Changes in glucose tolerance and insulin secretion in a cohort of cats with chronic obesity.

Obesity, which is the most common spontaneous nutritional disorder in cats, is a known risk factor for the development of diabetes mellitus and has been linked to insulin resistance, hyperinsulinemia, and altered adipose-derived hormone secretion in cats. The objective of this study was to monitor and report changes in the results of serial intravenous glucose tolerance testing (IVGTT) and other metabolic parameters in 4 obese cats over a 4-year period. Serial IVGTT, insulin sensitivity indices, adipokine concentrations, and lipid profiles were evaluated. All cats had IVGTT changes consistent with impaired glucose tolerance and altered insulin secretory patterns during the 4-year study period. There was no significant increase in the fasting blood glucose or insulin concentrations and no changes in the insulin sensitivity indices evaluated. The mean adiponectin concentration decreased significantly over time, but there was no significant increase in the leptin concentration and no changes were observed in lipid profiles. Although IVGTT can be used to document early and/or mild impairment of glucose tolerance and changes in insulin secretory pattern, this test cannot be easily or readily carried out on client-owned cats in most clinical settings. More work needs to be done to establish reliable, convenient methods for earlier identification of cats at risk of developing clinical diabetes mellitus.

L'obésité, qui est le désordre nutritionnel spontané le plus fréquent chez les chats, est un facteur de risque connu pour le développement du diabète mellitus et a été associé à une résistance à l'insuline, à de l'hyperinsulinémie et à une sécrétion altérée d'hormone dérivée du tissu adipeux chez les chats. L'objectif de cette étude était de surveiller et rapporter les changements dans les résultats de tests de tolérance au glucose intraveineux en série (IVGTT) et autres paramètres métaboliques chez quatre chats obèses sur une période de 4 ans. Des IVGTT en série, les indices de sensibilité à l'insuline, les concentrations d'adipokines et les profils lipidiques ont été évalués. Tous les chats avaient des changements d'IVGTT compatibles avec une tolérance réduite au glucose et des patrons de sécrétion d'insuline altérés durant la période d'étude de 4 ans. Il n'y avait pas d'augmentation significative des concentrations de glucose sanguin ou d'insuline à jeun et aucun changement dans les indices de sensibilité à l'insuline évalués. La concentration moyenne d'adiponectine a diminué de manière significative en fonction du temps, mais il n'y avait pas d'augmentation significative de la concentration de leptine et aucun changement n'a été observé dans les profils lipidiques. Bien que l'IVGTT peut être utilisé pour documenter une diminution naissante et/ou légère de la tolérance au glucose et des changements dans le patron de sécrétion d'insuline, ce test ne peut pas être réalisé facilement ou rapidement sur des chats de clients dans la plupart des milieux de pratique. Plus de travail doit être fait pour établir des méthodes fiables et pratiques pour une identification plus précoce des chats à risque de développer un diabète mellitus.(Traduit par Docteur Serge Messier).

Ultrasonographic evaluation of the effects of azithromycin on antral motility and gastric emptying in healthy cats.

BACKGROUND: Erythromycin, a macrolide antibiotic with motilin agonist properties, shortens gastric emptying (GE) time in healthy cats. Azithromycin, another macrolide antibiotic, is effective for treatment of gastric paresis in people. OBJECTIVES: To evaluate the effects of azithromycin on GE and gastric motility in healthy cats in comparison with erythromycin (positive control) and placebo. ANIMALS: Eight healthy purpose-bred cats. METHODS: Prospective, blinded, crossover study. Cats received either azithromycin (3.5 mg/kg PO q24h), erythromycin (1 mg/kg PO q8h), or placebo for 24 hours before and during evaluation of GE. A validated method using ultrasound for sequential measurements of antral area as well as amplitude and frequency of contractions was used to assess GE and evaluate gastric antral motility postprandially over an 8-hour period. RESULTS: GE was significantly faster (P < .05) after administration of azithromycin and erythromycin when compared to placebo in the late phase of fractional emptying from 75% (mean ± SD: 327 ± 51 minutes, 327 ± 22 minutes, and 367 ± 29 minutes, respectively), to 95% fractional emptying (399 ± 52 minutes, 404 ± 11 minutes, and 444 ± 24 minutes, respectively). The drugs had no significant effect on antral motility variables at any time point. CONCLUSIONS AND CLINICAL IMPORTANCE: Azithromycin and erythromycin shorten GE time in a comparable manner in healthy cats. Evaluation of their efficacy in cats with gastric dysmotility is warranted.

