Utility of a canine TSH assay for diagnosis and monitoring of feline hyperthyroidism.

OBJECTIVE: This retrospective study was initiated to evaluate the utility of TSH measurements using a common canine TSH assay to diagnose and monitor feline hyperthyroidism after radioiodine or thyreostatic drug treatment. MATERIAL AND METHODS: The electronic database of the University of Veterinary Medicine Vienna was searched for combined TSH and T4 measurements. 217 pairs of TSH and T4 from 136 cats with possible hyperthyroidism were assigned to group A (untreated; n = 24) and B (treated; n = 193). Measurements in group B were then subcategorized according to T4 concentrations (reference range 15-50 nmol/L): group B1 = elevated T4 (n = 46), group B2 = normal T4 (n = 84) and group B3 = decreased T4 (n = 63). Group B2 was further divided into cats with low normal (group B2a; n = 35), medium normal (group B2b; n = 29) and high normal (group B2c; n = 20) T4 concentrations. RESULTS: TSH was detectable in 4 (17 %) of the 24 untreated cats (group A) and did not return to normal despite seemingly successful therapy in two. Increased TSH concentrations were observed in 3.6 % of the treated cats in group B2 and 2.9 %, 6.9 %, and 0 % in subgroups B2a, B2b and B2c, respectively. Forty-four percent of the treated cats with a decreased T4 (group B3) had an increased TSH concentration. TSH correlated with treatment length (r = 0.358, p = 0.004) and was significantly higher in cats treated for more than 3 months (p = 0.008). CONCLUSION: TSH was detectable in a significant number of untreated hyperthyroid cats and thus this parameter should not be used to definitively rule out feline hyperthyroidism. Furthermore, the very low prevalence of increased TSH concentrations in treated hyperthyroid cats with a normal T4 and cost benefit calculations do not support the routine measurement of TSH in these cats. The fact that TSH correlated with time since treatment start and 56 % of the cats with a decreased T4 had TSH concentrations within the reference limits, suggests delayed recovery of the pituitary thyrotrophs which might explain the low prevalence of subclinical hypothyroidism in the present study. CLINICAL RELEVANCE: TSH measurement in cats with suspected or treated hyperthyroidism using a canine assay lacks diagnostic sensitivity and can only complement therapeutic decision-making.

Quality of life and response to treatment in cats with hypersomatotropism: the owners' point of view.

OBJECTIVES: The aim of this study was to collect clinical information from owners of cats with hypersomatotropism (HS) distributed worldwide, assessing the impact of HS and its treatments on cats' quality of life (QoL) and survival time. METHODS: A survey focused on clinical presentation, diagnostic procedures, treatments, cats' QoL and disease progression was distributed worldwide to owners of cats with HS. The owner's perception of the cats' QoL before and after or during treatment was defined using a score ranging from 1 (poor) to 5 (excellent). Improvement following treatment (IFT) was quantified using a score ranging from 1 (absent) to 5 (obvious). Different treatment groups, including at least five cases, were compared. RESULTS: A total of 127 cats were included from at least 11 different countries. Among these, 120 (95%) were diabetic and 7 (5%) were not. Out of 120 diabetic cats, 55 (46%) were treated with insulin as a single treatment (INS). Other treatments were not mentioned to owners in 35/120 (29%) cases. The median QoL score at diagnosis was 2 (range 1-5) and improved after treatment in all groups. Cabergoline (4; range 1-5), radiotherapy (4; range 2-5) and hypophysectomy (5; range 4-5) showed better median IFT scores compared with INS (3; range 1-5) (P = 0.046, P <0.002 and P <0.0001, respectively). Hypophysectomy IFT proved superior to cabergoline (P = 0.047) and was equal to radiotherapy IFT (P = 0.32). No difference was found between cabergoline and radiotherapy IFT (P = 0.99). The median survival time (MST) was 24 months (range 0-75 months). Cats treated with INS showed shorter MST (22 months; range 0-69 months) compared with cats treated with causal treatments combined (36 months; range 3-75 months) (P = 0.04). CONCLUSIONS AND RELEVANCE: Not all cats with HS will have diabetes mellitus. Causal treatments seem associated with the greatest improvements in perceived cats' QoL and survival; such treatments should therefore be discussed with owners. Cabergoline could be an effective alternative management option.

