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Abstract

Objective—To characterize clinical and clinicopathologic findings, response to treatment, and causes of systemic hypertension in cats with hypertensive retinopathy.

Design—Retrospective study.

Animals—69 cats with hypertensive retinopathy.

Procedure—Medical records from cats with systemic hypertension and hypertensive retinopathy were reviewed.

Results—Most cats (68.1%) were referred because of vision loss; retinal detachment, hemorrhage, edema, and degeneration were common findings. Cardiac abnormalities were detected in 37 cats, and neurologic signs were detected in 20 cats. Hypertension was diagnosed concurrently with chronic renal failure (n = 22), hyperthyroidism (5), diabetes mellitus (2), and hyperaldosteronism (1). A clearly identifiable cause for hypertension was not detected in 38 cats; 26 of these cats had mild azotemia, and 12 did not have renal abnormalities. Amlodipine decreased blood pressure in 31 of 32 cats and improved ocular signs in 18 of 26 cats.

Conclusions and Clinical Relevance—Retinal lesions, caused predominantly by choroidal injury, are common in cats with hypertension. Primary hypertension in cats may be more common than currently recognized. Hypertension should be considered in older cats with acute onset of blindness; retinal edema, hemorrhage, or detachment; cardiac disease; or neurologic abnormalities. Cats with hypertensioninduced ocular disease should be evaluated for renal failure, hyperthyroidism, diabetes mellitus, and cardiac abnormalities. Blood pressure measurements and funduscopic evaluations should be performed routinely in cats at risk for hypertension (preexisting renal disease, hyperthyroidism, and age > 10 years). Amlodipine is an effective antihypertensive agent in cats.(J Am Vet Med Assoc 2000;217:695–702)

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the prevalence of infections developing postoperatively, document the contribution of infection to increased risk of death, and identify risk factors associated with the development of infectious complications in cats after renal transplantation.

Design—Retrospective study.

Animals—169 cats that received renal allograft transplants.

Procedures—Medical records of cats receiving renal transplants at the University of California from January 1987 through December 2003 were reviewed.

Results—47 infections developed in 43 of 169 cats. Bacterial infections were most common (25/47 cats), followed by viral (13/47), fungal (6/47), and protozoal (3/47) infections. The median duration from transplant surgery to development of infection was 2.5 months. Infection was the second most common cause of death after acute rejection of the transplant, accounting for 14% of deaths overall. Cats with concurrent diabetes mellitus had a significantly increased risk of developing an infection after renal transplantation. Sex, increasing age, concurrent neoplasia, and previous treatment for transplant rejection were not associated with development of infection.

Conclusions and Clinical Relevance—Infection was a common complication and an important cause of death or euthanasia in cats after renal transplantation. Development of diabetes mellitus after transplantation significantly increased the risk of infection. (J Am Vet Med Assoc 2005;227:948–953)

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in Journal of the American Veterinary Medical Association

Objective

To determine the effect of hyperthyroidism on serum fructosamine concentration in cats.

Design

Cohort study.

Animals

22 cats with overt hyperthyroidism.

Procedure

Hyperthyroidism was diagnosed on the basis of clinical signs, detection of a palpable thyroid gland, and high total serum thyroxine (T4) concentrations. Hyperthyroid cats with abnormal serum albumin, total protein, and glucose concentrations were excluded from the study. Samples for determination of serum fructosamine concentration were obtained prior to initiating treatment. Results were compared with fructosamine concentrations in healthy cats, cats in which diabetes had recently been diagnosed, and cats with hypoproteinemia. In 6 cats, follow-up measurements were obtained 2 and 6 weeks after initiating treatment with carbimazole.

Results

Serum fructosamine concentrations ranged from 154 to 267 μmol/L (median, 198 μmol/L) and were significantly lower than values in healthy cats. Eleven (50%) of the hyperthyroid cats had serum fructosamine concentrations less than the reference range. Serum fructosamine concentrations in hyperthyroid, normoproteinemic cats did not differ from values in hypoproteinemic cats. During treatment, an increase in serum fructosamine concentration was detected.

