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Summary

Medical records from 333 cats with diabetes mellitus were studied retrospectively, using epidemiologic methods to determine the incidence of and risk factors for diabetes mellitus in this species. Abstracts were derived, using the Veterinary Medical Data Program with its 17 participating academic institutions in the United States and Canada. A reference population of 135,651 cats was derived from the same hospital population and time span (july 1980 to June 1986).

The incidence of diabetes mellitus in cats was determined to be 2.45 cases/1,000 cat-years-of-risk during the 6-year study period. Breed had no detectable effect on risk for diabetes mellitus. In contrast, body weight, age, gender, and neutering had a significant (P ≤ 0.01) effect. Body weight of cats was categorized as being < or ≥ 6.8 kg. The higher body weight, probably indicating obesity, contributed a 2.2-fold increase in risk, even after adjustment for age and gender (adjusted odds ratio). The etiologic fraction for high body weight was 3.8%, suggesting that an estimated 3.8% of cases of diabetes mellitus was attributable to this factor alone. Over 50% of diabetic cats were > 10 years old, and the etiologic fraction for age > 7 years alone was 73.5%. Age was a significant (P < 0.001) and the most important single risk factor for development of the disease in cats, with adjusted odds ratios of 8.3 and 14.4 for age 7 to 10 years and > 10 years, respectively. Unlike human beings and dogs, male cats were at 1.5 times greater risk for developing diabetes mellitus than were females, and neutered cats were at nearly twice the risk as sexually intact cats. The adjusted odds-risk ratio for neutered males, sexually intact males, spayed females, and sexually intact females was 2.8, 2.1, 1.9, and 1, respectively.

Free access
in Journal of the American Veterinary Medical Association

Objective—

To determine prevalence and severity of systemic arterial hypertension and proteinuria in dogs with naturally developing diabetes mellitus (DM) and to determine whether these abnormalities were related to age, sex, duration of DM, or degree of control of glycemia.

Design—

Case series and cohort study.

Animals—

Fifty dogs with naturally developing DM.

Procedures—

Blood pressure was measured in all 50 dogs. Thirty-eight dogs were evaluated once, and 12 were evaluated sequentially. Thirty-five were evaluated for proteinuria by determining protein-to-creatinine ratio in urine (n = 35) or by electrophoresis of urine (33).

Results—

Hypertension was detected in 23 on the basis of a systolic pressure > 160 mm HG (12 dogs), a diastolic pressure > 100 mm HG (21), or a mean pressure > 120 mm HG (23). All dogs with systolic hypertension had concurrent diastolic and mean hypertension, and 19 of 21 dogs with diastolic hypertension had concurrent high mean pressure. Ten of 12 dogs reevaluated at subsequent visits had no change in blood pressure. Blood pressure remained consistent in 3 dogs tested at different times during the day on a single visit. Duration of DM and presence of proteinuria were significant predictors of hypertension. Seven of 35 (20%) dogs had an increased protein-to-creatinine ratio in their urine. Albumin concentration and albumin-to-creatinine ratio were significantly higher in urine from diabetic dogs, compared with healthy, nondiabetic dogs. Hypertension was associated with an increased albumin-to-creatinine ratio.

Clinical Implications—

Systemic hypertension and proteinuria may be common in diabetic dogs, but the clinical importance of these findings are, as yet, unknown. (J Am Vet Med Assoc 1998;213:822-825)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate glycemic response to insulin treatment in dogs with diabetes mellitus.

Design—Retrospective study.

Animals—221 dogs with diabetes mellitus.

Procedure—Type and dosage of insulin used, minimum and maximum blood glucose concentrations, time of blood glucose concentration nadir, and optimal duration of action of insulin were determined on the basis of data obtained prior to initial examination at the teaching hospital (127 dogs), at the time of initial examination (212 dogs), at the time a second follow- up blood glucose curve was performed (59 dogs), and at the time of clinical control of diabetes mellitus (83 dogs).

Results—Prior to examination, 69 of 127 dogs (54%) received 1 SC insulin injection daily. Thirty-one dogs (24%) received a high dose of insulin (ie, > 1.5 U/kg [0.7 U/lb] of body weight); 27 of these dogs (87%) received 1 injection/d. Eleven of 16 dogs (69%) that were hypoglycemic (blood glucose concentration < 80 mg/dl) also received 1 injection/d. However, optimal duration of action of insulin was > 12 hours in only 5 of 83 dogs (6%) evaluated at the time diabetes mellitus was clinically controlled. At that time, only 1 dog (1%) received a high dose of insulin, and the dog received 2 injections/d. Moreover, 8 of 10 dogs (80%) with hypoglycemia received 1 injection/d.