Factors affecting survival in 516 dogs that underwent cholecystectomy for the treatment of gallbladder mucocele.

Gallbladder mucocele (GBM) is a commonly diagnosed disease process in dogs that is associated with high morbidity and mortality if not recognized and appropriately managed. Although the exact mechanism of this disease process is not completely understood, previous studies in smaller populations of dogs have identified multiple factors that predispose to the development of GBM and affect survival. The purpose of this cross-sectional, retrospective study was to evaluate the effects of age, breed category, sex, preoperative antibiotic administration, gallbladder rupture, and a positive biliary culture in dogs that had a cholecystectomy performed for the treatment of GBM. The age (median: 11 years) and percentage of dogs that died within 14 days of cholecystectomy (16.7%) are similar to what have been reported in other studies. Gallbladder rupture and a positive biliary culture occurred in 20.4% and 12.5% of dogs, respectively. Dogs with a gallbladder rupture and positive biliary culture were 2.74 and 3.10 times more likely to die within 14 days of cholecystectomy, respectively. This contradicts a recent study that failed to find a significant association between survival and biliary culture result. Interestingly, younger age was associated with an increased occurrence of gallbladder rupture in that population. Because of the potential effect of gallbladder rupture and a biliary tract infection, abdominal imaging, biliary culture, and empirical preoperative antimicrobial therapy are recommended in dogs undergoing cholecystectomy for the treatment of GBM.

Facteurs affectant la survie chez 516 chiens ayant subi une cholécystectomie pour le traitement de la mucocèle de la vésicule biliaire. La mucocèle de la vésicule biliaire (GBM) est un processus pathologique couramment diagnostiqué chez les chiens qui est associé à une morbidité et une mortalité élevées s'il n'est pas reconnu et géré de manière appropriée. Bien que le mécanisme exact de ce processus pathologique ne soit pas complètement compris, des études antérieures sur de plus petites populations de chiens ont identifié de multiples facteurs qui prédisposent au développement du GBM et affectent la survie. Le but de cette étude rétrospective transversale était d'évaluer les effets de l'âge, de la catégorie de race, du sexe, de l'administration préopératoire d'antibiotiques, de la rupture de la vésicule biliaire et d'une culture biliaire positive chez les chiens ayant subi une cholécystectomie pour le traitement du GBM. L'âge (médiane : 11 ans) et le pourcentage de chiens décédés dans les 14 jours suivant la cholécystectomie (16,7 %) sont similaires à ceux rapportés dans d'autres études. Une rupture de la vésicule biliaire et une culture biliaire positive se sont produites chez 20,4 % et 12,5 % des chiens, respectivement. Les chiens présentant une rupture de la vésicule biliaire et une culture biliaire positive étaient respectivement 2,74 et 3,10 fois plus susceptibles de mourir dans les 14 jours suivant la cholécystectomie. Cela est en contradiction avec une étude récente qui n'a pas réussi à trouver une association significative entre la survie et le résultat de la culture biliaire. Fait intéressant, un âge plus jeune était associé à une fréquence accrue de rupture de la vésicule biliaire dans cette population. En raison de l'effet potentiel d'une rupture de la vésicule biliaire et d'une infection des voies biliaires, une imagerie abdominale, une culture biliaire et un traitement antimicrobien préopératoire empirique sont recommandés chez les chiens subissant une cholécystectomie pour le traitement du GBM.(Traduit par Dr Serge Messier).

Thyroid storm in a dog secondary to thyroid carcinoma.

