Feline Diabetes Melliuts Flashcards
What’s the most common form of diabetes in the cat?
type II
Does gestational diabetes happen in cats?
not reported yet; has been reported in dogs
What are some risk factors for feline diabetes mellitus?
- age
- gender (Male > female)
- obesity
- indoor
- inactivity
- prolonged/ repeated steroids/ megestrol acetate
Which genetic mutation is shared between people and cats with diabetes mellitus?
melanocortin 4 receptor gene (Mc4R)
What are the 2 key features of type 2 diabetes mellitus?
- insulin resistance/ decreased sensitivity
- for every 1kg gain = 30% decrease in insulin sensitivity - decreased insulin secretion
- amylin/ islet amyloid polypeptide deposition
- chronic inflammation
- oxidative damage
Define impaired fasting glucose and impaired glucose tolerance.
Impaired fasting glucose:
= fasting glucose 6.5-10mmol/L
Impaired glucose tolerance (50% dextrose IV)
= glucose >9.9mmol/L (@ 2h with 0.5mg/kg glucose), or
= glucose > 6.5mmol/L (@ 3h with 1mg/kg)
Both conditions = prediabetic
At what glycemic level is the cat considered diabetic?
resting glucose > 10mmol/L
What resting glucose level is considered prediabetic in a cat?
if it’s below the renal threshold (14-16mmol/L), then glucosuria won’t be present
but is still considered prediabetic of glucose >10mmol/L
What are some signs of DKA?
- anorexia
- vomiting
- depression
Is plasma beta-hydroxybutyrate a reliable marker to differentiate between stress glycemia and diabetes?
No, if blood glucose <20mmol/L, beta-hydroxybutyrate is unlikely going to be increased
What does fructosamine concentration mean in cats?
likely reflective of the glycemic control in the preceding week. Only glucose >33mmol/L is likely to have a significance
Does have fructosamine = diabetes in cats?
No, if blood glucose is <20mmol/L, should still consider serial blood glucose check, glucosuria, and clinical signs
What’s the likelihood of relapse once in diabetic remissions? what’s the chance of a 2nd remission?
- 25-30% will relapse
- <25% will have a 2nd remission
What’s the treatment goal for diabetic cats that still have not achieved remission after 6m of treatment?
improving/ resolving clinical signs without inducing hypoglycemia
What are some known factors that can influence remission rate?
- older age (better)
- aiming for tight glycemic control
- recent glucocorticoid usage
- glucose <16mmol/L after insulin
- using long acting insulin (glargine, detemir)
- low carb diet
- lower maximum dose of insulin (glargine dose <0.4U/kg or 3IU/cat)
- absence of neuropathy
- lower cholesterol concentration
What’s the goal for blood glucose concentration for newly diagnosed diabetic cat?
- achieving normal to near normal glucose level (4 to <10mmol/L) while avoiding hypoglycemia
- increases likelihood of going into diabetic remission (2-4 weeks of euglycemia without treatments)
