Term
| What are the three general causes of persistence of diabetic clinical signs? |
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Definition
1) Insulin problems
2) Client problems
3) Patient problems: insulin resistance |
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Term
| What are some of the insulin problems that can lead to persistence of diabetic clinical signs? |
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Definition
-insuling under dosing or too short of duration
-insulin overdosing => Somogyyi
-improper handling: avoid shaking vigorously
-improper storage: refrierator, expiration date
-diluting insulin |
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Term
| What are some of the client problems that can lead to persistence of diabetic clinical signs? |
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Definition
-improper SQ admin
-not rotating sites of injection
-improper syringe filling
-incorrect syringes |
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Term
| What is insulin resistace? |
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Definition
| -normal amount of insulin produces subnormal biolobic response |
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Term
| What are the common causes of insulin resistence? |
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Definition
-obesity
-inflammation
-hormone excess
-hormone deficiency: hypothyroidism
-misc disease |
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Term
| Why does inflammation lead to insulin resistance? What are some examples? |
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Definition
-antagonize insulin and may stimulate release of glucagon
-ex: pancreatitis, UTI, neoplasia, periodontal disease, pyoderma |
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Term
| What are some conditions that produce excess of hormones that antagonize insulin? |
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Definition
-Hyperadrenocorticism
-Acromegaly: sommon in cats
-Pregnancy or diestrus: spay
-Uncommon syndromes: pheochromocytoma, glucagonoma, hyperhyroidism |
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Term
| What are some of the miscellaneous causes of insulin resistance? |
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Definition
-kidney disease
-liver disease
-cardiac disease
-hyperlipidemia |
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Term
| What diagnostics do we run on a suspected insulin resistance case? |
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Definition
-History
-PHysical
-CBC, biochem panel, TT$ (cat)
-UA
-urine culture
-imaging
-misc |
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Term
| How do we diagnose a UTI? |
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Definition
-pyuria or bactieruria may be absent
-positive urine culture |
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Term
| What are the clinical sindings in a dog with pancreatitis? What about a cat? |
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Definition
-Dog: vomiting, diarrhea, anorexia, abdominal pain
-Cat: hiding, anorexia, +/- vomiting, +/- ab pain |
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Term
| How do we diagnose pancreatitis? |
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Definition
-cPLi or fPLi
-abdominal US |
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Term
| In which species is hyperadrenocorticism more common? Which gender? What does it commonly cause in cats? |
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Definition
-dog >>> cat
-female cat >> male cat
-most common cuase of fragile skin syndrome in cats |
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Term
| What is acromegaly? In which species and gender is it most common? |
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Definition
-pituitary adenoma: excess growth hormone, exciss insulin like growth factor
-cats >>>>>> dogs
-male cats >> female cats |
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Term
| What are the clinical findings of acromegaly? |
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Definition
-weight GAIN with poor glycemic control
-broad face
0widened interdental spaces
-resp stridor
-abdominal organomegaly |
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Term
| How do we diagnose acromegaly? How do we treat it? |
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Definition
-Diagnosis: blood IGF-1 level, may be normal for 1-2 months after start of insulin, brain MR to conirm
-Tx: external beanm radiation (dec insulin requirements and may achieve diabetic remission) |
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Term
| How do we treat insulin resistance? |
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Definition
-treat underlying disease
-weight loss diet if severely obese
-ovariohysterectomy if intact
-dental care if periodontal dz |
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