OBJECTIVE: To describe the clinical presentation, clinical course, and management of a dog with thyroid storm (TS) secondary to a functional thyroid carcinoma. CASE SUMMARY: A 12-year-old neutered female Golden Retriever was evaluated for severe weight loss, hyperthermia, and tachycardia. The dog had a ventral neck mass and markedly increased thyroxine concentration. Cervical ultrasound showed a suspected left thyroid mass with invasion into the jugular vein. Despite aggressive therapy, the patient progressed to a clinical TS. Postmortem examination was supportive of the clinical diagnosis. NEW OR UNIQUE INFORMATION PROVIDED: To the authors' knowledge, this is the first report of TS in a dog.

Acute hyperkalemia as anesthetic complication in a diabetic dog undergoing tumor excision.

A mixed-breed dog with a history of diabetes mellitus underwent surgical removal of multiple colonic adenocarcinomas. The dog acutely developed electrocardiographic changes compatible with hyperkalemia during manipulation of the tumors, which was confirmed and treated. Although it was not possible to confirm clinical tumor lysis syndrome in this dog, the hyperkalemia and resultant arrhythmia that occurred during tumor manipulation were suggestive of acute tumor lysis syndrome. Key clinical message: Hyperkalemia is a serious anesthetic and intraoperative complication that should be considered in dogs undergoing solid tumor resection due to the potential risk of developing acute tumor lysis syndrome. Diabetic patients may also be at increased risk of developing hyperkalemia. Both the potassium concentration and ECG should be routinely monitored during these procedures.

Hyperkaliémie aiguë comme complication lors de l'anesthésie d'un chien diabétique subissant une excision tumorale. Un chien de race croisée avec une historique de diabète mellitus a subi une chirurgie pour retirer de multiples adénocarcinomes coloniques. Le chien développa de manière aiguë des changements électrocardiographiques compatibles avec une hyperkaliémie durant la manipulation des tumeurs, ce qui fut confirmé et traité. Bien qu'il ne soit pas possible de confirmer un syndrome clinique de lyse des tumeurs chez ce chien, l'hyperkaliémie et l'arythmie qui en résulta durant la manipulation des tumeurs étaient suggestives du syndrome aigu de lyse des tumeurs.Message clinique clé :L'hyperkaliémie est une complication sérieuse lors de l'anesthésie et de la chirurgie qui devrait être considérée chez les chiens subissant la résection d'une tumeur solide dû au risque potentiel de développer le syndrome aigu de lyse des tumeurs. Les patients diabétiques pourraient également présenter un risque plus grand de développer une hyperkaliémie. La concentration de potassium et l'ECG devraient être surveillés de routine durant ces procédures.(Traduit par Dr Serge Messier).

Ultrasonographic assessment of the effect of metoclopramide, erythromycin, and exenatide on solid-phase gastric emptying in healthy cats.

BACKGROUND: Available data on the effect of gastrointestinal motility-modifying drugs in cats are limited. Most recommendations for drug usage and dosage are based on collective clinical experience. OBJECTIVES: To assess the effects of metoclopramide, erythromycin, and exenatide on gastric emptying (GE) and gastric motility in comparison to placebo. We hypothesized that metoclopramide and erythromycin would have prokinetic gastric effects, whereas exenatide would prolong GE times and decrease the motility index (MI) of antral contractions. ANIMALS: Eight healthy domestic shorthair cats. METHODS: Each cat had 4 separate ultrasonographic assessments. In a prospective, randomized, double-blind, 4-way crossover design, cats received placebo, metoclopramide, erythromycin, or exenatide for 2 days followed by a minimum 5-day washout period. Ultrasonographic GE times and MI were compared to placebo. RESULTS: When compared to placebo, the rate of GE was significantly faster after administration of metoclopramide and erythromycin. Significant differences were found at all fractions of GE after administration of erythromycin and all but 1 fraction after metoclopramide when compared to placebo. The rate of GE in the first half of the GE curve was significantly slower after exenatide administration. The total area under the Ml curve was significantly larger after administration of metoclopramide and erythromycin than after placebo. CONCLUSIONS AND CLINICAL IMPORTANCE: Metoclopramide and erythromycin shorten GE times and increase the MI of antral contractions, thus having a prokinetic effect in the stomach of healthy cats, whereas exenatide causes an initial delay in GE.

