Measuring body composition in dogs using bioelectrical impedance spectroscopy

Assessment of body composition is an essential aspect of veterinary canine care, particularly as prevalence of overweight and obesity in dogs is increasing. Few quantitative objective methods for body composition measurement are available for routine clinical use. Bioelectrical impedance analysis is widely used in human medicine and nutritional assessment and although it has shown promise in production animals it has not yet been adopted for companion animals. The present study validated bioimpedance spectroscopy (BIS) against the reference method of dual-energy X-ray absorptiometry. Resistivity coefficients for use in BIS were determined: ρe = 444.8 and ρi = 1477.8 ohm.cm and used to predict fat-free mass (FFM) in a cohort of 35 mixed breed dogs. Overall, FFM was predicted to within 3.5% of reference values. At an individual level, FFM was predicted within 2 standard deviations (95% confidence) of 10%. BIS provides an objective quantitative alternative to the widely used semi-quantitative body condition scoring. In addition, BIS provides estimates of body water volumes (total, extra-and intracellular), information that can be useful in fluid management. BIS is inexpensive, and simple to perform but does require brief (<5 min) sedation of the animal.

Relationship between sources of pet acquisition and euthanasia of cats and dogs in an animal shelter: a pilot study

OBJECTIVE

Approximately 140,000 unwanted dogs and cats are culled in Australia annually. There is a paucity of information linking sources of pet acquisition with subsequent euthanasia, which may inform evidence-based strategies to reduce euthanasia rates. This pilot study aimed to determine whether there is a higher risk of euthanasia related to the source of acquisition for pets surrendered to an animal shelter.

METHODS

Data for 5391 dogs and 5581 cats surrendered to one Queensland shelter between January 2006 and December 2009 were analysed.

RESULTS

The main sources of acquisition for owner-surrendered dogs were 'shelter' and 'pet shop' and for owner-surrendered cats were 'own litter' and 'shelter'. Euthanasia rates for different sources varied. For adult dogs, acquisition through newspaper advertisements was associated with the highest euthanasia rate. Adult cats obtained as gifts (from friend or family member) had the highest euthanasia rate. For junior cats, the overwhelming source was the owner's own litter (68% of intake) and only kittens acquired as strays were at significantly higher risk of euthanasia. For both dogs and cats, animals acquired from shelters had lower rates of euthanasia than most other sources, which suggests that shelter-sourced animals may be considered a preferred source for pet acquisition to assist in reducing the number of adoptable pets euthanased.

CONCLUSION

There was evidence from the study animal shelter that the risk of euthanasia was related to acquisition source. These findings should be confirmed by prospective studies, which should also investigate the interaction between acquisition source and other factors, using larger data sets from a variety of shelters.

Basal plasma insulin and homeostasis model assessment (HOMA) are indicators of insulin sensitivity in cats

The objective of this study was to compare simpler indices of insulin sensitivity with the minimal model-derived insulin sensitivity index to identify a simple and reliable alternative method for assessing insulin sensitivity in cats. In addition, we aimed to determine whether this simpler measure or measures showed consistency of association across differing body weights and glucose tolerance levels. Data from glucose tolerance and insulin sensitivity tests performed in 32 cats with varying body weights (underweight to obese), including seven cats with impaired glucose tolerance, were used to assess the relationship between Bergman's minimal model-derived insulin sensitivity index ( SI), and various simpler measures of insulin sensitivity. The most useful overall predictors of insulin sensitivity were basal plasma insulin concentrations and the homeostasis model assessment (HOMA), which is the product of basal glucose and insulin concentrations divided by 22.5. It is concluded that measurement of plasma insulin concentrations in cats with food withheld for 24 h, in conjunction with HOMA, could be used in clinical research projects and by practicing veterinarians to screen for reduced insulin sensitivity in cats. Such cats may be at increased risk of developing impaired glucose tolerance and type 2 diabetes mellitus. Early detection of these cats would enable preventative intervention programs such as weight reduction, increased physical activity and dietary modifications to be instigated.

Dosing obese cats based on body weight spuriously affects some measures of glucose tolerance

The primary objective was to investigate whether dosing glucose by body weight results in spurious effects on measures of glucose tolerance in obese cats because volume of distribution does not increase linearly with body weight. Healthy research cats (n = 16; 6 castrated males, 10 spayed females) were used. A retrospective study was performed using glucose concentration data from glucose tolerance and insulin sensitivity tests before and after cats were fed ad libitum for 9 to 12 mo to promote weight gain. The higher dose of glucose (0.5 vs 0.3 g/kg body weight) in the glucose tolerance tests increased 2-min glucose concentrations (P < 0.001), and there was a positive correlation between 2-min and 2-h glucose (r = 0.65, P = 0.006). Two-min (P = 0.016 and 0.019, respectively), and 2-h (P = 0.057 and 0.003, respectively) glucose concentrations, and glucose half-life (T1/2; P = 0.034 and <0.001 respectively) were positively associated with body weight and body condition score. Glucose dose should be decreased by 0.05 g for every kg above ideal body weight. Alternatively, for every unit of body condition score above 5 on a 9-point scale, observed 2-h glucose concentration should be adjusted down by 0.1 mmol/L. Dosing glucose based on body weight spuriously increases glucose concentrations at 2 h in obese cats and could lead to cats being incorrectly classified as having impaired glucose tolerance. This has important implications for clinical studies assessing the effect of interventions on glucose tolerance when lean and obese cats are compared.

Diagnosis of prediabetes in cats: glucose concentration cut points for impaired fasting glucose and impaired glucose tolerance

Diabetes is typically diagnosed in cats once clinical signs are evident. Diagnostic criteria for prediabetes in cats have not been defined. The objective of the study was to establish methodology and cut points for fasting and 2-h blood glucose concentrations in healthy client-owned senior cats (≥8 yr) using ear/paw samples and a portable glucose meter calibrated for feline blood. Of the 78 cats, 27 were ideal (body condition score [BCS] 4 or 5 of 9), 31 overweight (BCS 6 or 7), and 20 obese (BCS 8 or 9); 19 were Burmese and 59 non-Burmese. After an 18-24-h fast and an ear/paw blood glucose measurement using a portable glucose meter, glucose (0.5 g/kg bodyweight) was administered intravenous and blood glucose measured at 2 min and 2 h. Cut points for fasting and 2-h glucose concentrations were defined as the upper limits of 95% reference intervals using cats with BCS 4 or 5. The upper cut point for fasting glucose was 6.5 mmol/L. Of the overweight and obese cats, 1 (BCS 7) was above this cut point indicating evidence of impaired fasting glucose. The cut point for 2-h glucose was 9.8 mmol/L. A total of 7 cats (4 with BCS 8 or 9 including 1 Burmese; 3 with BCS 6 or 7, non-Burmese) were above this cut point and thus had evidence of impaired glucose tolerance. In conclusion, the methodology and cutpoints for diagnosis of prediabetes are defined for use in healthy cats 8 yr and older with a range of BCSs.

Associations between meal size, gastric emptying and post-prandial plasma glucose, insulin and lactate concentrations in meal-fed cats

Plasma glucose and insulin concentrations are increased for 12-24 h in healthy cats following moderate- to high-carbohydrate meals. This study investigated associations between gastric emptying time and post-prandial plasma glucose, insulin and lactate concentrations in cats fed an extruded dry, high-carbohydrate, moderate-fat, low-protein diet (51, 28, 21% metabolizable energy, respectively) once daily by varying meal volume. Eleven healthy, non-obese, neutered adult cats were enrolled in a prospective study and fed to maintain body weight. Ultrasound examinations were performed for up to 26 h, and blood collections over 24 h after eating meals containing approximately 100% and 50% of the cats' daily caloric intake (209 and 105 kJ/kg BW, respectively). Gastric emptying time was increased after a meal of 209 kJ/kg BW compared with 105 kJ/kg BW (median gastric emptying times 24 and 14 h, respectively; p = 0.03). Time for glucose to return to fasting was longer after the 209 kJ/kg BW meal (median 20 h; 25th and 75th percentiles 15 and 23 h, respectively) than the 105 kJ/kg BW meal (13, 12 and 14 h; p < 0.01); however, peak glucose was not higher after the 209 kJ/kg BW meal compared with the 105 kJ/kg BW meal [(mean ± SD) 6.6 ± 0.6 and 7.8 ± 1.2 mmol/l, respectively, p = 0.07]. Times for insulin to return to fasting were not significantly longer after the 209 kJ/kg BW meal than the 105 kJ/kg BW meal (p = 0.29). d- and l-lactate concentrations were not associated with gastric emptying time or post-prandial blood glucose and insulin. Based on results obtained, prolonged gastric emptying contributes to prolonged post-prandial hyperglycemia in cats meal fed a high-carbohydrate, low-protein, dry diet and fasting times for cats' meal-fed diets of similar composition should be 14-26 h, depending on meal size.

