Veterinary Clinics of North America: Small Animal Practice Veterinary Clinics of North America: Small Animal Practice RSS feedThis is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Insulin Therapy in Small Animals, Part 2: Cats
No insulin formulation should be considered best by default for management of feline diabetes. Rather, the choice of insulin formulation should be tailored to the specific clinical situation. In most cats that have some residual beta cell function, administering only a basal insulin might lead to complete normalization of blood glucose concentrations. Basal insulin requirements are constant throughout the day. Therefore, for an insulin formulation to be effective and safe as a basal insulin, its action should be roughly the same every hour of the day. At present, only insulin glargine U300 approaches this definition in cat...
Source: Veterinary Clinics of North America: Small Animal Practice - March 9, 2023 Category: Veterinary Research Authors: Linda Fleeman, Chen Gilor Source Type: research

Insulin Therapy in Small Animals, Part 1: General Principles
Understanding the pharmacology of insulin and how it relates to the pathophysiology of diabetes can lead to better clinical outcomes. No insulin formulation should be considered “best” by default. Insulin suspensions (NPH, NPH/regular mixes, lente, and PZI) as well as insulin glargine U100 and detemir are intermediate-acting formulations that are administered twice daily. For a formulation to be an effective and safe basal insulin, its action should be roughly the same every hour of the day. Currently, only insulin glargine U300 and insulin degludec meet this standard in dogs, whereas in cats, insulin glargine U300 is ...
Source: Veterinary Clinics of North America: Small Animal Practice - March 9, 2023 Category: Veterinary Research Authors: Linda Fleeman, Chen Gilor Source Type: research

Insulin Therapy in Small Animals, Part 3: Dogs
Insulin therapy should ideally mimic a basal-bolus pattern. Lente, NPH, NPH/regular mixes, PZI, glargine U100, and detemir are intermediate-acting formulations that are administered twice daily in dogs. To minimize hypoglycemia, intermediate-acting insulin protocols are usually geared towards alleviating (but not eliminating) clinical signs. Insulin glargine U300 and insulin degludec meet the criteria for an effective and safe basal insulin in dogs. In most dogs, good control of clinical signs is achieved when using a basal insulin alone. In a small minority, bolus insulin at the time of at least one meal per day may be ad...
Source: Veterinary Clinics of North America: Small Animal Practice - March 9, 2023 Category: Veterinary Research Authors: Linda Fleeman, Chen Gilor Source Type: research

Insulin Therapy Part 3: Cats
No insulin formulation should be considered best by default for management of feline diabetes. Rather, the choice of insulin formulation should be tailored to the specific clinical situation. In most cats that have some residual beta cell function, administering only a basal insulin might lead to complete normalization of blood glucose concentrations. Basal insulin requirements are constant throughout the day. Therefore, for an insulin formulation to be effective and safe as a basal insulin, its action should be roughly the same every hour of the day. At present, only insulin glargine U300 approaches this definition in cat...
Source: Veterinary Clinics of North America: Small Animal Practice - March 9, 2023 Category: Veterinary Research Authors: Linda Fleeman, Chen Gilor Source Type: research

Hypersomatotropism and Other Causes of Insulin Resistance in Cats
True insulin resistance should be differentiated from management-related difficulties (eg, short insulin duration, inappropriate insulin injection, inappropriate storage). Hypersomatotropism (HST) is the number one cause of insulin resistance in cats, with hypercortisolism (HC) occupying a more distant second place. Serum insulinlike growth factor-1 is adequate for screening for HST, and screening at the time of diagnosis, regardless of presence of insulin resistance, is advocated. Treatment of either disease centers on removal of the overactive endocrine gland (hypophysectomy, adrenalectomy) or inhibition of the pituitary...
Source: Veterinary Clinics of North America: Small Animal Practice - March 9, 2023 Category: Veterinary Research Authors: Stijn J.M. Niessen Source Type: research

Cushing ’s Syndrome and Other Causes of Insulin Resistance in Dogs
The most common causes of insulin resistance in diabetic dogs are Cushing syndrome, diestrus, and obesity. Cushing-associated effects include insulin resistance, excessive postprandial hyperglycemia, perceived short duration of insulin action, and/or substantial within-day and/or day-to-day glycemic variability. Successful strategies to manage excessive glycemic variability include basal insulin monotherapy and combined basal-bolus insulin treatment. Ovariohysterectomy and insulin treatment can achieve diabetic remission in about 10% of cases of diestrus diabetes. Different causes of insulin resistance have an additive eff...
Source: Veterinary Clinics of North America: Small Animal Practice - March 8, 2023 Category: Veterinary Research Authors: Linda Fleeman, Renea Barrett Source Type: research

Glucose Counterregulation
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 de crease 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 ep...
Source: Veterinary Clinics of North America: Small Animal Practice - March 8, 2023 Category: Veterinary Research Authors: Jocelyn Mott, Chen Gilor Source Type: research

Diabetes Ketoacidosis and Hyperosmolar Hyperglycemic Syndrome in Companion Animals
Diabetes mellitus is a common endocrinopathy in dogs and cats. Diabetes ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are life-threatening complications of diabetes resulting from an imbalance between insulin and the glucose counter-regulatory hormones. The first part of this review focuses on the pathophysiology of DKA and HHS, and rarer complications such as euglycemic DKA and hyperosmolar DKA. The second part of this review focuses on the diagnosis and treatment of these complications. (Source: Veterinary Clinics of North America: Small Animal Practice)
Source: Veterinary Clinics of North America: Small Animal Practice - March 8, 2023 Category: Veterinary Research Authors: Arnon Gal, Adesola Odunayo Source Type: research