Long-Term Survival and Glycemic Control with Toceranib Phosphate and Prednisone for a Metastatic Canine Insulinoma.

Canine insulinoma is a highly metastatic neoplasm that is associated with a guarded to poor prognosis in dogs with distant metastases. A median survival of 6 mo has been reported for dogs with metastatic insulinoma. The dog in this report, diagnosed with stage III pancreatic insulinoma, had long-term glycemic control with survival of over 24 mo while receiving prednisone and toceranib phosphate after partial pancreatectomy. Toceranib phosphate has been shown to be an efficacious therapy for canine mast cell tumors with increasing evidence that it may be beneficial in the medical management of neuroendocrine tumors.

Outcomes in dogs with uroabdomen: 43 cases (2006-2015).

OBJECTIVE To determine the rate of and factors associated with survival to hospital discharge in dogs with uroabdomen. DESIGN Retrospective case series. ANIMALS 43 dogs with uroabdomen confirmed at 2 veterinary teaching hospitals from 2006 through 2015. PROCEDURES Medical records were reviewed and data extracted regarding cause and location of urinary tract rupture, serum creatinine concentration and other variables at hospital admission, and outcomes. Variables were tested for associations with survival to hospital discharge. RESULTS Urinary tract rupture occurred in the urinary bladder (n = 24 [56%]), urethra (11 [26%]), kidney (2 [5%]), ureter (1 [2%]), both the urinary bladder and kidney (1 [2%]), and undetermined sites (4 [9%]). Rupture causes included traumatic (20 [47%]), obstructive (9 [21%]), and iatrogenic (7 [16%]) or were unknown (7 [16%]). Surgery was performed for 37 (86%) dogs; the defect was identified and surgically corrected in 34 (92%) of these dogs. Hypotension was the most common intraoperative complication. Nineteen dogs had information recorded on postoperative complications, of which 10 (53%) had complications that most often included death (n = 3) and regurgitation (3). Thirty-four (79%) dogs survived to hospital discharge. Dogs with intraoperative or postoperative complications were significantly less likely to survive than dogs without complications. Serum creatinine concentration at admission was not associated with survival to discharge. CONCLUSIONS AND CLINICAL RELEVANCE A high proportion of dogs with uroabdomen survived to hospital discharge. No preoperative risk factors for nonsurvival were identified. Treatment should be recommended to owners of dogs with uroabdomen.

Sepsis and multi-organ dysfunction associated with postgrooming furunculosis in a dog.

BACKGROUND: Postgrooming furunculosis, as previously described in the dog, is a type of pyoderma that typically responds to routine antimicrobial therapy. Systemic clinical signs are common but are usually mild. ANIMAL: A 3-year-old spayed female great dane was presented with marked dorsal furunculosis of 24 h duration. The clinical signs and blood analyses were consistent with sepsis, systemic inflammatory response syndrome and disseminated intravascular coagulopathy (DIC). METHODS AND RESULTS: Skin culture revealed multi-drug resistant Pseudomonas aeruginosa infection. The dog did not respond to aggressive medical therapy including intravenous antibiotic therapy, fresh frozen plasma and haemodynamic support, and was humanely euthanized. Postmortem findings were consistent with postgrooming furunculosis with associated sepsis and DIC affecting multiple organs including the lungs and brain. CONCLUSIONS AND CLINICAL IMPORTANCE: Postgrooming furunculosis can progress to sepsis and multiple organ dysfunction in the dog and can lead to death.

Persistent right aortic arch with an aberrant left subclavian artery, Kommerell's diverticulum and bicarotid trunk in a 3-year-old cat.

