RESUMEN
This study evaluated the outcome of cats with diabetes mellitus treated with a loose-control approach using protamine zinc insulin and identified factors that influence the likelihood of remission and survival in these cats. A total of 185 client-owned domestic cats were followed until death, lost to follow-up, or the end of the 11-year study. These cats were treated primarily basing insulin dose adjustments on clinical response. Patient records were used to examine factors suspected of influencing success of diabetes management. The remission probability was 56.2%. Survival time ranged from 0 to 3808 days with a median of 1488 days. Recent pre-diabetic corticosteroid use, lower mean blood glucose concentration during treatment, and lower mean insulin dose significantly increased the likelihood of remission. A low-carbohydrate diet, occurrence of remission, lack of diabetic ketoacidosis at diagnosis, lower mean blood glucose value during treatment, and lower blood glucose value at diagnosis were significantly associated with increased survival time.
Contrôle relâché du diabète sucré à l'aide de l'insuline au zinc de protamine chez les chats : 185 cas (20052015). Cette étude a évalué les résultats chez les chats atteints de diabète sucré traités à l'aide d'une approche de contrôle relâché ayant recours à l'insuline de zinc de protamine et a identifié les facteurs qui influencent la probabilité de rémission et de survie chez ces chats. Un total de 185 chats domestiques appartenant à des clients ont été suivis jusqu'à la mort, la perte de suivi ou à la fin de l'étude de 11 ans. Une approche de contrôle relâché et d'insuline au zinc de protamine a été utilisée, surtout sur la base des ajustements de la dose d'insuline en fonction de la réaction clinique. Les dossiers des patients ont été utilisés pour examiner les facteurs soupçonnés d'influencer le succès de la gestion du diabète. La probabilité de rémission était de 56,2 %. Le temps de survie s'échelonnait de 0 à 3808 jours avec une médiane de 1488 jours. L'usage récent de corticostéroïdes prédiabétiques, un taux de glycémie moyen inférieur durant le traitement et une dose d'insuline moyenne inférieure augmentaient significativement la probabilité de rémission. Une diète faible en glucides, l'occurrence de la rémission, l'absence de kétoacidose diabétique, une valeur moyenne inférieure de glycémie durant le traitement et une valeur inférieure de glycémie étaient significativement associées à des temps de survie accrus.(Traduit par Isabelle Vallières).
Asunto(s)
Enfermedades de los Gatos , Diabetes Mellitus/veterinaria , Cetoacidosis Diabética/veterinaria , Animales , Glucemia , Gatos , Insulina , Insulina IsófanaRESUMEN
OBJECTIVE: To determine prevalence of histologic abnormalities in cats suspected, on the basis of compatible clinical signs and ultrasonographic findings, to have chronic small bowel disease; identify the most common underlying causes in affected cats; and compare methods for differentiating among the various causes of chronic small bowel disease. DESIGN: Retrospective case series. ANIMALS: 300 client-owned domestic cats suspected to have chronic small bowel disease. PROCEDURES: Medical records were reviewed to identify cats evaluated because of chronic vomiting, chronic small bowel diarrhea, or weight loss that also had ultrasonographic evidence of thickening of the small intestine. Cats were included in the study if full-thickness biopsy specimens had been obtained from ≥ 3 locations of the small intestine by means of laparotomy and biopsy specimens had been examined by means of histologic evaluation and, when necessary to obtain a diagnosis, immunohistochemical analysis and a PCR assay for antigen receptor rearrangement. RESULTS: Chronic small bowel disease was diagnosed in 288 of the 300 (96%) cats. The most common diagnoses were chronic enteritis (n = 150) and intestinal lymphoma (124). CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that a high percentage of cats with clinical signs of chronic small bowel disease and ultrasonographic evidence of thickening of the small intestine had histologic abnormalities. Furthermore, full-thickness biopsy specimens were useful in differentiating between intestinal lymphoma and chronic enteritis, but such differentiation was not possible with ultrasonography or clinicopathologic testing alone.