Comparison of ultrasonographic echogenicity and outcome in cats with suspected pancreatitis.

OBJECTIVES: The aim of this study was to determine whether ultrasonographic pancreatic echogenicity, especially hypoechogenicity, has an impact on the prognosis of cats with suspected pancreatitis. We hypothesised that cats with a hypoechoic pancreas have a longer duration of hospitalisation, higher treatment costs and a higher mortality rate. METHODS: This was a retrospective study, which included cats with clinical signs of pancreatitis, a SNAP fPL test result above the reference interval and ultrasonographic abnormalities consistent with pancreatitis. Medical records and follow-up information were retrieved from the local electronic database. Cases were assigned to one of three groups based on pancreatic echogenicity: hypoechoic, hyperechoic or mixed echogenicity. Statistical analysis aimed to assess differences in outcome, ultrasonographic abnormalities, historical features, physical examination findings, laboratory results, concurrent diseases or treatment costs. RESULTS: Thirty-six (64%) cats with a hypoechoic, seven (13%) with a hyperechoic and 13 (23%) cats with a mixed echoic pancreas were included. Cats with a hypoechoic pancreas had a significantly lower median body weight (P = 0.010) and lower median body condition score (P = 0.004) compared with the other cats. Furthermore, they were presented as being lethargic significantly more often (P = 0.014), were more likely to have a homogeneously enlarged pancreas (P <0.001) and were less likely to have concurrent abnormalities or diseases, such as ultrasonographic enteric abnormalities (P = 0.020), triaditis (P = 0.013) and diabetes mellitus (P = 0.041). However, there was no difference in treatment costs (P = 0.961), duration of hospitalisation (P = 0.898), survival of hospitalisation (P = 0.419) or survival time (P = 0.256) between groups. CONCLUSIONS AND RELEVANCE: In this study, echogenicity was of no prognostic value in cats with suspected pancreatitis. Cats with a hypoechoic pancreas were not associated with a poorer outcome than cats with a hyperechoic or mixed echoic pancreas.

Evaluation of fructosamine concentration as an index marker for glycaemic control in diabetic dogs.

BACKGROUND: Although fructosamine is a commonly used surrogate marker to assess glycaemic control in diabetic dogs, its diagnostic accuracy has been questioned. The main objective of this study was to evaluate the reliability of fructosamine measurements to diagnose well and poorly controlled diabetes mellitus (DM), using continuous glucose monitoring as a gold standard. METHODS: Twenty-four dogs with treated DM and continuous glucose monitoring for mean (±SD) 13.1 (±1.7) days were retrospectively analysed. Two assessment strategies were applied to categorize glycaemic control, and fructosamine concentrations were determined shortly after sensor cessation using a colorimetric assay. RESULTS: Correlations of individual fructosamine concentrations with mean glucose as well as percentage of measurements > 15 mmol/L were not significant (p = 0.372, p = 0.129). Fructosamine did not differ between dogs with and without hypoglycaemic episodes (p = 0.64). Receiver operating characteristic analysis for fructosamine to diagnose either good or poor glycaemic control revealed AUC values of 0.71 (p = 0.025) indicating moderate accuracy, and 0.7 (p = 0.135) indicating AUC is non-discriminatory, respectively. The respective positive likelihood ratios for the optimal cutoffs to identify good (<396 µmol/L) and poor control (>449 µmol/L) were three. CONCLUSIONS: Fructosamine measurement is an imperfect surrogate marker for classifying glycaemic control in diabetic dogs and can only complement serial glucose measurements.

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.

Successful Insulin Glargine Treatment in Two Pet Guinea Pigs with Suspected Type 1 Diabetes Mellitus.

