Hypothermia, anemia, hyperglycemia, and severe hypoglycemia are significant prognostic indicators of death in client-owned ferrets (Mustela putorius furo).

OBJECTIVE: To determine whether rectal temperature, Hct, or blood glucose at presentation were associated with all-cause mortality in ferrets (Mustela putorius furo). ANIMALS: 321 client-owned ferrets. METHODS: A medical record database was searched for ferrets from January 2012 through September 2022. Records from 1,189 individual examinations were evaluated. Inclusion criteria were rectal temperature, Hct, and/or blood glucose measured at presentation and data on survival status 7 days postpresentation. Data were included from 321 ferrets from 571 examinations. Rectal temperature in 244 ferrets from 346 examinations, Hct in 181 ferrets from 277 examinations, and blood glucose in 260 ferrets from 420 examinations were available. RESULTS: The odds of death for hypothermic ferrets (< 37.8 °C) were 3.72 times (OR, 3.72; 95% CI, 2.30 to 6.01) the odds of death for normothermic ferrets (37.8 to 40 °C). For every 0.56 °C below normal rectal temperature, the odds of death increased 1.49 times (OR, 1.49; 95% CI, 1.21 to 1.90). The odds of death for anemic ferrets (Hct < 33%) were 4.74 times (OR, 4.74; 95% CI, 1.70 to 13.21) the odds of death for ferrets with a normal Hct (33% to 57%). The odds of death for hyperglycemic ferrets (> 152 mg/dL) were 2.61 times (OR, 2.61; 95% CI, 1.29 to 5.30) the odds of death for normoglycemic ferrets (74 to 152 mg/dL). The odds of death for severely hypoglycemic ferrets (< 40 mg/dL) were 9.45 times (OR, 9.45; 95% CI, 3.18 to 28.12) the odds of death for normoglycemic ferrets. CLINICAL RELEVANCE: Hypothermia, anemia, hyperglycemia, and severe hypoglycemia were significant prognostic indicators of death in ferrets. Further investigation into the causes and management of these derangements is warranted.

Development of a requirement for exogenous insulin treatment in dogs with hyperglycemia.

BACKGROUND: It has been suggested that overt diabetes mellitus in dogs be defined based on a persistent fasting blood glucose concentration (BGC) >144 mg/dL. OBJECTIVE: Determine the number of dogs with randomly identified hyperglycemia without insulin-treated diabetes mellitus (ITDM) that later develop a need for exogenous insulin treatment. ANIMALS: A total of 1318 dogs examined at a university teaching hospital without ITDM and with randomly identified hyperglycemia. METHODS: Retrospective longitudinal study. Hyperglycemia was defined as randomly identified BGC above >112 mg/dL, moderate hyperglycemia as BGC >144 mg/dL but <200 mg/dL and pronounced hyperglycemia as BGC ≥200 mg/dL. Dogs were defined as having ITDM if they were treated with insulin. Follow-up was attempted 7 to 12 years after hyperglycemia was documented to determine if over time dogs developed a need for exogenous insulin treatment. RESULTS: Twenty-nine of 824 dogs (3.5%) with hyperglycemia and follow-up information developed ITDM, including 3/824 dogs (0.4%) with moderate hyperglycemia, and 2/824 dogs (0.2%) with pronounced hyperglycemia. Most dogs with hyperglycemia that developed ITDM (24/29, 83%) had BGC ≤144 mg/dL. Among dogs that eventually developed a need for exogenous insulin treatment, no association was found between the degree of hyperglycemia and the time interval between documentation of hyperglycemia and diagnosis of ITDM. Logistic regression determined that BGC is not significantly associated with ITDM. CONCLUSIONS AND CLINICAL IMPORTANCE: Most dogs with randomly identified hyperglycemia did not develop a need for exogenous insulin treatment. Other criteria could be required to augment the definition of overt DM in non-insulin treated dogs.

Spontaneous remission and relapse of diabetes mellitus in a male dog.