Glycemic status and predictors of relapse for diabetic cats in remission

Background

It is unknown if diabetic cats in remission have persistent abnormalities of glucose metabolism and should be considered prediabetic, or have normal glucose tolerance.

Objective

To characterize glycemic status of diabetic cats in remission and to determine predictors of relapse.

Animals

A total of 21 cats in diabetic remission and 28 healthy control cats.

Methods

At a median of 107 days after remission, screening blood glucose concentration was measured on entry to the clinic. After a 24‐hour fast in hospital, fasting blood glucose, fructosamine and feline pancreatic lipase concentrations were measured, and 3 hours later, a simplified IV glucose tolerance test (1 g glucose/kg) performed. Twenty cats were monitored for relapse for at least 9 months.

Results

Of the 21 cats in remission, 19% (4/21) had impaired fasting glucose concentration and 76% (16/21) had impaired glucose tolerance. Of cats followed up for 9 months after testing, 30% (6/20) had relapsed and required insulin treatment. Fasting blood glucose concentration ≥7.5 mmol/L (≥135 mg/dL) (odds ratio [OR] = 12.8) and severely impaired glucose tolerance (≥5 hours to return to <6.5 mmol/L or <117 mg/dL; OR = 15.2) were significantly associated with relapse. Blood glucose concentration >14 mmol/L; 252 mg/dL at 3 hours was significantly associated with relapse (OR = 10.1).

Conclusion and Clinical Importance

Most cats in diabetic remission have impaired glucose tolerance and a minority have impaired fasting glucose concentration and should be considered prediabetic. More severe glucose intolerance and impaired fasting glucose concentration are predictors of relapse. Ongoing glucose monitoring of diabetic cats in remission is recommended.

Metabolic determinants of body weight after cats were fed a low-carbohydrate high-protein diet or a high-carbohydrate low-protein diet ad libitum for 8 wk

Overweight and obese conditions are common in cats and are associated with the development of a number of diseases. Knowledge of metabolic determinants and predictors of weight gain may enable better preventative strategies for obesity in cats. Lean, healthy cats were fed either a low-carbohydrate high-protein diet (n 16) or a high-carbohydrate low-protein (n 16) diet ad libitum for 8 wk. Potential determinants and predictors of final body weight assessed were body fat and lean masses, energy required for maintenance, energy requirements above maintenance for each kilogram of weight gain, insulin sensitivity index, fasting, mean 24-h and peak plasma glucose, insulin, and leptin concentrations, and fasting and mean 24-h serum adiponectin concentrations. In cats fed the low-carbohydrate high-protein diet, after adjusting for initial body weight, those with higher energy requirements for weight gain and higher fasting glucose concentration had higher final body weights (P ≤ 0.01). Predicted final body weights using initial body weight, fasting glucose and mean 24-h insulin concentrations (partial R(2) 37.3%) were imprecise. An equation using just initial body weight and fasting glucose concentration would be of more practical value, but was marginally less precise. In cats fed the high-carbohydrate low-protein diet, those with lower fasting leptin concentration initially had higher final body weights (P = 0.01). Predicted final body weights using initial body weight, energy requirements for maintenance, total body fat percentage and fasting leptin concentration (partial R(2) 39.2%) were reasonably precise. Further studies are warranted to confirm these findings and to improve the precision of predicted final body weights.

Obesity and sex influence insulin resistance and total and multimer adiponectin levels in adult neutered domestic shorthair client-owned cats

In this study, we estimated insulin sensitivity and determined plasma concentrations of total-, low-molecular-weight (LMW), and high-molecular-weight (HMW) adiponectin and leptin in 72 domestic shorthair, neutered, client-owned cats. Glucose tolerance was assessed with an intravenous glucose tolerance test and body fat percentage (BF%) was measured with dual-energy x-ray absorptiometry. Total adiponectin was measured with 2 different ELISAs. Low-molecular-weight and HMW adiponectin plasma concentrations were determined by Western blot analysis after sucrose-gradient velocity centrifugation, and the adiponectin multimer ratio [SA = HMW/(HMW + LMW)] was calculated. Differences in glucose tolerance, leptin, total adiponectin, and multimer ratio among lean (BF% <35; n = 26), overweight (35 <BF% <45; n = 28), and obese (BF% >45; n = 18) cats as well as between male (n = 34) and female (n = 38) neutered cats were evaluated by linear regression and 2-way ANOVA. Sex and age were included as covariates for analysis of BF%, whereas BF%, fat mass, and lean body mass were covariates for analysis of sex differences. Increased BF% was negatively correlated with multimer ratio (SA, r = -45; P < 0.002), whereas no differences were found in total adiponectin concentrations among BF% groups (P > 0.01). Male cats had indices of decreased insulin tolerance and significantly lower total adiponectin concentrations than did female cats (mean ± SEM, 3.7 ± 0.4 vs 5.4 ± 0.5 μg/mL; P < 0.02). Altered SAs could contribute to an obesity-associated decreasing glucose tolerance in cats, and low total adiponectin concentrations may relate to increased risk of diabetes mellitus in neutered male cats.

Fat mass, and not diet, has a large effect on postprandial leptin but not on adiponectin concentrations in cats

Leptin and adiponectin play important roles in carbohydrate and lipid metabolism in different species. Information is limited on the effects of diet, weight gain, and fat mass on their concentrations in cats. This study compared fasting and postprandial blood leptin and total adiponectin concentrations before and after 8 wk of ad libitum feeding to promote weight gain in adult cats (n = 32) fed either a low-carbohydrate, high-protein (23% and 47% ME) or a high-carbohydrate, low-protein (51% and 21% ME) diet. There were significant effects of total, abdominal, and nonabdominal fat mass, but not diet or body weight, on mean 24-h and peak leptin (P < 0.01); observed increases in mean and peak leptin were greatest for abdominal fat mass (50% and 56% increase for every extra 100 g, respectively). After weight gain, postprandial leptin concentration increased markedly relative to when cats were lean, and the duration of the increase was longer after a mean weight gain of 37% with the low-carbohydrate, high-protein diet group compared with 17% with the high-carbohydrate, low-protein group (P ≤ 0.01). Adiponectin was lower than fasting at some time points during the postprandial period in both groups (P ≤ 0.05). For both fasting and mean 24-h adiponectin, there was no significant diet effect (P ≥ 0.19) or changes in weight gain relative to when cats were lean (P ≥ 0.29). In conclusion, fat mass, and not diet, has a large effect on postprandial leptin but not adiponectin concentrations in cats.

Effect of dietary carbohydrate, fat, and protein on postprandial glycemia and energy intake in cats

BACKGROUND

Reducing carbohydrate intake is recommended in diabetic cats and might also be useful in some healthy cats to decrease diabetes risk.

OBJECTIVE

To compare postprandial glucose and insulin concentrations and energy intakes between cats fed diets high in protein, fat, or carbohydrate.

ANIMALS

Twenty-four lean cats with normal glucose tolerance.

METHODS

In a prospective randomized study, each of 3 matched groups (n = 8) received a different test diet for 5 weeks. Diets were high in either protein (46% of metabolizable energy [ME]), fat (47% ME), or carbohydrate (47% ME). Glucose and insulin were measured during glucose tolerance, ad libitum, and meal-feeding tests.

RESULTS

During ad libitum feeding, cats fed the high-carbohydrate diet consumed 25% and 18% more carbohydrate than cats fed diets high in fat and protein, respectively, and energy intake was highest when the high-fat and high-protein diets were fed. Regardless of the feeding pattern, cats fed the high-carbohydrate diet had 10-31% higher peak and mean glucose compared with both other diets; peak glucose in some cats reached 10.4 mmol/L (188 mg/dL) in cats fed 47% ME carbohydrate and 9.0 mmol/L (162 mg/dL) in cats fed 23% ME.