Conclusions and Clinical Relevance—Most dogs with diabetes mellitus are clinically regulated with 2 daily insulin injections. Administration of a high dose of insulin or development of hypoglycemia may be more common in diabetic dogs that receive insulin once daily, compared with dogs that receive insulin twice daily. ( J Am Vet Med Assoc 2000;216:217–221)

Full access
in Journal of the American Veterinary Medical Association

Objective

To evaluate the effect of a high insolublefiber (HF) diet containing 12% cellulose in dry matter and a low insoluble-fiber (LF) diet on control of glycemia in dogs with naturally acquired insulin-dependent diabetes mellitus.

Design

Prospective randomized crossover controlled trial.

Animals

11 dogs with naturally acquired diabetes mellitus.

Procedure

Dogs were fed HF and LF diets for 8 months each in 1 of 2 randomly assigned diet sequences. Caloric intake and insulin treatment were adjusted as needed to maintain stable body weight and control of glycemia, respectively. After a 2-month adaptation period, control of glycemia was evaluated every 6 weeks for 6 months. Variables assessed included serum glucose concentration measured during the preprandial state, blood glycosylated hemoglobin concentration, serum glucose concentration measured every 2 hours for 24 hours beginning at the time of the morning insulin injection, 24-hour mean serum glucose concentration, mean serum glucose concentration fluctuation from the 24-hour mean serum glucose concentration, and 24-hour urinary excretion of glucose.

Results

Significant differences in mean daily caloric intake, body weight, or daily insulin dosage among dogs fed HF and LF diets were not found. Mean preprandial serum glucose concentration, most postprandial serum glucose concentrations, 24-hour mean serum glucose concentration, and 24-hour urinary excretion of glucose were significantly lower in dogs fed the HF diet, compared with the LF diet.

Clinical Implications

Results of this study support feeding of commercially available insoluble fiber diets to dogs with naturally acquired diabetes mellitus. (J Am Vet Med Assoc 1998; 212:380-386)

Free access
in Journal of the American Veterinary Medical Association

Objective

To assess pretreatment clinical and laboratory findings in cats with diabetes mellitus and to determine the influence of ketoacidosis on pretreatment findings.

Design

Retrospective case series.

Animals

104 cats with diabetes melliitus, 38 of which had ketoacidosis.

Procedure

Medical records of cats with diabetes mellitus examined over a 20-month period were reviewed. Cats that had received previous treatment for diabetes mellitus, or for which medical records were incomplete, were excluded from this study.

Results

Cats ranged in age from 1 to 19 years (median, 11 years). Male cats were twice as likely to develop diabetes as females. The most common historical signs were polyuria, polydipsia, weight loss, and diminished activity. Anorexia or poor appetite was reported more commonly than polyphagia, especially in cats with ketoacidosis. Diminished activity, anorexia, weakness, and vomiting were all significantly more common in ketoacidotic cats than in nonketoacidotic cats. Forty-four cats were considered thin, and 34 were considered obese. All cats had hyperglycemia and most had hypercholesterolemia and high activities of 1 or more hepatic enzymes. Compared with nonketoacidotic cats, ketoacidotic cats were more likely to have had low serum electrolyte values. All cats had glucosuria and 42 (40.4%) had ketonuria. Baseline serum insulin concentrations were measured in 18 cats and were low or at the low end of the reference range in 14 (77.8%) cats. Serum fructosamine concentration, determined in 22 cats, was high in 20 (90.9%) cats. Twenty-three of the 104 (22.1%) cats had concurrent disease, the most common of which were hyperthyroidism, inflammatory bowel disease, and eosinophilic granuloma complex.

Clinical Implications

In more than a third of cats, diabetes mellitus is complicated by development of ketoacidosis, which increases the severity of clinical and laboratory abnormalities. Diagnosis of diabetes mellitus is made on the basis of signalment (eg, middle-aged to old male cats), owner complaints (eg, polyuria, polydipsia, and weight loss), physical examination findings (eg, lethargy or muscle wasting), and laboratory findings {eg, hyperglycemia and glucosuria). (J Am Vet Med Assoc 1996,209:943-949)

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate effects of dietary insoluble fiber on control of glycemia in cats with naturally acquired diabetes mellitus.

Design—Randomized controlled crossover trial.

Animals—16 cats with naturally acquired diabetes mellitus.

Procedure—Cats were fed a diet high in insoluble fiber (HF) containing 12% cellulose (dry-matter basis) or a diet low in insoluble fiber (LF) for 24 weeks; they were fed the other diet for the subsequent 24 weeks. Caloric intake and insulin treatment were adjusted to maintain stable body weight and control of glycemia, respectively. Cats were allowed an adaption period of 6 weeks after initiation of a diet, after which control of glycemia was evaluated at 6-week intervals for 18 weeks. Variables assessed included serum glucose concentration measured during the preprandial state, blood glycated hemoglobin concentration, serum glucose concentration measured at 2-hour intervals for 12 hours beginning at the time of the morning insulin injection, 12-hour mean serum glucose concentration, and mean fluctuation in serum glucose concentration from the 12-hour mean serum glucose concentration.

