R W Nelson

University of California, Davis, Davis, California, United States

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Publications (92)116.22 Total impact

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    ABSTRACT: Spontaneous hyperadrenocorticism (HAC) is rare in cats. Clinical findings, diagnostic test results, and response to various treatment options must be better characterized. To report the clinical presentation, clinicopathologic findings, diagnostic imaging results, and response to treatment of cats with HAC. Cats with spontaneous HAC. Retrospective descriptive case series. Thirty cats (15 neutered males, 15 spayed females; age, 4.0-17.6 years [median, 13.0 years]) were identified from 10 veterinary referral institutions. The most common reason for referral was unregulated diabetes mellitus; dermatologic abnormalities were the most frequent physical examination finding. Low-dose dexamethasone suppression test results were consistent with HAC in 27 of 28 cats (96%), whereas ACTH stimulation testing was suggestive of HAC in only 9 of 16 cats (56%). Ultrasonographic appearance of the adrenal glands was consistent with the final clinical diagnosis of PDH or ADH in 28 of 30 cats (93%). Of the 17 cats available for follow-up at least 1 month beyond initial diagnosis of HAC, improved quality of life was reported most commonly in cats with PDH treated with trilostane. Dermatologic abnormalities or unregulated diabetes mellitus are the most likely reasons for initial referral of cats with HAC. The dexamethasone suppression test is recommended over ACTH stimulation for initial screening of cats with suspected HAC. Diagnostic imaging of the adrenal glands may allow rapid and accurate differentiation of PDH from ADH in cats with confirmed disease, but additional prospective studies are needed.
    No preview · Article · Jan 2014 · Journal of Veterinary Internal Medicine
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    ABSTRACT: No other title offers such dedication to the depth, experience, and focus of endocrinology as Canine and Feline Endocrinology, 4th Edition. Comprehensive coverage includes virtually every common and uncommon condition in endocrinology, plus the most updated information on nutrition, geriatric care, pathophysiology, testing procedures, and cost-effective and expedient diagnostic protocols. With its logical, step-by-step guidance for decision making, diagnosis, and prescribing, you will be well-equipped to care for the wide spectrum of endocrine and metabolic disorders in dogs and cats. © 2015 by Saunders, an imprint of Elsevier Inc. All rights reserved.
    No preview · Article · Jan 2014
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    ABSTRACT: Studies in humans identified the synthesis and secretion of inhibin from adrenocortical tumors, but not pheochromocytoma (PHEO). Inhibin has not been examined in dogs as a serum biomarker for adrenal gland tumors. To determine serum inhibin concentration in dogs with adrenal gland disease and in healthy dogs. Forty-eight neutered dogs with adrenal disease including pituitary-dependent hyperadrenocorticism (PDH, 17), adrenocortical tumor (18), and PHEO (13), and 41 healthy intact or neutered dogs. Prospective observational study. Dogs were diagnosed with PDH, adrenocortical tumor (hyperadrenocorticism or noncortisol secreting), or PHEO based on clinical signs, endocrine function tests, abdominal ultrasound examination, and histopathology. Inhibin concentration was measured by radioimmunoassay in serum before and after ACTH stimulation, and before and after treatment. In neutered dogs, median inhibin concentration was significantly higher in dogs with adrenocortical tumors (0.82 ng/mL) and PDH (0.16 ng/mL) than in dogs with PHEO and healthy dogs (both undetectable). Median inhibin concentration was significantly higher in dogs with adrenocortical tumors than in those with PDH and decreased after adrenalectomy. Median inhibin concentration was significantly higher in intact than in neutered healthy dogs and was similar in pre- and post-ACTH stimulation. Sensitivity, specificity, and accuracy of serum inhibin concentration for identifying an adrenal tumor as a PHEO were 100, 88.9, and 93.6%, respectively. Adrenocortical tumors and PDH but not PHEOs are associated with increased serum inhibin concentration; undetectable inhibin is highly supportive of PHEO in neutered dogs with adrenal tumors.