Scientific information on spontaneous type I diabetes mellitus (DM) and treatment modalities in guinea pigs is scarce. As most diabetic guinea pigs are overweight and respond to dietary changes, a disorder resembling type II-DM in humans seems to be most prevalent in this species. In the present report, a nine-month-old female intact guinea pig (GP1) was presented because of a cataract and polyphagia. The physical examinations in GP1 and its littermate, GP2, were unremarkable. Laboratory tests revealed hyperglycemia, hyperlipidemia, elevated fructosamine concentrations, and glucosuria in GP1 and GP2. Not responding to dietary changes, an insulin-dependent diabetes mellitus was suspected in both animals. Treatment with 0.5 IU of glargine insulin (Lantus®) per guinea pig subcutaneously (s.c.) once daily was initiated in both animals. Monitoring included repeated clinical evaluations and the measurement of plasma glucose and fructosamine concentrations. Capillary glucose concentration was measured using a glucometer, and glucosuria was monitored by dipstick. Blood glucose concentrations decreased quickly in both GPs, and glucosuria resolved. Including several dose adjustments, DM remained controlled for over 1.5 years. Bilateral cataracts and lens-induced uveitis in GP1 were medically managed with only slight progression. This is the first report of guinea pigs with insulin-dependent diabetes mellitus that were successfully treated with long-acting basal insulin glargine.

Patterns of the low-dose dexamethasone suppression test in canine hyperadrenocorticism revisited.

BACKGROUND: The low-dose dexamethasone suppression test (LDDT) is considered an accurate screening and valuable differentiation test in dogs with suspected hyperadrenocorticism (HAC). A recent study showed that the different response patterns not only provide complementary information about etiology, but also the probability of HAC in these patients. OBJECTIVES: We aimed to determine the diagnostic test performance of LDDT response patterns in a population of dogs from an animal hospital. METHODS: The electronic database was retrospectively searched for dogs suspected of HAC that were given an LDDT. Dogs with acute non-adrenal illnesses during the test were excluded. Response patterns were classified as complete suppression, lack of suppression, partial suppression, escape, inverse, and increasing patterns. Cortisol concentrations ≥ 27.59 nmol/L (≥1 µg/dL) 8 hours after dexamethasone administration were considered positive results irrespective of the patterns observed. Calculations included likelihood ratios (LRs) and predictive values (PVs). RESULTS: HAC and non-adrenal illness were diagnosed in 115 (54%) and 62 (46%) dogs, respectively. The positive (+) LRs (95% CI) for the lack of suppression, partial suppression, escape, and an inverse pattern to diagnose HAC were infinite, 8.09 (2-32.72), 3.23 (0.75-14), and 0.2 (0.06-0.73), respectively. CONCLUSIONS: The study confirms that the "lack of suppression" pattern strongly supports a diagnosis of HAC. It shows that the "partial suppression" pattern moderately increases, and the "inverse" pattern decreases the likelihood of HAC. The fact that the study found no association between the "escape" pattern and a diagnosis of HAC, does not support its integration into decision making.

Flash glucose monitoring in diabetic dogs: a feasible method for evaluating glycemic control.

OBJECTIVE: To alleviate clinical signs and avoid life-threatening complications in dogs with diabetes mellitus, individualized treatment plans and frequent reassessments are necessary. Performing blood glucose profiles every 7-14 days following insulin adjustments and monthly thereafter, is recommended. In 2016, a factory calibrated continuous blood glucose monitoring system was presented as a possible alternative to glucometer readings. The objectives of this study were to summarize the experiences with this new technology and to show, that in combination with simple rules, already the first measurement period can improve glycemic control. MATERIAL AND METHODS: The electronic database of the endocrine unit of the clinic was retrospectively searched for diabetic dogs with flash glucose monitoring. In case of repeated sensor implantations, only the first sensor was considered. The recordings of day A (starting at midnight after sensor placement) were compared to the measurements of day B (day before sensor failure) and all owners were contacted to fill in a standardized questionnaire. RESULTS: The final study population consisted of 24 dogs weighing 3.4 to 36 kg. Although the clicking noise during sensor placement irritated most dogs, the application was considered easy and painless. Waiting for disinfectant evaporation and fixation of the sensor disc with forceps helped to avoid sensor detachment when removing the application device. Although transient mild to moderate skin irritations were observed in 80 % of the dogs, 95 % of the owners were highly satisfied with this new monitoring technology. Mean and maximum glucose (p = 0.043, p = 0.003) as well as glucose readings ≥ 11.1 mmol/l (p = 0.032) decreased from day A to B, whereas markers of glycemic variability did not change. CONCLUSION AND CLINICAL RELEVANCE: Flash glucose monitoring is a feasible, safe method with high user satisfaction and offers a possibility to improve glycemic control in diabetic dogs.

