discovered using both comparator groups. Australian terrier, Swedish lapphund, Samoyed, and Schipperke were at highest risk for DM. German Shepherd, Golden retriever, German pointing dog, and Collie presented as the breeds with lowest risk for DM. For hypothyroidism, Schnauzer, Eurasier, Dunker, and English setter were at highest risk for developing the disease. The breeds at lowest risk of developing hypothyroidism were Rottweiler, Dachshund, German shepherd, and Border collie. The results from the different comparator groups gave different ORs and ranks, but the breeds with highest and lowest odds showed the same susceptibility using both comparators. CONCLUSIONS These findings support that there are breeds more and less prone to develop DM and hypothyroidism. A strong genetic predisposition involved in the aetiology of these two diseases is therefore likely. Interestingly, there also appeared to be an inverse relationship of odds for the two diseases for some of the breeds since some breeds that had a high OR for DM or hypothyroidism had a lower OR for the other disease. This indicates that there may be different risk alleles/haplotypes for the two diseases. The possible aetiological relationship between canine DM and hypothyroidism should be further investigated.
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Affiliation(s)
- N K Ringstad
- Department of Companion Animal Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway.
| | - F Lingaas
- Department of Preclinical Sciences and Pathology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway
| | - S I Thoresen
- Department of Preclinical Sciences and Pathology, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Ås, Norway.
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Influence of a Polyherbal Choline Source in Dogs: Body Weight Changes, Blood Metabolites, and Gene Expression. Animals (Basel) 2022; 12:ani12101313. [PMID: 35625159 PMCID: PMC9137459 DOI: 10.3390/ani12101313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/03/2022] [Accepted: 05/14/2022] [Indexed: 11/16/2022] Open
Abstract
Choline chloride is used to provide choline in dog foods; however, in other domestic species, it has been replaced with a polyherbal containing phosphatidylcholine. A polyherbal containing Achyrantes aspera, Trachyspermum ammi, Citrullus colocynthis, Andrographis paniculata, and Azadirachta indica was evaluated in adult dogs through body weight changes, subcutaneous fat thickness, blood metabolites, and gene expression. Forty dogs (4.6 ± 1.6 years old) who were individually housed in concrete kennels were randomly assigned to the following treatments: unsupplemented diet (377 mg choline/kg), choline chloride (3850 mg/kg equivalent to 2000 mg choline/kg diet), and polyherbal (200, 400, and 800 mg/kg) for 60 days. Blood samples were collected on day 59 for biochemistry, biometry, and gene expression analysis through microarray assays. Intake, final body weight, and weight changes were similar for the two choline sources. Feed intake variation among dogs (p = 0.01) and dorsal fat (p = 0.03) showed a quadratic response to herbal choline. Dogs that received the polyherbal diet had reduced blood cholesterol levels (Quadratic, p = 0.02). The gene ontology analysis indicated that 15 biological processes were modified (p ≤ 0.05) with implications for preventing cardiovascular and metabolic diseases, cancer prevention, inflammatory and immune response, and behavior and cognitive process. According to these results that were observed in a 60 day trial, the polyherbal form could replace choline chloride in dog diets at a concentration of 400 mg/kg.
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McClintock DE, Austel M, Banovic F. Response to Letter to the Editor by Coyner et al. Vet Dermatol 2022; 33:181-182. [DOI: 10.1111/vde.13070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Dayle E. McClintock
- Department of Small Animal Medicine and Surgery College of Veterinary Medicine, University of Georgia Athens GA USA
| | - Michaela Austel
- Department of Small Animal Medicine and Surgery College of Veterinary Medicine, University of Georgia Athens GA USA
| | - Frane Banovic
- Department of Small Animal Medicine and Surgery College of Veterinary Medicine, University of Georgia Athens GA USA
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Relationship between HbA1c, fructosamine and clinical assessment of glycemic control in dogs. PLoS One 2022; 17:e0264275. [PMID: 35213623 PMCID: PMC8880912 DOI: 10.1371/journal.pone.0264275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022] Open
Abstract
Background Serum fructosamine is a routine test used for clinical monitoring of diabetes mellitus (DM) but the usefulness of HbA1c for this purpose has not been extensively studied. Hypothesis The study aimed to compare the ability of blood HbA1c and serum fructosamine tests to correctly classify DM control determined using a clinically-based assessment. Animals 28 client-owned dogs with naturally-occurring diabetes mellitus. Methods Cross-sectional observational study. Ability of fructosamine and HbA1c tests to classify diabetes control in dogs was determined. Results Clinical assessment classified 50% of dogs as having good diabetic control and 82% as having acceptable diabetic control. Analysis using Cohen’s kappa test showed that agreements between fructosamine and HbA1c results and the clinical assessment ranged from poor to fair. Fructosamine and HbA1c results from each dog showed a moderate correlation. Overall, the HbA1c test showed the best agreement with the clinical assessment when diabetes control was considered either acceptable or unacceptable, although the strength of agreement was considered fair (kappa = 0.27). Conclusions and clinical importance The HbA1c concentration was found to be more consistent with clinical evaluation of diabetes control than was the serum fructosamine concentration. The HbA1c level is a useful tool for assessment of glycemic status in diabetic dogs but should be used alongside other tests for outpatient monitoring of clinically stable diabetic dogs.
