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Summary:

Hyperadrenocorticism caused by bilateral adrenocortical neoplasia was diagnosed in 4 dogs. Three dogs had bilateral adrenocortical adenomas, and 1 dog had bilateral adrenocortical carcinomas. The history, physical findings, clinicopathologic abnormalities, and results of acth stimulation and low-dose dexamethasone suppression tests were compatible with diagnosis of hyperadrenocorticism. Adrenocortical neoplasia was differentiated from pituitary-dependent hyperadrenocorticism on the basis of a combination of test results, including lack of suppression of plasma cortisol after being given a high dose dexamethasone (n = 4), undetectable (< 20 pg/ml) plasma endogenous acth concentration (n = 4), identification of a single mineralized adrenal mass by abdominal radiography (n = 2) and abdominal ultrasonography (n = 1), and identification of bilateral nonmineralized adrenal masses by ultrasonography (n = 1).

A left adrenal mass was excised from 1 dog. Clinical signs persisted and administration of mitotane was initiated. One dog was treated only with mitotane. Treatment with ketoconazole was attempted in 2 dogs. All dogs died or were euthanatized because of persistent hyperadrenocorticism. Necropsy and histologic evaluation of the pituitary and adrenal tissue confirmed bilateral adrenocortical neoplasia in all dogs. Bilateral adrenocortical neoplasia should be considered as an uncommon, but possible, cause of bilaterally large adrenal glands in dogs with hyperadrenocorticism.

Free access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

This study evaluated the use of detemir for treating diabetic dogs with comorbidities that were poorly controlled with intermediate-acting insulins.

ANIMALS

7 insulin-treated diabetic dogs.

PROCEDURES

Retrospective pilot study. Dogs were treated with detemir for at least 3 months, and glycemia was assessed by the owners at home initially 2 to 4 times daily for 6 to 8 weeks and twice daily thereafter. Clinical evaluations occurred on days 7 to 14, day 30, and then every 60 to 90 days, and dosage adjustments of detemir occurred as needed to control glycemia.

RESULTS

The mean, peak, nadir, morning, and evening preinsulin daily blood glucose concentrations were significantly lower after dosing with detemir for 1, 3, or 6 months and during the last month of treatment compared to the final month of treatment with intermediate-acting insulin. Intermediate-acting insulins resulted in significantly worse glycemic control than detemir in all 3 categories of control. The odds of a biochemical hypoglycemic measurement with detemir were not significantly different compared to intermediate-acting insulins. Clinical hypoglycemia did not occur following detemir treatment. When insulin was withheld because of low morning preinsulin blood glucose concentration < 6.7 mmol/L (≤ 120 mg/dL) and dogs were fed, mean blood glucose concentration was significantly higher 1 hour later. Glucose concentrations were also significantly higher 12 hours later on days when insulin was withheld in the morning or evening for either 1 or 12 hours.

CLINICAL RELEVANCE

Detemir is useful in diabetic dogs with other comorbidities and can be considered an alternative treatment in poorly controlled diabetic dogs.

Open access
in Journal of the American Veterinary Medical Association

Abstract

OBJECTIVE

To investigate an association between pancreatitis and chronic kidney disease (CKD) in cats.

ANIMALS

154 client-owned cats: 77 cats with pancreatitis and 77 control cats with no evidence of pancreatitis.

METHODS

Retrospective record review from October 1, 2017, to October 1, 2022, including cats with gastrointestinal clinical signs, pancreatic lipase immunoreactivity (PLI) ≥ 8.8 μg/L or PLI 4.5 to 8.7 μg/L with sonographic evidence of pancreatitis. Control cats had a PLI ≤ 4.4 μg/L with no sonographic evidence of pancreatitis.

RESULTS

Cats with pancreatitis had significantly higher International Renal Interest Society CKD stages than controls (P < .001; OR, 13 [95% CI, 6.3 to 31]), and mean creatinine was on average 0.79 mg/dL (95% CI, 0.56 to 1.0) higher than controls (P < .001; age covariate ANCOVA, P = .003). Odds of CKD in cats with pancreatitis compared to controls increased significantly with age (P = .002). Cats aged 10 to < 15 years and 15 to 20 years with pancreatitis had significantly higher prevalence of CKD stage 2 to 4 compared to controls (P < .001; OR, 10.9 [95% CI, 3.4 to 44]; and P = .001; OR, 66 [95% CI, 4.6 to > 1,000], respectively). Cats with pancreatitis had significantly more sonographic renal infarcts (P = .004; OR, 6.9 [95% CI, 1.8 to 46]) and concurrent diabetes mellitus (P = .002; OR, 6 [95% CI, 1.9 to 27]). Cats with pancreatitis were fed more exclusively dry-food diets compared to controls (P = .014).

CLINICAL RELEVANCE

Pancreatitis is associated with CKD in cats. Investigating and treating these diseases concurrently early in the disease process may reduce morbidity and mortality due to progressive disease and expensive hospitalizations. Renal infarcts may be associated with pancreatitis in cats without overt cardiac disease.

Open access
in Journal of the American Veterinary Medical Association
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