Term
| Describe the pathophysiology behind feline DM. |
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Definition
-obesity
-islet amyloidosis
-chronic pancreatitis
-concurrent illness
-drugs
-genetics
-immune-mediated
-insulin resistance
-chronic hyperinsulinemia: amyloidosis
-beta cell exhaustion
-hypoinsulinemia
-beta cell destruction |
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Term
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Definition
-amyloid: misfolded beta-pleated sheet protein that is resistant to proteases
-secreted concurrently with insulin thus hyperglycemia = hypersecration of amyloid
-amylin antagonizes insulin |
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Term
| What is the typical signalment of feline DM? |
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Definition
-neutered males most common
-age 9-12 y
-obesity common
-no breed predisposition |
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Term
| In addition to the clinical signs seen with canine DM, what do we specifically see in cats? |
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Definition
| -Peripheral neuropathy: plantigrade posture, +/- thoracic limbs |
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Term
| What diagnostics do we run on a feline DM case? |
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Definition
-CBC
-biochem analysis
-total T4
-UA
-Urine culture and sensitivity
-BP
-Hyperglycemia with glucosuria = DM |
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Term
| Describe dietary management of feline DM. |
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Definition
-high protein, low carb
-canned diets have less carbs
-PUrina DM, Hill's m/d: inc incidence of remision (improves glucose intolerance, dec insulin resistance, heps with obesity)
-transition soon after diagnosis
-treat obesity to improve chance of remission
-timing of meals as usual, postprandial hyperglycemia, keep animal on same schedule |
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Term
| Describe Insulin Galrgine as a solution. How is it administered? |
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Definition
-slight acidic solution = precips in physiologic pH to extend duration but cannot be mixed or diluted
-12 hour dosing |
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Term
| Is Insulin Glargine peakless in cats? What about Insulin Detemir? |
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Definition
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Term
| What kind of solution is Insulin Detemir? How is it dosed? |
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Definition
-fatty acid moiety on insulin molecuel, binds to albumin = extended duration
-12 hours doses |
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Term
| Is ProZinc approved by the FDA for cats? How is it dosed? Duration? |
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Definition
-yes
-dosed q12h
-duration 10-14h |
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Term
| What is the major downfall of ProZinc? |
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Definition
| -more variable onset and duration of action as compared with glargine or detemir |
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Term
| What are the goals of insulin therapy? |
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Definition
-resolution of clinical signs
-diabetic remission
-glucose range: 80-300 mg/dl
-Nadir: 80-150 mg/dl
-Glucose differential > 150 mg/dl |
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Term
| When can we claim remission for a cat with DM? |
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Definition
| -euglycemia for 2 weeks without insulin |
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Term
| In what percentage of cats do we get remission of DM? What gives us a higher chance? |
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Definition
-38-85%
-higher with: early good glycemic control, low carb diet, glargine or detemir vs PZI |
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Term
| When does remission usually occur with DM in the cat? |
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Definition
| -first 3 months, almost always within first year |
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Term
| How do we monitor feline DM? |
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Definition
-clinical sgns, body weight, glucose curve, and fructosamine
-recheck 5-7 days after dose change
-monthly for first year
-every 3-6 m therafter
-inc dose by 0.5-1U at a time |
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Term
| HOw do we advise owners to monitor feline DM at home? |
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Definition
-dec stress hyperglycemia: ears or footpads
-day to day variability
-validated glucometer
-AlphaTRAK |
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Term
| How do we monitor a fractious cat with DM? |
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Definition
-home glucose monitoring
-clincial signs and body weight
-fructosamine
-central line or PICC line |
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