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Leal KM, Rocha MB, Varela FV, Rodrigues L, Furtado PV, da Costa FVA, Pöppl ÁG. Is methylprednisolone acetate-related insulin resistance preventable in cats? Top Companion Anim Med 2022; 49:100648. [PMID: 35202848 DOI: 10.1016/j.tcam.2022.100648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
Methylprednisolone acetate (MPA) is often prescribed to cats despite being recognized eventually as diabetogenic. To assess MPA-related insulin resistance and evaluate the efficacy of metformin or an obesity and diabetes mellitus (O&D) adjuvant diet as protective factors, a randomized clinical trial was conducted with 28 owned cats undergoing glucocorticoid therapy. A single MPA dose of 20 mg intramuscularly was administered to each cat. Controls (n=10) received only MPA. In the diet group (n=9), replacement of their habitual diet by ad-libitum feeding of a feline commercial O&D diet (Equilíbrio O&D, Total Alimentos ADM) was made. In the metformin group (n=9), metformin chlorhydrate 25mg/cat PO/q24h was administered for 30 days. All patients were clinically evaluated at baseline (T0), day 15 (T15), and day 30 (T30) and blood draw for complete blood count, serum biochemistry, and determination of insulin concentrations. Fasting Insulin Sensitivity Index (SI), Amended Insulin to Glucose Ratio (AIGR), Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and Homeostatic Model Assessment of beta-cell function (HOMA-B) were calculated based on fasting glycemia and insulinemia. All groups showed significantly higher levels (p < 0.05) of neutrophils, albumin, glucose, cholesterol, triglycerides, and serum insulin at T15. Patients in the metformin group showed also higher SI, AIGR, and HOMA-IR results at T15. Also, at T15, reduced levels (p < 0.05) of eosinophils, lymphocytes, and creatinine were documented in all groups. An MPA single dose induced changes in insulin sensitivity in cats; however, neither metformin nor O&D feeding used in this study was effective as protective factors against MPA-related insulin resistance.
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Key Words
- AAFP, American Association of Feline Practitioners
- AIGR, amended insulin to glucose ratio
- CV, coefficient of variation
- ESVE, European Society of Veterinary Endocrinology
- FDM, feline diabetes mellitus
- GLP-1, glucagon-like peptide-1
- HOMA-B, homeostatic model assessment of beta-cell function
- HOMA-IR, homeostatic model assessment of insulin resistance
- LOD, limit of detection
- MPA, methylprednisolone acetate
- O&D, obesity and diabetes
- RIA, radioimmunoassay
- SI, Fasting insulin sensitivity index
- adjuvant feeding
- diabetes mellitus
- glucocorticoid therapy
- insulinaemia
- metformin
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Affiliation(s)
- Karine Marchioro Leal
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Veterinary Hospital UniRitter, Laureate International Universities, 2001 Manoel Elias Av., Mário Quintana, Porto Alegre, RS, 91240-260, Brazil
| | - Mariana Barcelos Rocha
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Fernanda Venzon Varela
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Luana Rodrigues
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Priscila Viau Furtado
- Hormonal Laboratory, Faculty of Veterinary Medicine and Zootecny, University of São Paulo (USP), 87 Orlando Marques de Paiva Av., Butantã, São Paulo, SP, 05508-270, Brazil
| | - Fernanda Vieira Amorim da Costa
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Department of Animal Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil
| | - Álan Gomes Pöppl
- Veterinary Sciences Post-Graduating Program, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul (UFRGS), 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil; Department of Animal Medicine, Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, 9090 Bento Gonçalves Av., Agronomia, Porto Alegre, RS, 91540-000, Brazil.
