Association between pancreatitis and chronic kidney disease in cats: a retrospective review of 154 cats presented to a specialty hospital between October 1, 2017, and October 1, 2022.

OBJECTIVE: To investigate an association between pancreatitis and chronic kidney disease (CKD) in cats. ANIMALS: 154 client-owned cats: 77 cats with pancreatitis and 77 control cats with no evidence of pancreatitis. METHODS: Retrospective record review from October 1, 2017, to October 1, 2022, including cats with gastrointestinal clinical signs, pancreatic lipase immunoreactivity (PLI) ≥ 8.8 µg/L or PLI 4.5 to 8.7 µg/L with sonographic evidence of pancreatitis. Control cats had a PLI ≤ 4.4 µg/L with no sonographic evidence of pancreatitis. RESULTS: Cats with pancreatitis had significantly higher International Renal Interest Society CKD stages than controls (P < .001; OR, 13 [95% CI, 6.3 to 31]), and mean creatinine was on average 0.79 mg/dL (95% CI, 0.56 to 1.0) higher than controls (P < .001; age covariate ANCOVA, P = .003). Odds of CKD in cats with pancreatitis compared to controls increased significantly with age (P = .002). Cats aged 10 to < 15 years and 15 to 20 years with pancreatitis had significantly higher prevalence of CKD stage 2 to 4 compared to controls (P < .001; OR, 10.9 [95% CI, 3.4 to 44]; and P = .001; OR, 66 [95% CI, 4.6 to > 1,000], respectively). Cats with pancreatitis had significantly more sonographic renal infarcts (P = .004; OR, 6.9 [95% CI, 1.8 to 46]) and concurrent diabetes mellitus (P = .002; OR, 6 [95% CI, 1.9 to 27]). Cats with pancreatitis were fed more exclusively dry-food diets compared to controls (P = .014). CLINICAL RELEVANCE: Pancreatitis is associated with CKD in cats. Investigating and treating these diseases concurrently early in the disease process may reduce morbidity and mortality due to progressive disease and expensive hospitalizations. Renal infarcts may be associated with pancreatitis in cats without overt cardiac disease.

Detemir improves diabetic regulation in poorly controlled diabetic dogs with concurrent diseases.

OBJECTIVE: This study evaluated the use of detemir for treating diabetic dogs with comorbidities that were poorly controlled with intermediate-acting insulins. ANIMALS: 7 insulin-treated diabetic dogs. PROCEDURES: Retrospective pilot study. Dogs were treated with detemir for at least 3 months, and glycemia was assessed by the owners at home initially 2 to 4 times daily for 6 to 8 weeks and twice daily thereafter. Clinical evaluations occurred on days 7 to 14, day 30, and then every 60 to 90 days, and dosage adjustments of detemir occurred as needed to control glycemia. RESULTS: The mean, peak, nadir, morning, and evening preinsulin daily blood glucose concentrations were significantly lower after dosing with detemir for 1, 3, or 6 months and during the last month of treatment compared to the final month of treatment with intermediate-acting insulin. Intermediate-acting insulins resulted in significantly worse glycemic control than detemir in all 3 categories of control. The odds of a biochemical hypoglycemic measurement with detemir were not significantly different compared to intermediate-acting insulins. Clinical hypoglycemia did not occur following detemir treatment. When insulin was withheld because of low morning preinsulin blood glucose concentration < 6.7 mmol/L (≤ 120 mg/dL) and dogs were fed, mean blood glucose concentration was significantly higher 1 hour later. Glucose concentrations were also significantly higher 12 hours later on days when insulin was withheld in the morning or evening for either 1 or 12 hours. CLINICAL RELEVANCE: Detemir is useful in diabetic dogs with other comorbidities and can be considered an alternative treatment in poorly controlled diabetic dogs.

Practical use of home blood glucose monitoring in feline diabetics.

With the use of handheld glucometers, most owners are able to regularly monitor their cat's blood glucose at home. The data generated from this protocol can be used by the clinician to better tailor insulin therapy to the patient. Along with improvements in long-acting insulin, and available low-carbohydrate, high-protein diets for cats, home blood glucose monitoring (home monitoring) allows for safe, intensive insulin therapy, which results in tighter glycemic control and improved case outcome, often including remission of the diabetic state.