Conclusions and Clinical Relevance

In hyperthyroid cats, concentration of serum fructosamine may be low because of accelerated protein turnover, independent of blood glucose concentration. Serum fructosamine concentrations should not be evaluated in cats with overt hyperthyroidism and diabetes mellitus. Additionally, concentration of serum fructosamine in hyperthyroid cats should not be used to differentiate between diabetes mellitus and transitory stress-related hyperglycemia. (J Am Vet Med Assoc 1999;215:1297–1300)

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in Journal of the American Veterinary Medical Association

Objective—

To characterize the frequency, medical history, clinical signs, methods of treatment, and outcome of insulin-induced hypoglycemia and to identify predisposing factors.

Design—

Retrospective study.

Animals—

8 dogs and 20 cats with diabetes mellitus that developed hypoglycemia because of insulin overdose.

Procedure—

Medical records of dogs and cats receiving insulin for treatment of diabetes mellitus were reviewed. Medical records of dogs and cats that had an episode of hypoglycemia were reviewed in detail.

Results—

Overdosing of insulin was more common in cats than in dogs. Median weight of diabetic cats that became hypoglycemic was significantly greater than that of the hospital population of diabetic cats at diagnosis. Eighty percent of cats that became hypoglycemic were receiving insulin doses > 6 U/injection, administered once or twice daily. Dose and type of insulin did not correlate with duration or severity of hypoglycemia. In 7 of 8 dogs and 10 of 20 cats, management factors or concurrent medical problems were considered to be predisposing causes for insulin overdose. Two dogs and 2 cats did not have clinical signs of hypoglycemia, despite documented low concentrations of glucose in their blood.

Clinical Implications—

Diabetic cats, especially if obese, are at greater risk of insulin overdose than are diabetic dogs. The reason for overdose may not be evident. Diabetic dogs and cats may become hypoglycemic without developing autonomic warning signs of hypoglycemia, or these signs may not be recognized (hypoglycemia unawareness). (J Am Vet Med Assoc 1997;211:326–330)

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in Journal of the American Veterinary Medical Association

Summary

We reviewed the medical records of 494 cats with a variety of nonthyroidal diseases in which serum thyroxine (T4) concentration was determined as part of diagnostic evaluation. The cats were grouped by category of disease (ie, renal disease, congestive heart failure, diabetes mellitus, focal neoplasia, systemic neoplasia, hepatopathy, inflammatory bowel disease, inflammatory pulmonary disease, miscellaneous diseases, or undiagnosed disease), degree of illness (ie, mild, moderate, or severe), survival (ie, lived, died, or euthanatized), and presence or absence of a palpable thyroid gland. The mean (± sd) serum T4 concentrations in all 10 groups of cats, which ranged from 10.5 ± 11.1 nmol/L in cats with diabetes mellitus to 18.7 ± 7.8 nmol/L in cats with focal neoplasia, were significantly (P < 0.001) lower than those of normal cats (27.0 ± 10.4 nmol/L). The number of ill cats with low serum T4 concentrations (<10 nmol/L) was highest in the cats with diabetes mellitus (59%), hepatopathy (54%), renal failure (48%), and systemic neoplasia (41%). When the serum T4 concentrations in cats with mild, moderate, and severe illness were compared, mean concentrations were progressively lower (21.3 ± 6.8, 14.8 ± 8.1, and 6.5 ± 5.8 nmol/L, respectively) as degree of illness increased. Severity of illness had a more significant (P < 0.001) effect in lowering serum T4 concentrations than did disease category. Mean serum T4 concentrations in the cats that died (7.8 ± 9.8 nmol/L) or were euthanatized (10.0 ± 7.0 nmol/L) were also significantly (P < 0.001) lower than those of cats that survived (15.2 ± 8.8 nmol/L). Of the 182 cats with low serum T4 concentrations, 74 (41%) died or were euthanatized. The 63 cats with palpable thyroid nodules had significantly (P < 0.001) higher mean serum T4 concentrations (21.7 ± 10.4 nmol/L) than the cats in which a thyroid nodule was not palpated (12.7 ± 8.1 nmol/L). Adenomatous hyperplasia of the thyroid gland was confirmed at necropsy in 2 cats with a palpable thyroid gland, and 4 cats that survived have subsequently developed overt hyperthyroidism. This suggests that, in some cats with early or mild hyperthyroidism, concomitant nonthyroidal disease may suppress serum T4 concentrations into the normal range.