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Insulins for the long term management of diabetes mellitus in dogs: a review. Canine Med Genet 2022; 9:1. [PMID: 35152907 PMCID: PMC8842735 DOI: 10.1186/s40575-022-00114-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/02/2022] [Indexed: 01/13/2023] Open
Abstract
The year 2021 marked the centenary of the isolation of a therapeutic form of insulin and its successful use in dogs. This was a landmark moment that subsequently and rapidly led to the commercial manufacture of insulin for use in humans. The impact of insulin was almost miraculous as those destined to die from their diabetes mellitus returned to life. Over the past 100 years, insulin formulations have been modified to attempt to provide a predictable and prolonged duration of action while avoiding the development of hypoglycaemia. This has led to an ever-growing variety of insulin types in human medicine, many of which have subsequently been used in dogs. The purpose of this review article is to provide an overview of available insulin types and their application to the chronic management of canine diabetes mellitus.
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Atkin SA, Moin ASM, Atkin SL, Butler AE. Hypoglycemia Impairs the Heat Shock Protein Response: A Risk for Heat Shock in Cattle? Front Vet Sci 2022; 9:822310. [PMID: 35224086 PMCID: PMC8866688 DOI: 10.3389/fvets.2022.822310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundHeat stress (HS) in cattle is a major debilitating problem, affecting health and milk yield. Physiologically, HS has been shown to lower blood glucose levels to 2.5 mmol/l (45 mg/dl) and results in upregulation of heat shock proteins (HSPs), eliciting the heat shock response (HSR) of which HSP90, 70 and 27 have been shown to be protective. However, it is unclear if the HSP response is blunted by decreased glucose, thereby preventing adaptive mechanisms. To address this question, this exploratory reverse translational study on the effects of hypoglycemia on the HSP pathway was undertaken.MethodsA human prospective, study in healthy control individuals (n = 23) was undertaken. Subjects underwent hyperinsulinemic-induced hypoglycemia [≤2.0 mmol/L (36 mg/dl)] with blood sampling at baseline, at hypoglycemia and for a 24-h post-hypoglycemia follow-up period. Proteomic analysis of the heat shock-related protein pathway, the pathway associated with HS in cattle, was performed.ResultsIn response to hypoglycemia, HS pathway proteins were significantly decreased (p < 0.05): HSP70 and HSP27 (at hypoglycemia); DnaJ homolog subfamily B member 1 (DNAJB1), Stress-induced-phosphoprotein 1 (STIP1) and the ubiquitin pathway proteins, Ubiquitin-conjugating enzyme (UBE2L3) and Ubiquitin-conjugating enzyme E2 N (UBE2N) (at 30-min post-hypoglycemia); HSP90 (at 2-h post-hypoglycemia). STIP1, UBE2L3, and UBE2N remained suppressed at 24-h.ConclusionHeat stress in cattle reduces blood glucose that, in turn, may blunt the HS pathway protective response, including HSP 90, 70, 27 and the ubiquitin proteins, leading to adverse outcomes. Monitoring of blood glucose in susceptible cattle may allow for earlier intervention and may also identify those animals at greatest risk to ensure that milk yield is not compromised.