CONCLUSIONS AND CLINICAL IMPORTANCE

High-carbohydrate diets increase postprandial glycemia in healthy cats compared with diets high in fat or protein, although energy intake is lower. Avoidance of high- and moderate-carbohydrate diets can be advantageous in cats at risk of diabetes. Maintenance energy requirements should be fed to prevent weight gain when switching to lower carbohydrate diets.

The effect of experimentally induced chronic hyperglycaemia on serum and pancreatic insulin, pancreatic islet IGF-I and plasma and urinary ketones in the domestic cat (Felis felis)

Like in humans, diabetes mellitus is on the rise in cats. Feline diabetes is a suitable model for human type-2 diabetes. We investigated magnitude and timing of insulin suppression with induced hyperglycaemia and its relationship to plasma and urinary ketones and to pancreatic islet insulin. IGF-I is under discussion as a protective mechanism but little is known about its role in diabetes in general and its distinct localisation in feline pancreatic islets in particular. Thirteen healthy, adult cats were allocated to 2 groups and infused with glucose to maintain their blood glucose at a high or moderate concentration for 42 days resulting in insulin secretion suppression. After initial increase, insulin levels declined to baseline but were still detectable in the blood at a very low level after 6 weeks of glucose infusion and then increased after a 3 week recovery period. While IGF-I in healthy cats was primarily located in glucagon cells, in hyperglycaemia-challenge IGF-I was pronounced in the β-cells 3 weeks after ceasation of infusion. Six/8 cats developing glucose toxicity became ketonuric after 3-4 weeks. Gross lipaemia occurred approx 1 week prior to ketonuria. Ketonuric cats required 1-2 weeks of insulin therapy after-infusion until β-cell recovery. In conclusion, ketosis and hyperlipidaemia are likely to occur in diabetic cats with glucose at 30 mmol/L, especially after ≥2 weeks. Three weeks after ceasation of infusions, clinical and morphological recovery occurred. We propose a local protective effect of IGF-I to support survival and insulin production in the hyperglycaemic state and recovery period.

Jugular vascular access port implantation for frequent, long-term blood sampling in cats: methodology, assessment, and comparison with jugular catheters

Long-term, frequent venous access for diagnostic, therapeutic, or research purposes in cats is problematic. Frequent blood sampling over extended periods is necessary for some therapeutic regimes and often required for clinical research in veterinary science. In this paper, we describe the implantation of vascular access ports (VAPs) and assess their use for repeated blood sampling over 16 weeks and 38 weeks, as well as the use of jugular catheters for one week. The VAP placement procedure was well-tolerated with few minor complications (minor swelling, contusion, or superficial dermatitis from self-trauma), which were not observed when neck bandages were applied immediately after surgery. Thromboembolism occurred in two cats, but did not occur after switching to a smaller catheter with a rounded tip and taurolidine-citrate locking solution. Although duration of access was much longer with VAPs compared to jugular catheters, patency rates were similar (89% (n=28) to 92% (n=12) after 16 weeks and 75% (n=12) after 38 weeks for VAPs; 88% (n=49) after one week for jugular catheters). Behavioural reactions to blood collection from 30 cats-assessed over 16 weeks and comprising 378 collections-were absent or minor in 99% of collections. These findings indicate that VAPs offer a viable alternative to jugular catheters for studies requiring frequent blood sampling and lasting more than 2 weeks.

Association of postprandial serum triglyceride concentration and serum canine pancreatic lipase immunoreactivity in overweight and obese dogs

BACKGROUND

Hypertriglyceridemia has been proposed to contribute to the risk of developing pancreatitis in dogs.

OBJECTIVES

To determine associations between postprandial serum triglyceride concentrations and canine pancreatic lipase immunoreactivity (cPLI) concentrations or pancreatic disease.

ANIMALS

Thirty-five client-owned overweight (n = 25) or obese (n = 10) dogs weighing >10 kg.

METHODS

Healthy dogs were prospectively recruited for a cross-sectional study. Serum triglyceride concentrations were measured before and hourly for 12 hours after a meal. Fasting cPLI and canine trypsin-like immunoreactivity (cTLI) concentrations were assayed. Cut-off values for hypertriglyceridemia were set a priori for fasting (≥ 88, ≥ 177, ≥ 354, ≥ 885 mg/dL) and peak postprandial (≥ 133, ≥ 442, ≥ 885 mg/dL) triglyceride concentrations. The association between hypertriglyceridemia and high cPLI concentrations was assessed by exact logistic regression. Follow-up was performed 4 years later to determine the incidence of pancreatic disease.

RESULTS

Eight dogs had peak postprandial triglycerides >442 mg/dL and 3 dogs had fasting serum cPLI concentrations ≥ 400 μg/L. Odds of high cPLI concentrations were 16.7 times higher in dogs with peak postprandial triglyceride concentrations ≥ 442 mg/dL relative to other dogs (P < .001). Fasting triglyceride concentration was not significantly associated with cPLI concentrations. None of the dogs with high triglyceride concentrations and one of the dogs with low fasting and peak postprandial triglyceride concentrations developed clinically important pancreatic disease.

CONCLUSIONS AND CLINICAL IMPORTANCE

Overweight and obese dogs with peak serum postprandial triglyceride concentrations ≥ 442 mg/dL after a standard meal are more likely to have serum cPLI concentrations ≥ 400 μg/L, but did not develop clinically important pancreatic disease.

Spontaneously obese dogs exhibit greater postprandial glucose, triglyceride, and insulin concentrations than lean dogs

Dogs do not appear to progress from obesity-induced insulin resistance to type 2 diabetes mellitus. Both postprandial hyperglycemia and postprandial hypertriglyceridemia have been proposed to cause or maintain beta cell failure and progression to type 2 diabetes mellitus in other species. Postprandial glucose, triglyceride, and insulin concentrations have not been compared in lean and obese dogs. We measured serum glucose, triglyceride, and insulin concentrations in nine naturally occurring obese and nine age- and gender-matched lean dogs. After a 24-h fast, dogs were fed half their calculated daily energy requirement of a standardized diet that provided 37% and 40% of metabolizable energy as carbohydrate and fat, respectively. Fasting and postprandial glucose and triglyceride concentrations were greater in the obese dogs (P < 0.001), although the mean insulin concentration for this group was five times greater than that of the lean group (P < 0.001). Most of the 0.6 mM (11 mg/dL) difference in mean postprandial glucose concentrations between lean and obese dogs was attributable to a subset of persistently hyperglycemic obese dogs with mean postprandial glucose concentrations 1.0 mM (18 mg/dL) greater than that in lean dogs. Persistently hyperglycemic obese dogs had lower triglyceride (P = 0.02 to 0.04) and insulin (P < 0.02) concentrations than other obese dogs. None of the dogs developed clinical signs of diabetes mellitus during follow-up for a median of 2.6 yr. We conclude that pancreatic beta cells in dogs are either not sensitive to toxicity because of mild hyperglycemia or lack another component of the pathophysiology of beta cell failure in type 2 diabetes mellitus.

A diet lower in digestible carbohydrate results in lower postprandial glucose concentrations compared with a traditional canine diabetes diet and an adult maintenance diet in healthy dogs

The aim of this study was to compare the effects of three diets with varying macronutrient and fibre contents on postprandial plasma glucose, triglyceride, free fatty acid, and insulin concentrations over a 12 h period in 12 healthy neutered lean dogs. Each diet was fed to each dog for 3 weeks in a three-period cross-over study. Plasma analyte concentrations were measured prior to and after a meal at the end of the third week of each period. Postprandial glucose concentrations for the moderate carbohydrate and fibre diet were 0.4-0.7 mmol/L (8-12 mg/dL) lower than for both higher carbohydrate diets (p≤0.02). Postprandial glucose, insulin, and triglyceride concentrations in some dogs did not return to baseline by 12 h after feeding of each of the three diets. These results indicate that the moderate carbohydrate and fibre diet warrants evaluation in diabetic dogs. Variables should be measured over at least 12 h after feeding to fully evaluate postprandial dietary effects on these analytes.