Results—Mean daily caloric intake, body weight, or daily insulin dosage did not differ significantly between cats when fed HF and LF diets. Mean preprandial serum glucose concentration, most postprandial serum glucose concentrations, and the 12-hour mean serum glucose concentration were significantly lower when cats consumed the HF diet, compared with values when cats consumed the LF diet.

Conclusions and Clinical Relevance—These results support feeding a commercially available diet containing approximately 12% insoluble fiber (dry-matter basis) to cats with naturally acquired diabetes mellitus. (J Am Vet Med Assoc 2000;216:1082–1088)

Full access
in Journal of the American Veterinary Medical Association

SUMMARY

After IV administration of 0.5 mg of glucagon/cat, glucose tolerance and insulin secretory response were evaluated in 10 lean cats, 10 obese cats, and 30 cats with diabetes mellitus. Blood samples for glucose and insulin determinations were collected immediately before and at 5, 10, 15. 30, 45, and 60 minutes after IV administration of glucagon. Baseline serum insulin concentration and insulin secretory response were used to classify diabetes mellitus in the 30 cats as type I or type II.

Mean (± SEM) baseline and 30-minute serum glucose concentrations in obese cats were significantly (P < 0.05) decreased, compared with values in lean cats, but were similar at all other blood sample collection times. Serum glucose concentration in diabetic cats was significantly (P < 0.05) greater than values in obese and lean cats at all blood sample collection times. Two statistically different insulin responses to IV administration of glucagon were seen in diabetic cats. Of the 30 diabetic cats, 23 had minimal insulin secretory response after glucagon administration (ie, serum insulin concentration was at or below sensitivity of the insulin assay). Seven diabetic cats had baseline serum insulin concentration similar to that of obese cats and significantly (P < 0.05) greater than that of lean cats and of the other 23 diabetic cats. In these 7 diabetic cats, serum insulin concentration increased after glucagon administration. Total insulin secretion was not significantly different between these 7 diabetic cats and the lean and obese cats, and was significantly (P < 0.05) greater than total insulin secretion in the other 23 diabetic cats. Results support existence of type-I and type-II diabetes mellitus in cats.

Free access
in American Journal of Veterinary Research

SUMMARY

The effect of a high insoluble-fiber (if) diet containing 15% cellulose in dry matter, high soluble-fiber (sf) diet containing 15% pectin in dry matter, and low-fiber (lf) diet on glycemic control in 6 dogs with alloxan-induced insulin-dependent diabetes mellitus was evaluated. Each diet contained > 50% digestible carbohydrate in dry matter. A crossover study was used with each dog randomly assigned to a predetermined diet sequence. Each dog was fed each diet for 56 days. Caloric intake was adjusted weekly as needed to maintain each dog within 1.5 kg of its body weight measured prior to induction of diabetes mellitus. All dogs were given pork lente insulin and half of their daily caloric intake at 12-hour intervals.

Mean (± sem) daily caloric intake was significantly (P < 0.05) less when dogs consumed the if diet vs the sf and lf diets (66 ± 3 kcal/kg, 81 ± 5 kcal/kg, and 79 ± 4 kcal/kg, respectively). Serum alkaline phosphatase activity was significantly (P < 0.05) higher when dogs consumed the lf diet vs the if and sf diets (182 ± 37 IU/L, 131 ± 24 IU/L, and 143 ± 24 IU/L, respectively). Mean postprandial plasma glucose concentration measured every 2 hours for 24 hours, beginning at the time of the morning insulin injection, was significantly (P < 0.05) lower at most blood sampling times in dogs fed if and sf diets, compared with dogs fed the lf diet. As a result, 24-hour mean plasma concentration of glucose (if, 165 ± 17 mg/dl; sf, 169 ± 19 mg/dl; lf, 218 ± 29 mg/dl), 24-hour mean plasma-glucose fluctuation (if, 49 ± 2 mg/dl; sf, 47 ± 4 mg/dl; lf, 63 ± 7 mg/dl), and 24-hour urine-glucose excretion (if, 31 ± 10 g/d; sf, 42 ± 16 g/d; lf, 67 ± 13 g/d) were significantly (P < 0.05) lower in dogs fed if and sf diets, compared with dogs fed the lf diet. These variables were not significantly different between dogs fed if and sf diets. Mean glycosylated hemoglobin concentration also was significantly (P < 0.05) lower when dogs consumed the if diet, compared with the lf diet (4.3 ± 0.4% vs 5.2 ± 0.4%, respectively).