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Affiliation(s)
- Samuel A. Atkin
- School of Veterinary Medicine, University of Liverpool, Liverpool, United Kingdom
| | | | | | - Alexandra E. Butler
- Royal College of Surgeons in Ireland Bahrain, Adliya, Bahrain
- *Correspondence: Alexandra E. Butler ;
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Linari G, Fleeman L, Gilor C, Giacomelli L, Fracassi F. Insulin glargine 300 U/ml for the treatment of feline diabetes mellitus. J Feline Med Surg 2022; 24:168-176. [PMID: 34009061 PMCID: PMC10812176 DOI: 10.1177/1098612x211013018] [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] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The study aimed to evaluate the efficacy and safety of insulin glargine 300 U/ml (IGla-U300) in cats with variable duration of diabetes mellitus (DM). METHODS Thirteen client-owned cats with DM completed a prospective clinical trial. Four cats were highly suspected of hypersomatotropism and excluded from the insulin efficacy evaluation. All cats were treated with IGla-U300 SC at a starting dosage of 0.5 U/kg q12h and fed with a low carbohydrate diet. Cats were monitored for 8 weeks with a once-weekly at-home 16 h blood glucose curve (BGC) and a questionnaire evaluating the presence of DM-related clinical signs. In-clinic evaluations, including serum fructosamine measurement, were scheduled within 3 days of the first, third, sixth and eighth BGC. Glycemic variability was assessed by calculating the SD of each BGC. RESULTS Excluding four cats suspected of hypersomatotropism, at the time of the eighth BGC, improved or absent polyuria, polydipsia, polyphagia, weight loss, lethargy and improved or normal general demeanor were reported in 8/9 (88%), 8/9 (88%), 7/9 (77%), 7/9 (77%), 7/9 (77%) and 8/9 (88%) cats, respectively. Two cats achieved remission after 29 and 53 days. Another two cats went into remission after the end of the study (days 82 and 96). All cats that achieved remission were newly diagnosed diabetics. Median (range) serum fructosamine concentration significantly decreased when comparing the time of enrollment (604 [457-683] µmol/l) with the eighth week of treatment (366 [220-738] µmol/l) (P = 0.02). In all 13 cats, biochemical hypoglycemia (blood glucose <60 mg/dl; <3.3 mmol/l) was detected in 13/104 (12.5%) BGCs, while clinical signs suggesting hypoglycemic episodes were not reported. Glycemic variability was significantly lower at the fifth BGC when comparing cats that achieved remission with cats that did not achieve remission (P = 0.02). CONCLUSIONS AND RELEVANCE IGla-U300 seems effective and safe for the treatment of feline diabetes, but more long- term and comparative clinical trials are needed.
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Affiliation(s)
- Guido Linari
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | | | - Chen Gilor
- College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - Lucia Giacomelli
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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Gilor C, Hulsebosch SE, Pires J, Bannasch MJ, Lancaster T, Delpero A, Ragupathy R, Murikipudi S, Zion T. An ultra-long-acting recombinant insulin for the treatment of diabetes mellitus in cats. J Vet Intern Med 2021; 35:2123-2130. [PMID: 34190365 PMCID: PMC8478034 DOI: 10.1111/jvim.16150] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Treatment of diabetes mellitus (DM) in cats typically requires insulin injections q12h-q24h, posing a major compliance barrier for caregivers. Novel treatments enabling decreased injection frequency while maintaining safety are highly desirable. Insulin fused with feline immunoglobulin fragment crystallizable (Fc) has an ultra-long plasma half-life because it recycles through cells where it is protected from proteolysis. HYPOTHESIS Glycemic control can be achieved in diabetic cats with a recombinant fusion protein of a synthetic insulin and feline Fc (AKS-267c) administered SC weekly. ANIMALS Five cats with spontaneous DM. METHODS Cats previously controlled using insulin glargine q12h were transitioned to once-weekly injection of AKS-267c. The dose of AKS-267c was titrated weekly for 7 weeks based on continuous glucose monitoring. Clinical signs, body weight, fructosamine concentrations, and mean interstitial glucose concentrations (IG) were compared between baseline (week 0, on insulin glargine) and the last week of treatment. Data were assessed for normality and compared using parametric or nonparametric paired tests (as appropriate). RESULTS After 7 weeks of once-weekly injections, compared to baseline, there were no significant changes in clinical signs, body weight (median [range] gain, 0.1 kg [-0.1 to +0.7]; P = .5), fructosamine (-60 mmol/L [-338 to +206]; P = .6), and mean IG concentrations (change = -153 mmol/L [-179 to +29]; P = .3), and no adverse reactions were reported. CONCLUSION Successful control of clinical signs and maintenance of glycemia was achieved with this once-weekly novel insulin treatment. The efficacy and safety of this novel formulation should be further assessed in a large clinical trial.
