Clinical management of Feline Diabetes Mellitus

Abstract

IntroductionThe aim of this thesis was to improve the clinical management of diabetes mellitus in cats. Therenare many aspects of this field of research in which there is scant information in the literature,nleading to problems with management of diabetic cats for veterinary practitioners. Due to thenvariety of issues which are unresolved in the management of feline diabetes, this thesisninvestigated some of the clinically important issues for the management of diabetes in cats, usingna multifaceted approach. This included development of a method for repeated blood sampling ofnnon-diabetic and diabetic cats, studies on aspects of food and feeding in diabetic cats, annevaluation of the clinical use and pharmacological properties of an insulin registered for veterinarynuse in Australia, an investigation of clinical and biochemical indicators of diabetic control in cats,nand studies of changes in certain plasma proteins and lipids shown to be of importance inndiabetes and diabetic treatment in other species.Diabetic cats for the studies reported in this thesis were recruited by referral from veterinarynpractitioners during 1996 through 1998. Details of the cats are given in Table 1. In all the chaptersnof the thesis, the same numbering system is used for the diabetic cats. In addition, detailednresults from the studies are included on a CD-ROM included at the end of the thesis.A search of the literature failed to identify a method of central catheterisation of cats which wasnsafe, efficacious for ongoing blood sampling, and which would assure resumption of patency ofnthe vein after the catheter was removed. Management of diabetes in cats and studies to benperformed on cats in this thesis required reliable venous access which could exceed one week,nand this had to be performed at least twice in the cats studied. To fulfill these requirements, annew design of indwelling jugular catheter was developed, along with a suitable procedure fornplacement and maintenance. Details of the catheters, the placement method, maintenancenprocedures, their problems and complications, in a group of diabetic cats, are reported in thisnchapter (Chapter 3 - Evaluation of central venous catheters in diabetic and non-diabetic cats).Previous reports regarding management of diabetic cats vary in their recommendations fornfeeding regimes. Most information available has been extrapolated directly from the literature onnhuman diabetics, despite the different nutritional requirements and feeding behavior of cats. Also,nan overnight fast is often recommended before measuring baseline blood glucose concentrationsnin cats, with no experimental data reported which confirms that this is necessary. Limited studiesnhave been undertaken in normal (non-diabetic) cats on post-prandial hyperglycaemia, but nonstudies had been reported in diabetic cats. Limited studies on the effect of hypoglycaemia in catsnon appetite are somewhat equivocal in their findings. The studies reported in this chaptern(Chapter 4 - Feeding and blood glucose in diabetic cats) from both normal (non-diabetic) andndiabetic cats, aimed to give meaningful information on the effect of eating on blood glucose inndiabetic cats. The objective was to provide the basis of feeding recommendations of diabetic catsnas part of clinical management.n n n