Distinct adiponectin profiles might contribute to differences in susceptibility to type 2 diabetes in dogs and humans

Dogs develop obesity-associated insulin resistance but not type 2 diabetes mellitus. Low adiponectin is associated with progression to type 2 diabetes in obese humans. The aims of this study were to compare total and high molecular weight (HMW) adiponectin and the ratio of HMW to total adiponectin (S(A)) between dogs and humans and to examine whether total or HMW adiponectin or both are associated with insulin resistance in naturally occurring obese dogs. We compared adiponectin profiles between 10 lean dogs and 10 lean humans and between 6 lean dogs and 6 age- and sex-matched, client-owned obese dogs. Total adiponectin was measured with assays validated in each species. We measured S(A) with velocity centrifugation on sucrose gradients. The effect of total and HMW adiponectin concentrations on MINMOD-estimated insulin sensitivity was assessed with linear regression. Lean dogs had total and HMW adiponectin concentrations three to four times higher than lean humans (total: dogs 32 ± 5.6 mg/L, humans 10 ± 1.3 mg/L, P<0.001; HMW: dogs 25 ± 4.5 mg/L, humans 6 ± 1.3 mg/L, P<0.001) and a higher S(A) (dogs: 0.78 ± 0.05; humans: 0.54 ± 0.08, P = 0.002). Adiponectin concentrations and S(A) were not lower in obese dogs (0.76 ± 0.05 in both groups; P=1). Total adiponectin, HMW adiponectin, and S(A) were not associated with insulin sensitivity in dogs. We propose that differences in adiponectin profiles between humans and dogs might contribute to the propensity of humans but not dogs to develop type 2 diabetes. Dogs with chronic, naturally occurring obesity do not have selectively reduced HMW adiponectin, and adiponectin does not appear to be important in the development of canine obesity-associated insulin resistance.

Compensation for obesity-induced insulin resistance in dogs: assessment of the effects of leptin, adiponectin, and glucagon-like peptide-1 using path analysis

The hormonal mediators of obesity-induced insulin resistance and compensatory hyperinsulinemia in dogs have not been identified. Plasma samples were obtained after a 24-h fast from 104 client-owned lean, overweight, and obese dogs. Plasma glucose and insulin concentrations were used to calculate insulin sensitivity and β-cell function with the use of the homeostasis model assessment (HOMA(insulin sensitivity) and HOMA(β-cell function), respectively). Path analysis with multivariable linear regression was used to identify whether fasting plasma leptin, adiponectin, or glucagon-like peptide-1 concentrations were associated with adiposity, insulin sensitivity, and basal insulin secretion. None of the dogs were hyperglycemic. In the final path model, adiposity was positively associated with leptin (P < 0.01) and glucagon-like peptide-1 (P = 0.04) concentrations. No significant total effect of adiposity on adiponectin in dogs (P = 0.24) was observed. If there is a direct effect of leptin on adiponectin, then our results indicate that this is a positive relationship, which at least partly counters a negative direct relationship between adiposity and adiponectin. Fasting plasma leptin concentration was directly negatively associated with fasting insulin sensitivity (P = 0.01) and positively associated with β-cell function (P < 0.01), but no direct association was observed between adiponectin concentration and either insulin sensitivity or β-cell function (P = 0.42 and 0.11, respectively). We conclude that dogs compensate effectively for obesity-induced insulin resistance. Fasting plasma leptin concentrations appear to be associated with obesity-associated changes in insulin sensitivity and compensatory hyperinsulinemia in naturally occurring obese dogs. Adiponectin does not appear to be involved in the pathophysiology of obesity-associated changes in insulin sensitivity.

Adiposity and adiponectin in dogs: investigation of causes of discrepant results between two studies

Although one study showed lower adiponectin concentrations in obese dogs, other recent studies indicate that adiponectin might not be decreased in obese dogs, raising the possibility that the physiology of adiponectin is different in dogs than in humans. The aim of this study was to investigate possible causes of the discrepancy between the two largest studies to date that assessed the association between adiposity and adiponectin concentration in dogs, including the validity of the assay, laboratory error, and the effects of breed, sex, and neuter status on the relationship between adiposity and adiponectin concentrations. Adiponectin concentrations measured with a previously validated adiponectin ELISA were compared with those estimated by Western blotting analysis of reduced and denatured plasma samples. The possibility of laboratory error and the effect of EDTA anticoagulant and aprotinin were tested. Adiponectin concentration was measured by ELISA in 20 lean dogs (10 male and 10 female, 5 neutered in each sex). There was close correlation between adiponectin concentrations measured by ELISA and those estimated by Western blotting analysis (r = 0.90; P < 0.001). There was no substantial effect of EDTA, aprotinin, or laboratory error on the results. There was confounding by neuter status of the relationship between adiposity and adiponectin concentrations, but adiponectin concentrations were not significantly lower in male than in female lean dogs (females, 36 mg/L; males, 26 mg/L; P > 0.20) and were not significantly lower in intact than in neutered lean male dogs (intact, 28 mg/L; neutered, 23 mg/L; P = 0.49). We conclude that the adiponectin ELISA previously validated for use in dogs appears to be suitable for determination of canine adiponectin concentrations and that testosterone does not appear to have a strong effect on plasma adiponectin concentrations in dogs. Obesity might decrease adiponectin concentrations in intact but not in neutered dogs.

Basal measures of insulin sensitivity and insulin secretion and simplified glucose tolerance tests in dogs

There is need for simple, inexpensive measures of glucose tolerance, insulin sensitivity, and insulin secretion in dogs. The aim of this study was to estimate the closeness of correlation between fasting and dynamic measures of insulin sensitivity and insulin secretion, the precision of fasting measures, and the agreement between results of standard and simplified glucose tolerance tests in dogs. A retrospective descriptive study using 6 naturally occurring obese and 6 lean dogs was conducted. Data from frequently sampled intravenous glucose tolerance tests (FSIGTTs) in 6 obese and 6 lean client-owned dogs were used to calculate HOMA, QUICKI, fasting glucose and insulin concentrations. Fasting measures of insulin sensitivity and secretion were compared with MINMOD analysis of FSIGTTs using Pearson correlation coefficients, and they were evaluated for precision by the discriminant ratio. Simplified sampling protocols were compared with standard FSIGTTs using Lin's concordance correlation coefficients, limits of agreement, and Pearson correlation coefficients. All fasting measures except fasting plasma glucose concentration were moderately correlated with MINMOD-estimated insulin sensitivity (|r| = 0.62-0.80; P < 0.03), and those that combined fasting insulin and glucose were moderately closely correlated with MINMOD-estimated insulin secretion (r = 0.60-0.79; P < 0.04). HOMA calculated using the nonlinear formulae had the closest estimated correlation (r = 0.77 and 0.74) and the best discrimination for insulin sensitivity and insulin secretion (discriminant ratio 4.4 and 3.4, respectively). Simplified sampling protocols with half as many samples collected over 3 h had close agreement with the full sampling protocol. Fasting measures and simplified intravenous glucose tolerance tests reflect insulin sensitivity and insulin secretion derived from frequently sampled glucose tolerance tests with MINMOD analysis in dogs.

Using 20-gauge percutaneous peripheral catheters to reliably collect serial 4-mL blood samples from conscious dogs

OBJECTIVE

To determine the reliability of collecting serial 4-mL blood samples over 13 h using a 20-gauge, cephalic catheter in conscious dogs.

DESIGN

Prospective, observational study.

ANIMALS

Twelve (6 males, 6 females) healthy, neutered, lean dogs.

PROCEDURE

Percutaneous placement of a 20-gauge, 1.1 x 30 mm intravenous over-the-needle catheter into the cephalic vein was performed in each dog on three occasions. Catheter patency was maintained by intermittent flushing with 0.9% saline and 1 IU/mL heparinised saline solutions. Blood samples (4 mL) were obtained at 10 time-points over 13 h, with close monitoring of the dogs and the indwelling catheters. Blood volume, resistance on aspirating blood sample (minimal or marked resistance) and the methods used to improve blood flow were recorded.