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Affiliation(s)
- Chen Gilor
- Department of Veterinary Medicine and EpidemiologyUniversity of California, DavisDavisCaliforniaUSA
- Department of Small Animal Clinical SciencesUniversity of Florida, College of Veterinary MedicineGainesvilleFloridaUSA
| | - Sean E. Hulsebosch
- Department of Veterinary Medicine and EpidemiologyUniversity of California, DavisDavisCaliforniaUSA
| | - Jully Pires
- Department of Veterinary Medicine and EpidemiologyUniversity of California, DavisDavisCaliforniaUSA
| | - Michael J. Bannasch
- Department of Veterinary Medicine and EpidemiologyUniversity of California, DavisDavisCaliforniaUSA
| | | | | | | | | | - Todd Zion
- Akston BiosciencesBeverlyMassachusettsUSA
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Shea EK, Hess RS. Validation of a flash glucose monitoring system in outpatient diabetic cats. J Vet Intern Med 2021; 35:1703-1712. [PMID: 34223655 PMCID: PMC8295694 DOI: 10.1111/jvim.16216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Interstitial glucose (IG) concentration measurement using a flash glucose monitoring system (FGMS) is a noninvasive, affordable, and informative method to regulate patients with diabetes mellitus (DM) but has not been fully validated in outpatient cats with DM. OBJECTIVES To further validate the FreeStyle Libre FGMS in outpatient diabetic cats. ANIMALS Eight client-owned cats with DM. METHODS Prospective observational validation study. Tissue glue was used to attach the sensor to the cat. Lin's concordance correlation coefficient (ρc ) was used to compare IG concentrations measured by the FGMS to blood glucose concentrations measured using an automated biochemistry analyzer (ABA) and point-of-care glucometer (POCG). RESULTS Data from 15 sensor placements in 8 cats were analyzed. Paired IG and ABA glucose concentrations (139 samples) had excellent correlation (ρc = 0.96) as did IG and POCG glucose concentrations (142 samples, ρc = 0.92). Sensor failure or displacement were recorded for 12/15 (80%) sensor placements. Median time of sensor activity was 7 days (range, 2-13 days). CONCLUSIONS AND CLINICAL IMPORTANCE In outpatient cats with DM, the FGMS-measured IG concentration correlated well with ABA-measured blood glucose concentration, but a high rate of sensor failures was observed.
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Affiliation(s)
- Emily K. Shea
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Rebecka S. Hess
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
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Pöppl ÁG, Valle SC, Mottin TS, Leal JS, González FHD, Kucharski LC, Da Silva RSM. Pyometra-associated insulin resistance assessment by insulin binding assay and tyrosine kinase activity evaluation in canine muscle tissue. Domest Anim Endocrinol 2021; 76:106626. [PMID: 33866106 DOI: 10.1016/j.domaniend.2021.106626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/03/2021] [Accepted: 03/16/2021] [Indexed: 11/18/2022]
Abstract
Diestrus is associated with insulin resistance in bitches and pyometra can further impair insulin sensitivity. This study aimed to compare insulin sensitivity, insulin binding, and tyrosine kinase activity in bitches in anestrus, diestrus, or with pyometra. Patients submitted to elective ovariohysterectomy were divided into anestrus (n = 11) or diestrus (n = 13) according to reproductive history, vaginal cytology, and uterine histology. The group pyometra (n = 8) included bitches diagnosed with the disease based on clinical presentation and abdominal ultrasound findings and further confirmed by uterine histopathology. All patients were submitted to an intravenous glucose tolerance test (IVGTT) before ovariohysterectomy, and rectus abdominis muscle samples were collected during surgery for plasmatic membrane suspension preparation. Muscle-membranes were submitted to cold saturation insulin binding assay for dissociation constant (Kd) and maximum binding capacity (Bmax) determination, as well as exogenous substrate Poly (Glu: Tyr 4:1) phosphorylation assay for basal tyrosine kinase evaluation. Bitches with pyometra showed higher basal insulin (P < 0.001) and higher area under the curve (AUC) for insulin (P = 0.01) and glucose (P < 0.001) response during the IVGTT in comparison with bitches in anestrus or diestrus. Diestrus (P < 0.0001) and pyometra (P = 0.001) were associated with reduced tyrosine kinase activity in comparison with anestrus. No differences were documented in Kd and Bmax results for the low-affinity/high-capacity insulin receptors; however, high-affinity/low-capacity insulin receptors showed higher Kd and Bmax results in bitches in diestrus or with pyometra (P < 0.05) in comparison with anestrus. Despite the pyometra group showed the highest Kd values (P < 0.01), its Bmax results did not differ from the diestrus group (P > 0.05). Diestrus' higher Kd values and reduced tyrosine kinase activity in muscle tissue were compensated by increased total insulin binding capacity. Absent differences in IVGTT results between diestrus and anestrus bitches corroborate this finding. However, in bitches with pyometra, the highest Kd values were not compensated by increased total insulin binding capacity. This finding was associated with insulin resistance and glucose intolerance in IVGTT results. Moreover, pyometra resolution restored insulin sensitivity and glucose tolerance. These features can play a key role in pyometra-associated CDM, as well as in diabetic remission after pyometra resolution.
