A dose titration protocol for once-daily insulin glargine 300 U/mL for the treatment of diabetes mellitus in dogs.

Background: In purpose-bred dogs, insulin glargine 300 U/mL (IGla300) has long duration of action, peakless time-action profile, and low potency, making it suitable for use as a basal insulin.

Hypothesis: To evaluate IGla300 in client-owned diabetic dogs monitored using a flash glucose monitoring system (FGMS).

Animals: Ninety-five client-owned diabetic dogs, newly diagnosed or previously treated with other insulin formulations, with or without concurrent diseases.

Insulin Therapy in Small Animals, Part 1: General Principles.

Understanding the pharmacology of insulin and how it relates to the pathophysiology of diabetes can lead to better clinical outcomes. No insulin formulation should be considered "best" by default. Insulin suspensions (NPH, NPH/regular mixes, lente, and PZI) as well as insulin glargine U100 and detemir are intermediate-acting formulations that are administered twice daily.

Insulin Therapy in Small Animals, Part 2: Cats.

No insulin formulation should be considered best by default for management of feline diabetes. Rather, the choice of insulin formulation should be tailored to the specific clinical situation. In most cats that have some residual beta cell function, administering only a basal insulin might lead to complete normalization of blood glucose concentrations.

Insulin Therapy in Small Animals, Part 3: Dogs.

Insulin therapy should ideally mimic a basal-bolus pattern. Lente, NPH, NPH/regular mixes, PZI, glargine U100, and detemir are intermediate-acting formulations that are administered twice daily in dogs. To minimize hypoglycemia, intermediate-acting insulin protocols are usually geared towards alleviating (but not eliminating) clinical signs.

Cushing's Syndrome and Other Causes of Insulin Resistance in Dogs.

The most common causes of insulin resistance in diabetic dogs are Cushing syndrome, diestrus, and obesity. Cushing-associated effects include insulin resistance, excessive postprandial hyperglycemia, perceived short duration of insulin action, and/or substantial within-day and/or day-to-day glycemic variability. Successful strategies to manage excessive glycemic variability include basal insulin monotherapy and combined basal-bolus insulin treatment.

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).

One hundred years of insulin: Is it time for smart?

Smarter understanding of diabetes pathophysiology and pharmacology of insulin therapy can lead to better clinical outcomes. Rather than looking for an insulin formulation that is considered "best" for a general population, it could be appropriate to seek the "smart" insulin choice, tailored to the specific clinical situation. Different treatment goals should be considered, with pros and cons to each.

Insulin glargine 300 U/ml for the treatment of feline diabetes mellitus.

Objectives: The study aimed to evaluate the efficacy and safety of insulin glargine 300 U/ml (IGla-U300) in cats with variable duration of diabetes mellitus (DM).

Methods: Thirteen client-owned cats with DM completed a prospective clinical trial. Four cats were highly suspected of hypersomatotropism and excluded from the insulin efficacy evaluation.

Mapping of Diabetes Susceptibility Loci in a Domestic Cat Breed with an Unusually High Incidence of Diabetes Mellitus.

Genetic variants that are associated with susceptibility to type 2 diabetes (T2D) are important for identification of individuals at risk and can provide insights into the molecular basis of disease. Analysis of T2D in domestic animals provides both the opportunity to improve veterinary management and breeding programs as well as to identify novel T2D risk genes. Australian-bred Burmese (ABB) cats have a 4-fold increased incidence of type 2 diabetes (T2D) compared to Burmese cats bred in the United States.

Mapping the genetic basis of diabetes mellitus in the Australian Burmese cat (Felis catus).

Diabetes mellitus, a common endocrinopathy affecting domestic cats, shares many clinical and pathologic features with type 2 diabetes in humans. In Australia and Europe, diabetes mellitus is almost four times more common among Burmese cats than in other breeds. As a genetically isolated population, the diabetic Australian Burmese cat provides a spontaneous genetic model for studying diabetes mellitus in humans.

Updates in Feline Diabetes Mellitus and Hypersomatotropism.

Flash glucose monitoring is a novel, noninvasive monitoring technique that is increasingly used in the management of small animal diabetes. This article provides guidance on the use of flash glucose monitoring in cats and demonstrates how this technique can be used in a range of feline diabetic cases, including those where management is proving challenging. Other aspects of complicated feline diabetic care are also discussed, including management of the sick diabetic cat, potassium depletion myopathy, and treatment options for cats with hypersomatotropism-associated diabetes mellitus.

