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Prevalence of feline diabetes mellitus in a feline private practice [abstract]
... Less is understood about how the level of exercise and activity in dogs and cats relates to obesity. For dogs, reduced daily exercise has been associated with obesity (Bland et al., 2009;Courcier et al., 2010a), as has limited or no outdoor activity for cats (Rowe et al., 2015). ...
... The price of pet food has been found to be associated with obesity; owners of obese dogs are more likely to indicate the importance of inexpensive foods (Kienzle et al., 1998). Obesity has also been associated with the number of meals and snacks fed and feeding of kitchen/table scraps, fresh meat and commercial treats for dogs (Kienzle et al., 1998;Bland et al., 2009;Sallander et al., 2010) as well as feeding ad libitum in cats (Courcier et al., 2010b) Human-related (i.e. pet owner) risk factors for canine and feline obesity include owner household income and exercise habits (Kienzle et al., 1998;Courcier et al., 2010a). ...
... In the USA, one study reports that feline diabetes has increased from 0.08% to 1.2% in 30 years (Prahl et al., 2007) and a prevalence of 0.4% has been recorded in the UK (McCann et al., 2007). Risk factors for type 2 diabetes include obesity and increasing age (Rand, 1997;Baral et al., 2003;McCann et al., 2007). Most affected cats are >8 years of age, and most commonly between 10 and 12 years old, when they get diabetes (Rand, 1997;McCann et al., 2007;Lederer et al., 2007). ...
This article reviews the biology, prevalence and risks for obesity in people and companion dogs and cats, and explores the links between obesity and diabetes mellitus and cancer across these species. Obesity is a major healthcare problem in both human and veterinary medicine and there is an increasing prevalence of obesity in people and pets. In people and animals, obesity is a complex disorder involving diet, level of physical activity, behavioural factors, socioeconomic factors, environment exposures, genetics, metabolism and the microbiome. Pets and people share a number of obesity-related comorbidities. Obesity is a major risk factor for type 2 diabetes mellitus in people and in cats, but this association is not recognized in dogs. Obesity is a recognized risk factor for a number of human cancers, but there are fewer data available describing this association with canine neoplastic disease. One approach to addressing the problem of obesity is by taking a ‘One Health’ perspective. Comparative clinical research examining shared lifestyle and environmental risk factors and the reasons underlying species differences should provide new perspectives on the fundamental biology of obesity. One Health programmes involving human healthcare professionals and veterinarians could help address obesity with simple interventions at the community level.
... Diabetes mellitus is the second most common endocrine disease in domestic cats, and some cats achieve remission of their diabetes with appropriate treatment. [1][2][3] Diabetes can be a challenging diagnosis for owners, because treatment and management typically require twice-daily insulin injections and monitoring, which can include frequent trips to the veterinary clinic. Costs, quality of life for the cat and an impact on the owner's schedule may make clients reluctant to pursue treatment. ...
... 6,28,29 Diabetes is almost four times more common in Burmese cats in Australia, the UK and Europe, and Burmese was the second most common breed (21%) in our study. 2,3,30 Burmese cats managed with this protocol were five times more likely to achieve remission than other breeds and were more likely to have increased survival. A study of 93 diabetic cats reported that age at diagnosis was significantly higher in Burmese cats compared with other breeds (13.6 vs 10.9 years), and it has also been reported that remission is more likely in cats with a higher age at diagnosis. ...
Objectives
The aim of the present study was to retrospectively assess remission rates and survival in diabetic cats managed using a moderate-intensity, low-cost protocol of home blood glucose measurements and insulin adjustment by clients of a cat-only practice, and to determine if predictors of remission, relapse or survival could be identified.
Methods
The records of a cat-only practice were used to identify 174 cats with newly diagnosed diabetes managed using only pre-insulin home blood glucose measurements for insulin dose adjustments based on a protocol provided to clients aimed at maintaining pre-insulin blood glucose in the range of 6.5–11.9 mmol/l (117–214 mg/dl). Cats were excluded for the following reasons: insufficient follow-up in the records; a lack of owner compliance was recorded; they were receiving ongoing corticosteroids for the management of other conditions; they were euthanased at the time of diagnosis; or they were diagnosed with acromegaly or hyperadrenocorticism.
Results
Using only pre-insulin blood glucose measurements at home to adjust the insulin dose to maintain glucose in the range of 6.5–11.9 mmol/l, 47% of cats achieved remission, but 40% of those cats relapsed. A minority (16%) of cats were hospitalised for hypoglycaemia. The survival time was significantly longer in cats in remission and Burmese cats.
