PathogenesisK Inadequate production or secretion of antidiuretic hormone (ADH-vasopressin) by the posterior pituitary (central diabetes insipidus), or lack of responsiveness to ADH by the kidney (nephrogenic diabetes insipidus). K Reported cases in cats have all been central diabetes insipidus. K Underlying identified etiologies for central diabetes insipidus include congenital anomalies, trauma, and neoplasia, but idiopathic cases are also reported.
Classical SignsK Marked polyuria due to inability to concentrate urine. The polyuria is accompanied by marked polydipsia, often in excess of 200 mL/kg/q 24 h. K Urine-specific gravity (USG) is consistently low, usually < 1.010.
DiagnosisK Diagnosis requires elimination of other causes of polyuria/polydipsia. K Confirmation of diabetes insipidus requires performance of a water deprivation test; patients with diabetes insipidus are unable to concentrate their urine after 3-5% dehydration. K Patients with central diabetes insipidus are able to concentrate their urine following administration of synthetic ADH. K Patients with nephrogenic diabetes insipidus are unable to respond to administration of synthetic ADH. K Assessment of response to a therapeutic trial with the ADH analogue desmopressin (1-deamino 9-D-arginine vasopressin; DDAVP) is a safer alternative to performance of a water deprivation test.
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