    Full-text · Article · Jan 2013 · Journal of Veterinary Internal Medicine
  • A Della Maggiore · R W Nelson · J Dennis · E Johnson · P H Kass
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    ABSTRACT: Alternative insulin preparations are needed when NPH insulin is ineffective in diabetic dogs. This study evaluated the efficacy of recombinant human protamine zinc insulin (rhPZI) for treating diabetic dogs. rhPZI is effective for treating diabetic dogs. Six newly diagnosed and 11 insulin-treated diabetic dogs. Prospective clinical trial. Dogs were treated with rhPZI for 60 days. Control of glycemia was assessed on days 7, 14, 30, and 60 by evaluation of history, physical examination, body weight, serum fructosamine concentration, and blood glucose concentrations measured before and 2, 4, 6, 8, and 10 hours after rhPZI administration. Adjustments in dosage of rhPZI were made as needed to control glycemia. rhPZI administration resulted in a significant decrease in 10-hour mean blood glucose (MBG(10h) ; 299 ± 115 versus 457 ± 38 mg/dL, X ± SD, P = .0003) and serum fructosamine (478 ± 83 versus 557 ± 104 μmol/L, P = .006) concentration at day 60, compared with day 1, respectively. By day 60, polyuria and polydipsia had improved in 14, body weight was stable or increased in 16, MBG(10h) had decreased in 16, and serum fructosamine concentration had decreased in 11 of 17 dogs, compared with day 1. Hypoglycemia (<80 mg/dL) was the only consistent adverse event. rhPZI is effective in diabetic dogs and can be considered as an alternative treatment in diabetic dogs that are poorly controlled using other insulin preparations.
    No preview · Article · Dec 2011 · Journal of Veterinary Internal Medicine
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    R W Nelson · K Henley · C Cole
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    ABSTRACT: This study describes the efficacy of a new protamine zinc recombinant human insulin (PZIR) preparation for treating diabetic cats. To evaluate effects of PZIR on control of glycemia in cats with newly diagnosed or poorly controlled diabetes mellitus. One hundred and thirty-three diabetic cats 120 newly diagnosed and 13 previously treated. Prospective, uncontrolled clinical trial. Cats were treated with PZIR twice daily for 45 days. Control of glycemia was assessed on days 7, 14, 30, and 45 by evaluation of change in water consumption, frequency of urination, appetite, and body weight, serum fructosamine concentration, and blood glucose concentrations determined 1, 3, 5, 7, and 9 hours after administration of PZIR. Adjustments in dosage of PZIR were made as needed to control glycemia. PZIR administration resulted in a significant decrease in 9-hour mean blood glucose (199+/-114 versus 417+/-83 mg/dL, X+/-SD, P<.001) and serum fructosamine (375+/-117 versus 505+/-96 micromol/L, P<.001) concentration and a significant increase in mean body weight (5.9+/-1.4 versus 5.4+/-1.5 kg, P=.017) in 133 diabetic cats at day 45 compared with day 0, respectively. By day 45, polyuria and polydipsia had improved in 79% (105 of 133), 89% (118 of 133) had a good body condition, and 9-hour mean blood glucose concentration, serum fructosamine concentration, or both had improved in 84% (112 of 133) of the cats compared with day 0. Hypoglycemia (<80 mg/dL) was identified in 151 of 678, 9-hour serial blood glucose determinations and in 85 of 133 diabetic cats. Hypoglycemia causing clinical signs was confirmed in 2 diabetic cats. PZIR is effective for controlling glycemia in diabetic cats and can be used as an initial treatment or as an alternative treatment in diabetic cats that do not respond to treatment with other insulin preparations.