Basal glucose excretion in dogs: The impact of feeding, obesity, sex, and age.

BACKGROUND: The urine glucose (UG) measurements are an integral part of urinalyses, especially in dogs with polyuria and polydipsia. A positive dipstick result is considered pathologic for disease. This paradigm has been challenged by new ultrasensitive tests, where the manufacturers recommend tolerating slightly positive results. It implies that, as in other species, basal urine glucose losses can exceed the lower limits of detection using ultrasensitive glucose dipsticks in healthy dogs. OBJECTIVES: We aimed to determine whether glucose is routinely detectable using a sensitive quantitative wet chemistry method in the urine of nondiabetic, nonazotemic dogs, and investigate the impact of food intake, obesity, sex, castration status, and age. METHODS: Serial UG measurements were performed in healthy clinic-owned Beagle dogs that were randomly fasted or fed. Glucose was measured in morning urine samples from normal-weight healthy and obese dogs, and the university's electronic database was searched for quantitative UG measurements (Gluco-quant Enzyme Kit/Roche Diagnostics). RESULTS: Small amounts of glucose were detected in 555 (99.1%) of 560 urine samples analyzed. All urine samples from the clinic-owned Beagle dogs, as well as from privately owned obese and normal-weight healthy dogs that tested positive for glucose. The median (range) UG concentration obtained from the university's electronic database was 0.39 (0-1.55) mmol/L, and 2.2% of the samples tested negative. Feeding, obesity, gender, castration status, and age did not affect UG concentrations. CONCLUSIONS: Studies, including a larger number of healthy dogs, are warranted to define a cut-off between physiologic and pathologic glucosuria.

[Semiquantitative glucose measurements in urine samples and urine soaked cat litter]. / Semiquantitative Glukosemessungen in Katzenharnproben und in mit Harn verklumpter Einstreu.

OBJECTIVE: Semiquantitative urine glucose measurements are a proposed alternative for the treatment surveillance of unmanageable diabetic cats. The primary objectives of this study were to determine the accuracy of 5 commercially available dipsticks, to re-evaluate a technique for detecting glucosuria in urine-soaked "clumping" type of cat litter described by Schaer and to validate a cat toilet with a sieve bottom. MATERIAL AND METHODS: A total of 93 urine samples were analysed using 5 different urine dipsticks. The correlation with a laboratory reference method and the diagnostic accuracy to diagnose pathological glucosuria > 1.48 mmol/l and urinary glucose concentrations ≥ 13.9 mmol/l (therapeutically important cut-off) were determined. Furthermore, the viability of 10 types of cat litter, a cat toilet with sieve bottom, 2 disinfectants, 2 cleaning agents and 2 cat litter deodorants were tested. RESULTS: The correlations of the dipstick results with the reference method were moderate (rSP = 0.633) to good (rSP = 0.846). The sensitivities and specificities to diagnose pathological glucosuria were 0.7-1 and 0.94-1, respectively. Urine glucose concentrations ≥ 13.9 mmol/l were detected with sensitivities of 0.65-1 and specificities of 0.97-1. Four cat litters, one dipstick and a disinfectant containing hydrogen peroxide caused false-positive colour reactions. Depending on the dipsticks and litter used, the measurements from soaked cat litter reduced the urine glucose concentrations by a median of 70-77 %. Pouring the probes into the cat toilet and subsequent measurements from the collecting tank did not falsify the results. CONCLUSION AND CLINICAL RELEVANCE: Not all urine dipsticks are suitable to monitor insulin therapy in diabetic cats. False positive colour reactions are possible when using dipsticks with high analytical sensitivities, some cat litters and oxidizing disinfectants. Measurements from the collecting tank of the cat toilet are superior to measurements using soaked clumping type of cat litter.

Prednisolone dosages in Addisonian dogs after integration of ACTH measurement into treatment surveillance.