An 8-year-old male neutered Miniature Schnauzer was diagnosed with diabetes mellitus based on fasting hyperglycemia and glucosuria after a 2-week history of polydipsia and periuria, in line with the Agreeing Language in Veterinary Endocrinology consensus definition. Treatment of insulin and dietary management was initiated. The insulin dose was gradually reduced and eventually discontinued over the next year based on spot blood glucose concentrations that revealed euglycemia or hypoglycemia. After discontinuation, the dog remained free of clinical signs for 1 year until it was again presented for polyuria/polydipsia with fasting hyperglycemia and glucosuria. Insulin therapy was resumed and continued for the remainder of the dog's life. Although diabetic remission often occurs in cats and humans, the presumed etiopathogenesis of pancreatic beta cell loss makes remission rare in dogs, except for cases occurring with diestrus or pregnancy. This case demonstrates that diabetic remission is possible in dogs, even in cases without an identifiable reversible trigger.

Association between Hyperglycemia and Canine Serum Pancreatic Lipase Immunoreactivity Concentration in Diabetic Dogs.

It has been reported that hypertriglyceridemia can partially mediate between diabetes mellitus (DM) and pancreatitis in dogs, implying that another mediator, such as chronic hyperglycemia, might exist. Therefore, this study aimed to evaluate the relationship between hyperglycemia and serum canine pancreatic lipase immunoreactivity (cPLI) concentration in diabetic dogs. This retrospective cohort study included 26 client-owned diabetic dogs, divided according to their serum fructosamine levels (<500 µmol/L = well-controlled DM group; ≥500 µmol/L = untreated or poorly controlled DM group). Five of the 26 DM dogs (19.2%) had serum cPLI concentrations consistent with pancreatitis, among which two showed ultrasonographic evidence of pancreatitis without clinical signs. The serum cPLI concentrations (median [interquartile range]) were significantly higher in the untreated or poorly controlled group (520 µg/L [179.76-1000 µg/L]) than in the well-controlled group (77 µg/L [32.22-244.6 µg/L], P = 0.0147). The serum fructosamine concentration was positively correlated with the serum cPLI concentration (r = 0.4816; P = 0.0127). Multivariate analysis revealed serum triglyceride and fructosamine concentrations were associated with the serum cPLI concentration. In conclusion, this study suggests that chronic hyperglycemia may induce pancreatic inflammation in diabetic dogs; however, the clinical significance of increased cPLI concentration is unknown.

Hematological differentiation of bladder rupture and complete/partial urethral obstruction in castrated Hanwoo (Korean indigenous cattle) with urolithiasis.

This case report describes the hematological and radiological examination of urinary bladder rupture and complete urethral obstruction. associated with urolithiasis in Hanwoo. Hyponatremia, hypochloremia, azotemia, and hyperglycemia were observed in both urethral obstruction and urinary bladder rupture. However, cattle with urethral obstruction showed hyperkalemia and mild hyperglycemia, whereas cattle with bladder rupture showed marked hyperglycemia and normal potassium levels. In ultrasonography, the urethral obstruction showed a dilated bladder with a thick bladder wall. In contrast to previous literature, in this study, severe electrolyte changes such as severe hyponatremia, hypochloremia, and hyperkalemia occurred in a case of complete urethral obstruction.

Comparison of a commercially available veterinary digital refractometer to analogue refractometer and laboratory chemistry analyzer in the evaluation of canine serum total protein.

OBJECTIVE: To assess the agreement between measurements of total protein (TP) concentrations in canine serum samples between a commercially available veterinary digital refractometer (DR), an analog handheld refractometer (AR), and a laboratory-based chemistry analyzer (LAB). An additional objective was to assess the effects of various potential interferents (ie, hyperbilirubinemia, increased BUN, hyperglycemia, hemolysis, and lipemia) on DR measurements. SAMPLE: 108 canine serum samples. PROCEDURES: Serum samples were measured in duplicate on the DR, which reported TP concentration, assessed via optical reflectance and critical angle measurement. These serum samples were also assessed on the AR and LAB for comparison. Serum samples with grossly visible lipemia, hemolysis, and icterus were noted. Medical records were retrospectively assessed to determine concentrations of BUN, glucose, and bilirubin. RESULTS: Method comparisons among the various data generated by the analyzers were completed using linear regression, Bland Altman, and calculation of intraclass coefficients. Mean bias between DRTP and LABTP in samples without potential interferents was 0.54 g/dL with 95% limits of agreement of -0.17 to 1.27 g/dL. One-third of DRTP samples without potential interferents had > 10% difference from their LABTP comparison. Interferents, particularly marked hyperglycemia, can result in inaccurate measurements on the DR. CLINICAL RELEVANCE: There was a statistically significant difference between DRTP and LABTP measurements. TP measurements in samples with any potential interferent, particularly hyperglycemia, should be assessed cautiously on DR and AR.