RESULTS

A high proportion (93%) of blood sample collections achieved the required 4-mL volume, and the remaining samples were greater than 1.5 mL. Of the 358 collections via the cephalic catheter, 311 (87%) were obtained with 'minimal resistance'. The remaining collections had 'marked resistance' (n=47) and were associated with a loose catheter in 11% (5/47) and of unknown cause in 89% (42/47). After 'marked resistance' had been encountered and the catheter was flushed with saline and heparin solutions, subsequent sampling with 'minimal resistance' was frequently possible from the same catheter.

CONCLUSION

Use of a percutaneous, 20-gauge intravenous cephalic catheter allowed reliable serial collection of 4-mL blood samples over 13 h in conscious dogs.

Control of diabetes mellitus in cats with porcine insulin zinc suspension

The required dose rate of porcine insulin zinc suspension to control the signs of diabetes mellitus in 25 cats was assessed, and their response to insulin treatment was investigated over 12 months. The cats required a median dose of 0.5 iu/kg bodyweight twice a day, and only two of the cats required doses higher than 1.0 iu/kg twice a day. Their lowest blood glucose concentration was on average significantly higher during the night than during the day. Seven of the cats went into diabetic remission during the study, and the control of the clinical signs in the others was either excellent or good by the end of the study.

Comparisons of different measurements for monitoring diabetic cats treated with porcine insulin zinc suspension

Clinical measurements, including a subjective clinical score and water intake, and biochemical measurements, including blood glucose, fructosamine, beta-hydroxybutyrate, cholesterol, triglycerides, triglycerides corrected for free glycerol, glycerol and urine glucose were compared for monitoring diabetic cats treated with porcine insulin zinc suspension. The data were grouped by subjective clinical score and the sensitivity of each measurement in differentiating the grouped data was assessed. None of the measurements was able to differentiate between the ranked clinical score groups, but two-hourly measurements of blood glucose over 24 hours, water intake, urine glucose and fructosamine were useful in differentiating cats that subjectively had the water and food consumption and general appearance of a normal cat from cats in which the signs of diabetes were less well controlled. Measurements of plasma lipids were not well correlated with the other measurements. The measurements that were most closely correlated with apparently perfect clinical control were the J index, water intake and maximum and mean blood glucose concentrations. In practice, water intake, maximum blood glucose concentration, mean blood glucose concentration and urine glucose would be the most useful indicators of clinical control in diabetic cats treated with porcine insulin zinc suspension.

Separation of serum glycated proteins by agarose gel electrophoresis and nitroblue tetrazolium staining in diabetic and normal cats

BACKGROUND

The total glycated protein (fructosamine) concentration in serum consists mainly of glycated albumin and lipoproteins. Measurement of fructosamine is used to diagnose and monitor diabetes mellitus in cats.

OBJECTIVE

The aims of this study were to measure glycated proteins in diabetic and healthy (nondiabetic) cats using a semiquantitative technique and to determine whether measurement of any of the fractions of glycated protein could be potentially advantageous for the diagnosis and monitoring of diabetic cats.

METHODS

Serum samples from 6 cats with diabetes mellitus and 10 clinically healthy adult cats were assayed for total glycated protein using a nitroblue tetrazolium (NBT) fructosamine assay. Serum proteins were separated by agarose gel electrophoresis and stained with NBT to identify individual glycated proteins within the bands. Gels were scanned by densitometry at 525 nm and the glycated protein content was calculated with reference to the total glycated protein content of the sample.

RESULTS

Diabetic cats with increased total fructosamine concentrations had higher concentrations of glycated albumin and glycated alpha- and beta-lipoproteins compared with healthy cats. The concentration of glycated proteins in each of the fractions had a positive linear association with the total glycated protein content of serum, but there was large variation in the relative contributions of the 3 protein fractions to the total glycated protein concentration.

CONCLUSIONS

Based on the results of this study, measurement of individual glycated fractions does not seem to offer any potential diagnostic advantage over measurement of total glycated protein (fructosamine) concentration alone. In some diabetic and healthy cats, glycated lipoproteins formed the major part of the total glycated protein, whereas in other cats albumin was the major contributor.

Plasma leptin concentrations are independently associated with insulin sensitivity in lean and overweight cats

This study investigated relationships between plasma leptin, insulin concentrations, insulin sensitivity and glucose tolerance in lean and overweight cats. Leptin concentrations were measured in 16 cats during glucose tolerance tests before and after gaining weight, and after feeding a test meal in overweight cats. An important finding of this study is that in both lean (r=-0.79) and overweight (r=-0.89) cats, the higher the leptin concentrations, the more insulin resistant the cat, independent of the degree of adiposity. Leptin concentrations at baseline and after consuming a meal tended to be higher in overweight cats with glucose intolerance, compared to overweight cats with normal glucose tolerance, although the difference was not significant. After feeding the test meal to overweight cats in the early morning, plasma leptin concentrations initially decreased before subsequently rising to peak 15 h later, which coincided with late evening. The leptin peak occurred 9 h after the insulin peak following ingestion of the test meal. Importantly, this study suggests that increased leptin concentrations may contribute to the diminished insulin sensitivity seen in overweight cats. Alternatively, the compensatory hyperinsulinaemia found with insulin resistance in overweight cats could stimulate leptin production.

Dietary chromium tripicolinate supplementation reduces glucose concentrations and improves glucose tolerance in normal-weight cats

The effect of dietary chromium supplementation on glucose and insulin metabolism in healthy, non-obese cats was evaluated. Thirty-two cats were randomly divided into four groups and fed experimental diets consisting of a standard diet with 0 ppb (control), 150 ppb, 300 ppb, or 600 ppb added chromium as chromium tripicolinate. Intravenous glucose tolerance, insulin tolerance and insulin sensitivity tests with minimal model analysis were performed before and after 6 weeks of feeding the test diets. During the glucose tolerance test, glucose concentrations, area under the glucose concentration-time curve, and glucose half-life (300 ppb only), were significantly lower after the trial in cats supplemented with 300 ppb and 600 ppb chromium, compared with values before the trial. Fasting glucose concentrations measured on a different day in the biochemistry profile were also significantly lower after supplementation with 600 ppb chromium. There were no significant differences in insulin concentrations or indices in either the glucose or insulin tolerance tests following chromium supplementation, nor were there any differences between groups before or after the dietary trial.Importantly, this study has shown a small but significant, dose-dependent improvement in glucose tolerance in healthy, non-obese cats supplemented with dietary chromium. Further long-term studies are warranted to determine if the addition of chromium to feline diets is advantageous. Cats most likely to benefit are those with glucose intolerance and insulin resistance from lack of exercise, obesity and old age. Healthy cats at risk of glucose intolerance and diabetes from underlying low insulin sensitivity or genetic factors may also benefit from long-term chromium supplementation.

Acute stress hyperglycemia in cats is associated with struggling and increased concentrations of lactate and norepinephrine

We characterized the changes in blood glucose concentrations in healthy cats exposed to a short stressor and determined the associations between glucose concentrations, behavioral indicators of stress, and blood variables implicated in stress hyperglycemia (plasma glucose, lactate, insulin, glucagon, cortisol, epinephrine, and norepinephrine concentrations). Twenty healthy adult cats with normal glucose tolerance had a 5-minute spray bath. Struggling and vocalization were the most frequent behavioral responses. There was a strong relationship between struggling and concentrations of glucose and lactate. Glucose and lactate concentrations increased rapidly and significantly in all cats in response to bathing, with peak concentrations occurring at the end of the bath (glucose baseline 83 mg/dL, mean peak 162 mg/dL; lactate baseline 6.3 mg/dL, mean peak 64.0 mg/dL). Glucose response resolved within 90 minutes in 12 of the 20 cats. Changes in mean glucose concentrations were strongly correlated with changes in mean lactate (r = .84; P < .001) and mean norepinephrine concentrations (r = .81; P < .001). There was no significant correlation between changes in mean glucose concentrations and changes in mean insulin, glucagon, cortisol, or epinephrine concentrations. Struggling and lactate concentrations were predictive of hyperglycemia. Gluconeogenesis stimulated by lactate release is the likely mechanism for hyperglycemia in healthy cats in this model of acute stress. Careful handling techniques that minimize struggling associated with blood collection may reduce the incidence of stress hyperglycemia in cats.

