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Hadd MJ, Bienhoff SE, Little SE, Geller S, Ogne‐Stevenson J, Dupree TJ, Scott‐Moncrieff JC. Safety and effectiveness of the sodium-glucose cotransporter inhibitor bexagliflozin in cats newly diagnosed with diabetes mellitus. J Vet Intern Med 2023; 37:915-924. [PMID: 37148170 PMCID: PMC10229323 DOI: 10.1111/jvim.16730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 04/15/2023] [Indexed: 05/08/2023] Open
Abstract
BACKGROUND Bexagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. A pilot study has shown that bexagliflozin can decrease dependence on exogenous insulin in cats with diabetes mellitus (DM). OBJECTIVE To evaluate the safety and effectiveness of bexagliflozin as a monotherapy for DM in previously untreated cats. ANIMALS Eighty-four client-owned cats. METHODS Historically controlled prospective open-label clinical trial. Cats were dosed PO with 15 mg bexagliflozin once daily for 56 days, with a 124-day extension to evaluate safety and treatment effect durability. The primary endpoint was the proportion of cats experiencing a decrease in hyperglycemia and improvement in clinical signs of hyperglycemia from baseline on day 56. RESULTS Of 84 enrolled cats, 81 were evaluable on day 56, and 68 (84.0%) were treatment successes. Decreases in mean serum glucose, fructosamine, and β-hydroxybutyrate (β-OHB) concentrations were observed, and investigator assessments of cat neurological status, musculature, and hair coat quality improved. Owner evaluations of both cat and owner quality of life were favorable. The fructosamine half-life in diabetic cats was found to be 6.8 days. Commonly observed adverse events included emesis, diarrhea, anorexia, lethargy, and dehydration. Eight cats experienced serious adverse events, 3 of which led to death or euthanasia. The most important adverse event was euglycemic diabetic ketoacidosis, diagnosed in 3 cats and presumed present in a fourth. CONCLUSION AND CLINICAL IMPORTANCE Bexagliflozin decreased hyperglycemia and observed clinical signs in cats newly diagnosed with DM. As a once-daily PO medication, bexagliflozin may simplify management of DM in cats.
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Affiliation(s)
| | | | | | - Samuel Geller
- Quakertown Veterinary ClinicQuakertownPennsylvaniaUSA
| | | | | | - J. Catharine Scott‐Moncrieff
- Department of Veterinary Clinical SciencesPurdue University College of Veterinary MedicineWest LafayetteIndianaUSA
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Mott J, Gilor C. Glucose Counterregulation: Clinical Consequences of Impaired Sympathetic Responses in Diabetic Dogs and Cats. Vet Clin North Am Small Anim Pract 2023; 53:551-564. [PMID: 36898860 DOI: 10.1016/j.cvsm.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Insulin induced hypoglycemia (IIH) is common in veterinary patients and limits the clinician's ability to obtain adequate glycemic control with insulin therapy. Not all diabetic dogs and cats with IIH exhibit clinical signs and hypoglycemia might be missed by routine blood glucose curve monitoring. In diabetic patients, counterregulatory responses to hypoglycemia are impaired (lack of decrease in insulin levels, lack of increase in glucagon, and attenuation of the parasympathetic and sympathoadrenal autonomic nervous systems) and have been documented in people and in dogs but not yet in cats. Antecedent hypoglycemic episodes increase the patient's risk for future severe hypoglycemia.
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Affiliation(s)
- Jocelyn Mott
- College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32610-0126, USA
| | - Chen Gilor
- Small Animal Internal Medicine, College of Veterinary Medicine, University of Florida, 2015 Southwest 16th Avenue, Gainesville, FL 32610-0126, USA.
