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Veterinary Forum February 2007 (Vol 24, No 2)

Experts recommend diagnostic and management guidelines for feline diabetes

by Daniel Gingerich, DVM, MS, Rebekah Cintolo, Janna Strobel, PhD

    ORLANDO, Fla.— Feline diabetes is a complicated disease, likely to be caused by several contributing factors. As a result, it is a difficult condition to diagnose and manage, according to research presented at The North American Veterinary Conference.

    A considerable obstacle to an accurate diagnosis is the lack of standardized diagnostic criteria, according to Jacquie Rand, BVSc, DSc, DACVIM, of the Centre for Companion Animal Health and School of Veterinary Science at the University of Queensland in Brisbane, Australia. Clinical signs such as polydipsia/polyuria, weight loss, or polyphagia are nonspecific, and diagnosis cannot be confirmed by physical examination.

    For a definitive diagnosis, veterinarians should extract a blood sample while the cat is not struggling, as stress can confound test results. Signs of diabetes occur once the blood ­glucose concentration exceeds the renal threshold, which is approximately 288 mg/dl for normal cats. Measuring water intake is an inexpensive and useful method of confirming polydipsia once the blood glucose concentration exceeds the renal threshold. In normal cats, total water intake ranges from 60 to 100 ml/kg/day, Rand explained. A fructosamine level greater than 400 µmol/L further supports a diagnosis of diabetes.

    Therapy for diabetes should be instituted as soon as possible after diagnosis, according to J. Catharine Scott-Moncrieff, MA, MS, VetMB, MRCVS, DACVIM, DECVIM. The aims of therapy are to treat any underlying disease and achieve good glycemic control, Rand added. Administration of insulin and dietary modification are the principal therapies used for management of ­diabetic cats. Scott-Moncrieff suggested starting with a low-carbohydrate diet and moving to a high-fiber diet if clinical remission is not achieved and better glycemic control is needed.

    Oral hypoglycemic drugs may be useful in some cats, depending on the loss of function from glucose toxicity, residual b-cell mass, and concurrent therapy. A recent study has shown that if good glycemic control is achieved early in newly diagnosed diabetic cats, very high remission rates can occur within weeks of treatment.

    The NAVC seminar was sponsored by Intervet.

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