Conclusions and relevance
The cost and time burden of treating diabetic cats may cause some clients to choose euthanasia over treatment. While the highest rates of diabetic remission have been reported in studies of newly diagnosed cats treated with intensive long-acting insulin protocols and low carbohydrate diets, these protocols may not be suitable for all clients. Nearly 50% of cats with newly diagnosed diabetes achieved remission with this low-cost, moderate-intensity, insulin dosing protocol. As remission was significantly associated with survival time, discussing factors in treatment to optimise remission is important, but it is also important to offer clients a spectrum of options. No cats that started treatment in this study were euthanased because the owner did not wish to continue the diabetes treatment.
... Une diète faible en glucides, l'occurrence de la rémission, l'absence de kétoacidose diabétique, une valeur moyenne inférieure de glycémie durant le traitement et une valeur inférieure de glycémie étaient significativement associées à des temps de survie accrus. Introduction F ollowing hyperthyroidism, diabetes mellitus (DM) is the second most common endocrine disease of domestic cats (1)(2)(3). The frequency has been reported at 43/10 000 (0.43%) in all cats and 159/10 000 (1.6%) in Burmese in a population of insured cats in the UK (4), 124/10 000 (1.2%) in teaching hospitals in the US (5), 50/10 000 (0.5%) in domestic shorthair cats, and 200/10 000 (2.0%) in Burmese in a private practice in Australia (1). ...
... Introduction F ollowing hyperthyroidism, diabetes mellitus (DM) is the second most common endocrine disease of domestic cats (1)(2)(3). The frequency has been reported at 43/10 000 (0.43%) in all cats and 159/10 000 (1.6%) in Burmese in a population of insured cats in the UK (4), 124/10 000 (1.2%) in teaching hospitals in the US (5), 50/10 000 (0.5%) in domestic shorthair cats, and 200/10 000 (2.0%) in Burmese in a private practice in Australia (1). ...
This study evaluated the outcome of cats with diabetes mellitus treated with a loose-control approach using protamine zinc insulin and identified factors that influence the likelihood of remission and survival in these cats. A total of 185 client-owned domestic cats were followed until death, lost to follow-up, or the end of the 11-year study. These cats were treated primarily basing insulin dose adjustments on clinical response. Patient records were used to examine factors suspected of influencing success of diabetes management. The remission probability was 56.2%. Survival time ranged from 0 to 3808 days with a median of 1488 days. Recent pre-diabetic corticosteroid use, lower mean blood glucose concentration during treatment, and lower mean insulin dose significantly increased the likelihood of remission. A low-carbohydrate diet, occurrence of remission, lack of diabetic ketoacidosis at diagnosis, lower mean blood glucose value during treatment, and lower blood glucose value at diagnosis were significantly associated with increased survival time. © 2019 Canadian Veterinary Medical Association. All Rights Reserved.
... Diabetes mellitus is a common and serious metabolic disorder associated with many functional and structural complications. It is one of the most frequently diagnosed endocrinopathies in both humans (1) and household pets (cats and dogs) (2)(3)(4)(5). Obesity and physical inactivity are major predisposing factors in both humans (1) and pet animals (6,7). Diabetes increases the risk of fracture (8) and interferes with healing processes (9,10) by slowing bone formation. ...
This randomized experimental study was conducted to determine the effect of melatonin on bone healing processes in diabetic rats with bone defects. Adult male Sprague Dawley rats (n = 64) were divided into diabetic and control groups. The diabetic group was administered with streptozotocin (60 mg/kg BW, (intraperi-toneally) I.P.), whereas the control group was administered with saline containing 6% ethanol intraperito-neally. Defects were created in the left tibias, and rats were then administered with either saline or melatonin (10 mg/kg BW, I.P.) for 21 or 42 days. Overall, the diabetic rats had significantly higher serum glucose concentrations than the control rats (462 vs. 118 mg/dl; P<0.0001). Melatonin administration increased serum glucose by 5% in the control groups and decreased it by 43% in the diabetic groups (P<0.0001). Serum melatonin concentrations in the control rats were lower than in the diabetic rats (666 vs. 745 pmol/L; P<0.006). Melatonin administration increased serum melatonin concentrations to a similar extent in both groups (by 15%). Diabetes was associated with pathologies (degranulation, vacuolization, degeneration, and necrosis) in pancreatic β cells and aggravated inflammation indicators (P<0.0001 for all). Melatonin administration considerably decreased the number of rats with pancreatic β cell pathologies (63%) and depressed inflammation indicators (from P<0.004 to P<0.0008). Melatonin administration increased osteogenesis indicators (collagen, cartilage, and osteocyte intensities) (2.0 vs. 1.0; P<0.04) and numerically decreased inflammation indicators (macrophage, lymphocyte, and polymorph nuclear leukocyte) (1.0 vs. 2.0) at a greater extent in the diabetic rats than in the control rats. In conclusion, postoperative administration of melatonin supports bone healing in diabetic rats apparently through alleviating pancreatic cytopathology and hyperglycemia.