Insulin sensitivity decreases with obesity, and lean cats with low insulin sensitivity are at greatest risk of glucose intolerance with weight gain

This study quantifies the effects of marked weight gain on glucose and insulin metabolism in 16 cats which increased their weight by an average of 44.2% over 10 months. Significantly, the development of feline obesity was accompanied by a 52% decrease in tissue sensitivity to insulin and diminished glucose effectiveness. In addition, glucose intolerance and abnormal insulin response occurred in some cats. An important finding was that normal weight cats with low insulin sensitivity and glucose effectiveness were at increased risk of developing impaired glucose tolerance with obesity. High basal insulin concentrations or low acute insulin response to glucose also independently increased the risk for developing impaired glucose tolerance. Male cats gained more weight relative to females and this, combined with their tendency to lower insulin sensitivity and higher insulin concentrations, may explain why male cats are at greater risk for diabetes. Results suggest an underlying predisposition for glucose intolerance in some cats, which is exacerbated by obesity. These cats may be more at risk of progressing to overt type 2 diabetes mellitus.

Management of feline diabetes mellitus

Up to one quarter of diabetic cats can be well controlled with oral hypoglycemic drugs, although at least 75% require insulin therapy. Most available insulins provide good clinical control but only moderate glycemic control. Because mild to moderate hyperglycemia is well tolerated by cats receiving insulin but hypoglycemia can be life threatening, conservative insulin dosing is recommended. Clinical signs and water intake indicate whether a dose adjustment is required, but serial blood glucose measurements are usually needed to determine the direction of the adjustment. Starting doses of 0.3 to 0.5 IU/kg administered twice daily (rounded down to the nearest whole unit) are usually safe. Dose adjustments should not exceed 1 IU per cat every 2 to 4 weeks unless clinical hypoglycemia has occurred. Cats with clinical hypoglycemia need to be reassessed to see if they are in remission. If not, a 50% to 75% reduction in dose is advised. Approximately 30% of cats go into diabetic remission 1 to 4 months after an adequate treatment protocol is instituted.

Management of canine diabetes

The majority of diabetic dogs appear to have a form of type 1 diabetes analogous to the latent autoimmune diabetes of adults (LADA) in humans. Evidence of acute or chronic pancreatitis occurs in about 40% of diabetic dogs. Blindness caused by cataract formation eventually occurs in the majority of diabetic dogs and is not dependent on glycemic control. Insulin is the mainstay of therapy for diabetic dogs, and a conservative approach to insulin therapy is crucial. Most diabetic dogs require twice-daily dosing with lente or NPH insulin to adequately control their clinical signs. The diet fed should primarily be palatable and nutritionally balanced. Improved glycemic control may be achieved in some dogs if the diet contains increased insoluble fiber.

Determination of reference values for glucose tolerance, insulin tolerance, and insulin sensitivity tests in clinically normal cats

OBJECTIVE

To determine reference values and test variability for glucose tolerance tests (GTT), insulin tolerance tests (ITT), and insulin sensitivity tests (IST) in cats.

ANIMALS

32 clinically normal cats.

PROCEDURE

GTT, ITT, and IST were performed on consecutive days. Tolerance intervals (ie, reference values) were calculated as means +/- 2.397 SD for plasma glucose and insulin concentrations, half-life of glucose (T1/2 glucose), rate constants for glucose disappearance (Kglucose and Kitt), and insulin sensitivity index (Si). Tests were repeated after 6 weeks in 8 cats to determine test variability.

RESULTS

Reference values for T1/2glucose, Kglucose, and fasting plasma glucose and insulin concentrations during GTT were 45 to 74 minutes, 0.93 to 1.54 %/min, 37 to 104 mg/dl, and 2.8 to 20.6 microU/ml, respectively. Mean values did not differ between the 2 tests. Coefficients of variation for T1/2glucose, Kglucose, and fasting plasma glucose and insulin concentrations were 20, 20, 11, and 23%, respectively. Reference values for Kitt were 1.14 to 7.3%/min, and for SI were 0.57 to 10.99 x 10(4) min/microU/ml. Mean values did not differ between the 2 tests performed 6 weeks apart. Coefficients of variation for Kitt and SI were 60 and 47%, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

GTT, ITT, and IST can be performed in cats, using standard protocols. Knowledge of reference values and test variability will enable researchers to better interpret test results for assessment of glucose tolerance, pancreatic beta-cell function, and insulin sensitivity in cats.

Pharmacology of a 40 IU/ml porcine lente insulin preparation in diabetic cats: findings during the first week and after 5 or 9 weeks of therapy

The aim of this study was to measure the pharmacokinetics and pharmacodynamics of subcutaneously injected 40 IU/ml porcine lente insulin preparation (Caninsulin, Intervet BV, The Netherlands) in diabetic cats. The pharmacological properties of the insulin in poorly controlled or untreated cats were compared with those after several weeks of treatment, to determine if improved diabetic stability altered the pharmacology of this insulin. In addition, the pharmacological properties of intravenously injected 100 IU/ml regular porcine insulin (Actrapid MC, NovoNordisk, Denmark) were measured. Serial plasma samples were collected after subcutaneous injection of porcine lente insulin from 25 diabetic cats in the first week of admission to a 12-month diabetic treatment trial. Samples were also collected after 4 or 8 weeks of treatment, in those cats which had not achieved diabetic remission by this time. At this time, serial plasma samples were also collected from these cats after intravenous injection of porcine regular insulin. Plasma samples were assayed for glucose, anti-insulin antibodies were extracted using a PEG technique, and samples were assayed for insulin using an RIA kit with low sensitivity for endogenous feline insulin, but high sensitivity for exogenous porcine insulin in feline plasma. Caninsulin injected subcutaneously in diabetic cats led to a peak insulin concentration in plasma after 1.7+/-0.1 h, and a nadir of blood glucose after 4.1+/-0.3 h. Insulin and glucose concentrations returned to baseline within 12 h. There was no significant change in the onset or duration of Caninsulin action between the first week of treatment and 5 or 9 weeks of treatment. Actrapid MC injected intravenously had a peak insulin at 0.36+/-0.03 h, and a nadir of blood glucose at 1.9+/-0.3 h. Insulin and glucose returned to baseline within 6 h. It was concluded that Caninsulin injected subcutaneously has suitable pharmacological properties for the twice-daily treatment of diabetes mellitus in cats. In addition, Actrapid MC insulin injected intravenously has suitable pharmacological properties for injection every 4-6 h in diabetic cats.

Plasma leptin concentrations in cats: reference range, effect of weight gain and relationship with adiposity as measured by dual energy X-ray absorptiometry

The aims of our study were to determine a reference range for plasma leptin in healthy, normal-weight cats and to measure the effect of weight gain on plasma leptin levels. To increase our understanding of the association between leptin and feline obesity, we investigated the relationship between plasma leptin and measures of adiposity in cats. Twenty-six normal-weight cats were used to determine the reference range for feline leptin using a multispecies radioimmunoassay. In the second part of the study, plasma leptin concentrations were determined in 16 cats before and after approximately 10 months of spontaneous weight gain. Dual energy X-ray absorptiometry scans (DEXA) were performed after weight gain. The tolerance interval for plasma leptin concentrations was 0.92-11.9 ng/ml Human Equivalent (HE) with a mean concentration of 6.41+/-2.19 ng/ml HE. In part two of the study, 16 cats gained on average 44.2% bodyweight over 10 months. The percentage of body fat in obese cats ranged from 34.2 to 48.7%. Mean plasma leptin concentrations increased from 7.88+/-4.02 ng/ml HE before weight gain to 24.5+/-12.1 ng/ml HE after weight gain, (P<0.001). Total body fat and body fat per cent were the strongest predictors of plasma leptin in obese cats (r=0.8 and r=0.78, P<0.001, respectively). In conclusion, plasma leptin concentrations increased three-fold in cats as a result of weight gain and were strongly correlated with the amount of adipose tissue present. Despite elevated leptin levels, cats continued to eat and gain weight, suggesting decreased sensitivity to leptin. This investigation into the biology of leptin in cats may aid the overall understanding of the role of leptin and the development of future treatments to help prevent and manage feline obesity.