Free access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus.

Design—Prospective clinical study.

Animals—10 dogs with diabetes mellitus.

Procedure—Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2.

Results—Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was < 180 mg/dL (10 mmol/L) on 1 or both days. In this subset of 20 paired curves, an opposite recommendation for dosage adjustment was made on 40% of occasions.

Conclusions and Clinical Relevance—There is large day-to-day variation in parameters of serial blood glucose concentration curves in diabetic dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control. (J Am Vet Med Assoc 2003;222:317–321)

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in Journal of the American Veterinary Medical Association

SUMMARY

Serum glucose and immunoreactive insulin concentrations were monitored after topical administration of an insulin-containing ophthalmic solution in 20 clinically normal cats. Three ophthalmic surface-acting agents, benzalkonium chloride, dimethyl sulfoxide, and proparacaine hydrochloride, were evaluated individually for their effectiveness in enhancing absorption of topically applied insulin. The ophthalmic effects of insulin-containing ophthalmic preparations were assessed by complete ophthalmic examination before and at the conclusion of each test period. Withholding of food overnight (12 hours) preceded each topical application of insulin-containing ophthalmic solution (12.25 to 26.4 U/cat), either alone or in combination with surface-acting agents, after which blood samples were drawn serially from an indwelling iv catheter over a period of 8 hours. Baseline serum insulin concentration, after food was withheld for 12 hours, in nonstressed cats was 6.0 μU/ml (geometric mean), and an exponentiation of the logarithmic quantity (mean ± sd) yielded values of 1.5 to 23.0 μU/ml. All ophthalmic solutions tested failed to significantly lower serum glucose concentration or increase serum insulin concentration. Solutions used did not induce deleterious effect on ocular structures. Results indicate that topical administration of insulin-containing ophthalmic solution, either alone at the concentrations used or in combination with surfaceacting agents, did not result in effective absorption of insulin across the conjunctival and lacrimal nasal mucosa in biologically relevent quantities. Thus, this route of insulin administration, under these specific conditions, is not an effective alternative or adjunct to SC administration of insulin for treatment of cats with insulin-dependent diabetes mellitus or severe noninsulin-dependent diabetes mellitus.

Free access
in American Journal of Veterinary Research

Objective

To determine the association between body condition and disease in cats.

Design

Prospective study.

Sample Population

Information on 1,457 cats without major illnesses from 27 veterinary hospitals in the northeastern United States.

Procedure

Cats that had body conditions determined from 1991 to 1992, using a set of 6 body condition silhouettes, had their health experiences and body conditions assessed for the subsequent 4.5 years. Cats were described by the following 6 body conditions: cachectic, lean, optimally lean, optimal weight, heavy, and obese. Data obtained from medical records and owner interviews were collected, using standard forms. Associations between body condition and specific diseases were analyzed. Findings in cats with body conditions other than optimal were compared with findings in cats with optimal body condition.

Results

Compared with optimal weight cats, heavy cats were 2.9 times as likely to be taken to veterinarians because of lameness not associated with cat bite abscesses. Obese cats were also 3.9 times as likely to develop diabetes mellitus, 2.3 times as likely to develop nonallergic skin conditions, and 4.9 times as likely to develop lameness requiring veterinary care. Cats considered thin (cachectic and lean) were 1.7 times as likely to be presented to veterinary hospitals for diarrhea.

