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Abstract

Objective—To evaluate the effects of diets differing in type and quantity of fiber on glycemic control in dogs with naturally occurring insulin-dependent diabetes mellitus.

Design—Prospective randomized crossover controlled trial.

Animals—7 dogs with well-regulated naturally occurring insulin-dependent diabetes mellitus.

Procedure—Dogs were fed 1 of 3 diets for 1 month each in 1 of 6 randomized diet sequences. Diets included a low-fiber diet (LF) and 2 high-fiber diets; 1 contained only insoluble fiber (HIF), and 1 contained soluble fiber in addition to insoluble fiber (HSF). Caloric intake was unchanged throughout the study. Glycemic control was assessed after each feeding trial by measuring serum fructosamine concentration and performing 5 serial measurements of blood glucose concentration every 2 hours after the morning feeding and insulin injection.

Results—Significant differences were not detected in body weight, required insulin dosage, or albumin concentration among dogs fed the HIF, HSF, and LF diets. Mean and maximum blood glucose concentrations and area under the blood glucose curve were significantly lower in dogs fed the HIF diet, compared with values in the same dogs fed the HSF or LF diet. Fructosamine concentration was significantly lower in dogs fed the HIF or HSF diet, compared with values in the same dogs fed the LF diet.

Conclusions and Clinical Relevance—In dogs with naturally occurring insulin-dependent diabetes mellitus, a dry, high insoluble-fiber diet may aid in glycemic control. (J Am Vet Med Assoc 2000;216:1076–1081)

Full access
in Journal of the American Veterinary Medical Association

SUMMARY

Fructosamine, a glycated serum protein, was evaluated as an index of glycemic control in normal and diabetic cats. Fructosamine was determined manually by use of a modification of an automated method. The within-run precision was 2.4 to 3.2%, and the day-to-day precision was 2.7 to 3.1%. Fructosamine was found to be stable in serum samples stored for 1 week at 4 C and for 2 weeks at − 20 C. The reference range for serum fructosamine concentration in 31 clinically normal colony cats was 2.19 to 3.47 mmol/L (mean, 2.83 ± 0.32 mmol/L). In 27 samples from 16 cats with poorly controlled diabetes mellitus, the range for fructosamine concentration was 3.04 to 8.83 mmol/L (mean, 5.93 ± 1.35 mmol/L). Fructosamine concentration was directly and highly correlated to blood glucose concentration. Fructosamine concentration also remained high in consort with increased blood glucose concentration in cats with poorly controlled diabetes mellitus over extended periods. It is concluded that measurement of serum fructosamine concentration can be a valuable adjunct to blood glucose monitoring to evaluate glycemic control in diabetic cats. The question of whether fructosamine can replace glucose for monitoring control of diabetes mellitus requires further study.

Free access
in American Journal of Veterinary Research

Abstract

Objective—To characterize skin lesions and causative infections in diabetic dogs and evaluate other potential causes of dermatologic disorders, including concurrent endocrinopathies, allergic skin disease, and long-term corticosteroid administration.

Design—Retrospective study.

Animals—45 dogs with diabetes mellitus (DM) that were examined by dermatologists.

Procedure—Medical records were reviewed for signalment; allergic conditions prior to development of DM; prior corticosteroid administration; and results of dermatologic examinations, ear and skin cytologic examinations, skin scrapings for parasites, bacteriologic and fungal culturing of ear and skin specimens, histologic examinations, and endocrine testing.

Results—Bacterial skin infection was the most common dermatologic disorder (n = 38 [84%]), followed by otitis (26 [58%]) and Malassezia-induced dermatitis (19 [42%]). Twenty-two (49%) dogs had pruritic skin disease consistent with allergic dermatitis, which preceded diagnosis of DM. Prior corticosteroid administration was reported in 21 (47%) dogs. Concurrent hyperadrenocorticism was diagnosed in 13 (29%) dogs, and concurrent hypothyroidism was diagnosed in 5 (11%) dogs. Iatrogenic hyperadrenocorticism was diagnosed in 1 additional dog. Only 10 (22%) dogs did not have a documented concurrent endocrinopathy or allergic disease that could have caused the dermatitis.

Conclusions and Clinical Relevance—Bacterial and yeast-induced dermatitis and otitis develop in dogs with DM. Many diabetic dogs with dermatologic problems have a preexisting allergic condition, history of prior corticosteroid administration, or concurrent endocrinopathy that may be a more likely cause of dermatologic problems than DM alone. (J Am Vet Med Assoc 2001:219: 203–208)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine which dog breeds are at low and high risk for developing diabetes mellitus (DM).

Design—Cohort study.

Animals—Hospital population of 221 dogs with DM and 42,882 dogs without DM during 5.5 years.

Procedure—165 breeds (including a mixed-breed category) were represented in the hospital population. Breed-specific expected numbers of dogs with DM were calculated by multiplying the proportion of all dogs admitted to the hospital that were determined to have DM during the study period by the breed-specific totals during the study period. Breeds or breed groups evaluated in the analysis (n = 20) were restricted to those that had a combined observed and expected count > 5 to document breeds at low and high risk for developing DM. Proportionate changes in the risk of developing DM by breed were calculated and presented using exact odds ratios, 95% confidence intervals, and P values. Mixed-breed dogs were chosen as the reference breed.