In dogs with alloxan-induced insulin-dependent diabetes mellitus, consumption of diets containing 15% cellulose or 15% pectin and > 50% digestible carbohydrate on a dry-matter basis resulted in improvement in glycemic control, compared with consumption of a diet containing > 50% digestible complex carbohydrate without added fiber.

Free access
in American Journal of Veterinary Research

Summary

An orally administered sulfonylurea drug, glipizide, was evaluated for treatment of diabetes mellitus. Confirmation of diabetes was based on evidence of appropriate clinical signs, persistent hyperglycemia, and glucosuria. Glipizide (5 mg, PO, q 12 h) was administered to each cat. Sixteen cats were fed a commercial high-fiber diet and 4 cats were fed a commercial low-fiber diet. Insulin was not administered to any cat during the study. Each cat was evaluated 2, 4, 8, and 12 weeks after initiation of treatment.

Three clinical responses to glipizide treatment were identified. Mean preprandial blood glucose concentration and mean blood glucose concentration during an 8-hour postprandial period decreased to < 200 mg/dl in 5 of 20 (25%) cats. In these 5 cats, glucosuria was no longer detected and clinical signs resolved by the 4-week reevaluation. Euglycemia was maintained after discontinuing glipizide treatment in 2 of these 5 cats. Glycemic control has been maintained in 2 of 5 of the responding cats for 5 and 7 months of glipizide treatment. One of 5 of the responding cats developed insulin-requiring diabetes mellitus after 6 months of glipizide treatment. Seven of 20 (35%) cats failed to respond to treatment. Mean preprandial blood glucose concentration and mean blood glucose concentration during an 8-hour postprandial period did not change from pretreatment values after 2 ± 1 months; glucosuria persisted and clinical signs progressively worsened. Insulin treatment was required to establish glycemic control in these 7 cats. Eight of 20 (40%) cats partially responded to glipizide treatment. Clinical signs and abnormalities identified on physical examination improved, and mean preprandial blood glucose concentration and mean blood glucose concentration during an 8-hour postprandial period decreased by 146 ± 105 and 110 ± 50 mg/dl, respectively, at the 12 week reevaluation, compared with pretreatment values, but blood glucose concentrations remained > 200 mg/dl and glucosuria persisted. These cats were treated with glipizide for a mean of 12 months (range, 7 to 21 months).

Adverse reactions to treatment included vomiting shortly after administration of glipizide (3 cats), hypoglycemia (3 cats), and increased serum hepatic enzyme activities (3 cats). Retrospective analysis of information obtained from the 20 cats at the time of entry into the study failed to identify any consistent factor that could be used to predict the cats’ response to glipizide treatment. Results of the study indicated that glipizide may be a viable alternative to insulin for treatment of diabetes mellitus in some cats.

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To characterize concurrent disorders in dogs with diabetes mellitus (DM).

Design—Retrospective study.

Animals—221 dogs with DM.

Procedure—Medical records were reviewed, and clinical signs, physical examination findings, and results of clinicopathologic testing, urinalysis, aerobic bacterial culture of urine samples, coagulation testing, endocrine testing, histologic evaluation, diagnostic imaging, and necropsy were recorded.

Results—For most dogs, CBC results were normal. Common serum biochemical abnormalities included hypochloremia (127 dogs, 60%) and high alanine aminotransferase (163, 78%), aspartate aminotransferase (78, 71%), and alkaline phosphatase (188, 90%) activities. Venous pH and serum ionized calcium concentration were measured in 121 and 87 dogs, respectively, and were low in 56 (46%) and 41 (47%) dogs. Lipemia was observed in 92 (42%) dogs. Urine samples from 159 (72%) dogs were submitted for aerobic bacterial culture, and 34 (21%) yielded bacterial growth. Escherichia coli was the most commonly isolated organism. Thirty-six (16%) dogs had dermatitis or otitis. Hyperadrenocorticism was diagnosed in 51 (23%) dogs on the basis of clinical signs and results of a low-dose dexamethasone suppression test (41 dogs), an adrenocorticotropic hormone stimulation test (5), both tests (4), or histologic evaluation of necropsy specimens (1). Acute pancreatitis was diagnosed in 28 (13%) dogs. Eleven (5%) dogs had tumors for which a histologic diagnosis was obtained. Eight (4%) dogs were hypothyroid.

Conclusions and Clinical Relevance—Results suggest that dogs with diabetes mellitus may have many concurrent disorders. The most commonly identified concurrent disorders included hyperadrenocorticism, urinary tract infection, dermatitis, otitis, acute pancreatitis, neoplasia, and hypothyroidism. (J Am Vet Med Assoc 2000;217:1166–1173)

Full access
in Journal of the American Veterinary Medical Association