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Rothlin‐Zachrisson N, Öhlund M, Röcklinsberg H, Ström Holst B. Survival, remission, and quality of life in diabetic cats. J Vet Intern Med 2023; 37:58-69. [PMID: 36637031 PMCID: PMC9889602 DOI: 10.1111/jvim.16625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 12/16/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Remission is documented in a substantial proportion of cats with diabetes. The effects of diabetes mellitus (DM) on the lives of cats and their owners should be considered when evaluating treatment success. OBJECTIVES To study outcome in cats with DM and the impact DM has on the life situation of cat and owner. ANIMALS Domestic and pedigree cats with a diagnosis of DM (n = 477) insured by a Swedish insurance company during 2009 to 2013. METHODS Retrospective cross-sectional study. A questionnaire was sent to 1369 owners of cats diagnosed with DM. The questions concerned the cat, treatment, owner perceptions of the disease and treatment and disease outcome. Data were analyzed using multiple linear and logistic regression, with outcomes set as survival for more than 4 weeks after diagnosis, survival time, achieving remission, remission without relapse and quality of life (QoL) for the cat. RESULTS The response rate was 35%, leaving 477 questionnaires for analysis. The remission rate among treated cats was 29% (118/405). Feeding a commercially available wet diet was associated with both remission (OR 3.16, 95% confidence interval 1.27-8.12) and remission without relapse (OR 14.8, 95% confidence interval 2.25-153.8). Remission was associated with a better QoL for the cat. CONCLUSIONS AND CLINICAL IMPORTANCE The association between feeding a commercially available wet diet and remission is important and strengthens the role of diet in treatment of DM in cats. Linking remission and a better QoL for the cat emphasizes remission as a goal in disease management.
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Affiliation(s)
| | | | - Helena Röcklinsberg
- Department of Animal Environment and HealthSwedish University of Agricultural SciencesUppsalaSweden
| | - Bodil Ström Holst
- Department of Clinical SciencesSwedish University of Agricultural SciencesUppsalaSweden
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Viebrock KA, Dennis J. Hypoglycemic episodes in cats with diabetes mellitus: 30 cases (2013-2015). J Feline Med Surg 2017; 20:563-570. [PMID: 28816090 DOI: 10.1177/1098612x17722853] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objectives The purpose of this study was to review the characteristics of diabetic cats presenting to a specialty and emergency center for signs attributed to hypoglycemia and to identify the factors that may have contributed to the hypoglycemic episode, the patient's clinical signs and laboratory findings, and the response of hypoglycemic cats to therapy. Methods Twenty-eight cats were presented a total of 30 times for symptomatic hypoglycemia. Data were collected from cat owners at the time of presentation and from subsequent patient records. Results The majority of cats presented for neurologic signs attributed to the reduced ingestion or subsequent vomiting of a meal after insulin had been administered or the accidental double-dosing of insulin. Concurrent illnesses that may have affected insulin requirements were also common. Conclusions and relevance Cats that demonstrated clinical improvement within 12 h of treatment were more likely to recover despite their mental status and glucose level on presentation.
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Affiliation(s)
| | - Jeff Dennis
- Internal Medicine, BluePearl, Overland Park, KS, USA
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5
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Gostelow R, Hazuchova K, Scudder C, Forcada Y, Church D, Niessen SJM. Prospective evaluation of a protocol for transitioning porcine lente insulin-treated diabetic cats to human recombinant protamine zinc insulin. J Feline Med Surg 2017; 20:114-121. [DOI: 10.1177/1098612x17697482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The objective was to evaluate a nadir-led protocol for transitioning porcine lente insulin suspension (PLIS)-treated diabetic cats onto human recombinant protamine zinc insulin (PZIR). Methods Recently diagnosed (<5 months) diabetic cats, treated with PLIS q12h for ⩾6 weeks, were recruited. Fructosamine, 24 h blood glucose curve (BGC), quality of life assessment (DIAQoL-pet score) and Diabetic Clinical Score (DCS) were assessed at enrolment (PLIS-treated) and 2, 4 and 12 weeks after transitioning to PZIR (starting dose 0.2–0.7 U/kg q12h). Short duration of insulin action was defined as <9 h. Linear mixed effects modelling assessed for change in fructosamine, mean blood glucose (MBG) during BGCs, DIAQoL-pet score, DCS and q12h insulin dose. McNemar’s tests compared the proportion of cats with hypoglycaemia at week 0 (PLIS-treated) and week 4 (PZIR-treated). Results Twenty-two cats were recruited. Median PLIS dose at enrolment was 0.5 U/kg (interquartile range 0.3–0.7 U/kg) q12h, equalling median PZIR starting dose (0.5 U/kg; interquartile range 0.3–0.7 U/kg q12h). Transitioning was followed by significant decreases in fructosamine ( P = 0.00007), insulin dose ( P = 0.02), DCS ( P = 8.1 × 10−8) and DIAQoL-pet score ( P = 0.003), indicating improved quality of life. MBG did not alter significantly ( P = 0.1). Five cats (22.7%) achieved remission. Hypoglycaemia was recorded in 30/190 12 h BGCs (15.8%) and five cats experienced clinical hypoglycaemia. The proportion of cats with hypoglycaemia did not differ between PLIS (week 0) and PZIR (week 4) ( P = 1.0). Duration of action was analysed in 19 cats. Six cats (31.6%) showed short duration of action on PLIS, compared with two cats (10.5%) after 4 weeks on PZIR. All six cats with short PLIS duration showed duration of ⩾9 h on PZIR. Conclusions and relevance Used alongside a low-carbohydrate diet, transitioning to PZIR was associated with significantly improved clinical signs and quality of life, with some cats achieving remission. Transition to PZIR should be considered for cats with short duration of action on PLIS.
