Mammary development, hyperestrogenemia, and hypocortisolemia in a male cat with an adrenal cortical carcinoma.

A 14-year-old neutered male domestic shorthaired cat was diagnosed with an adrenal cortical carcinoma causing hyperestrogenemia that resulted in mammary hyperplasia and sexual behavior. A right adrenalectomy and mammary gland biopsy were performed. Adrenal cortical neoplasia should be ruled out in any neutered male cat with mammary development and/or exhibiting sexual behavior.

Développement mammaire, hyperœstrogénémie et hypocortisolémie chez un chat mâle atteint d'un corticosurrénalome malin. Un corticosurrénalome malin, causant l'hyperœstrogénémie et produisant une hyperplasie mammaire et un comportement sexuel, a été diagnostiqué chez un chat domestique à poil court mâle stérilisé âgé de 14 ans. Une surranélectomie droite et une biopsie de la glande mammaire ont été réalisées. Un diagnostic de corticosurrénalome devrait être éliminée chez tout chat stérilisé ayant un développement mammaire et/ou manifestant un comportement sexuel.(Traduit par Isabelle Vallières).

Hypoadrenocorticism in a kindred of Pomeranian dogs.

Three adult Pomeranian dogs, full siblings from 2 litters, were diagnosed with primary hypoadrenocorticism following onset of hypoadrenal crisis. Review of the family history revealed the dogs' maternal grandmother also had hypoadrenocorticism. All 4 dogs were pedigree-certified by the American Kennel Club. An inherited basis for hypoadrenocorticism is proposed in these Pomeranian dogs.

Hypoadrénocorticisme dans un parentage de chiens Poméraniens. Trois chiens Poméraniens adultes, tous issus de deux portées ayant les mêmes parents, ont été diagnostiqués d'hypoadrénocorticisme primaire après l'apparition d'une crise hypoadrénale. L'examen des antécédents familiaux a révélé que la grand-mère maternelle des chiens souffrait aussi d'hypoadrénocorticisme. Le pédigrée des 4 chiens a été certifié par l'American Kennel Club. Une hérédité d'hypoadrénocorticisme est proposée chez ces Poméraniens.(Traduit par Isabelle Vallières).

Evaluation of bexagliflozin in cats with poorly regulated diabetes mellitus.

The aim of this study was to investigate the effect of bexagliflozin on glycemic control in poorly regulated diabetic cats and to evaluate for adverse events associated with this medication. Sodium-glucose cotransporter 2 inhibitors are a newer class of drugs used in the management of humans with type 2 diabetes mellitus. The objective of this study was to evaluate the effect of the orally administered drug, bexagliflozin in a group of poorly regulated diabetic cats over a 4-week study period. Five client-owned cats with poorly controlled diabetes mellitus receiving insulin therapy were enrolled. Bexagliflozin was administered once daily. Serum fructosamine, serum biochemistry profile, and 10-hour blood glucose curves were assessed at baseline (Day 0), Day 14, and Day 28. All cats had a significant reduction in insulin dose requirement (P = 0.015) and insulin was discontinued in 2 cats. There was a significant decrease in blood glucose concentration obtained from blood glucose concentration curves during the study period (P = 0.022). Serum fructosamine decreased in 4 of the 5 cats with a median decrease of 152 µmol/L (range: 103 to 241 µmol/L), which was not statistically significant (P = 0.117). No cats had any documented episodes of hypoglycemia. Adverse effects were mild. The addition of bexagliflozin significantly improved diabetic management in this group of cats.

Le but de cette étude était d'étudier l'effet de la bexagliflozine sur la maitrise de la glycémie chez les chats diabétiques mal régulés et d'évaluer les événements indésirables associés à ce médicament. Les inhibiteurs du cotransporteur sodium-glucose 2 sont une nouvelle classe de médicaments utilisés dans la prise en charge des personnes atteintes de diabète de type 2. L'objectif de cette étude était d'évaluer l'effet du médicament administré par voie orale, la bexagliflozine, dans un groupe de chats diabétiques mal régulés sur une période d'étude de 4 semaines. Cinq chats appartenant à des clients atteints de diabète sucré mal maitrisé et recevant une insulinothérapie ont été inclus. La bexagliflozine a été administrée une fois par jour. La fructosamine sérique, le profil biochimique sérique et les courbes de glycémie sur 10 heures ont été évalués au départ (jour 0), au jour 14 et au jour 28. Tous les chats ont présenté une réduction significative de la dose d'insuline requise (P = 0,015) et l'insuline a été interrompue chez deux chats. Il y avait une diminution significative de la concentration de glucose dans le sang obtenue à partir des courbes de concentration de glucose dans le sang au cours de la période d'étude (P = 0,022). La fructosamine sérique a diminué chez 4 des 5 chats avec une diminution médiane de 152 µmol/L (plage : 103 à 241 µmol/L), ce qui n'était pas statistiquement significatif (P = 0,117). Aucun chat n'a eu d'épisodes documentés d'hypoglycémie. Les effets indésirables étaient légers. L'ajout de bexagliflozine a considérablement amélioré la gestion du diabète dans ce groupe de chats.(Traduit par Docteur Serge Messier).