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Affiliation(s)
- Á G Pöppl
- Laboratório de Metabolismo e Endocrinologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Sarmento Leite 500, Porto Alegre - RS, Brazil. CEP: 90050-170; Departamento de Medicina Animal, Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, Porto Alegre - RS, Brazil. CEP: 91540-000; Hospital de Clínicas Veterinárias, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, Porto Alegre - RS, Brazil. CEP: 91540-000.
| | - S C Valle
- Laboratório de Metabolismo e Endocrinologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Sarmento Leite 500, Porto Alegre - RS, Brazil. CEP: 90050-170
| | - T S Mottin
- Hospital de Clínicas Veterinárias, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, Porto Alegre - RS, Brazil. CEP: 91540-000
| | - J S Leal
- Setor de Patologia Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, Porto Alegre - RS, Brazil. CEP: 91540-000
| | - F H D González
- Departamento de Patologia Clínica Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Bento Gonçalves 9090, Porto Alegre - RS, Brazil. CEP: 91540-000
| | - L C Kucharski
- Laboratório de Metabolismo e Endocrinologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Sarmento Leite 500, Porto Alegre - RS, Brazil. CEP: 90050-170
| | - R S M Da Silva
- Laboratório de Metabolismo e Endocrinologia Comparada, Departamento de Fisiologia, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul (UFRGS), Av. Sarmento Leite 500, Porto Alegre - RS, Brazil. CEP: 90050-170
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Shoelson AM, Mahony OM, Pavlick M. Complications associated with a flash glucose monitoring system in diabetic cats. J Feline Med Surg 2021; 23:557-562. [PMID: 33078691 PMCID: PMC10741285 DOI: 10.1177/1098612x20965012] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Glucose monitoring is an integral part of diabetes management. Interstitial glucose monitoring systems are increasingly commonly being used for this purpose in dogs and cats, including the use of a flash glucose monitoring system (FGMS). The aim of this study was to describe the incidence and nature of complications associated with the use of an FGMS in diabetic cats. METHODS The medical records of all cats that had placement of a 14-day FGMS during a 1-year period were retrospectively reviewed. Data retrieved included the number of days the sensor remained attached and functional, location of sensor placement and complications associated with the sensor. Complications were defined as early sensor detachment, sensor failure prior to the end of the 14-day monitoring period and dermatologic changes at the sensor site. Descriptive statistics were used to characterize the data. RESULTS Twenty cats had a total of 33 FGMSs placed. The majority (30/33 [91%]) of sensors were placed over the dorsolateral aspect of the thorax just caudal to the scapula. Twenty (61%) FGMSs remained attached and functional for the full 14 days. The overall incidence of complications associated with FGMS use was 10/33 (30%). The most frequent complication was early sensor detachment (n = 5/33 [15%]). Mild dermatologic changes (erythema, crusts) were noted with 4/33 (12%) FGMSs. More serious complications (skin erosions, abscess formation) were noted with 2/33 (6%) FGMSs. CONCLUSIONS AND RELEVANCE The use of the FGMS is relatively safe in cats, although there are potential complications that owners should be made aware of.
