Background: A factory-calibrated flash glucose monitoring system (FGMS; FreeStyle Libre) recently was evaluated in dogs with uncomplicated diabetes mellitus. It is not known if this system is reliable during diabetic ketoacidosis (DKA). Objectives: To assess the performance of the FGMS in dogs with DKA and to determine the effect of severity of ketosis and acidosis, lactate concentration, body condition score (BCS), and time wearing the sensor on the accuracy of the device. Animals: Fourteen client-owned dogs with DKA. Methods: The interstitial glucose (IG) measurements were compared with blood glucose (BG) measurements obtained using a validated portable glucometer. The influence of changes in metabolic variables (β-hydroxybutyrate, pH, bicarbonate, and lactate) and the effect of BCS and time wearing on sensor performance were evaluated. Accuracy was determined by fulfillment of ISO15197:2013 criteria. Results: Metabolic variables, BCS, and time wearing were not associated with the accuracy of the sensor. Good agreement between IG measurements and BG was obtained both before and after DKA resolution (r = .88 and r = .93, respectively). Analytical accuracy was not achieved, whereas clinical accuracy was demonstrated with 100% and 99.6% of results in zones A + B of the Parkes consensus error grid analysis before and after DKA resolution, respectively. Conclusions and Clinical Importance: Changes in metabolic variables, BCS, and time wearing do not seem to affect agreement between IG and BG. Despite not fulfilling the ISO requirements, the FGMS provides clinically accurate estimates of BG in dogs with DKA.

OBJECTIVE To evaluate the performance of 2 assays for measurement of serum fructosamine (SF) and glycated hemoglobin (HbA1c) values in dogs and to compare the usefulness of the 2 glycated proteins for assessment of glycemic control in dogs with diabetes mellitus (DM). SAMPLE Blood samples from 40 healthy dogs, 13 diabetic dogs, and 23 anemic normoglycemic nondiabetic dogs and results of 200 assessments of glycemic control in 46 diabetic dogs. PROCEDURES Colorimetric and immunoturbidimetric methods were used for measurement of SF and HbA1c values, respectively. Linearity and precision were determined. The usefulness of SF and HbA1c values for assessment of glycemic control was evaluated with a clinical scoring method used as the reference standard. Cutoff values obtained from receiver operating characteristic curves were used to identify the percentage of dogs correctly categorized by means of SF and HbA1c values. RESULTS Mean intra-assay and interassay coefficients of variation were 3.8% and 2.5%, respectively, for the SF assay, and 1.2% and 1.8%, respectively, for the HbA1c assay. Excellent linearity (R2 > 0.99) was obtained for both assays. Values for SF and HbA1c were inversely correlated (r = −0.40 and −0.33, respectively) with clinical score and correctly indicated glycemic control in 99 of 200 (50%) and 88 of 200 (44%) assessments, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The SF and HbA1c assays were precise, had good linearity, and appeared to be suitable for routine use in veterinary medicine. However, they performed poorly for classifying glycemic control in diabetic dogs.

Background: Flash glucose monitoring system (FGMS; FreeStyle Libre) was recently validated for use in diabetic dogs (DD). It is not known if this system is clinically useful in monitoring DD. Objective: To compare the clinical utility of FGMS against blood glucose curves (BGCs) obtained with a portable blood glucose meter (PBGM) in monitoring DD. Animals: Twenty dogs with diabetes mellitus. Methods: Prospective study. Dogs with diabetes mellitus on insulin treatment for at least 1 month were included. Comparisons of insulin dose recommendations based on the in-hospital GCs acquired using FGMS and a PBGM, consecutive-day interstitial GCs (IGCs) acquired at home using the FGMS, and consecutive-day, home vs hospital IGCs acquired using the FGMS were made using concordance analysis. Results: There was good concordance between insulin dose recommendations based on FGMS and PBGM generated GCs and IGCs obtained in the 2 different environments on 2 consecutive days, but almost absent concordance between IGCs obtained on 2 consecutive days at home. Glucose nadirs were detected in 34/43 (79%) of Ambulatory Glucose Profile (AGP) reports of the FGMS. In comparison, concordant glucose nadirs were identified in 14/34 (41%) BGCs using PBGM. The individual FGMS scans and PBGM identified 60% and 9% of low IG/hypoglycemic episodes, respectively. Conclusions and Clinical Importance: Insulin dose adjustments based on BGCs can be suboptimal. The FGMS allows a more accurate identification of the glucose nadirs and hypoglycemic episodes compared to the use of a PBGM and assessment of dayto-day variations in glycemic control.

This large cross-sectional study suggests that postmenopausal women are at higher risk of type 2 diabetes after allowance for the effect of age. Other main determinants of risk of type 2 diabetes in women around menopause were low socioeconomic status and being overweight. Diabetes was found less frequently in those taking hormone replacement therapy.

Congenital hypothyroidism is uncommon in cats. This case report describes weight gain, clinicopathological and radiographic changes after early diagnosis and treatment of congenital hypothyroidism in three British shorthair cats’ siblings. Data were assessed at 53 (diagnosis), 83, 185 and 365 days of age. Correlations between serum insulin-like growth factor-1 (IGF-1) and body weight, levothyroxine dose, total thyroxine, and thyroid-stimulating hormone concentrations were evaluated. The body weights of the congenital hypothyroid kittens were compared with those of their two healthy siblings and British shorthair kittens of the same age. At diagnosis, the congenital hypothyroid kittens showed a significantly lower body weight compared to the healthy siblings (p = 0.03). After diagnosis, oral levothyroxine supplementation was started. The difference in body weight was no longer observed after one month of treatment. The clinical signs, clinicopathological and radiographic abnormalities ameliorated after one month of treatment. IGF-1 concentration was significantly positively correlated with body weight (rs = 0.80, p < 0.002). In conclusion, resolution of the clinical signs, achieving a consistent within-breed weight, and improvement of the clinicopathological and radiographic parameters demonstrated the importance of the early diagnosis and treatment of feline congenital hypothyroidism.