Safety and effectiveness of the sodium-glucose cotransporter inhibitor bexagliflozin in cats newly diagnosed with diabetes mellitus.

BACKGROUND: Bexagliflozin is a sodium-glucose cotransporter 2 (SGLT2) inhibitor. A pilot study has shown that bexagliflozin can decrease dependence on exogenous insulin in cats with diabetes mellitus (DM). OBJECTIVE: To evaluate the safety and effectiveness of bexagliflozin as a monotherapy for DM in previously untreated cats. ANIMALS: Eighty-four client-owned cats. METHODS: Historically controlled prospective open-label clinical trial. Cats were dosed PO with 15 mg bexagliflozin once daily for 56 days, with a 124-day extension to evaluate safety and treatment effect durability. The primary endpoint was the proportion of cats experiencing a decrease in hyperglycemia and improvement in clinical signs of hyperglycemia from baseline on day 56. RESULTS: Of 84 enrolled cats, 81 were evaluable on day 56, and 68 (84.0%) were treatment successes. Decreases in mean serum glucose, fructosamine, and ß-hydroxybutyrate (ß-OHB) concentrations were observed, and investigator assessments of cat neurological status, musculature, and hair coat quality improved. Owner evaluations of both cat and owner quality of life were favorable. The fructosamine half-life in diabetic cats was found to be 6.8 days. Commonly observed adverse events included emesis, diarrhea, anorexia, lethargy, and dehydration. Eight cats experienced serious adverse events, 3 of which led to death or euthanasia. The most important adverse event was euglycemic diabetic ketoacidosis, diagnosed in 3 cats and presumed present in a fourth. CONCLUSION AND CLINICAL IMPORTANCE: Bexagliflozin decreased hyperglycemia and observed clinical signs in cats newly diagnosed with DM. As a once-daily PO medication, bexagliflozin may simplify management of DM in cats.

Clinicopathological and radiographic indicators for orogastric decompression in rabbits presenting with intestinal obstruction at a referral hospital (2015-2018).

BACKGROUND: Orogastric decompression is regularly recommended as a part of both medical and pre-surgical treatment for small intestinal obstruction in rabbits. However, guidelines as to when orogastric decompression is indicated are sparse. METHODS: The medical records of 35 rabbits diagnosed with gastrointestinal obstruction over a 3-year period were examined. Differences in presentation, clinicopathological and radiographic examination findings, treatments and outcome were evaluated. RESULTS: Approximately 49% of the cases evaluated were considered to have non-life-threatening disease, while 51% were considered to have life-threatening disease. The severity of gastric obstruction was correlated with the severity of hyperglycaemia (average 25.7 mmol/L; 463 mg/dl) and corresponding hyponatraemia (Na < 138 mmol/L; 138 mEq/L). These patients were treated with orogastric decompression and medical management only. LIMITATIONS: This is a retrospective study and there are inherent limitations involving the quality of the data and data collection. Additional studies should be completed that strive for larger sample sizes to compare the differences in outcome between surgical and medical management, as well as investigate the outcomes of rabbits with hyperglycaemia and hyponatraemia that did not have an orogastric decompression performed. CONCLUSIONS: Blood glucose and sodium concentrations, in combination with radiographic findings, may aid clinicians in determining if orogastric decompression is indicated to stabilise rabbits with small intestinal obstructive disorders.

Protecting mechanism of Swietenia macrophylla ethanol extract nanoparticle on streptozotocin induced renal damage in rat.