Complications associated with a flash glucose monitoring system in diabetic cats.

OBJECTIVES: Glucose monitoring is an integral part of diabetes management. Interstitial glucose monitoring systems are increasingly commonly being used for this purpose in dogs and cats, including the use of a flash glucose monitoring system (FGMS). The aim of this study was to describe the incidence and nature of complications associated with the use of an FGMS in diabetic cats. METHODS: The medical records of all cats that had placement of a 14-day FGMS during a 1-year period were retrospectively reviewed. Data retrieved included the number of days the sensor remained attached and functional, location of sensor placement and complications associated with the sensor. Complications were defined as early sensor detachment, sensor failure prior to the end of the 14-day monitoring period and dermatologic changes at the sensor site. Descriptive statistics were used to characterize the data. RESULTS: Twenty cats had a total of 33 FGMSs placed. The majority (30/33 [91%]) of sensors were placed over the dorsolateral aspect of the thorax just caudal to the scapula. Twenty (61%) FGMSs remained attached and functional for the full 14 days. The overall incidence of complications associated with FGMS use was 10/33 (30%). The most frequent complication was early sensor detachment (n = 5/33 [15%]). Mild dermatologic changes (erythema, crusts) were noted with 4/33 (12%) FGMSs. More serious complications (skin erosions, abscess formation) were noted with 2/33 (6%) FGMSs. CONCLUSIONS AND RELEVANCE: The use of the FGMS is relatively safe in cats, although there are potential complications that owners should be made aware of.

Use of glargine and lente insulins in cats with diabetes mellitus.

The goals of this study were to compare the efficacy of once-daily administered Glargine insulin to twice-daily administered Lente insulin in cats with diabetes mellitus and to describe the use of a high-protein, low-carbohydrate diet designed for the management of diabetes mellitus in cats. All cats with naturally occurring diabetes mellitus were eligible for inclusion. Baseline testing included a physical examination, serum biochemistry, urinalysis and urine culture, serum thyroxine concentration, and serum fructosamine concentration. All cats were fed the high-protein, low-carbohydrate diet exclusively. Cats were randomized to receive either 0.5 U/kg Lente insulin q12h or 0.5 U/kg Glargine insulin q24h. Re-evaluations were performed on all cats at weeks 1, 2, 4, 8, and 12, and included an assessment of clinical signs, physical examination, 16-hour blood glucose curve, and serum fructosamine concentrations. Thirteen cats completed the study (Lente, n = 7, Glargine, n = 6). There was significant improvement in serum fructosamine and glucose concentrations in all cats but there was no significant difference between the 2 insulin groups. Four of the 13 cats were in complete remission by the end of the study period (Lente, n = 3; Glargine, n = 1). The results of the study support the use of once-daily insulin Glargine or twice-daily Lente insulin in combination with a high-protein, low-carbohydrate diet for treatment of feline diabetes mellitus.

Clinical findings, diagnostics and outcome in 33 cats with adrenal neoplasia (2002-2013).