    Preview · Article · Aug 2009 · Journal of Veterinary Internal Medicine
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    ABSTRACT: Some studies in dogs undergoing adrenalectomy for pheochromocytoma suggest that anesthetic complications and perioperative mortality are common. In humans, surgical outcome has improved with the use of phenoxybenzamine (PBZ) before adrenalectomy. Dogs treated with PBZ before adrenalectomy have increased survival compared with untreated dogs. Forty-eight dogs that underwent adrenalectomy for pheochromocytoma. A retrospective medical record review for dogs that underwent adrenalectomy for pheochromocytoma at a veterinary medical teaching hospital over the period from January 1986 through December 2005. Twenty-three of 48 dogs were pretreated with PBZ (median dosage: 0.6 mg/kg PO q12h) for a median duration of 20 days before adrenalectomy. Duration of anesthesia and surgery, percentage of dogs with pheochromocytoma involving the right versus left adrenal gland, size of tumor, and presence of vascular invasion were similar for PBZ-treated and untreated dogs. Thirty-three (69%) of 48 dogs survived adrenalectomy in the perioperative period. PBZ-treated dogs had a significantly (P = .014) decreased mortality rate compared with untreated dogs (13 versus 48%, respectively). Additional significant prognostic factors for improved survival included younger age (P = .028), lack of intraoperative arrhythmias (P = .0075), and decreased surgical time (P = .0089). Results from this retrospective study support treatment with PBZ before surgical removal of pheochromocytoma in dogs.
    No preview · Article · Oct 2008 · Journal of Veterinary Internal Medicine
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    ABSTRACT: Identification and control of infections are important in the management of diabetic cats. Urinary tract infections have not been well characterized in diabetic cats. This retrospective study was performed to review and characterize urinary tract infections in diabetic cats. Urinary tract infections are common in diabetic cats. A review was made of the medical records of 141 diabetic cats that had had urine obtained for culture by antepubic cystocentesis and that had not been treated with antibiotics, undergone urinary tract catheterization or urinary tract surgery within 2 weeks of urine collection or had urethral obstruction at the time of urine collection. A review of medical records. Urinary tract infection was identified in 18 of 141 diabetic cats. Escherichia coli was the most common isolate (67%). Female cats were at increased risk (prevalence odds ratios [POR], 3.7; 95% confidence interval [CI], 1.3 to 10.2; P = .013). Clinical signs of lower urinary tract disease and findings on urine sediment examination were good predictors of positive urine cultures. Urinary tract infections are common in diabetic cats regardless of status of diabetic control, suggesting routine monitoring with urine sediment exams or urine culture is warranted.
    Full-text · Article · Jul 2006 · Journal of Veterinary Internal Medicine
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    ABSTRACT: Background: Identification and control of infections are important in the management of diabetic cats. Urinary tract infections have not been well characterized in diabetic cats. This retrospective study was performed to review and characterize urinary tract infections in diabetic cats.Hypothesis: Urinary tract infections are common in diabetic cats.Animals: A review was made of the medical records of 141 diabetic cats that had had urine obtained for culture by antepubic cystocentesis and that had not been treated with antibiotics, undergone urinary tract catheterization or urinary tract surgery within 2 weeks of urine collection or had urethral obstruction at the time of urine collection.Methods: A review of medical records.Results: Urinary tract infection was identified in 18 of 141 diabetic cats. Escherichia coli was the most common isolate (67%). Female cats were at increased risk (prevalence odds ratios [POR], 3.7; 95% confidence interval [CI], 1.3 to 10.2; P= .013). Clinical signs of lower urinary tract disease and findings on urine sediment examination were good predictors of positive urine cultures.Conclusions and Clinical Importance: Urinary tract infections are common in diabetic cats regardless of status of diabetic control, suggesting routine monitoring with urine sediment exams or urine culture is warranted.
    Full-text · Article · Jun 2006 · Journal of Veterinary Internal Medicine
  • R W Nelson
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    ABSTRACT: Five classes of oral hypoglycaemic drugs and two trace minerals used to treat diabetes mellitus in humans are reviewed and current knowledge on the use of these drugs in diabetic dogs and cats is presented. Oral sulphonylurea drugs stimulate insulin secretion and have been used successfully to treat diabetes in cats but not dogs. Preliminary studies evaluating the efficacy of the biguanide, metformin, in diabetic cats have not been promising. Pharmacokinetic studies have been performed in healthy cats, but clinical studies evaluating the efficacy of the insulin-sensitising drugs, thiazolidinediones, have not been reported. Treatment with the alpha-glucosidase inhibitor, acarbose, improved control of glycaemia in diabetic dogs; similar studies have not been reported in cats. Although chromium picolinate did not improve control of glycaemia in diabetic dogs, vanadium has improved control of the abnormality in diabetic cats.