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Affiliation(s)
- Ruth Gostelow
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Katarina Hazuchova
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Christopher Scudder
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Yaiza Forcada
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - David Church
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
| | - Stijn JM Niessen
- Diabetic Remission Clinic, Department of Clinical Science and Services, The Royal Veterinary College, London, UK
- Newcastle Medical School, Newcastle upon Tyne, UK
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Sparkes AH, Cannon M, Church D, Fleeman L, Harvey A, Hoenig M, Peterson ME, Reusch CE, Taylor S, Rosenberg D. ISFM Consensus Guidelines on the Practical Management of Diabetes Mellitus in Cats. J Feline Med Surg 2015; 17:235-50. [DOI: 10.1177/1098612x15571880] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Practical relevance: Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. Clinical challenges: Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently – unless hypoglycaemia is encountered. Evidence base: The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a consensus view on practical management of cats with DM based on available clinical data and experience. However, in many areas, substantial data are lacking and there is a need for better studies in the future to help inform and refine recommendations for the clinical management of this common disease.
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Affiliation(s)
| | | | - David Church
- Professor, Small Animal Medicine and Surgery Group, The Royal Veterinary College, North Mymms, Hatfield, Hertfordshire AL9 7TA, UK
| | - Linda Fleeman
- Animal Diabetes Australia, Rowville Veterinary Clinic, Rowville, VIC 3178, Australia
| | - Andrea Harvey
- Small Animal Specialist Hospital, North Ryde, NSW 2113, Australia
| | - Margarethe Hoenig
- Professor, Department of Veterinary Clinical Medicine, University of Illinois College of Veterinary Medicine, Urbana-Champaign, Illinois, USA
| | - Mark E Peterson
- Animal Endocrine Clinic, 21 West 100th Street, New York, NY 10025, USA
| | - Claudia E Reusch
- Professor & Director, Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | | | - Dan Rosenberg
- Micen Vet Centre, 58 Rue Auguste Perret, Parc Technologique, Europarc, 9400 Créteil, France
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Systematic review of feline diabetic remission: separating fact from opinion. Vet J 2014; 202:208-21. [PMID: 25312717 DOI: 10.1016/j.tvjl.2014.08.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 07/22/2014] [Accepted: 08/15/2014] [Indexed: 12/30/2022]
Abstract
It is increasingly recognised that diabetic remission is possible in the cat. This systematic review, following Cochrane Collaboration (CC) guidelines, critically appraises the level of evidence on factors influencing remission rate and factors predicting remission. A systematic online, bibliographic search and reference list examination was conducted. A level of evidence was assigned to each identified article by five internists using the Newcastle-Ottawa Scale for follow-up, cohort, case-series and case-control studies, the CC's risk of bias tool for trials and the Cochrane Effective Practice and Organisation of Care Group risk of bias criteria for before and after trials. Twenty-two studies were included in the review, assessing influence of pharmaceutical intervention (n = 14) and diet (n = 4), as well as diagnostic tests (n = 9) and feline patient characteristics (n = 5) as predictors of remission. The current level of evidence was found to be moderate to poor. Common sources of bias included lack of randomisation and blinding among trials, and many studies were affected by small sample size. Failure to provide criteria for the diagnosis of diabetes, or diabetic remission, and poor control of confounding factors were frequent causes of poor study design. Addressing these factors would significantly strengthen future research and ultimately allow meta-analyses to provide an excellent level of evidence. No single factor predicts remission and successful remission has been documented with a variety of insulin types and protocols. Dietary carbohydrate reduction might be beneficial, but requires further study. A lack of well-designed trials prevents reliable remission rate comparison. Factors associated with remission resemble those in human medicine and support the hypothesis that reversal of glucotoxicity is a major underlying mechanism for feline diabetic remission.