Cushing Syndrome and Other Causes of Insulin Resistance in Dogs
The most common causes of insulin resistance in diabetic dogs are Cushing syndrome, diestrus, and obesity. Cushing-associated effects include insulin resistance, excessive postprandial hyperglycemia, perceived short duration of insulin action, and/or substantial within-day and/or day-to-day glycemic variability. Successful strategies to manage excessive glycemic variability include basal insulin monotherapy and combined basal-bolus insulin treatment. Ovariohysterectomy and insulin treatment can achieve diabetic remission in about 10% of cases of diestrus diabetes. Different causes of insulin resistance have an additive eff...
Source: Veterinary Clinics of North America: Small Animal Practice - March 8, 2023 Category: Veterinary Research Authors: Linda Fleeman, Renea Barrett Source Type: research

Pathophysiology of Prediabetes, Diabetes, and Diabetic Remission in Cats
Diabetes mellitus (DM) has a heterogenous cause, and the exact pathogenesis differs between patients. Most diabetic cats have a cause similar to human type 2 DM but, in some, DM is associated with underlying conditions, such as hypersomatotropism, hyperadrenocorticism, or administration of diabetogenic drugs. Predisposing factors for feline DM include obesity, reduced physical activity, male sex, and increasing age. Gluco(lipo)toxicity and genetic predisposition also likely play roles in pathogenesis. Prediabetes cannot be accurately diagnosed in cats at the current time. Diabetic cats can enter remission, but relapses are...
Source: Veterinary Clinics of North America: Small Animal Practice - March 8, 2023 Category: Veterinary Research Authors: Ruth Gostelow, Katarina Hazuchova Source Type: research

Nutritional Management of Cats and Dogs with Diabetes Mellitus
This article reviews the nutritional assessment and management of diabetic dogs and cats. It discusses how to determine appropriate nutritional goals for individual patients, including comorbid patients with diabetes. Considerations for macronutrient and micronutrient modifications will be reviewed. (Source: Veterinary Clinics of North America: Small Animal Practice)
Source: Veterinary Clinics of North America: Small Animal Practice - February 27, 2023 Category: Veterinary Research Authors: Valerie J. Parker, Richard C. Hill Source Type: research

Anesthetic Considerations in Dogs and Cats with Diabetes Mellitus
Understanding the effects of diabetes and hyperglycemia on hydration, acid –base status, and immune function is paramount to safely anesthetizing diabetic cats and dogs. Preoperative stabilization of glucose concentrations, hydration, and electrolyte imbalances is key to minimizing morbidity and mortality. Blood glucose monitoring perioperatively will help guide insulin and dextrose administration. Specific anesthetic considerations, and peri-anesthetic management of animals with diabetes mellitus, including anesthetic drugs and recommended insulin protocols are discussed. (Source: Veterinary Clinics of North America: Small Animal Practice)
Source: Veterinary Clinics of North America: Small Animal Practice - February 26, 2023 Category: Veterinary Research Authors: Renata S. Costa, Teela Jones Source Type: research

The Future of Diabetes Therapies
As the prevalence of diabetes mellitus increases, so too does the number of available treatment modalities. Many diabetic therapies available in human medicine or on the horizon could hold promise in the management of small animal diabetes. However, it is important to consider how species differences in pathophysiology, management practices and goals, and lifestyle may affect the translation of such treatment modalities for veterinary use. This review article aimed to familiarize veterinarians with the more promising novel diabetic therapies and explore their possible applications in the treatment of canine and feline diab...
Source: Veterinary Clinics of North America: Small Animal Practice - February 26, 2023 Category: Veterinary Research Authors: Jennifer M. Reinhart, Thomas K. Graves Source Type: research

Etiology and Pathophysiology of Diabetes Mellitus in Dogs
Canine diabetes results from a wide spectrum of clinical pathophysiological processes that cause a similar set of clinical signs. Various causes of insulin deficiency and beta cell loss, insulin resistance, or both characterize the disease, with genetics and environment playing a role. Understanding the genetic and molecular causes of beta cell loss will provide future opportunities for precision medicine, both from a therapeutic and preventative perspective. This review presents current knowledge of the etiology and pathophysiology of canine diabetes, including the importance of disease classification. Examples of potenti...
Source: Veterinary Clinics of North America: Small Animal Practice - February 26, 2023 Category: Veterinary Research Authors: Allison L. O ’Kell, Lucy J. Davison Source Type: research

Diabetes Mellitus and the Kidneys
The pathomechanisms implicated in diabetic kidney disease in people are present in dogs and cats and, in theory, could lead to renal complications in companion animals with long-standing diabetes mellitus. However, these renal complications develop during a long period, and there is little to no clinical evidence that they could lead to chronic kidney disease in companion animals. (Source: Veterinary Clinics of North America: Small Animal Practice)
Source: Veterinary Clinics of North America: Small Animal Practice - February 26, 2023 Category: Veterinary Research Authors: Arnon Gal, Richard K. Burchell Source Type: research