OBJECTIVE: To examine the prednisolone and fludrocortisone dosages in dogs with primary hypoadrenocorticism after integrating endogenous ACTH (eACTH) determination into the surveillance regimen. MATERIALS AND METHODS: The local electronic medical records database was searched for dogs with primary hypoadrenocorticism and a complete follow-up including routine eACTH measurements until stabilisation. Dogs were considered stable if they showed no signs of glucocorticoid deficiency or excess, sodium and potassium were within the laboratory reference limits and no change of prednisolone and/or fludrocortisone dosage was recommended by the clinician. To avoid subclinical glucocorticoid overreplacement prednisolone was routinely reduced in case of eACTH concentrations below the detection limit of the assay. RESULTS: Thirteen client-owned dogs were eligible for inclusion in the study. Stabilisation was achieved after a median (range) of 14 (1-36) months and 4 (2-9) visits. After exclusion of two patients that did not need additional glucocorticoids, the prednisolone dosage was 0.06 (0.02-0.26) mg/kg/day and 9.1 times lower than the starting dose. No correlation was identified between prednisolone dosage in mg/kg/day and bodyweight (rSP = -0.369, p = 0.215). The final fludrocortisone dose was 0.022 (0.013-0.036) mg/kg/day. The median (range) survival time of the dogs that had died during the study period (n = 6) and all dogs was 74.5 (62-98) months and 71 (18-104) months, respectively. CONCLUSION AND CLINICAL RELEVANCE: The integration of eACTH measurement into treatment surveillance helps to optimise glucocorticoid replacement therapy. It supports treatment recommendations and is a particular aid in dogs with ambiguous clinical signs. The results suggest that most dogs on fludrocortisone substitution therapy benefit from additional very low dose prednisolone.

Radial vs coccygeal artery Doppler blood pressure measurement in conscious cats.

Objectives The aims of the study were to compare the results of systolic blood pressure (SBP) measurements at the radial and coccygeal artery by Doppler ultrasonography and to assess the impact of gender, age, body weight, body condition score (BCS) and stress score on disagreements. Methods Eighty cats were included in this prospective, block randomised crossover trial. Blood pressure measurements were performed at home, during hospitalisation or in a local animal shelter by a single trained observer according to the latest ISFM consensus guidelines. Statistical analysis included Spearman's correlation and ANOVA. Results Measurement or site order had no effect on blood pressure measurements ( P = 0.157, P = 0.965). Correlation of radial and coccygeal SBP was moderate (rsp = 0.519, P <0.001) and measurements at the tail were by mean 18.7 ± 37 mmHg higher. The differences between the measuring sites were neither correlated with age (rsp = 0.044, P = 0.710) nor with body weight (rsp = 0.122, P = 0.337). A significant effect of BCS ( P = 0.016), but not gender ( P = 0.246) or stress score ( P = 0.424) was identified. Of the 25 cats with a coccygeal SBP ⩾170 mmHg, 14 (56%) were categorised as mildly hypertensive or normotensive when measurements were performed at the forelimb. Conclusions and relevance Choice of the measuring site, coccygeal vs radial artery, has a significant impact on Doppler ultrasonographic SBP results. In many cats, these discrepancies are huge and would certainly affect treatment decisions. Possible explanations include cone-shaped tails, especially in obese cats, leading to distal gapping or slippage of cylindrical cuffs and peripheral pulse pressure amplification. Further studies are urgently needed to clarify whether the discordances are artefacts or have a pathological background.

Hypochloremia in cats - prevalence and associated diseases.