Background: Hyperglycemia increases reactive oxygen species (ROS), which contributes to diabetic complications such as kidney cell damage. Antioxidant administration could inhibit ROS and kidney cell damage commonly seen in hyperglycemia. Aim: We want to demonstrate that the antioxidant properties of Swietenia macrophylla ethanol extract nanoparticles can prevent kidney cell damage brought on by streptozotocin (STZ) in the current investigation. Methods: This study employs high-energy ball milling to produce nanoparticles from S. macrophylla extract. Additionally, dynamic light scattering (DLS) is utilized to characterize the nanoparticle sizes of the S. macrophylla ethanol extract. Five groups, each consisting of 8 rats, were formed from 40 rats. Control rats received distilled water, the diabetic rats were administered STZ injections, while S. macrophylla rats were given S. macrophylla extract nanoparticles orally and STZ injection. After the trial, blood from a rat was drawn intracardially to check the levels of blood urea nitrogen (BUN) and creatinine. The levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) were then assessed in kidney tissue samples. Histological alterations were evaluated in kidney section samples. Results: A DLS analysis estimated the size of the S. macrophylla ethanol extract nanoparticles to be about 91.50 ± 23.06 nm. BUN and creatinine levels were significantly raised after STZ treatment. STZ significantly decreased SOD and GPx levels in kidney tissue while raising MDA levels (p < 0.05). Swietenia macrophylla ethanol extract nanoparticle caused the decreased levels of BUN and creatinine in blood to normal levels (p < 0.05), indicating that S. macrophylla ethanol extract prevented the STZ-induced kidney cell damage. Additionally, S. macrophylla nanoparticles significantly raise GPx and SOD levels in kidney tissue while lowering MDA levels (p < 0.05). These actions are thought to have prevented kidney histological alterations (degeneration and necrosis) in diabetic rats. Conclusion: According to these results, the anti-oxidative stress properties of S. macrophylla nanoparticles make them potentially effective nephroprotective therapies for STZ-induced kidney cell damage.

A randomized clinical trial on effects of alfaxalone combined with medetomidine and midazolam in preventing stress-related neurohormonal and metabolic responses of isoflurane-anesthetized cats undergoing surgery.

OBJECTIVE: To evaluate the effects of IM and IV administration of alfaxalone alone and in combination with medetomidine, midazolam, or both on key stress-related neurohormonal and metabolic changes in isoflurane-anesthetized cats undergoing ovariohysterectomy or castration. ANIMALS: 72 client-owned mixed-breed cats undergoing ovariohysterectomy or castration between October 4, 2018, and January 10, 2020. PROCEDURES: For each type of surgery, cats were assigned to 1 of 6 premedication protocols groups, with 6 cats/group: physiologic saline (0.9% NaCl) solution (0.5 mL, IM) and alfaxalone (5 mg/kg, IV); physiologic saline solution (0.5 mL, IM) and alfaxalone (5 mg/kg, IM); medetomidine (50 µg/kg, IM) and alfaxalone (5 mg/kg, IV); medetomidine (50 µg/kg, IM) and alfaxalone (5 mg/kg, IM); midazolam (0.5 mg/kg, IM), medetomidine (50 µg/kg, IM), and alfaxalone (5 mg/kg, IV); or midazolam (0.5 mg/kg, IM), medetomidine (50 µg/kg, IM), and alfaxalone (5 mg/kg, IM). Venous blood was taken before pretreatment, pre- and postoperatively during anesthesia with isoflurane and oxygen, and during early and complete recovery. RESULTS: Compared with baseline concentrations, plasma adrenaline and noradrenaline concentrations decreased during anesthesia in cats premedicated with alfaxalone alone and in combination with medetomidine. The combination of medetomidine, midazolam, and alfaxalone prevented an excessive increase in catecholamines during anesthesia and surgery in cats. Postoperative plasma cortisol concentration after ovariohysterectomy was lower for cats premedicated with the combination of medetomidine and alfaxalone or the combination of medetomidine, midazolam, and alfaxalone, compared with cats premedicated with alfaxalone alone. Cats treated with combinations that included medetomidine and midazolam had hyperglycemia during anesthesia. Cats treated with medetomidine or medetomidine and midazolam in combination with alfaxalone, compared with alfaxalone alone, had lower concentrations of nonesterified fatty acids during anesthesia. Behavioral recovery scores were lower (better) for cats that received medetomidine in addition to alfaxalone, compared with alfaxalone alone. CLINICAL RELEVANCE: Results indicated that pretreatments with medetomidine and alfaxalone or with medetomidine, midazolam, and alfaxalone were useful for preventing stress-related hormonal and metabolic responses, other than hyperglycemia, during isoflurane anesthesia and surgery in cats.