The effect of interday variation and a short-term stressor on insulin sensitivity in clinically normal cats

To determine whether there is a day-to-day variation in insulin sensitivity in cats, we subjected six clinically normal cats to four insulin-modified frequently sampled intravenous glucose tolerance tests (FSIVGTTs) over 7 days. The insulin-modified FSIVGTTs were analysed by the minimal model method. Minimal model insulin sensitivity (S(I)) averaged 2.9+/-0.4 x 10(-4) min(-1)/microU/ml (range 1.9-4.6 x 10(-4) min(-1)/microU/ml), with a mean interday coefficient of variation (CV) of 35.4+/-6.4% (range 12.8-58.5%). Glucose effectiveness (S(G)) averaged 0.029+/-0.002 min(-1)(range 0.024-0.037 min(-1)), and showed less interday variability with a mean CV of 24.7+/-4.3% (range 7.9-39.3%). Insulin sensitivity was also measured after a short-term stressor (5-min spray bath) of sufficient magnitude to elevate blood glucose levels. The mean insulin sensitivity after the stressor was 3.6+/-0.8 x 10(-4) min(-1)/microU/ml (range 1.6-7.3 x 10(-4) min(-1)/microU/ml), which was not significantly different to the mean insulin sensitivity before the short-term stressor (P=0.237). The mean glucose effectiveness after the stressor was 0.046+/-0.004 min(-1)(range 0.032-0.057 min(-1)), which was significantly different from mean glucose effectiveness before the short-term stressor (P=0.003). We conclude that insulin sensitivity is highly variable from day to day in normal cats, and that hyperglycaemia in response to short-term stressors is probably due to increased hepatic glucose production, rather than peripheral insulin resistance.

Food intake and blood glucose in normal and diabetic cats fed ad libitum

Ten diabetic cats were studied at intervals for up to 12 months with twice-daily insulin injections. Ten clinically healthy cats were also studied. Diets fed were based on the individual cat's performance, using mainly commercial dry or canned cat foods and fresh meat. In most cases more than one food was offered. Food was given fresh twice daily, and the cats allowed to eat ad libitum. The food intake and blood glucose were measured every 2 h in diabetic cats after insulin injection and in diabetic and normal cats without insulin injections. Food was quantified by the energy consumed (kJ ME), crude protein (g), crude fat (g), and carbohydrate (g). The blood glucose in 10 diabetic cats was measured for 2 h following a 20-min meal. Both diabetic cats and normal cats showed similar patterns of eating, with a higher food intake in the 2 h after fresh food was placed. Both groups of cats ate multiple small meals spread through the day and night. There was little or no correlation between the blood glucose and the amount of food consumed over the previous 2-h period, in insulin- or non-insulin-treated diabetic cats, or in normal cats. An overnight fast did not significantly alter morning blood glucose in diabetic cats. No demonstrable appetite stimulation occurred following an occurrence of low blood glucose; however, recorded incidences were few. No post-prandial hyperglycaemia was seen in the 10 diabetic cats during a 2-h period following the ingestion of typical cat foods.

Insulin sensitivity in normal and diabetic cats

Estimates of in vivo insulin sensitivity (S(I)) can be derived from minimal model analysis of a frequently sampled intravenous glucose tolerance test (FSIVGTT). Modification of the FSIVGTT by the injection of insulin allows insulin sensitivity to be measured in diabetics. To establish and compare reference values for insulin sensitivity in clinically normal and diabetic cats, we subjected 10 clinically normal cats and five diabetic cats to the insulin-modified FSIVGTT with minimal model analysis. Diabetic cats had a significantly lower insulin sensitivity than clinically normal cats (P<0.05). Mean insulin sensitivity in clinically normal cats was 3.22x10(-4)/min/microU/ml (range 1.71-5.23x10(-4)/min/microU/ml). In contrast, the mean insulin sensitivity in diabetic cats was 0.58x10(-4)/min/microU/ml (range 0.136-0.88x10(-4)/min/microU/ml), or approximately six times less insulin sensitive than clinically normal cats. Mean glucose effectiveness in clinically normal cats was 0.030/min (range 0.021-0.045/min). Mean glucose effectiveness in diabetic cats was 0.014/min (range 0.008-0.021/min). Our data demonstrate that insulin resistance is a feature of feline diabetes mellitus and that diabetic cats have a similar relative decrease in insulin sensitivity to humans with type 2 diabetes.

Evaluation of a polyurethane jugular catheter in cats placed using a modified Seldinger technique

OBJECTIVE

To describe and evaluate the placement of a new design of polyurethane jugular catheter in cats using a modification of the technique of Seldinger. The maintenance and use of these catheters for repeated blood sampling over several days in healthy and diabetic cats is reported.

PROCEDURE

Thirty polyurethane jugular catheters were placed in 10 clinically healthy cats and 10 cats with diabetes mellitus using the modified Seldinger technique. Catheters were placed while the cats were under general anaesthesia.

RESULTS

The catheters remained in place for a range of 2 to 14 days (median 5 days) with no major complications. In all cats patency of the catheters was maintained until removal. All cats examined had patent jugular veins when assessed 4 or more weeks after the catheters were removed.

CONCLUSIONS

These polyurethane jugular catheters, when placed by a modified Seldinger technique, are effective and safe in cats, and jugular patency returns after the catheters are removed.

Reference values for glucose tolerance and glucose tolerance status in cats

OBJECTIVE

To determine the reference range for glucose tolerance, using a simplified glucose tolerance test (GTT), and to evaluate glucose tolerance status in cats.

DESIGN

Prospective study.

ANIMALS

57 clinically normal cats.

PROCEDURE

2 catheters were placed in the cephalic veins of nonsedated cats at least 3 hours before the test. Blood samples were obtained before (0 minutes) and 2, 5, 10, 15, 30, 45, 60, 90, and 120 minutes after glucose (0.5 g/kg [0.23 g/lb] of body weight) was injected i.v. Blood glucose concentration was measured by a glucose meter. Glucose half-life (t1/2) and disappearance of glucose (Kglucose) were calculated.

RESULTS

Glucose tolerance in cats was considered normal when upper limits for glucose concentration were < or = 159 mg/dl at 0 minutes, < or = 322 mg/dl at 60 minutes, < or = 238 mg/dl at 90 minutes, or < or = 171 mg/dl at 120 minutes and glucose t1/2 was < or = 94.7 minutes or Kglucose was > or = 0.41%/min. Impaired glucose tolerance in cats was defined as a glucose concentration > or = 160 mg/dl at 0 minutes, > or = 323 mg/dl at 60 minutes, > or = 239 mg/dl at 90 minutes, or > or = 172 mg/dl at 120 minutes. The frequency of impaired glucose tolerance was 2%. Five cats had stress-affected GTT. Significant differences in glucose t1/2 or Kglucose between cats < 7 and > or = 7 years old were not found.

CLINICAL IMPLICATIONS

The simplified GTT and measurement of glucose concentration by a glucose meter provides a simple and low-cost method of assessing glucose tolerance status in cats that are normoglycemic after food is withheld. Use of absolute glucose concentrations overcomes the need to calculate glucose t1/2 values. The high glucose concentration at 0 minutes found in this study may reflect a more realistic concentration to use in assessing client-owned cats in a hospital environment.

Over representation of Burmese cats with diabetes mellitus

OBJECTIVE

To determine if Burmese cats in Queensland have an increased risk of diabetes mellitus.

DESIGN

A retrospective study of diabetic and nondiabetic cats that had blood submitted to a veterinary clinical laboratory over a 22 month study period.

SAMPLE POPULATION

4402 cats

PROCEDURE

Cats were considered diabetic if blood glucose concentration was > 11 mmol/L and fructosamine was > 406 mumol/L or hydroxybutyrate was > 1 mmol/L. Cats were grouped into Burmese and non-Burmese. Adjusted odds ratios of diabetes were calculated for breed, gender and age group amongst cats with blood glucose > 11 mmol/L.