OBJECTIVE: To describe the prevalence and possible causes of hypochloremia in the local hospital cat population. MATERIAL AND METHODS: Retrospective study consisting of two parts. Data were collected from the local electronic medical records database using the search terms "chloride" and "cats" (part A), and "blood gas analysis" and "cats" (part B). The medical records of the hypochloremic cats were then reviewed to determine prior treatment or infusions and to identify major underlying disease processes. Part A included an age and gender matched non-hypochloremic control group, whereas in part B acid-base status was assessed. RESULTS: Hypochloremia was detected in 367 (27%) of 1363 blood samples. The application of a correction formula to adjust for free water changes decreased the number of hypochloremic cats to 253 (19%). Only a minority had received glucocorticoids or loop diuretics and the prevalence of vomiting was 44%. Common associated disorders were gastrointestinal and respiratory diseases, as well as azotemia and diabetes mellitus. Polyuria/polydipsia, dehydration, prednisolone or furosemide pretreatment, azotemia and diabetes mellitus increased, whereas fluid therapy and the diagnosis of neoplasia decreased the prevalence of hypochloremia. An inverse correlation was found between corrected chloride and standardized base excess (rs = -0.597, p = 0.001) as well as anion gap (rs = -0.4, p = 0.026). 99% of the hypochloremic cats had derangements of acid-base balance. CONCLUSION: Hypochloremia is a common electrolyte disorder in the local cat population. The correction formula is necessary to adjust for changes in plasma osmolality. Although associated with metabolic alkalosis, most of the hypochloremic cats have a normal or decreased pH. The inverse correlation of chloride and anion gap als well as the high proportion of azotemic or diabetic animals support the concept of compensatory acidosis induced hypochloremia. CLINICAL RELEVANCE: Hypochloremia should prompt the clinician to performe blood-gas analysis. Diabetes mellitus (especially ketoacidosis) and renal disease should be included in current algorithms for the evaluation of hypochloremic patients.

Metabolic and hormonal responses to subcutaneous glucagon in healthy beagles.

OBJECTIVE: To compare the effects of subcutaneous (SC) and intravenous (IV) glucagon on glucose concentrations, and insulin and cortisol secretion. DESIGN: Prospective randomized 3-way crossover study. SETTING: University teaching hospital. ANIMALS: Five healthy beagles. INTERVENTIONS: Diabetes mellitus and adrenal insufficiency were excluded by repeated glucose and fructosamine measurements, urinalysis, abdominal ultrasonography, and ACTH stimulation tests. Blood samples were collected before and after the SC and IV injection of 1 milligram (1 mg = 1 mL) commercially available synthetic glucagon and analyzed for insulin-like immunoreactivity (insulin-imr), glucose, ACTH and cortisol concentrations. The results were compared with those obtained after the SC injection of 1 mL saline (placebo). Measurements were performed over a period of up to 3 hours. MEASUREMENTS AND MAIN RESULTS: SC glucagon significantly increased glucose and insulin-imr (P < 0.001 and 0.043, respectively). Peak glucose concentrations were observed after 20 minutes and were lower than after IV injection (mean ± SD: 6.5 ± 1.1 mmol/L versus 9.3 ± 0.8 mmol/L [117.1 ± 19.8 mg/dL versus 167.6 ± 14.4 mg/dL]; P = 0.001). The route of application had no significant effect on insulin-imr (peak concentration: median [range]: 83.3 [13.9-312.5] pmol/L versus 194.5 [118.1-284.7] pmol/L [12 [2-45] µU/mL versus 28 [17-41] µU/mL; P = 0.151). SC glucagon did not increase cortisol or ACTH concentrations at any time point of observation (P > 0.05). Aside from somnolence, no adverse events were recorded. CONCLUSIONS: SC glucagon has the potential to be used as a simple and safe test in diabetic animals, but is of little use in animals with suspected corticotrophic insufficiency. The hyperglycemic effects are significant, implying that the commercially available human emergency kit could be useful in the home treatment of canine hypoglycemic emergencies.

Alternative sampling site for blood glucose testing in cats: giving the ears a rest.

UNLABELLED: BACKGROUND AND STUDY RATIONALE: Home monitoring is an important part of the long-term management of diabetic cats. Despite the extensive use of glucometers in this species, up until now only the pinna of the ear has been validated as a testing site. This cross-sectional study investigated the feasibility and validity of sampling from the metacarpal/metatarsal pads in hospitalised cats with various diseases. INVESTIGATIONS: The large pads were compared with the ear as a sampling site in 75 cats. Lancing the pads was tolerated very well. If the initial drop of blood was too small, an adequate volume of blood was almost always achieved by squeezing the pads. No significant differences were observed in first-attempt success rate or glucose values between the two sites. Due to the inability to obtain an adequate volume of blood or struggling, no measurement was possible in four cats. PRACTICAL RELEVANCE: While further work is necessary to assess the utility of this technique, especially in the home environment, the results indicate that the metacarpal pads, in particular, may offer a viable alternative testing site for the measurement of blood glucose concentrations, especially if ear sampling fails.