Use of the SGLT2 inhibitor canagliflozin for control of refractory equine hyperinsulinemia and laminitis.

Background: Hyperinsulinemia associated with pituitary pars intermedia dysfunction (PPID) and/or equine metabolic syndrome is well documented to put horses at high risk of laminitis. While dietary control of simple sugars and starch is the most effective therapy to control hyperinsulinemia, some horses fail to respond. Case Descriptions: Ten horses with hyperinsulinemia refractory to diet control, metformin, levothyroxine, and pergolide (if diagnosed with PPID) were treated with sodium-glucose cotransporter-2 inhibitor canagliflozin (Invokana®). Nine horses were hyperglycemic (>5.5 mmol/l) or had a history of hyperglycemia. Before instituting therapy, renal function was assessed by determining serum creatinine and blood urea nitrogen concentrations. Canagliflozin was administered orally once a day, with food. Dipstick urinalysis was performed every 2 weeks to confirm glucosuria and screen for proteinuria. Owners were also instructed regarding clinical signs consistent with urinary tract infection. All horses responded with a substantial decrease in serum insulin concentrations to normal or near normal values. Laminitis pain resolved in all cases, with regression of fat deposits. Owner satisfaction with outcomes was 100%. Conclusion: Once daily administration of the SGLT2 inhibitor canagliflozin corrected hyperglycemia, reduced insulin to normal or near normal levels, and was 100% effective in reversing or reducing abnormal fat pads and eliminating laminitis pain in horses with refractory hyperinsulinemia and laminitis. The core aspects of therapy-diet control, exercise when possible, and adequate treatment of PPID-must also be maintained if using canagliflozin. Canagliflozin should be reserved for refractory cases. Further controlled trials to investigate canagliflozin pharmacokinetics, pharmacodynamics, efficacy, and safety are needed.

SARS-CoV-2 Infection Causes Hyperglycemia in Cats.

Isolated reports of new-onset diabetes in patients with coronavirus disease 2019 (COVID-19) have led researchers to hypothesize that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects human exocrine and endocrine pancreatic cells ex vivo and in vivo. However, existing research lacks experimental evidence indicating that SARS-CoV-2 can infect pancreatic tissue. Here, we found that cats infected with a high dose of SARS-CoV-2 exhibited hyperglycemia. We also detected SARS-CoV-2 RNA in pancreatic tissues of these cats, and immunohistochemical staining revealed the presence of SARS-CoV-2 nucleocapsid protein (NP) in islet cells. SARS-CoV-2 NP and spike proteins were primarily detected in glucagon-positive cells, and most glucagon-positive cells expressed ACE2. Additionally, immune protection experiments conducted on cats showed that blood glucose levels of immunized cats did not increase postchallenge. Our data indicate cat pancreas as a SARS-CoV-2 target and suggest that the infection of glucagon-positive cells could contribute to the metabolic dysregulation observed in SARS-CoV-2-infected cats.

Inverse relationship between eosinophil profiles and serum glucose concentration in dogs with naturally occurring hypercortisolism.