CASE SUMMARY: A 3-year-old male, neutered, domestic shorthair cat with a history of chronic regurgitation since being obtained as a kitten was presented for weight loss and regurgitation of all ingested food. The cat was in poor body condition and had a firm swelling in the ventral neck at the time of presentation. Thoracic radiographs showed severe dilation of the entire cervical and cranial intrathoracic esophagus to the level of the heart base. Computed tomographic angiography (CTA) showed a persistent right aortic arch with an aberrant left subclavian artery and severe dilation of the cervical and intrathoracic esophagus cranial to the heart base. CTA also showed a bicarotid trunk and Kommerell's diverticulum to be present, which are rare vascular structures in the cat. Esophagoscopy showed esophageal dilation and multiple compact trichobezoars obstructing the esophagus. Removal of the obstructing trichobezoars resulted in resolution of clinical signs, and the cat was able to drink water and eat a canned food slurry without regurgitation. Surgical correction was not pursued. RELEVANCE AND NOVEL INFORMATION: Vascular ring anomaly (VRA) should be considered in all cats with a history of regurgitation, regardless of their age at the time of presentation. CTA is a valuable diagnostic imaging procedure that allows differentiation of a VRA from other causes of esophageal obstruction and provides information about the VRA that can be used to determine amenability to surgical correction.

Glucose detection and concentration estimation in feline urine samples with the Bayer Multistix and Purina Glucotest.

The Bayer Multistix are commonly used for detection and estimation of feline glucosuria by veterinarians and cat owners. A newer product, the Purina Glucotest, utilizes the same enzymatic technology for detection of glucose, but has been designed for home use as a litter additive that allows interpretation of glucosuria over an 8-h period. The objectives of this study were to assess the sensitivity, specificity, and accuracy of the Glucotest and Multistix, and to assess the 8-h color stability of the Glucotest. Overall, the Glucotest had greater sensitivity and specificity than the Multistix, and more accurately estimated urine glucose concentration if evaluated at least 30 min after exposure to urine. A significant lack of agreement between the results obtained immediately after exposure to urine vs after 30 min and 8 h contradicts the 8-h color stability claim, but the change in urine glucose concentration estimation over time resulted in improved test accuracy at the 30 and 480 min time points.

Development of strategies for effective communication of food risks and benefits across Europe: design and conceptual framework of the FoodRisC project.

BACKGROUND: European consumers are faced with a myriad of food related risk and benefit information and it is regularly left up to the consumer to interpret these, often conflicting, pieces of information as a coherent message. This conflict is especially apparent in times of food crises and can have major public health implications. Scientific results and risk assessments cannot always be easily communicated into simple guidelines and advice that non-scientists like the public or the media can easily understand especially when there is conflicting, uncertain or complex information about a particular food or aspects thereof. The need for improved strategies and tools for communication about food risks and benefits is therefore paramount. The FoodRisC project ("Food Risk Communication - Perceptions and communication of food risks/benefits across Europe: development of effective communication strategies") aims to address this issue. The FoodRisC project will examine consumer perceptions and investigate how people acquire and use information in food domains in order to develop targeted strategies for food communication across Europe. METHODS/DESIGN: This project consists of 6 research work packages which, using qualitative and quantitative methodologies, are focused on development of a framework for investigating food risk/benefit issues across Europe, exploration of the role of new and traditional media in food communication and testing of the framework in order to develop evidence based communication strategies and tools. The main outcome of the FoodRisC project will be a toolkit to enable coherent communication of food risk/benefit messages in Europe. The toolkit will integrate theoretical models and new measurement paradigms as well as building on social marketing approaches around consumer segmentation. Use of the toolkit and guides will assist policy makers, food authorities and other end users in developing common approaches to communicating coherent messages to consumers in Europe. DISCUSSION: The FoodRisC project offers a unique approach to the investigation of food risk/benefit communication. The effective spread of food risk/benefit information will assist initiatives aimed at reducing the burden of food-related illness and disease, reducing the economic impact of food crises and ensuring that confidence in safe and nutritious food is fostered and maintained in Europe.