    No preview · Article · Dec 2000 · Journal of Small Animal Practice
  • E C Feldman · R W Nelson

    No preview · Article · Oct 2000 · Journal of Feline Medicine & Surgery
  • R W Nelson

    No preview · Article · Jul 2000 · Journal of Feline Medicine & Surgery
  • C R Norris · R W Nelson · M M Christopher
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    ABSTRACT: To determine magnesium (Mg) status in cats with naturally acquired diabetes mellitus (DM) and diabetic ketoacidosis (DKA), evaluate changes in Mg status after treatment for DKA, and correlate Mg status with systemic blood pressure and degree of glycemic control. Case series and cohort study. 12 healthy cats (controls), 21 cats with DM, and 7 cats with DKA. Serum total magnesium (tMg) and ionized magnesium (iMg) concentrations and spot urinary fractional excretion of magnesium (FEmg) were determined, using serum and urine samples obtained from all cats when they were entered in the study and from cats with DKA 12, 24, and 48 hours after initiating treatment. Indirect blood pressure and degree of glycemic control were determined in 10 and 21 cats with DM, respectively. Initially, 2 and 13 cats with DM and 1 and 4 cats with DKA had serum tMg and iMg concentrations, respectively, less than the low reference limit (mean-2 SD) determined for controls. In cats with DKA, serum tMg concentration decreased significantly over time after initiating treatment. Urinary FEmg was significantly higher in cats with DM or DKA, compared with controls. Systemic hypertension was not detected nor was there a correlation between Mg status and degree of glycemic control in cats with DM. Hypomagnesemia was a common finding in cats with DM and DKA and was more readily identified by measuring serum iMg concentration than tMg concentration. The clinical ramifications of hypomagnesemia in such cats remain to be determined.
    No preview · Article · Dec 1999 · Journal of the American Veterinary Medical Association
  • C R Norris · M M Christopher · KA Howard · R W Nelson
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    ABSTRACT: To evaluate the efficacy of using serum total and ionized magnesium (Mg) concentrations and urine Mg concentrations to identify Mg deficiency in cats. 6 healthy castrated male cats. A Mg-replete diet was fed for 37 days, followed by a Mg-deficient diet for 37 days. On days 1, 3, and 7 of the last week of each diet, serum ionized and total Mg concentrations were determined; in addition, urine Mg concentration was determined each day of the last week. Serum total and ionized Mg concentrations were compared with urine Mg concentration, amount of Mg excreted during 24 hours (24-hour urine Mg excretion), ratio of urine Mg concentration to urine creatinine concentration (Umg:Ucr), and urinary fractional excretion of Mg (FEmg) to determine which variable best predicted Mg status. Cats fed Mg-deficient diets had significantly lower serum total and ionized Mg concentrations and 24-hour urine Mg excretion values, compared with cats fed Mg-replete diets. Serum total Mg concentration was the best predictor of Mg status. Twenty-four-hour urine Mg excretion was a repeatable, reliable measurement and had the best correlation with serum total Mg concentration. Serum total Mg concentration also correlated with urine Mg concentration, Umg:Ucr, and FEmg. Serum total and ionized Mg concentrations can be used to identify cats with dietary-induced Mg deficiencies. Twenty-four-hour urine Mg excretion and urine Mg concentration correlated best with serum total Mg concentration and, therefore, may be the most useful urine variables for identifying Mg deficiency.