Hyperglycemia and eosinopenia are well-known characteristics of hypercortisolism (HC) in humans, however, their association in dogs with HC has rarely been reported. This study aimed to evaluate the association between eosinophils and serum fasting glucose concentration in dogs with HC. Forty-seven dogs with HC and 43 dogs with non-adrenal illness were included. In this retrospective cohort study, the complete blood count, blood chemistry profile, and pre- and post-adrenocorticotropic hormone (ACTH) cortisol concentrations were analyzed. Significant differences were found in neutrophil, monocyte, eosinophil, and platelet counts; eosinophil percentage; neutrophil-to-lymphocyte ratio; aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyl transferase activities (P < 0.05) between the groups. In dogs with HC, the eosinophil percentage was inversely correlated with fasting blood glucose (r = -0.3515, P = 0.0154) and post-ACTH cortisol concentrations (r = -0.6509, P < 0.0001). The neutrophil-to-lymphocyte ratio was inversely correlated with the eosinophil percentage (r = -0.4573, P = 0.0012) and count (r = -0.3688, P = 0.0108), but positively correlated with the fasting blood glucose level (r = 0.3888, P = 0.0069). Such correlations were not identified in dogs with non-adrenal illness. A multivariate analysis showed that only eosinophil percentage was associated with the presence of hyperglycemia in dogs with HC (odds ratio = 2.100, 95% confidence interval = 1.051-4.199, P = 0.0360). Therefore, eosinopenia induced by excess cortisol might be associated with altered glucose metabolism in dogs with HC. A better understanding of this correlation could be valuable to predict and prevent the complications of HC.

TAZ promotes PDX1-mediated insulinogenesis.

Transcriptional co-activator with PDZ-binding motif (TAZ) is a key mediator of the Hippo signaling pathway and regulates structural and functional homeostasis in various tissues. TAZ activation is associated with the development of pancreatic cancer in humans, but it is unclear whether TAZ directly affects the structure and function of the pancreas. So we sought to identify the TAZ function in the normal pancreas. TAZ defect caused structural changes in the pancreas, particularly islet cell shrinkage and decreased insulin production and ß-cell markers expression, leading to hyperglycemia. Interestingly, TAZ physically interacted with the pancreatic and duodenal homeobox 1 (PDX1), a key insulin transcription factor, through the N-terminal domain of TAZ and the homeodomain of PDX1. TAZ deficiency decreased the DNA-binding and transcriptional activity of PDX1, whereas TAZ overexpression promoted PDX1 activity and increased insulin production even in a low glucose environment. Indeed, high glucose increased insulin production by turning off the Hippo pathway and inducing TAZ activation in pancreatic ß-cells. Ectopic TAZ overexpression along with PDX1 activation was sufficient to produce insulin in non-ß-cells. TAZ deficiency impaired the mesenchymal stem cell differentiation into insulin-producing cells (IPCs), whereas TAZ recovery restored normal IPCs differentiation. Compared to WT control, body weight increased in TAZ-deficient mice with age and even more with a high-fat diet (HFD). TAZ deficiency significantly exacerbated HFD-induced glucose intolerance and insulin resistance. Therefore, TAZ deficiency impaired pancreatic insulin production, causing hyperglycemia and exacerbating HFD-induced insulin resistance, indicating that TAZ may have a beneficial effect in treating insulin deficiency in diabetes.

Quantification of tear glucose levels and their correlation with blood glucose levels in dogs.

BACKGROUND: No previous studies have quantified tear glucose (TG) levels in dogs or compared changes in TG and blood glucose (BG) concentrations. OBJECTIVE: To quantify TG concentration and evaluate its correlation with BG level in dogs. METHODS: Twenty repetitive tests were performed in alternate eyes of four dogs, with a minimum washout period of 1 week. Tears and blood were collected at 30-min intervals with successive glucose injections (1 g/kg) every 30 min. Cross-correlations of BG and TG levels were assessed. The delay and association between TG and corresponding BG levels were analysed for each dog; samples were collected at 5-min intervals. The tears were collected using microcapillary tubes. Collected tears and blood were analysed for glucose concentration using a colorimetric assay and commercially available glucometer, respectively. RESULTS: The average baseline BG and TG levels were 4.76 ± 0.58 and 0.39 ± 0.04 mmol/L, respectively. Even with highly fluctuating BG levels, a significant cross-correlation coefficient (r = 0.86, p < 0.05) was observed between changes of BG and TG levels. The delay time between BG and TG levels was 10 min. On average, BG levels were 16.34 times higher than TG levels. There was strong correlation between BG and TG levels (rs  = 0.80, p < 0.01). Significant differences in TG concentrations between normoglycaemia, mild hyperglycaemia, and severe hyperglycaemia were found (p < 0.05). CONCLUSIONS: Canine TG concentrations have not been quantified previously. Our findings suggest preliminary data for future research on TG levels in dogs and show TG measurement could be used to screen for diabetes mellitus in dogs.