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8
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Aptekmann KP, Armstrong J, Coradini M, Rand J. Owner Experiences in Treating Dogs and Cats Diagnosed With Diabetes Mellitus in the United StatesS. J Am Anim Hosp Assoc 2014; 50:247-53. [DOI: 10.5326/jaaha-ms-6101] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The objective of this study was to report owner experiences and satisfaction in treating a pet with diabetes mellitus using a descriptive report from an Internet-based survey. Descriptive analysis of results was performed, χ2 tests were used to detect differences in responses between dog and cat owners, and correlations were assessed using the nonparametric Spearman rank correlation. A total of 834 owners participated in the survey. More diabetic dogs (97%) than cats (82%) were treated with insulin injections. Insulin was administered twice daily in 87% of dogs and 73% of cats. Porcine lente and neutral protamine Hagedorn were the most commonly administered insulins in dogs. In cats, glargine and protamine zinc insulin were the most commonly used insulins. Most pets were not fed a prescribed diabetes diet. More cat (66%) than dog (50%) owners were satisfied with the diabetic control achieved. Cat owners were more likely to use home blood glucose monitoring. Treatment was considered expensive by the majority of owners. Few published reports follow diabetic pets after diagnosis or report owner satisfaction. The results of this study provide useful information that may help veterinarians better educate owners and set expectations regarding diabetes treatment and quality of life for diabetic pets.
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Affiliation(s)
- Karina P. Aptekmann
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Jane Armstrong
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Marcia Coradini
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
| | - Jacquie Rand
- Departamento de Medicina Veterinária, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, Alegre, Espírito Santo, Brazil (K.A.); Veterinary Clinical Sciences Department, College of Veterinary Medicine, University of Minnesota, St. Paul, MN (J.A.); and Centre for Companion Animal Health, School of Veterinary Medicine, The University of Queensland, Brisbane, Australia (M.C., J.R.)
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9
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Hoelmkjaer KM, Spodsberg EMH, Bjornvad CR. Insulin detemir treatment in diabetic cats in a practice setting. J Feline Med Surg 2014; 17:144-51. [DOI: 10.1177/1098612x14538642] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Insulin detemir is a long-acting insulin analogue and may represent a valuable treatment option for diabetic cats. So far, only one study addressing detemir treatment of diabetic cats has been published, and this was based on an intensive blood glucose monitoring protocol. The aim of the current, retrospective study was to evaluate the effect of detemir therapy in diabetic cats in a general clinical setting. Fourteen diabetic cats with a follow-up period of at least 3 months were included. Data were collected from medical records at the University Hospital for Companion Animals, University of Copenhagen, Denmark. Thirteen of 14 cats achieved moderate or excellent control of clinical symptoms within the initial 3 months of detemir therapy, including five cats previously treated unsuccessfully with other types of insulin. Clinical improvements were noted after 1 month of therapy and continued over time. Three cats achieved remission within the initial 3 months and none experienced a diabetic relapse during the study period. One cat achieved remission after 13 months of therapy. Improvements in clinical symptoms were markedly better than indicated by blood glucose and serum fructosamine concentrations. The safety of detemir was very high, with only two reported episodes of clinical hypoglycaemia, neither of which required veterinary attention. Based on these results detemir can be recommended for the treatment of diabetic cats, including cats previously treated unsuccessfully with other types of insulin.
