Endocrinology

Is the feline diabetic patient every veterinarian's nightmare? Since diabetes mellitus is one of the most common endocrinopathies in cats, it is likely you will face this disease many times in your veterinary career.

Hepatic lipidosis is the most common liver disease in cats in North America. In a retrospective study performed at the University of Minnesota evaluating liver biopsy specimens obtained from cats over a 10-year period, hepatic lipidosis accounted for 50% of all cases.

Pancreatitis is being diagnosed more and more frequently in cats. Cats typically have chronic pancreatitis whereas dogs usually suffer acute disease. The difference in presentation between the species as well as a lack of appropriate diagnostic tools led to pancreatitis in cats being widely underdiagnosed.

Calcium is involved in many cellular and extracellular processes that include neuromuscular transmission, muscle contraction/tone, hormone secretion, bone homeostasis, coagulation, membrane transport systems, and other cell regulatory pathways. Calcium is measured as ionized (active form, roughly 50%) or total (ionized + albumin bound + anion bound).

While less commonly seen than in their canine counterparts, cats can suffer from an excessive production of cortisol by the adrenal glands. 85% of the cases of feline hyperadrenocorticism are due to a pituitary tumor whereas 15% stem from an adrenal tumor. Progesterone-secreting adrenal tumors have been documented a handful of cats.

Dogs and cats with diabetes can be managed to reduce clinical signs for years after their diabetes diagnosis, but it takes a committed owner to achieve these results.

Even with the advances in diabetic care, diabetes in pets has remained a particular point of interest and discussion among veterinary professionals.

Answers to your questions about diabetes mellitus.

A tip for treating this endocrine disease in cats.

Dr. David Bruyette answers this reader question.

It is unlikely the low-dose prednisone treatment is resulting in the panting the owner is reporting.

Dr. Audrey Cook explains how the new guidelines were created.

A diagnostic tip for this common endocrine disease.

This study's goal was to determine and compare the likelihood of remission in cats with newly diagnosed diabetes mellitus when treated with glargine insulin, protamine zinc insulin (PZI), or Lente insulin.

What steps would you take to help this dog?

To teach owners of newly diagnosed diabetic pets how to inject insulin, I have them practice with sterile water.

In our April issue as an accompaniment to the article "Identifying the reasons behind difficult-to-control diabetes in dogs" by Dr. Audrey Cook, we asked you if you had questions for Dr. Cook about diabetes. Here is a second installment of her responses.

Trilostane, currently the most used treatment for PDH, is a synthetic steroid analogue. It competitively inhibits the 3-beta hydroxysteroid dehydrogenase enzyme blocking cortisol, aldosterone and sex hormone production.

Jaundice (or icterus), broadly defined, refers to the accumulation of excessive amounts of bilirubin in either the circulation or the tissues.

Naturally occurring hyperadrenocorticism (HAC) is an endocrine disorder resulting from the excess production of cortisol or other adrenal hormones by the adrenal cortex. The clinical syndrome was first documented in people by Dr. Harvey Cushing in 1932 and is also known as Cushing's syndrome.

In 2005 Eli Lily announced the discontinuation of the majority of animal derived source insulins in addition to the lente and ultralente lines of product. This changed the landscape of veterinary diabetic management. Ultimately, the best insulin for your patient may be the one you are most familiar with; however, general guidelines will help choose the insulin that will give you the best success with your patients.

There are several manifestations of adrenal disease in cats, ranging from hypoadrenocorticsm to several forms of hyperadrenal activity. All are considered relatively rare, but it is possible that we may discover some more frequently if we have a higher index of suspicion.

Canine hypothyroidism is one of the more common endocrine diseases seen by small animal clinicians. As thyroid screening has become more frequently utilized, practitioners have become more aware of the frequency with which hypothyroidism occurs.

Normal neural stimulation of the hypothalamus produces corticotropin-releasing hormone (CRH). Corticotropin-releasing hormone stimulates the release of adrenocorticotropic hormone (ACTH) from the anterior pituitary. ACTH exerts its effects on the adrenal cortex and stimulates the zona fasiculata to release cortisol, the zona reticularis to release androgens and the zona glomerulosa to release mineralocorticoids, but the primary effect of ACTH is on cortisol release.

There have been several new findings in canine and feline endocrinology. We will highlight those that are useful and applicable to clinical practice. New diagnostic protocols and treatments will be discussed where appropriate.