Acute insulin-responsive hyperglycemia and hypocalcemia in Theileria spp. infected goat.

Theileriosis can be manifested in appreciably variable clinical forms among domestic ruminants and may often become life-threatening. The present report narrates, the quick remarkable clinical recovery of a lactating goat infected with Theileria spp., exhibiting acute insulin-responsive hyperglycemia and hypocalcemia, by providing intensive therapy. A four year old doe was presented with the complaint of acute manifestation of weakness, ventroflexion of neck with flaccid muscles, recumbency, hypersalivation, severe abdominal breathing, anorexia and polyuria since last eighteen hours. The animal kidded three kids one month before, out of which one was mummified. Clinical examination revealed severe depression, dehydration, dyspnoea, congested mucous membrane, sluggish rumen motility and reduced pupillary light reflex. Laboratory investigation revealed severe granulocytopenia, thrombocytopenia, hypocalcemia, hyperglycemia and Theileria spp. infection. The animal showed significant improvement within a few minutes of initiating the evidence-based stabilization therapy to correct hydration status, cellular glucose uptake, calcium levels and Theileria spp. infection. This case indicates the significance of investigating the metabolic status of animals suffering from theileriosis for achieving better clinical responses. Also, future studies may focus on the endocrinological perspectives of metabolic impact of Theileria spp. infection in goats.

Prevalence, association with systemic inflammatory response syndrome and outcome of stress hyperglycaemia in sick cats.

OBJECTIVES: To determine the prevalence of stress hyperglycaemia in sick cats, and to investigate the association of stress hyperglycaemia with systemic inflammatory response syndrome and outcome. MATERIALS AND METHODS: Medical records (2004 to 2013) from sick cats admitted to the Medicine Unit of a Veterinary Teaching Hospital were retrospectively reviewed. Cases were enrolled if a serum glucose measurement and a complete medical record were available. Cats that were healthy, hypoglycaemic, diabetic, sedated or had a previous administration of drugs (apart from vaccination and deworming) were excluded. RESULTS: The study included 647 cats; stress hyperglycaemia (serum glucose >8.3 mmol/L) was found in 194 (30%) cats, while 453 (70%) cats were normoglycaemic. The prevalence of systemic inflammatory response syndrome was significantly higher in cats with stress hyperglycaemia (25/174, 14.4%) compared to normoglycaemic cats (26/399, 6.5%). Significantly, more cats with stress hyperglycaemia were hospitalised [97/194 (50.0%)] compared to normoglycaemic cats [171/453 (37.7%)]. However, the median duration of hospitalisation was not significantly different [4 (1 to 26) days and 4 (1 to 24) days, respectively]. The prevalence of cats with negative outcome was not significantly different between the two groups (cats with stress hyperglycaemia: 37.1%, normoglycaemic cats: 33.9%). Nonetheless, when modelling of outcome prediction included breed, age, stress hyperglycaemia and disease category as factors, cats with stress hyperglycaemia had 2.8 times the odds to have a negative outcome (95% confidence interval: 1.3 to 6.4). CLINICAL SIGNIFICANCE: Based on the cut-off employed in this study, Stress hyperglycaemia, as defined by the cut-off is common in sick cats. Stress hyperglycaemia is associated with systemic inflammatory response syndrome development and seem to be a negative prognostic indicator.

Glargine versus regular insulin protocol in feline diabetic ketoacidosis.