OBJECTIVES: The objective of this retrospective study was to describe the clinical signs and diagnostic findings in cats with histopathologically confirmed adrenal neoplasms, and to assess correlations with survival data. METHODS: Study data were acquired by reviewing medical records for all cats diagnosed with adrenal neoplasms at seven referral institutions between 2002 and 2013. Inclusion criteria required a histopathologic diagnosis of an adrenal neoplasm (ante-mortem or on necropsy). RESULTS: Thirty-three cats met the inclusion criteria for the study. The most common presenting complaints included weakness (n = 12), respiratory signs (n = 4), blindness (n = 4) or gastrointestinal signs (n = 3). Laboratory abnormalities included hypokalemia (n = 18), alkalemia (n = 12), elevated creatine kinase (>3000, n = 5) and azotemia (n = 4). In addition, hypertension was noted in 13 cats. Thirty cats were diagnosed with cortical tumors (17 carcinomas, 13 adenomas) and three cats were diagnosed with pheochromocytomas. Twenty-five cats underwent tests to evaluate the function of the adrenal tumors; 19/25 cats had functional tumors (hyperaldosteronism [n = 16], hypercortisolemia [n = 1], high estradiol [n = 1], and hypersecretion of aldosterone, estradiol and progesterone [n = 1]). Twenty-six cats underwent adrenalectomy, one cat was medically managed and six were euthanized without treatment. Long-term survival postoperatively ranged from 4-540 weeks, with 20 (77%) cats surviving the perioperative period of 2 weeks. The only variable that was found to be negatively associated with survival was female sex. The most common complications noted during the perioperative period were hemorrhage and progressive lethargy and anorexia. CONCLUSIONS AND RELEVANCE: Surgical treatment for feline adrenal tumors (regardless of tumor type) resulted in good long-term survival. Given that pre- and postoperative hypocortisolemia was identified in this study, and, in addition, hypersecretion of more than one adrenal hormone occurred in one cat, adrenal panels prior to surgery may be beneficial as part of the preoperative work-up.

A pilot study comparing a protocol using intermittent administration of glargine and regular insulin to a continuous rate infusion of regular insulin in cats with naturally occurring diabetic ketoacidosis.

OBJECTIVE: The goal of this pilot study was to compare regular insulin administered by continuous rate infusion (CRI) to an approach using insulin glargine and regular insulin administered intermittently. DESIGN: Prospective randomized clinical trial. SETTING: University teaching hospital. ANIMALS: Sixteen cats with diabetic ketoacidosis (DKA). INTERVENTIONS: Cats with DKA were randomized to either low-dose regular insulin CRI (CRI group; n = 8) or intermittent short- and long-acting insulin injections (subcutaneous [SC] glargine plus intramuscular [IM] regular insulin; SC/IM group; n = 8). MEASUREMENTS AND MAIN RESULTS: Time of normalization of pH, bicarbonate, hyperglycemia, ketonemia, and appetite, as well as duration of hospitalization were recorded. Eleven of 16 cats (59%) survived to discharge, with no difference in survival between groups (P = 0.99). Times of resolution of hyperglycemia (P = 0.02) and ketonemia (P = 0.04), and normalization of pH (P = 0.04), and bicarbonate (P = 0.03) were significantly shorter in the SC/IM group. Cats in the SC/IM group also had a significantly shorter duration of hospitalization (SC/IM: median = 54 hr [range, 19-118 hr]; CRI: median = 111 hr [range, 58-271 hr]; P = 0.04). Time of first meal was not significantly different between groups. CONCLUSIONS: Although further research is required, an approach using intermittent short- and long-acting insulin injections appeared to be an effective option for treatment of DKA in cats.

Relationship of pancreatic duct dilation to age and clinical findings in cats.

Dilation of the pancreatic duct has been described as an ultrasonographic feature of pancreatitis in cats. The purpose of this study was to determine normal pancreatic duct width in healthy older cats and assess the significance of pancreatic duct dilation observed in a clinical population. In a prospective study, pancreatic ultrasound was performed in 15 healthy cats (mean age 13 +/- 3 years). Mean pancreatic width of left lobe, body, and right lobe was 0.65 +/- 0.16 cm (0.46-1.03 cm), 0.64 +/- 0.14 cm (0.46-0.9 cm), and 0.43 +/- 0.09 cm (0.3-0.57 cm), respectively. Mean pancreatic duct width was 0.13 +/- 0.04 cm (0.06-0.24 cm), which was significantly larger than previously reported for younger cats (0.08 +/- 0.025 cm) (P < 0.001). One hundred and four of 1445 clinical patients (7.2%) were diagnosed with a dilated pancreatic duct and were reviewed in a retrospective study. Incidence of pancreatic duct dilation was significantly higher in older than in younger cats (2.7% in cats < 1-5 years vs. 18.1% in cats 15 years or older; P < 0.001). Mean pancreatic duct width was 0.23 +/- 0.07 cm (0.14-0.52 cm), and there was a significant correlation between age and pancreatic duct width (P = 0.01). There was also a significant relationship between the mean ratio of pancreatic duct width and pancreatic thickness (n = 98) (0.29 +/- 0.09; 0.09-0.58; P = 0.041). There was no significant difference in age between cats with and without pancreatic disease. There was no association between pancreatic disease and pancreatic duct width or pancreatic duct width/pancreatic thickness ratio. Pancreatic duct width and pancreatic duct width/pancreatic thickness ratio in cats are significantly associated with age.