Clinical Management of Diabetes Mellitus in Cats

Rhett Marshall (2010). Clinical Management of Diabetes Mellitus in Cats PhD Thesis, Veterinary Science and Animal Production, The University of Queensland.

       
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Author Rhett Marshall
Thesis Title Clinical Management of Diabetes Mellitus in Cats
School, Centre or Institute Veterinary Science and Animal Production
Institution The University of Queensland
Publication date 2010
Thesis type PhD Thesis
Supervisor Prof. Jacquie Rand
Dr John Morton
Total pages 161
Total colour pages 16
Total black and white pages 145
Subjects 07 Agricultural and Veterinary Sciences
Abstract/Summary The aim of this study was to investigate insulin treatments in diabetic cats and develop a targeted therapy for achieving long-term diabetic remission. The pharmacological effects of the glargine insulin formulation were first investigated in healthy cats and compared with the longest-acting insulin currently available for veterinary use (protamine zinc insulin, PZI) and the most commonly used insulin in Australia and the United Kingdom (lente). The effect of administering glargine once daily or twice daily in divided doses was also investigated in healthy cats. The clinical usefulness of glargine was then assessed by comparing the glycaemic control and remission probability in newly-diagnosed diabetic cats treated twice daily with either glargine, PZI or lente insulin. Two additional clinical applications (or indications) for glargine use were then identified. The treatment and outcome of administering glargine intramuscularly with or without subcutaneous glargine for the initial stabilisation of cats with diabetic ketoacidosis was studied and described. Lastly, the long-term resolution of urinary candidiasis in a diabetic cat following treatment with glargine insulin is reported. The initial studies involving healthy cats showed that glargine had a very long duration of action which was similar to PZI and significantly longer than lente. In addition, a carry-over effect was evident regardless of whether insulin was administered once or twice daily and was expected to be advantageous in treating diabetic cats with glargine (because the effects of exogenous insulin will continue until the next insulin injection, regardless of whether dosed once or twice daily). The most important finding in this thesis was made when assessing glargine’s usefulness in treating diabetic cats. In newly-diagnosed diabetic cats twice daily treatment with glargine provided better glycaemic control and increased probability of diabetic remission compared to twice daily treatment with PZI or lente insulin. The beneficial effects of glargine treatment were not confined to uncomplicated diabetes. Intramuscular glargine combined with or without subcutaneous glargine, was effective in treating cats with diabetic ketoacidosis, and of note, were the lack of mortalities. The superior glycaemic control achieved with glargine was found to be crucial in resolving urinary candidiasis in a case study and indicates another potential clinical use for glargine, although larger scale studies are required. The findings of my PhD research therefore provides information and methods to significantly improve the clinical management of feline diabetes.
Keyword Diabetes
feline
insulin
glucose
glargine
PZI
lente
glucose toxicity
remission
monitoring
Additional Notes 39, 85, 122-125, 138-139, 154-161

 
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Created: Fri, 19 Nov 2010, 07:52:30 EST by Mr Rhett Marshall on behalf of Library - Information Access Service