Saturday, May 14, 2011

Top Endocrine Publications of 2010: Canine and Feline Diabetes Mellitus

I know that many of you are very busy and may have trouble keeping up with the latest research studies and publications on issues concerning companion animal endocrinology. Therefore, I’ve compiled a fairly extensive list of some of the best clinical endocrine papers written last year (in 2010), and I’ll be sharing these with you over the next few weeks.

We are going to start off with papers that deal with the theme of Diabetes mellitus and its diagnosis and treatment in dogs and cats.

Listed below are 29 research papers written in 2010 that deal with a variety of diabetic topics and issues.

These range from the use of continuous glucose monitoring systems (1, 15, 22) to home glucose monitoring (5, 28); from insulin autoantibodies (4, 18) to insulin resistance (11, 25, 26);  from new insulin analogues (8, 10, 24) to diabetic cataracts (12, 21); and from the causes of secondary diabetes (2, 6, 13, 14, 16) to diabetic remission (29).

2010 Papers on Canine and Feline Diabetes Mellitus:
  1. Affenzeller N, Benesch T, Thalhammer JG, et al. A pilot study to evaluate a novel subcutaneous continuous glucose monitoring system in healthy Beagle dogs. Veterinary Journal 2010;184:105-110.
  2. Blois SL, Dickie EL, Kruth SA, et al. Multiple endocrine diseases in cats: 15 cases (1997-2008). Journal of Feline Medicine and Surgery 2010;12:637-642.
  3. Claus MA, Silverstein DC, Shofer FS, et al. Comparison of regular insulin infusion doses in critically ill diabetic cats: 29 cases (1999-2007). Journal of Veterinary Emergency and Critical Care 2010;20:509-517.
  4. Davison LJ, Herrtage ME, Catchpole B. Autoantibodies to recombinant canine proinsulin in canine diabetic patients. Research in Veterinary Science 2010.
  5. Dobromylskyj MJ, Sparkes AH. Assessing portable blood glucose meters for clinical use in cats in the United Kingdom. The Veterinary Record 2010;167:438-442.
  6. Fall T, Hedhammar A, Wallberg A, et al. Diabetes mellitus in elkhounds is associated with diestrus and pregnancy. Journal of Veterinary Internal Medicine 2010;24:1322-1328.
  7. Furrer D, Kaufmann K, Reusch CE, et al. Amylin reduces plasma glucagon concentration in cats. Veterinary Journal 2010;184:236-240.
  8. Gilor C, Graves TK. Synthetic insulin analogs and their use in dogs and cats. The Veterinary Clinics of North America Small Animal Practice 2010;40:297-307.
  9. Gilor C, Graves TK, Lascelles BD, et al. The effects of body weight, body condition score, sex, and age on serum fructosamine concentrations in clinically healthy cats. Veterinary Clinical Pathology 2010;39:322-328.
  10. Gilor C, Ridge TK, Attermeier KJ, et al. Pharmacodynamics of insulin detemir and insulin glargine assessed by an isoglycemic clamp method in healthy cats. Journal of Veterinary Internal Medicine 2010;24:870-874.
  11. Hess RS. Insulin resistance in dogs. The Veterinary Clinics of North America Small Animal Practice 2010;40:309-316.
  12. Kador PF, Webb TR, Bras D, et al. Topical KINOSTAT ameliorates the clinical development and progression of cataracts in dogs with diabetes mellitus. Veterinary Ophthalmology 2010;13:363-368.
  13. McLauchlan G, Knottenbelt C, Augusto M, et al. Retrospective evaluation of the effect of trilostane on insulin requirement and fructosamine concentration in eight diabetic dogs with hyperadrenocorticism. The Journal of Small Animal Practice 2010;51:642-648.
  14. Meij BP, Auriemma E, Grinwis G, et al. Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy. Journal of Feline Medicine and Surgery 2010;12:406-410.
  15. Moretti S, Tschuor F, Osto M, et al. Evaluation of a novel real-time continuous glucose-monitoring system for use in cats. Journal of Veterinary Internal Medicine 2010;24:120-126.
  16. Niessen SJ. Feline acromegaly: an essential differential diagnosis for the difficult diabetic. Journal of feline medicine and surgery 2010;12:15-23.
  17. Niessen SJ, Powney S, Guitian J, et al. Evaluation of a quality-of-life tool for cats with diabetes mellitus. Journal of Veterinary Internal Medicine 2010;24:1098-1105.
  18. Nishii N, Takasu M, Kojima M, et al. Presence of anti-insulin natural autoantibodies in healthy cats and its interference with immunoassay for serum insulin concentrations. Domestic Animal Endocrinology 2010;38:138-145.
  19. Nishii N, Yamasaki M, Takasu M, et al. Plasma leptin concentration in dogs with diabetes mellitus. The Journal of Veterinary Medical Science 2010;72:809-811.
  20. O'Brien MA. Diabetic emergencies in small animals. The Veterinary Clinics of North America Small Animal Practice 2010;40:317-333.
  21. Oliver JA, Clark L, Corletto F, et al. A comparison of anesthetic complications between diabetic and nondiabetic dogs undergoing phacoemulsification cataract surgery: a retrospective study. Veterinary Ophthalmology 2010;13:244-250.
  22. Reineke EL, Fletcher DJ, King LG, et al. Accuracy of a continuous glucose monitoring system in dogs and cats with diabetic ketoacidosis. Journal of Veterinary Emergency and Critical Care 2010;20:303-312.
  23. Rucinsky R, Cook A, Haley S, et al. AAHA diabetes management guidelines. Journal of the American Animal Hospital Association 2010;46:215-224.
  24. Sako T, Mori A, Lee P, et al. Time-action profiles of insulin detemir in normal and diabetic dogs
  25. Scott-Moncrieff JC. Insulin resistance in cats. The Veterinary Clinics of North America Small Animal Practice 2010;40:241-257.
  26. Verkest KR, Fleeman LM, Rand JS, et al. Basal measures of insulin sensitivity and insulin secretion and simplified glucose tolerance tests in dogs. Domestic Animal Endocrinology 2010;39:194-204.
  27. Zeugswetter F, Handl S, Iben C, et al. Efficacy of plasma beta-hydroxybutyrate concentration as a marker for diabetes mellitus in acutely sick cats. Journal of Feline Medicine and Surgery 2010;12:300-305.
  28. Zeugswetter FK, Rebuzzi L, Karlovits S. Alternative sampling site for blood glucose testing in cats: giving the ears a rest. Journal of Feline Medicine and Surgery 2010;12:710-713.
  29. Zini E, Hafner M, Osto M, et al. Predictors of clinical remission in cats with diabetes mellitus. Journal of Veterinary Internal Medicine 2010;24:1314-1321.