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10
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Bloom CA, Rand JS. Diabetes and the Kidney in Human and Veterinary Medicine. Vet Clin North Am Small Anim Pract 2013; 43:351-65. [DOI: 10.1016/j.cvsm.2012.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Smith JR, Vrono Z, Rapoport GS, Turek MM, Creevy KE. A survey of southeastern United States veterinarians’ preferences for managing cats with diabetes mellitus. J Feline Med Surg 2012; 14:716-22. [DOI: 10.1177/1098612x12450169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study evaluated primary practitioners’ perceptions of managing feline diabetics. Surveys distributed during local continuing education events achieved a response rate of 46% (90/195). A mean of 74% feline diabetics required chronic insulin; 26% were transient diabetics. Choice of insulin was most influenced by duration of action: human recombinant protamine zinc insulin was ranked first (42%) and glargine second (27%). Dietary management was always/usually recommended by 97% respondents, with prescription or proprietary low-carbohydrate, high-protein diets recommended in 93% responses. More recent graduates ( P = 0.0419), those who worked in larger practices ( P = 0.0315), and those who saw more transient diabetics ( P = 0.0288) were more likely to recommend dietary change. In-house blood glucose curves (BGCs) were the most popular method of assessing glycemic control, while at-home BGCs were least popular, although their use correlated positively with annual diabetic caseload (r = 0.43, P = 0.0239). Owners mishandling insulin was cited as the most common cause of poor glycemic control, while clinical signs of acromegaly were rarely recognized.
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Affiliation(s)
- Jo R Smith
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Zak Vrono
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Gregg S Rapoport
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Michelle M Turek
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
- Department of Anatomy and Radiology, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Kate E Creevy
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
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Scott-Moncrieff JCR, Moore GE, Coe J, Lynn RC, Gwin W, Petzold R. Characteristics of commercially manufactured and compounded protamine zinc insulin. J Am Vet Med Assoc 2012; 240:600-5. [DOI: 10.2460/javma.240.5.600] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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13
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Maggiore AD, Nelson RW, Dennis J, Johnson E, Kass PH. Efficacy of Protamine Zinc Recombinant Human Insulin for Controlling Hyperglycemia in Dogs with Diabetes Mellitus. J Vet Intern Med 2011; 26:109-15. [DOI: 10.1111/j.1939-1676.2011.00861.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 11/13/2011] [Accepted: 11/23/2011] [Indexed: 11/26/2022] Open
Affiliation(s)
| | | | - J. Dennis
- BluePearl Specialty and Emergency Medicine for Pets-; Kansas City; Kansas City; KS
| | - E. Johnson
- Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis; CA
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CLARK M, THOMASETH K, HEIT M, HOENIG M. Pharmacokinetics and pharmacodynamics of protamine zinc recombinant human insulin in healthy dogs. J Vet Pharmacol Ther 2011; 35:342-50. [DOI: 10.1111/j.1365-2885.2011.01329.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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15
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Jiang Y, Shi K, Xia D, Piao H, Quan P, Song T, Cui F. Protamine modified metal ion–protein chelate microparticles for sustained release of interferon. Int J Pharm 2011; 407:31-7. [DOI: 10.1016/j.ijpharm.2011.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 11/28/2010] [Accepted: 01/05/2011] [Indexed: 11/29/2022]
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Gilor C, Graves TK, Lascelles BDX, Thomson AE, Simpson W, Halpern DS. ORIGINAL RESEARCH: The effects of body weight, body condition score, sex, and age on serum fructosamine concentrations in clinically healthy cats. Vet Clin Pathol 2010; 39:322-8. [DOI: 10.1111/j.1939-165x.2010.00227.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nelson R, Henley K, Cole C. Field Safety and Efficacy of Protamine Zinc Recombinant Human Insulin for Treatment of Diabetes Mellitus in Cats. J Vet Intern Med 2009; 23:787-93. [DOI: 10.1111/j.1939-1676.2009.0342.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Treatment of 46 cats with porcine lente insulin – a prospective, multicentre study. J Feline Med Surg 2008; 10:439-51. [DOI: 10.1016/j.jfms.2007.10.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2007] [Indexed: 11/21/2022]