    No preview · Article · Oct 1999 · American Journal of Veterinary Research
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    ABSTRACT: To compare outcome of surgical versus medical treatment of dogs with beta cell neoplasia. Retrospective study. 39 dogs with clinical signs of hypoglycemia and serum glucose and insulin concentrations consistent with a diagnosis of beta cell neoplasia. Information on signalment; clinical history; physical examination findings; results of CBC, serum biochemical analyses, and urinalysis; serum glucose and insulin concentrations; results of thoracic radiography and abdominal ultrasonography; treatment and treatment complications; survival time; and cause of death were obtained from medical records. 26 dogs underwent exploratory celiotomy and partial pancreatectomy; 13 dogs were treated medically (i.e., dietary change and prednisone). Median survival time was significantly longer for dogs treated surgically than for dogs treated medically. Significant differences were not found in mean age, body weight, duration of clinical signs prior to diagnosis, serum glucose and insulin concentration, or results of other serum biochemical tests between dogs treated surgically and dogs treated medically; also, there was no significant correlation between any of these parameters and survival time for either group of dogs. Results suggest that exploratory celiotomy and partial pancreatectomy are indicated once a tentative diagnosis of beta cell neoplasia is established in dogs.
    No preview · Article · Aug 1999 · Journal of the American Veterinary Medical Association
  • DA Elliott · R W Nelson · C E Reusch · E C Feldman · LA Neal
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    ABSTRACT: To correlate serum fructosamine concentrations with established measures of glycemic control and to compare serum fructosamine and blood glycosylated hemoglobin (GHb) concentrations as a means for assessing glycemic control in diabetic cats. Longitudinal cohort study. 26 healthy cats, 5 cats with stress-induced hyperglycemia, 15 untreated diabetic cats, and 36 treated diabetic cats. Control of glycemia was classified and monitored and serum fructosamine and blood GHb concentrations were measured for 12 poorly controlled diabetic cats before and after improving glycemic control, 8 well-controlled treated diabetic cats before and after glycemic control deteriorated, and 5 cats with diabetes mellitus before and after onset of stress-induced hyperglycemia. Mean serum fructosamine and blood GHb concentrations were significantly higher in untreated diabetic cats, compared with healthy cats, and in 24 poorly controlled diabetic cats, compared with 12 well-controlled diabetic cats. Mean serum fructosamine and blood GHb concentrations decreased significantly in 12 poorly controlled diabetic cats after improving glycemic control and increased significantly in 8 well-controlled diabetic cats after glycemic control deteriorated. A significant stress-induced increase in mean blood glucose concentration was evident 12 hours after insulin administration, but not in 5 docile diabetic cats that became fractious. Serum fructosamine and blood GHb concentrations are clinically useful tools for monitoring control of glycemia in cats with diabetes mellitus.
    No preview · Article · Jul 1999 · Journal of the American Veterinary Medical Association
  • R.W. Nelson · E.C. Feldman

    No preview · Article · Jun 1999 · Irish Veterinary Journal
  • J Robertson · R. W. Nelson · P Kass · L Neal
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    ABSTRACT: 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. 5 healthy dogs fed a high-fiber diet. 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. 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. 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. 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.
    No preview · Article · Jun 1999 · American Journal of Veterinary Research
  • J.C.R. Scott-Moncrieff · R W Nelson
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    ABSTRACT: To determine whether measuring change in serum thyroid-stimulating hormone (TSH) concentration in response to thyrotropin-releasing hormone (TRH) administration can be used as a test of thyroid function in dogs suspected of having hypothyroidism. Case-cohort study. 13 healthy dogs, 20 hypothyroid dogs, and 18 euthyroid dogs with concurrent diseases. Blood samples were collected before and 30 minutes after TRH administration, and serum TSH concentration was measured. The 13 healthy dogs were used to establish a reference range for change in TSH concentration after TRH administration. The remaining 38 dogs were categorized as hypothyroid or euthyroid on the basis of baseline total thyroxine (T4) and TSH concentrations, T4 concentration 4 hours after TRH administration, and clinical response to administration of sodium levothyroxine. Median baseline TSH concentration was 0.25 ng/ml (range, 0.03 to 0.44 ng/ml) in healthy dogs, 0.93 ng/ml (0.21 to 3.5 ng/ml) in hypothyroid dogs, and 0.21 ng/ml (0.03 to 0.63 ng/ml) in euthyroid dogs with concurrent diseases. Median percentage change in TSH concentration after TRH administration was 207% (range, 25 to 2,200%) in healthy dogs, 24% (-21 to 134%) in hypothyroid dogs, and 167% (69 to 1,800%) in euthyroid dogs with concurrent diseases. Overall accuracy of using the TRH-induced change in TSH concentration to identify hypothyroid dogs was 90%. Although percentage change in TSH concentration in response to TRH administration can be used to differentiate euthyroid from hypothyroid dogs, the test has little advantage over measurement of baseline TSH and total or free T4 concentration.