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Affiliation(s)
- Adam M Shoelson
- Department of Clinical Sciences, Cummings
School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
| | - Orla M Mahony
- Department of Clinical Sciences, Cummings
School of Veterinary Medicine at Tufts University, North Grafton, MA, USA
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Puglisi SC, Mackiewicz AL, Ardeshir A, Garzel LM, Christe KL. Comparison of Insulins Glargine and Degludec in Diabetic Rhesus Macaques ( Macaca mulatta) with CGM Devices. Comp Med 2021; 71:247-255. [PMID: 34034855 DOI: 10.30802/aalas-cm-20-000075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Treating and monitoring type 2 diabetes mellitus (T2DM) in NHP can be challenging. Multiple insulin and hypoglycemic therapies and management tools exist, but few studies demonstrate their benefits in a NHP clinical setting. The insulins glargine and degludec are long-acting insulins; their duration of action in humans exceeds 24 and 42 h, respectively. In the first of this study's 2 components, we evaluated whether insulin degludec could be dosed daily at equivalent units to glargine to achieve comparable blood glucose (BG) reduction in diabetic rhesus macaques (Macaca mulatta) with continuous glucose monitoring (CGM) devices. The second component assessed the accuracy of CGM devices in rhesus macaques by comparing time-stamped CGM interstitial glucose values, glucometer BG readings, and BG levels measured by using an automated clinical chemistry analyzer from samples that were collected at the beginning and end of each CGM device placement. The CGM devices collected a total of 21,637 glucose data points from 6 diabetic rhesus macaques that received glargine followed by degludec every 24 h for 1 wk each. Ultimately, glucose values averaged 29 mg/dL higher with degludec than with glargine. Glucose values were comparable between the CGM device, glucometer, and chemistry analyzer, thus validating that CGM devices as reliable for measuring BG levels in rhesus macaques. Although glargine was superior to degludec when given at the same dose (units/day), both are safe and effective treatment options. Glucose values from CGM, glucometers, and chemistry analyzers provided results that were analogous to BG values in rhesus macaques. Our report further highlights critical clinical aspects of using glargine as compared with degludec in NHP and the benefits of using CGM devices in macaques.
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Affiliation(s)
| | | | - Amir Ardeshir
- California National Primate Research Center, Davis, California
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Zeugswetter FK, Luckschander-Zeller N, Karlovits S, Rand JS. Glargine versus regular insulin protocol in feline diabetic ketoacidosis. J Vet Emerg Crit Care (San Antonio) 2021; 31:459-468. [PMID: 33945208 PMCID: PMC8360016 DOI: 10.1111/vec.13062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 10/15/2019] [Accepted: 10/21/2019] [Indexed: 12/24/2022]
Abstract
Objectives To determine whether basal‐bolus administration of glargine insulin is a safe and effective alternative treatment compared to the standard continuous rate infusion (CRI) protocol. Design Prospective randomized clinical trial. Setting University teaching hospital. Animals Twenty cats diagnosed with diabetic ketoacidosis (DKA). Interventions The cats were block‐randomized to either a CRI protocol using regular insulin (CRI‐group; n = 10) or a basal‐bolus SC and IM glargine protocol (glargine‐group, n = 10). Baseline blood gases, electrolytes, glucose, and β‐hydroxybutyrate (β‐OHB) concentrations were measured at the time of admission and later at predefined intervals until reaching the primary endpoint of the study, defined as a β‐hydroxybutyrate concentration < 2.55 mmol/L. Measurements and main results The main outcome measure was time (h) to resolution of ketonemia. Secondary outcome measures were time until first improvement of hyperglycemia and ketonemia, decrease of glucose to ≤13.9 mmol/L (250 mg/dL), resolution of acidosis, consumption of first meal, and discharge from hospital. Additionally, occurrence of treatment‐associated adverse events and death were compared. Seventeen cats (85%) survived to discharge, with no difference in survival between groups (P = 1.0). Median times to β‐OHB < 2.55 mmol/L were 42 (CRI‐group) and 30 (glargine‐group) hours, respectively (P = 0.114). Median times to first improvement of hyperglycemia (glargine‐group: 2 h; CRI‐group: 6 h; P = 0.018) and until discharge from hospital (glargine‐group: 140 h; CRI‐group: 174 h; P = 0.033) were significantly shorter in the glargine‐group. No significant differences were observed in any other parameter under investigation (P > 0.05). Conclusions Basal‐bolus administration of glargine insulin appears to be an effective and safe alternative to the current standard CRI‐protocol for the management of DKA in cats. The positive outcomes and simplicity make it a viable option for the treatment of feline DKA.