... Diabetes mellitus (DM) is one of the most common endocrinopathies in cats, and its incidence is increasing because of a rise in predisposing factors, such as obesity and physical inactivity. 1,23 Although DM is frequently diagnosed in cats, few studies have characterized the histopathologic changes occurring in the endocrine pancreas. In one investigation, islet lesions were found in 33 of 35 (94.3%) diabetic cats, including islet cell atrophy and hydropic degeneration (27 of 35, 77.1%) and moderate to severe amyloidosis (8 of 35, 22.9%). ...
Pancreatic amyloidosis and loss of α and β cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats (P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups (P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats (n = 8 of 37; 21.6%) than control cats (n = 1 of 20; 5.0%). The results confirm previous observations that loss of β cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with β-cell loss.
© The Author(s) 2015.
Diabetes mellitus, a common endocrinopathy affecting domestic cats, shares many clinical and pathologic features with type 2 diabetes in humans. In Australia and Europe, diabetes mellitus is almost four times more common among Burmese cats than in other breeds. As a genetically isolated population, the diabetic Australian Burmese cat provides a spontaneous genetic model for studying diabetes mellitus in humans. Studying complex diseases in pedigreed breeds facilitates tighter control of confounding factors including population stratification, allelic frequencies and environmental heterogeneity. We used the feline SNV array and whole genome sequence data to undertake a genome wide-association study and runs of homozygosity analysis, of a case–control cohort of Australian and European Burmese cats. Our results identified diabetes-associated haplotypes across chromosomes A3, B1 and E1 and selective sweeps across the Burmese breed on chromosomes B1, B3, D1 and D4. The locus on chromosome B1, common to both analyses, revealed coding and splice region variants in candidate genes, ANK1, EPHX2 and LOX2, implicated in diabetes mellitus and lipid dysregulation. Mapping this condition in Burmese cats has revealed a polygenic spectrum, implicating loci linked to pancreatic beta cell dysfunction, lipid dysregulation and insulin resistance in the pathogenesis of diabetes mellitus in the Burmese cat.
Objectives
The objectives of this study were to determine the reference interval for screening blood glucose in senior cats, to apply this to a population of obese senior cats, to compare screening and fasting blood glucose, to assess whether screening blood glucose is predicted by breed, body weight, body condition score (BCS), behaviour score, fasting blood glucose and/or recent carbohydrate intake and to assess its robustness to changes in methodology.
Methods
The study included a total of 120 clinically healthy client-owned cats aged 8 years and older of varying breeds and BCSs. Blood glucose was measured at the beginning of the consultation from an ear/paw sample using a portable glucose meter calibrated for cats, and again after physical examination from a jugular sample. Fasting blood glucose was measured after overnight hospitalisation and fasting for 18–24 h.
Results
The reference interval upper limit for screening blood glucose was 189 mg/dl (10.5 mmol/l). Mean screening blood glucose was greater than mean fasting glucose. Breed, body weight, BCS, behaviour score, fasting blood glucose concentration and amount of carbohydrate consumed 2–24 h before sampling collectively explained only a small proportion of the variability in screening blood glucose.
Conclusions and relevance
Screening blood glucose measurement represents a simple test, and cats with values from 117–189 mg/dl (6.5–10.5 mmol/l) should be retested several hours later. Cats with initial screening blood glucose >189 mg/dl (10.5 mmol/l), or a second screening blood glucose >116 mg/dl (6.4 mmol/l) several hours after the first, should have fasting glucose and glucose tolerance measured after overnight hospitalisation.
Diabetes mellitus is one of the most common endocrine disorders in dogs and cats, with an estimated prevalence of 0.3-0.6%. Diabetes in many dogs has similarities to type 1 diabetes in humans and life-long insulin therapy is needed. The vast majority of cats suffer a type-2-like form of diabetes, which is characterised by insulin resistance and &bela;-cell dysfunction. Remission is possible in 25-50% of cats with adequate and early treatment. Relapse is possible at a later stage; however, remission may also last life-long. In some animals, diabetes develops as a sequela of another disease or problem such as pancreatitis, pancreatic carcinoma, hyperadrenocorticism, acromegaly (in cats), diestrus and steroid application. Diabetes is a disease of middle-aged to old animals; in cats the male gender is overrepresented. Some dog breeds and the Burmese cat have a higher risk of diabetes due to genetic predisposition. Diabetes is diagnosed by means of hyperglycaemia and increased fructosamine. Further work-up should include a search for any concurrent disease. The therapy consists of insulin BID, diet, weight loss, cessation of diabetogenic drugs and treatment of concurrent diseases. In most cases, adequate glycaemic control can be achieved within 2-3 months; remission usually also occurs during this time. Initially, frequent re-evaluations and adjustments of the insulin dose are required.
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