Clinical Implications

Results of this study substantiate reports of health risks associated with excess body weight in cats. Efforts to reduce weight in heavy and obese cats can lead to reduced risks of diabetes mellitus, lameness (presumably related to osteoarthritis and soft-tissue injuries), and skin problems unrelated to allergies. Cachectic and lean cats are more likely to have diarrhea that is not associated with a definitive diagnosis. (J Am Vet Med Assoc 1998;212: 1725–1731)

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in Journal of the American Veterinary Medical Association

Abstract

Objective

To determine effects of acarbose on baseline and postprandial serum glucose and insulin concentrations in healthy dogs, if effects of acarbose were dosage related, and if acarbose caused any short-term adverse effects.

Animals

5 healthy dogs fed a high-fiber diet.

Procedure

A Latin-square design was used. During each 1-week treatment period, dogs were given a placebo or 25, 50, 100, or 200 mg of acarbose, PO, twice daily immediately prior to feeding. There was a 1-week interval between periods. At the end of each treatment period, serum glucose and insulin concentrations were measured prior to feeding and at 30- to 60-minute intervals for 6 hours after feeding.

Results

Baseline serum glucose and insulin concentrations, insulin peak response, and total glucose absorption were not significantly different following treatment with placebo and treatment with acarbose; however, total insulin secretion was significantly decreased when dogs were treated with 100 or 200 mg of acarbose. Four dogs developed soft to watery stools when treated with 200 mg of acarbose, and 2 dogs lost weight during the study. Results of CBC and serum biochemical analyses were within reference ranges throughout the study.

Conclusions

Acarbose did not induce any serious adverse effects and was effective in healthy dogs in reducing total postprandial insulin secretion when administered immediately prior to meals.

Clinical Relevance

Results suggest that acarbose may help control hyperglycemia in dogs with insulin-dependent diabetes mellitus. Additional studies designed to evaluate the effect of acarbose on postprandial blood glucose concentrations in dogs with diabetes mellitus are indicated. (Am J Vet Res 1999;60:541–545)

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in American Journal of Veterinary Research

Abstract

Objective—To evaluate quantification of the amount of carbamylated hemoglobin (CarbHb), using capillary electrophoresis (CE) and a new dynamic capillary coating system to separate hemoglobin derivatives, and to assess the use of CarbHb amounts to evaluate long-term urea exposure and differential diagnoses of azotemia in dogs.

Animals—8 dogs with renal failure, 2 dogs with diabetes mellitus, and 7 control dogs.

Procedure—Optimal analytic conditions for separation of CarbHb and other hemoglobin derivatives in blood samples obtained from dogs were determined, using a commercial analysis system developed for the detection of glycohemoglobin Hb A1c (GlycHb) in human blood samples. Relative content of hemoglobin derivatives in blood from 10 dogs with renal failure or endocrine diseases were compared with values for 7 dogs without renal or endocrine diseases.

Results—Satisfactory resolution of hemoglobin derivatives was obtained, which permitted identification and quantitation of the amount of CarbHb as a percentage of the total amount of hemoglobin. Normal or increased amounts of GlycHb did not interfere with CarbHb analysis. Dogs with chronic renal failure had considerably higher peak amounts of CarbHb than dogs with acute renal failure, a dog with chronic renal failure that was treated by use of hemodialysis, or dogs without renal disease.

Conclusions and Clinical Relevance—Amounts of CarbHb in blood samples obtained from dogs can be readily quantified by use of capillary electrophoresis. Assessment of the amount of CarbHb can be used to facilitate evaluation of the cause of azotemia in dogs. (Am J Vet Res 2001;62:1302–1306)

Full access
in American Journal of Veterinary Research