    No preview · Article · Dec 1998 · Journal of the American Veterinary Medical Association
  • A L Struble · E C Feldman · R W Nelson · P H Kass
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    ABSTRACT: To determine prevalence and severity of systemic arterial hypertension and proteinuria in dogs with naturally developing diabetes mellitus (DM) and to determine whether these abnormalities were related to age, sex, duration of DM, or degree of control of glycemia. Case series and cohort study. Fifty dogs with naturally developing DM. Blood pressure was measured in all 50 dogs. Thirty-eight dogs were evaluated once, and 12 were evaluated sequentially. Thirty-five were evaluated for proteinuria by determining protein-to-creatinine ratio in urine (n = 35) or by electrophoresis of urine (33). Hypertension was detected in 23 on the basis of a systolic pressure > 160 mm HG (12 dogs), a diastolic pressure > 100 mm HG (21), or a mean pressure > 120 mm HG (23). All dogs with systolic hypertension had concurrent diastolic and mean hypertension, and 19 of 21 dogs with diastolic hypertension had concurrent high mean pressure. Ten of 12 dogs reevaluated at subsequent visits had no change in blood pressure. Blood pressure remained consistent in 3 dogs tested at different times during the day on a single visit. Duration of DM and presence of proteinuria were significant predictors of hypertension. Seven of 35 (20%) dogs had an increased protein-to-creatinine ratio in their urine. Albumin concentration and albumin-to-creatinine ratio were significantly higher in urine from diabetic dogs, compared with healthy, nondiabetic dogs. Hypertension was associated with an increased albumin-to-creatinine ratio. Systemic hypertension and proteinuria may be common in diabetic dogs, but the clinical importance of these findings are, as yet, unknown.
    No preview · Article · Oct 1998 · Journal of the American Veterinary Medical Association
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    ABSTRACT: Acromegaly was diagnosed in 3 cats with insulin-resistant diabetes mellitus (DM) on the basis of history and physical examination findings, which ruled out other causes of insulin-resistant DM, and by documenting high plasma concentrations of growth hormone. Computed tomography revealed a mass in the area of the pituitary gland in each cat. Pituitary gland tumors were irradiated with cobalt 60, and none of the cats developed complications to radiotherapy. Each cat received a total dose of 48 Gy of cobalt 60 during 12 treatments. After completion of radiotherapy, insulin requirements were less for all cats, although in 1 cat, this improvement was transient. Diabetes mellitus resolved in 2 of 3 cats. After treatment, decreases in insulin requirements correlated with decreases in plasma growth hormone concentrations in 2 of 3 cats in which DM resolved. On the basis of these findings, irradiation of pituitary gland tumors appears to be a treatment option for cats with acromegaly.
    No preview · Article · Sep 1998 · Journal of the American Veterinary Medical Association

Publication Stats

2k Citations
116.22 Total Impact Points

Institutions

  • 1982-2014
    • University of California, Davis
      • • School of Veterinary Medicine
      • • Veterinary Medicine Teaching & Research Center
      • • School of Medicine
      • • Area of Epidemiology and Preventive Medicine
      Davis, California, United States
  • 1995
    • Beverly Hospital, Montebello CA
      Montebello, California, United States
  • 1992
    • Shreveport Veterinary Internal Medicine
      Shreveport, Louisiana, United States
  • 1987-1992
    • Purdue University
      • Department of Veterinary Clinical Sciences (VCS)
      ウェストラファイエット, Indiana, United States
  • 1990
    • Weill Cornell Medical College
      • Department of Medicine
      New York, New York, United States