Epidemiological study of dogs with diabetes mellitus attending primary care veterinary clinics in Australia.

Background: The objectives of this study were to establish the prevalence, risk factors and comorbidities/sequelae for diabetes mellitus (DM) in Australian dogs presented to first-opinion veterinary practices.

Methods: Electronic patient records of dogs (n=134,329) attending 152 veterinary clinics during 2017 were sourced through VetCompass Australia. They included 418 dogs with DM; a prevalence of 0.

Update on insulin treatment for dogs and cats: insulin dosing pens and more.

Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient's requirements.

ISFM consensus guidelines on the practical management of diabetes mellitus in cats.

Practical Relevance: Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats.

Faecal microbiota of cats with insulin-treated diabetes mellitus.

Microorganisms within the gastrointestinal tract significantly influence metabolic processes within their mammalian host, and recently several groups have sought to characterise the gastrointestinal microbiota of individuals affected by metabolic disease. Differences in the composition of the gastrointestinal microbiota have been reported in mouse models of type 2 diabetes mellitus, as well as in human patients. Diabetes mellitus in cats has many similarities to type 2 diabetes in humans.

Acquired proximal renal tubulopathy in dogs exposed to a common dried chicken treat: retrospective study of 108 cases (2007-2009).

Background: Proximal renal tubulopathy was reported in Australian dogs with markedly increased frequency from September 2007.

Methods: Two veterinarian-completed surveys were launched in response to an increased incidence of acquired proximal renal tubulopathy in dogs. The selection criterion for inclusion was glucosuria with blood glucose < 10 mmol/L.

Continuous glucose monitoring in small animals.

The use of continuous glucose monitoring systems in veterinary patients is summarized and discussed. The current clinical uses in veterinary medicine, including monitoring of hospitalized/sick diabetic patients, long-term monitoring of stable diabetic patients, anesthetized patients, and other patients with altered blood glucose homeostasis are presented. The most important advantage of these systems over intermittent blood glucose measurements is that they facilitate detection of brief periods of hypoglycemia and provide information overnight.

Association of postprandial serum triglyceride concentration and serum canine pancreatic lipase immunoreactivity in overweight and obese dogs.

Background: Hypertriglyceridemia has been proposed to contribute to the risk of developing pancreatitis in dogs.

Objectives: To determine associations between postprandial serum triglyceride concentrations and canine pancreatic lipase immunoreactivity (cPLI) concentrations or pancreatic disease.

Animals: Thirty-five client-owned overweight (n = 25) or obese (n = 10) dogs weighing >10 kg.

Spontaneously obese dogs exhibit greater postprandial glucose, triglyceride, and insulin concentrations than lean dogs.

Dogs do not appear to progress from obesity-induced insulin resistance to type 2 diabetes mellitus. Both postprandial hyperglycemia and postprandial hypertriglyceridemia have been proposed to cause or maintain beta cell failure and progression to type 2 diabetes mellitus in other species. Postprandial glucose, triglyceride, and insulin concentrations have not been compared in lean and obese dogs.

A diet lower in digestible carbohydrate results in lower postprandial glucose concentrations compared with a traditional canine diabetes diet and an adult maintenance diet in healthy dogs.

The aim of this study was to compare the effects of three diets with varying macronutrient and fibre contents on postprandial plasma glucose, triglyceride, free fatty acid, and insulin concentrations over a 12 h period in 12 healthy neutered lean dogs. Each diet was fed to each dog for 3 weeks in a three-period cross-over study. Plasma analyte concentrations were measured prior to and after a meal at the end of the third week of each period.

Adiposity and adiponectin in dogs: investigation of causes of discrepant results between two studies.

Although one study showed lower adiponectin concentrations in obese dogs, other recent studies indicate that adiponectin might not be decreased in obese dogs, raising the possibility that the physiology of adiponectin is different in dogs than in humans. The aim of this study was to investigate possible causes of the discrepancy between the two largest studies to date that assessed the association between adiposity and adiponectin concentration in dogs, including the validity of the assay, laboratory error, and the effects of breed, sex, and neuter status on the relationship between adiposity and adiponectin concentrations. Adiponectin concentrations measured with a previously validated adiponectin ELISA were compared with those estimated by Western blotting analysis of reduced and denatured plasma samples.