Diagnostic performance of glycated haemoglobin (HbA1c) for diabetes mellitus in dogs.

The objective of this study was to determine the diagnostic performance of glycated haemoglobin (HbA1c) for canine diabetes mellitus (DM) and compare it with that of serum fructosamine. Aliquots of blood samples collected for diagnostic purposes from adult dogs were used. HbA1c was measured using a previously validated capillary electrophoresis assay. The dogs were allocated into four groups: (1) DM; (2) hyperadrenocorticism (HAC); (3) long-term corticosteroid therapy (CST); and (4) various chronic diseases (VD). In total, 88 dogs were included as follows: DM (n = 11), HAC (n = 10), CST (n = 14), and VD (n = 53). Fructosamine was measured in all four groups as follows: DM (n = 6), HAC (n = 7), CST (n = 9), and VD (n = 42). Median (range) serum glucose concentration was higher (P < 0.001) in the DM group (22.8 mmol/L; range, 15.6-29.3 mmol/L) compared to HAC (5.9 mmol/L; range, 4.2-6.8 mmol/L), CST (5.6 mmol/L; range, 4.3-23.3 mmol/L), and VD (5.5 mmol/L; range, 4.1-9.4 mmol/L) groups. Mean (± standard deviation) HbA1c was higher (P < 0.001) in the DM group (6.3% ± 1.5%) compared to HAC (1.9% ± 0.5%), CST (1.7% ± 0.5%), and VD (1.9% ± 0.5%) groups. All diabetic dogs and none of the other dogs had HbA1c levels above the cut-off value for DM (3.3%), indicating an accuracy of 100% in diagnosing DM. Significant differences (P < 0.01) were observed in median fructosamine between the DM group (389 µmol/L; range, 348-865 µmol/L) and the HAC (306 µmol/L; range, 167-348 µmol/L) and the VD (316 µmol/L; range, 189-500 µmol/L) groups. Fructosamine had an accuracy of 84.4% for the diagnosis of DM. When used for the diagnosis of canine DM, HbA1c measured with this specific assay had excellent diagnostic accuracy and was superior to serum fructosamine.

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.

Validation, reference intervals and overlap performance of a new commercially available automated capillary electrophoresis assay for the determination of the major fraction of glycated haemoglobin (HbA1c) in dogs.

Haemoglobin A1c (HbA1c), the major fraction of glycated haemoglobin, is widely used for the diagnosis and monitoring of diabetes mellitus in human beings. However, there is a paucity of literature on the most reliable methods available for measurement of canine HbA1c. The aim of this study was to validate a new automated capillary electrophoresis assay for canine HbA1c, to generate a reference interval and to assess the overlap performance of the assay for the diagnosis of diabetes mellitus. Eighty-three blood samples treated with EDTA were included in the study, comprising 63 from healthy dogs and 20 from diabetic dogs. Linearity was assessed by mixing canine samples of known HbA1c percentage in different proportions, precision was assessed by repeated (n=8) measurement of five canine samples, and stability was assessed by measuring canine samples stored at 4°C for 96h and -20°C for 4 weeks. The robust method was used to determine the reference interval. The assay was demonstrated to be linear (R2=0.943). Intra-assay and inter-assay coefficients of variation (CVs) were 4.8% and 7.0%, respectively. CVs for blood samples stored at 4°C and -20°C were 7.2% and 11.2%, respectively. The reference interval was 0.6-2.7%. Dogs with diabetes mellitus had significantly (P<0.001) higher mean HbA1c (5.24±0.88%) compared to the reference population (1.64±0.55%), with no overlap between results. A HbA1c cut-off of 3.3% clearly differentiated diabetic from healthy dogs. The capillary electrophoresis assay was properly validated for canine HbA1c and the reference interval was determined, while the overlap performance of the assay was excellent.

Α case of multiple bilateral testicular capsule mast cell tumours in a dog.

A 5-year-old intact male German Shepherd dog was referred with a diagnosis of leishmaniasis. Several testicular masses were palpated during the physical examination, while the diagnostic screening yielded no remarkable findings. Fine needle aspiration cytology of the masses revealed the presence of intermediately differentiated mast cell tumours. Scrotal ablation and orchiectomy were performed as a definitive treatment option. The pathological examination of the surgical specimens confirmed the diagnosis of grade II mast cell tumours and showed that they were all confined to the testicular capsule. At 7 months post-admission, the dog exhibited neither postsurgical complications nor metastatic foci and was, therefore, given a favourable prognosis. Despite their exceptionally rare occurrence, mast cell tumours should be considered for the differential diagnosis of testicular tumours.