Results—Samoyeds, Miniature Schnauzers, Miniature Poodles, Pugs, and Toy Poodles were at high risk for developing DM. Dog breeds found to be at low risk for developing DM were German Shepherd Dog, Golden Retriever, and American Pit Bull Terrier.

Conclusion and Clinical Relevance—The finding that certain dog breeds are at low or high risk for developing DM suggests that some genetic defects may predispose dogs to development of DM, whereas other genetic factors may protect dogs from development of DM. (J Am Vet Med Assoc 2000;216: 1414–1417)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To identify a technique for measurement of glycated hemoglobin percentage in blood samples obtained from various species of nonhuman primates (NHPs), to determine whether these percentages varied with respect to glycemic control, and to assess whether this physiologic variable provided a suitable test for diagnosing diabetes mellitus in NHPs.

Sample Population—166 blood samples collected from 121 NHPs comprising 22 species from the Haplorhine and Strepsirhine suborders and including nondiabetic, treated-diabetic, and diabetic animals in 23 zoologic institutions throughout the United States.

Procedure—Hemoglobin A1c percentage was measured in 154 samples by use of high-performance liquid chromatography. Total glycated hemoglobin percentage was measured in 159 samples by use of a boronate-affinity chromatographic assay. Glucose concentration was measured in 157 samples with an autochemical analyzer by use of a hexose kinase method.

Results—The boronate-affinity chromatographic technique for measurement of total glycated hemoglobin percentage was the most suitable method. Nondiabetic Haplorhines had percentages higher than those in nondiabetic Strepsirhines. In Haplorhines, diabetic animals had percentages higher than those in treated-diabetic animals, which had percentages higher than those in nondiabetic animals. In Strepsirhines, this pattern was less pronounced.

Conclusions and Clinical Relevance—Measurement of total glycated hemoglobin percentage provides useful information for diagnosing diabetes mellitus in Haplorhines and, possibly, in Strepsirhines. Until reference ranges are established for each species, it is recommended that results for samples from NHPs without clinical signs of diabetes mellitus be compared with results of samples collected concomitantly from NHPs with clinical signs of this condition. ( Am J Vet Res 2003;64:562–568)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate effects of protamine zinc insulin (PZI) on control of glycemia in cats with newly diagnosed diabetes mellitus or poorly controlled diabetes.

Design—Clinical trial.

Animals—67 diabetic cats.

Procedure—34 cats with newly diagnosed diabetes and 33 cats with poorly controlled diabetes were treated with PZI twice daily for 45 days. Control of glycemia was assessed on days 7, 14, 30, and 45 by evaluation of clinical response, change in body weight, serum fructosamine concentration, blood glucose concentration measured 1, 3, 5, 7, and 9 hours after administration of PZI, lowest blood glucose concentration, and mean blood glucose concentration during the 9-hour period after administration. Adjustments in dosage of PZI were made as needed to attain control of glycemia.

Results—For all cats, a significant increase in mean dosage of PZI and significant decreases in 9-hour mean blood glucose concentration, lowest mean blood glucose concentration, and mean serum fructosamine concentration were detected. For cats with poorly controlled diabetes, 9-hour mean blood glucose concentration and mean serum fructosamine concentration were significantly decreased on day 45, compared with day 0. Ninety percent of owners reported improvement or resolution of clinical signs by day 45.

Conclusions and Clinical Relevance—Results suggest that PZI was effective for control of glycemia in cats with newly diagnosed or poorly controlled diabetes and may be used as an initial treatment or as an alternative treatment in cats that do not respond to treatment with other types of insulin. ( J Am Vet Med Assoc 2001;218:38–42)

Full access
in Journal of the American Veterinary Medical Association

SUMMARY

The absorption kinetics of porcine regular insulin following iv, im, and sc administration were evaluated in 10 dogs with alloxan-induced diabetes mellitus. Plasma immunoreactive insulin (iri) concentrations were evaluated immediately prior to and at 10, 20, 30, 45, 60, 90, 120, 180, and 240 minutes following iv administration; and immediately prior to and every 30 minutes for 2 hours and then every hour for 6 hours following im and sc administration of 0.55 U of porcine regular insulin/kg of body weight. Model-independent pharmacokinetic analysis was performed on each data set.

Plasma iri concentration declined rapidly after iv administration of regular insulin and then returned to baseline iri concentration by 3.2 ± 0.8 hours. The absorption kinetics following iv administration of regular insulin were similar to those found in earlier studies in healthy dogs and human beings.

The im and sc routes of regular insulin administration resulted in a pharmacologic concentration of iri at 30 minutes. The peak mean (± SD) plasma iri concentration was significantly (P < 0.05) greater following sc administratin than it was following im administration of regular insulin (263 ± 185 and 151 ± 71 IμU/ml, respectively). The time of the peak plasma iri concentration (68 ± 31 minutes and 60 ± 30 minutes) and the time to return to baseline plasma iri concentration (5.8 ± 1.2 hours and 5.8 ± 1.3 hours) were not significantly different following sc and im administration of regular insulin, respectively. The absorption kinetics following sc administration of regular insulin were similar to those found in earlier studies in healthy dogs and human beings. The absorption kinetics following im administration of regular insulin differed from those found in earlier studies and was similar to the absorption kinetics of regular insulin administered sc in this study. The reasons for this similarity were not readily apparent.