patti said...

please would you have anything at all specifically on insulin auto antibodies on felines only. I belong to a group of individuals who keep track/study/learn about cats with acromegaly, Cushings, IAA. We meet thru the feline diabetes board and have the feline acromegaly board. We also have a group on facebook. We gather info and keep all our members current on latest papers out there. IAA has little info that I can find. Altho none of us currently are vet techs or vets, some of us are RN's and constantly reading whatever we can find. I would appreciate any help.

Dr. Mark E. Peterson said...

Hi Patti,

We don't know much about insulin antibodies in cats, but clinically they do not appear to cause clinical insulin resistance.

There was a recent report on anti-insulin antibodies in cats treated with various insulin types at the 2010 ECVIM-congress (European College of Veterinary Internal Medicine). I've put the whole research abstract below. The bottom line is that although the presence of insulin autoantibodies could be detected in about 20% of diabetic cats treated insulin, it was unclear what the clinical significance of these antibodies is. In my opinion, they are probably not very significant.

Anti-Insulin Antibodies in Insulin-Treated and Untreated Diabetic Cats
Jamie Adams; Brian Catchpole
Royal Veterinary College, North Mymms, UK

Treatment of diabetes mellitus in cats generally involves administration of exogenous insulin. The licensed insulin preparations in the UK are either of porcine (Caninsulin®, Intervet Schering-Plough Animal Health, Milton Keynes, UK) or bovine origin (Insuvet® Lente & Insuvet® PZI, Pfizer Animal Health, Sandwich, UK). Since both differ from feline insulin, treatment with either could stimulate an immune response. The aim of this study was to assess the prevalence of anti-insulin antibodies (AIA) in insulin-treated diabetic cats, and to examine any difference in immunogenicity between insulin preparations. Newly diagnosed, untreated diabetic cats were also assessed for presence of insulin autoantibodies. Additionally, anti-protamine antibodies were investigated in cats treated with protamine zinc insulin.

Serum samples were collected from 150 insulin-treated diabetic cats (comprising 50 cats treated with Caninsulin, 50 cats treated with Insuvet Lente and 50 cats treated with Insuvet PZI) and 25 newly-diagnosed untreated diabetic cats. Serum samples from 50 non-diabetic cats were used as controls. Antibodies against porcine/ bovine insulin and protamine were determined by enzyme-linked immunosorbent assay (ELISA).

There was a significant difference (p < 0.001) in AIA between the insulin-treated diabetic and control group. Serological reactivity was similar regardless of whether porcine or bovine insulin was used as the antigen in the ELISA. In total, 32 out of 150 (21%) insulin-treated diabetic cats demonstrated AIA. There was no significant difference in AIA prevalence between the treatment groups, with 16 of 50 cats receiving Caninsulin, 9 of 50 cats receiving Insuvet Lente, and 7 of 50 cats receiving Insuvet PZI demonstrating AIA.

There was no significant difference between the control group and the newly-diagnosed untreated diabetic cat group, with only one AIA positive diabetic cat. There was no significant difference in antibody reactivity to protamine, comparing non-diabetic and diabetic cats and comparing the different treatment groups.

This study demonstrates a low prevalence of AIA amongst insulin-treated diabetic cats. Treatment using porcine insulin did not give a significantly higher prevalence of AIA than treatment with bovine insulin. Presence of insulin autoantibodies in newly diagnosed diabetic cats was not demonstrated. Treatment with protamine zinc insulin did not seem to stimulate anti-protamine antibodies, and in fact some control cats demonstrated antibodies against this protein, possibly as the result of exposure in the diet. The clinical significance of AIA remains unclear and further work is needed to investigate any role in diabetes management.