RESULTS

Burmese cats comprised 20% of 45 diabetic cats of known breed, which was higher (P < 0.001) than among the normoglycemic reference population of 2203 cats (7% Burmese). There were more females among the diabetic Burmese (62%), but this did not differ (P > 0.05) from the Burmese reference population (45% females). In contrast, males seemed to predominate among diabetic non-Burmese (63%), although this also did not differ (P > 0.05) from the reference population (55%) of from diabetic Burmese (38% males). The majority (90%) of diabetic cats were older than 6 years, irrespective of breed (median age 12 years, interquartile range 10 to 13 years). This was higher (chi(2) = 8.13, P < 0.005) than among the normoglycaemic reference population, where 69% were older than 6 years.

CONCLUSIONS

Burmese cats were significantly over represented among cats with diabetes mellitus. Irrespective of breed, the risk of diabetes in the study population increased with age.

Evaluation of a simplified intravenous glucose tolerance test and a reflectance glucose meter for use in cats

A simplified intravenous glucose tolerance test has been developed for use in domestic cats and the results compared with those obtained using the standard test. The simplified test used two cephalic catheters, implanted in unsedated, unanaesthetised cats three hours before the test. Blood samples were collected before and after intravenous administration of glucose (0.5 g/kg bodyweight). Blood glucose concentration was measured with a reflectance glucose meter and an automated chemistry analyser. There were no significant differences between the results derived from the two tests. Because the simplified glucose tolerance test is easier to perform, requires no anaesthesia, uses only cephalic catheters and can be done on an outpatient basis, it is more cost effective and more clinically applicable. There were no significant differences between the results of glucose measurements with the two machines and the simplified glucose tolerance test can therefore be carried out with the reflectance glucose meter.

Subject-based problem-based learning in the veterinary science course at the University of Queensland

OBJECTIVE

To assess students' perceptions of subject-based problem-based learning in the fourth year of the veterinary science course at the University of Queensland.

DESIGN

A questionnaire-based study.

PROCEDURE

Subject-based problem-based learning was introduced into parts of two fourth year subjects in a 5-year veterinary science course. The problem-based learning exercise used modified clinical cases and was computer-assisted. Students worked in groups of two to four, and small group discussion sessions were tutorless. Lectures were replaced by large group discussion and feedback sessions, led by the teacher, with approximately 85 students.

RESULTS

There was a significant increase in the percentage of students who strongly agreed that they had better understanding of the subject, and had learned to apply principles from this class in new situations. The only consistent criticism by students was directed at the extra time required compared to traditional lecture-based subjects.

CONCLUSION

Students' perceptions of the learning outcome were very favourable for problem-based learning when compared to the lecture-based subject.

Detection of amyloid deposition in various regions of the feline pancreas by different staining techniques

Deposition of islet amyloid is a common finding in the pancreas of diabetic cats and it may contribute to the deterioration of glucose tolerance. Three techniques for detecting pancreatic amyloid deposition were compared in cats not known to be diabetic. Congo red (CR) staining was used for histological sections (35 cats) and tissue smear preparations (crush and smear [CS] technique; 35 cats, and an immunohistochemical method (18 cats) was used for the detection of amyloid derived from amylin. Six diabetic cats were used as positive controls for the immunohistochemical method. The amount of pancreatic amyloid demonstrated immunohistochemically was significantly correlated with that shown by CR staining in histological sections but not in CS preparations, which were less satisfactory. However, the amount of amyloid determined immunohistochemically was slightly but significantly higher than that seen in CR-stained sections. There was no difference in the amount of amyloid between the left limb middle segment and right limb of the pancreas. Amylin labelling was seen in about 70 to 80% of islet cells, mainly those located in the islet periphery and the labelling was most intense in the cell periphery.

Tail docking in dogs: a sample of attitudes of veterinarians and dog breeders in Queensland

One hundred veterinarians and 100 breeders of traditionally docked dogs from Queensland were surveyed by telephone to determine their attitudes towards tail docking. Eighty-four percent of the breeders surveyed were in favour of docking, whereas 83% of veterinarians were opposed to the practice. Most pups were docked between 1 and 3 days of age. All veterinarians surgically amputated the tail, whereas 16% of breeders applied rubber bands to the tail. Seventy-six percent of the veterinarians, but only 18% of the breeders believed that docking caused significant to severe pain. No veterinarians, but 25% of the dog breeders believed that docking was painless. Although recent changes to the Queensland Canine Control Council's rulings allow dogs with intact tails to be shown in traditionally docked classes, the requirement of breed standard was cited as the major reason for tail docking by both breeders and veterinarians.

Echocardiographic evaluation of the effects of medetomidine and xylazine in dogs

The echocardiographic effects of medetomidine and xylazine were evaluated in 6 healthy dogs. Values for echocardiographic variables were significantly different from pre-treatment values after administration of both drugs. The effects of medetomidine were similar to that of xylazine. Because of their cardiac depressant effects, both drugs should be used with care in sick dogs.

Plasma amylin and insulin concentrations in normoglycemic and hyperglycemic cats

The recently discovered pancreatic peptide amylin is postulated to be involved in the pathogenesis of feline diabetes mellitus. However, plasma amylin concentrations in normal and diabetic cats have not yet been published. The aim of the present study was to validate a commercial amylin radioimmunoassay kit for the measurement of feline amylin in unextracted plasma, and to measure plasma amylin concentrations in normal and diabetic cats. The kit had satisfactory specificity, sensitivity, accuracy, and precision, and can be recommended for measurement of feline amylin in unextracted EDTA plasma, when nonspecific binding of plasma samples is used in the calculation of measured amylin concentration. Fasting amylin concentration in cats with normal glucose tolerance was 97 +/- 4 pmol/L. Plasma amylin increased in parallel with insulin after glucose administration in cats with normal and impaired glucose tolerance. In contrast to cats with normal glucose tolerance, cats with impaired glucose tolerance had markedly delayed amylin and insulin secretion. Diabetic cats had basal hypoinsulinemia combined with hyperamylinemia. Hyperamylinemia may lead to reduced insulin secretion and insulin resistance, and contribute to the development of feline diabetes. In conclusion, feline amylin can be measured in unextracted EDTA plasma. Fasting amylin concentrations are approximately 100 pmol/L, and amylin and insulin are cosecreted in cats with normal and impaired glucose tolerance. Increased amylin concentrations may contribute to the development of feline diabetes mellitus.

Pathogenesis of feline diabetes mellitus

Cats are one of the few species that develop a form of diabetes mellitus that is clinically and histologically analogous to human type 2 diabetes mellitus. Figure 9 summarizes the etiologic factors thought to be involved in the development of feline and human type 2 diabetes. The main metabolic characteristics of type 2 diabetes mellitus are impaired insulin secretion and resistance to the action of insulin in its target tissues. Impaired beta cell function occurs before histologic changes become evident. The characteristic histologic finding in cats with type 2 diabetes is deposition of amyloid in pancreatic islets. Amyloid deposition occurs before the onset of clinical signs, but does not seem to be the primary defect. Pancreatic amyloid is derived form the recently discovered pancreatic hormone amylin. Amylin is synthesized in pancreatic beta cells, and is co-stored and co-secreted with insulin. Amylin has been postulated to be involved in the pathogenesis of feline diabetes mellitus both through its metabolic effects, which include inhibition of insulin secretion and induction of insulin resistance, and via progressive amyloid deposition and beta cell degeneration. Increased amylin concentration has been documented intracellularly in cats with impaired glucose tolerance and in the plasma of diabetic cats, and supports the hypothesis that amylin is involved in the pathogenesis of type 2 diabetes. Obesity is a common finding in diabetic felines and is a contributing factor to the insulin resistance present in type 2 diabetes. Clinical signs of diabetes develop once total insulin secretion decreases to 20% to 25% of normal levels. Many diabetic cats have been treated successfully with oral hypoglycemics, but 50% to 70% of diabetic cats are insulin dependent. Based on histologic evidence, this is the result of extensive amyloid deposition and subsequent beta cell degeneration, rather than autoimmune destruction of pancreatic beta cells associated with type 1 diabetes. Alternative ways of treating type 2 diabetes currently are being investigated. Amylin antagonists recently have been proposed as a novel treatment to reverse the deleterious effects of excessive amylin concentrations. The gastrointestinal hormone glucagon-like peptide-1 may also prove useful in treating diabetic cats, because of its stimulatory effect on insulin secretion and synthesis, and the absence of significant hypoglycemic effect.