Free access
in American Journal of Veterinary Research

Objective

To evaluate use of the oral hypoglycemic drug glipizide in diabetic cats.

Design

Prospective study.

Animals

50 cats with recently diagnosed but untreated diabetes mellitus.

Procedure

Each cat received glipizide (5 mg, q 12 h) for 16 weeks. Medication was not given during the subsequent 16 weeks; then glipizide treatment was repeated. Each cat was evaluated prior to treatment and at 2, 4, 8, 12, and 16 weeks during each of the 3 phases: blood samples for serum glucose and insulin determinations were obtained every 2 hours, from 8 AM to 6 PM. A preprandial blood glycosylated hemoglobin percentage was determined for the first sample obtained at each visit.

Results

During the first 22 weeks of the study, diabetes worsened in 28 of the 50 cats, which then were disqualified from the study and treated with insulin. Of the remaining 22 cats that improved clinically, 7 had corresponding metabolic improvement in each diabetes-related parameter assessed and did not become hypoglycemic. Six of the 22 cats became hypoglycemic. Glipizide was discontinued, and diabetes did not recur. Serum glucose concentration did not improve in 6. Three cats had metabolic and clinical improvement during initial glipizide treatment, but had recurrence of the disease during repeated treatment; glipizide was discontinued and insulin was administered. None of the 50 treated cats died, and observed morbidity was mild and transient. Transient anorexia and vomiting were observed in 8 cats, and 4 became transiently icteric with abnormal liver enzyme activities.

Clinical Implications

Trial use of glipizide is feasible in diabetic cats of owners who are unable or unwilling to administer insulin. (J Am Vet Med Assoc 1997;210:772–777

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate effect of acarbose on control of glycemia in dogs with diabetes mellitus.

Design—Prospective randomized crossover controlled trial.

Animals—5 dogs with naturally acquired diabetes mellitus.

Procedure—Dogs were treated with acarbose and placebo for 2 months each: in 1 of 2 randomly assigned treatment sequences. Dogs that weighed ≤ 10 kg (22 lb; n = 3) or > 10 kg (2) were given 25 or 50 mg of acarbose, respectively, at each meal for 2 weeks, then 50 or 100 mg of acarbose, respectively, at each meal for 6 weeks, with a 1-month interval between treatments. Caloric intake, type of insulin, and frequency of insulin administration were kept constant, and insulin dosage was adjusted as needed to maintain control of glycemia. Serum glucose concentrations, blood glycosylated hemoglobin concentration, and serum fructosamine concentration were determined.

Results—Significant differences in mean body weight and daily insulin dosage among dogs treated with acarbose and placebo were not found. Mean preprandial serum glucose concentration, 8-hour mean serum glucose concentration, and blood glycosylated hemoglobin concentration were significantly lower in dogs treated with insulin and acarbose, compared with insulin and placebo. Semisoft to watery feces developed in 3 dogs treated with acarbose.

Conclusions and Clinical Relevance—Acarbose may be useful as an adjunctive treatment in diabetic dogs in which cause for poor glycemic control cannot be identified, and insulin treatment alone is ineffective. (J Am Vet Med Assoc 2000;216:1265–1269)

Full access
in Journal of the American Veterinary Medical Association

Objective

To correlate serum fructosamine concentrations with established measures of glycemic control and to compare serum fructosamine and blood glycosylated hemoglobin (GHb) concentrations as a means for assessing glycemic control in diabetic cats.

Design

Longitudinal cohort study.

Animals

26 healthy cats, 5 cats with stress-induced hyperglycemia, 15 untreated diabetic cats, and 36 treated diabetic cats.

Procedure

Control of glycemia was classified and monitored and serum fructosamine and blood GHb concentrations were measured for 12 poorly controlled diabetic cats before and after improving glycemic control, 8 well-controlled treated diabetic cats before and after glycemic control deteriorated, and 5 cats with diabetes mellitus before and after onset of stress-induced hyperglycemia.

Results

Mean serum fructosamine and blood GHb concentrations were significantly higher in untreated diabetic cats, compared with healthy cats, and in 24 poorly controlled diabetic cats, compared with 12 well-controlled diabetic cats. Mean serum fructosamine and blood GHb concentrations decreased significantly in 12 poorly controlled diabetic cats after improving glycemic control and increased significantly in 8 well-controlled diabetic cats after glycemic control deteriorated. A significant stress-induced increase in mean blood glucose concentration was evident 12 hours after insulin administration, but not in 5 docile diabetic cats that became fractious.

Clinical Implications

Serum fructosamine and blood GHb concentrations are clinically useful tools for monitoring control of glycemia in cats with diabetes mellitus. (J Am Vet Med Assoc 1999;214:1794-1798)

Free access
in Journal of the American Veterinary Medical Association