Abstract
This prospective, multicentre, non-blinded, open study followed 46 cats with diabetes mellitus during treatment with porcine lente insulin (also known as porcine insulin zinc suspension, Caninsulin®, Intervet) for 16±1 weeks (stabilization phase), with additional monitoring of some cats ( n=23) for a variable period. At least three of the following were present at initial presentation: appropriate history of clinical signs consistent with diabetes mellitus, glucosuria, blood glucose greater than 15 mmol/l and fructosamine greater than 380 μmol/l. Insulin treatment was started at a dose rate of 0.25–0.5 IU/kg body weight twice daily, with a maximum starting dose of 2 IU/injection. Twenty-eight of the cats were classed as reaching clinical stability during the study, in 23 of these cats this was during the stabilization phase. Seven cats went into remission during the stabilization phase and one of the cats in week 56. Clinical signs of hypoglycaemia, significantly associated with a dose of 3 units or 0.5 IU/kg or more per cat (twice daily), were observed in nine of the 46 cats during the stabilization phase and concomitant biochemical hypoglycaemia was recorded in most cases. Biochemical hypoglycaemia, recorded in 6% of the blood glucose curves performed during the stabilization phase, was significantly associated with a dose rate of 0.75 IU/kg or more twice daily. This further highlights the need for cautious stepwise changes in insulin dose. The protocol used in the present study is suitable for and easy to use in practice. This study confirmed the efficacy and safety of porcine lente insulin (Caninsulin®) in diabetic cats under field conditions.
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Behrend EN. Update on Drugs Used to Treat Endocrine Diseases in Small Animals. Vet Clin North Am Small Anim Pract 2006; 36:1087-105, vii. [PMID: 16984828 DOI: 10.1016/j.cvsm.2006.05.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Drug therapy for the endocrine system is implemented to replace a hormone deficiency or to prevent or reduce the formation or effects of excess hormone. Treatment of endocrine disorders covers diseases of the pituitary, adrenal, parathyroid, and thyroid glands as well as the endocrine pancreas. This article focuses on new therapies currently available for specific diseases. Administration of trilostane for treatment of hyperadrenocorticism and use of insulin glargine, protamine zinc insulin (PZI), and porcine Lente insulin for diabetes mellitus are discussed. In addition, transdermal methimazole therapy for treatment of feline hyperthyroidism and administration of progestins for pituitary dwarfism are considered.
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Affiliation(s)
- Ellen N Behrend
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL 36849, USA.
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Weaver KE, Rozanski EA, Mahony OM, Chan DL, Freeman LM. Use of Glargine and Lente Insulins in Cats with Diabetes Mellitus. J Vet Intern Med 2006. [DOI: 10.1111/j.1939-1676.2006.tb02851.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Webb CB. Troubleshooting the diabetic small animal patient. CLINICAL TECHNIQUES IN SMALL ANIMAL PRACTICE 2002; 17:79-85. [PMID: 12219721 DOI: 10.1053/svms.2002.33037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Effective troubleshooting for a diabetic small animal patient starts with the initial diagnosis of diabetes. Preempting trouble with a thorough and complete history, physical examination, laboratory assessment, and extensive and thoughtful client education before discharge, are crucial first steps toward avoiding trouble altogether. As problems arise, careful consideration of the many variables that contribute to effective diabetic control is necessary. As monitoring strategies evolve and treatment options expand, the clinician's ability to accurately assess and adjust the glycemic control in his or her troubled diabetic patient improves. Common causes of trouble in diabetic patients are reviewed and various strategies for the diagnosis and management of these disorders are discussed in this article. Every effort was made to draw from recently published reports of clinical cases. Few diseases will tie together owner, patient, and therapy as intimately as diabetes mellitus, and few problems will be solved without fully considering all potential factors.
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Affiliation(s)
- Craig B Webb
- Colorado State University, Veterinary Teaching Hospital, 300 West Drake Rd, Ft. Collins, CO 80523, USA
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