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Affiliation(s)
- Florian K Zeugswetter
- University Hospital for Small Animals of the University of Veterinary Medicine, Vienna, Austria
| | | | - Sonja Karlovits
- University Hospital for Small Animals of the University of Veterinary Medicine, Vienna, Austria
| | - Jaquie S Rand
- School of Veterinary Science, The University of Queensland, Australia
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Teshima E, Brunetto MA, Teixeira FA, Gomes MDOS, Lucas SRR, Pereira GT, Carciofi AC. Influence of type of starch and feeding management on glycaemic control in diabetic dogs. J Anim Physiol Anim Nutr (Berl) 2021; 105:1192-1202. [PMID: 33904623 DOI: 10.1111/jpn.13556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/01/2021] [Accepted: 03/22/2021] [Indexed: 01/16/2023]
Abstract
The present study evaluated the effects of two diets with different starch sources and two feeding methods on the glycaemic control in dogs with diabetes mellitus. The diets had similar nutrient contents (40% starch and 16% dietary fibre), one formulated with 46% of broken rice and the other with 42% sorghum and 10% lentils (as-fed). Ten client-owned diabetic dogs were fed with each diet for 2 months, in a crossover design. Five dogs received NPH human insulin and food every 12 h (feeding method 1), and the other five received insulin every 12 h but were fed three times a day (feeding method 2). In feeding method 2, morning insulin was higher than the evening dose and dogs received the second meal after 4 to 5 h of the morning insulin and meal. Parameters evaluated included insulin dosage, 12- and 8-h glycaemic curves, complete blood count, biochemical profile and urinalysis. Glycaemic curves were analysed by ANOVA with repeated measures. Glycaemic control parameters (fasting, mean, minimum and maximum glycaemia and serum fructosamine) and glucose area under the curve (AUC) were calculated and analysed by paired t test (p < 0.05). In feeding method 1, dogs fed the sorghum-based diet presented lower mean (p = 0.04) and minimum blood glucose concentrations (p = 0.03), and a tendency to lower maximum blood glucose (p = 0.06) and glucose AUC (p = 0.08) than when fed the rice-based diet. When food was provided twice a day, the ingestion of the rice-based diet resulted in higher post-prandial glucose response than the diet with sorghum and lentil. In feeding method 2, there was no effect of diet on the assessed parameters (p > 0.05). No differences in insulin dosage were observed between groups or feeding methods (p > 0.05). Providing two meals a day followed by insulin administration associated with the sorghum- and lentil-based diet improved glycaemic control in diabetic dogs.
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Affiliation(s)
- Eliana Teshima
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil.,Farmina Pet Foods, Bragança Paulista, SP, Brazil
| | - Marcio Antonio Brunetto
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Fabio Alves Teixeira
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | | | - Silvia Regina Ricci Lucas
- School of Veterinary Medicine and Animal Science, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Gener Tadeu Pereira
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil
| | - Aulus Cavalieri Carciofi
- School of Agricultural and Veterinarian Sciences, São Paulo State University (UNESP), Jaboticabal, SP, Brazil
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Zeugswetter FK, Beer R, Schwendenwein I. Evaluation of fructosamine concentration as an index marker for glycaemic control in diabetic dogs. Vet Rec 2021; 190:e244. [PMID: 33870504 DOI: 10.1002/vetr.244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/12/2021] [Accepted: 02/12/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Although fructosamine is a commonly used surrogate marker to assess glycaemic control in diabetic dogs, its diagnostic accuracy has been questioned. The main objective of this study was to evaluate the reliability of fructosamine measurements to diagnose well and poorly controlled diabetes mellitus (DM), using continuous glucose monitoring as a gold standard. METHODS Twenty-four dogs with treated DM and continuous glucose monitoring for mean (±SD) 13.1 (±1.7) days were retrospectively analysed. Two assessment strategies were applied to categorize glycaemic control, and fructosamine concentrations were determined shortly after sensor cessation using a colorimetric assay. RESULTS Correlations of individual fructosamine concentrations with mean glucose as well as percentage of measurements > 15 mmol/L were not significant (p = 0.372, p = 0.129). Fructosamine did not differ between dogs with and without hypoglycaemic episodes (p = 0.64). Receiver operating characteristic analysis for fructosamine to diagnose either good or poor glycaemic control revealed AUC values of 0.71 (p = 0.025) indicating moderate accuracy, and 0.7 (p = 0.135) indicating AUC is non-discriminatory, respectively. The respective positive likelihood ratios for the optimal cutoffs to identify good (<396 μmol/L) and poor control (>449 μmol/L) were three. CONCLUSIONS Fructosamine measurement is an imperfect surrogate marker for classifying glycaemic control in diabetic dogs and can only complement serial glucose measurements.
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Affiliation(s)
- Florian K Zeugswetter
- Clinical Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Raphael Beer
- Clinical Department for Small Animals and Horses, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Ilse Schwendenwein
- Department of Pathobiology, Central Laboratory, University of Veterinary Medicine Vienna, Vienna, Austria
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