OBJECTIVES: To determine whether basal-bolus administration of glargine insulin is a safe and effective alternative treatment compared to the standard continuous rate infusion (CRI) protocol. DESIGN: Prospective randomized clinical trial. SETTING: University teaching hospital. ANIMALS: Twenty cats diagnosed with diabetic ketoacidosis (DKA). INTERVENTIONS: The cats were block-randomized to either a CRI protocol using regular insulin (CRI-group; n = 10) or a basal-bolus SC and IM glargine protocol (glargine-group, n = 10). Baseline blood gases, electrolytes, glucose, and ß-hydroxybutyrate (ß-OHB) concentrations were measured at the time of admission and later at predefined intervals until reaching the primary endpoint of the study, defined as a ß-hydroxybutyrate concentration < 2.55 mmol/L. MEASUREMENTS AND MAIN RESULTS: The main outcome measure was time (h) to resolution of ketonemia. Secondary outcome measures were time until first improvement of hyperglycemia and ketonemia, decrease of glucose to ≤13.9 mmol/L (250 mg/dL), resolution of acidosis, consumption of first meal, and discharge from hospital. Additionally, occurrence of treatment-associated adverse events and death were compared. Seventeen cats (85%) survived to discharge, with no difference in survival between groups (P = 1.0). Median times to ß-OHB < 2.55 mmol/L were 42 (CRI-group) and 30 (glargine-group) hours, respectively (P = 0.114). Median times to first improvement of hyperglycemia (glargine-group: 2 h; CRI-group: 6 h; P = 0.018) and until discharge from hospital (glargine-group: 140 h; CRI-group: 174 h; P = 0.033) were significantly shorter in the glargine-group. No significant differences were observed in any other parameter under investigation (P > 0.05). CONCLUSIONS: Basal-bolus administration of glargine insulin appears to be an effective and safe alternative to the current standard CRI-protocol for the management of DKA in cats. The positive outcomes and simplicity make it a viable option for the treatment of feline DKA.

Amitraz toxicosis in 3 dogs after being in a rice field.

OBJECTIVE: To describe the clinical course and novel biochemical findings in 3 dogs with amitraz toxicosis. CASE SERIES SUMMARY: Three Labrador Retrievers developed acute onset obtundation to stupor after being in a rice field. On admittance to the hospital, they all displayed bradycardia, hyperglycemia, hyperlactatemia, respiratory acidosis, and metabolic alkalosis. All clinical signs resolved in 18-48 hours with supportive care. One dog represented with similar clinical signs and biochemical abnormalities 3 days after discharge following spending time in a different rice field owned by the same owner. Toxicological analysis of serum from all 3 dogs and vomitus from 1 dog returned positive for amitraz and one of its metabolites. NEW OR UNIQUE INFORMATION PROVIDED: This is the first case series of dogs with confirmed amitraz toxicosis following an environmental exposure. Novel biochemical findings of hyperlactatemia, respiratory acidosis, and metabolic alkalosis were documented in all 3 dogs. Clinicians should be concerned for amitraz toxicosis when presented with an animal with the constellation of signs including decreased mental status, bradycardia, and hyperglycemia, particularly if relevant acid-base abnormalities are also detected.

Assessment of postprandial hyperglycemia and circadian fluctuation of glucose concentrations in diabetic dogs using a flash glucose monitoring system.

BACKGROUND: Postprandial hyperglycemia (PPH) and circadian glucose concentration fluctuations recorded in the home environment of dogs with naturally occurring diabetes mellitus (DM) have not been reported. OBJECTIVES: To determine if a flash glucose monitoring system (FGMS; FreeStyle Libre) can detect PPH and circadian fluctuations in glucose concentrations in dogs with variably controlled DM. ANIMALS: Fourteen client-owned dogs with DM. METHODS: Prospective observational study. Interstitial glucose (IG) concentrations measured by the FGMS during a 13-day study period were analyzed. RESULTS: A total of 17, 446 FGMS IG concentrations were analyzed. For all dogs analyzed together, median IG concentration measured within 30 (288 mg/dL), 60 (286 mg/dL), 90 (285 mg/dL), and 120 (285 mg/dL) minutes of meals was each significantly higher than the median IG concentration at all other times (260 mg/dL, 259 mg/dL, 258 mg/dL, and 257 mg/dL, respectively; range, 40-500 mg/dL; P < .001 for each). Median night-time IG concentration measured from all dogs on 3,547 samples recorded between 1:00 am and 6:00 am (268 mg/dL; range, 40-500 mg/dL) was significantly higher than median IG measured on 13, 899 samples at all other time points (259 mg/dL; range, 40-500 mg/dL; P < .001). CONCLUSIONS AND CLINICAL IMPORTANCE: The FGMS can be used for future studies of PPH and circadian fluctuations of glucose concentrations in dogs with DM in their home environment.