Cushing’s Syndrome and Other Causes of Insulin Resistance in Dogs

Fleeman, L. M.; Barrett, Renea

doi:10.1016/j.cvsm.2023.01.009

Cited by 7 publications

(12 citation statements)

References 33 publications

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“…This case challenges the classic assumption that dogs invariably have a permanent, absolute insulin deficiency at the time of DM diagnosis, 2 and supports the presence of fluctuating contributors to beta cell function or peripheral insulin resistance. Though an identifiable underlying condition to explain the dog's remission was lacking, he had historic (obesity and corticosteroid therapy), recent (feeding of table scraps, which might be high in fat), and ongoing (breed predisposition to hypercortisolism) risk factors for insulin resistance 3‐9 . The dog's relapse 1 year after insulin discontinuation suggests that his pancreatic beta cell function did not fully recover, despite his apparent ability to maintain euglycemia during the intervening period.…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous remission and relapse of diabetes mellitus in a male dog

Rak,

Gilor,

Niessen

et al. 2024

Veterinary Internal Medicne

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An 8‐year‐old male neutered Miniature Schnauzer was diagnosed with diabetes mellitus based on fasting hyperglycemia and glucosuria after a 2‐week history of polydipsia and periuria, in line with the Agreeing Language in Veterinary Endocrinology consensus definition. Treatment of insulin and dietary management was initiated. The insulin dose was gradually reduced and eventually discontinued over the next year based on spot blood glucose concentrations that revealed euglycemia or hypoglycemia. After discontinuation, the dog remained free of clinical signs for 1 year until it was again presented for polyuria/polydipsia with fasting hyperglycemia and glucosuria. Insulin therapy was resumed and continued for the remainder of the dog's life. Although diabetic remission often occurs in cats and humans, the presumed etiopathogenesis of pancreatic beta cell loss makes remission rare in dogs, except for cases occurring with diestrus or pregnancy. This case demonstrates that diabetic remission is possible in dogs, even in cases without an identifiable reversible trigger.

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Section: Discussionmentioning

confidence: 99%

“…Glucocorticoids are another potential source of insulin resistance 8 . Exogenous glucocorticoid therapy is associated with DM risk in dogs, 34 and there is a report of a dog with DM remission after cessation of glucocorticoid therapy 4 .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous remission and relapse of diabetes mellitus in a male dog

Rak,

Gilor,

Niessen

et al. 2024

Veterinary Internal Medicne

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“…The global prevalence of CDM from published literature ranges from 0.15 to 1.33% while sex and gonadal status (entire or desexed) predisposition to CDM varies according to the population studied [ 6 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. However, it is generally accepted that entire females are at increased risk for CDM development due to the influence of diestrus [ 3 , 4 , 5 , 6 , 7 , 8 , 9 , 11 , 26 ]. Female dogs have a two-fold higher CDM incidence compared to males, and nearly 75% of the diagnosed dogs with DM are females [ 5 , 6 , 7 , 8 , 26 , 27 ]; however, this distribution can show a vast range.…”

Section: The Relevance Of Progesterone-related Diabetes Mellitus Subtypementioning

confidence: 99%

“…Given the heterogeneous pathogenesis of CDM, common risk factors associated with insulin-resistant diabetes (IRD) such as obesity, diestrus, hypercortisolism, hypersomatotropism, progestins, and glucocorticoid exposure can act as triggers in previously susceptible dogs [ 2 , 5 , 6 , 9 , 11 , 28 ]. Environmental factors triggering types 1 and 2 DM in humans are well understood, and potentially other environmental factors such as diet, exercise, infections, and diseases (pancreatitis, pyometra) also have a role in these complex interactions regarding CDM pathogenesis [ 2 ].…”

Section: The Relevance Of Progesterone-related Diabetes Mellitus Subtypementioning

confidence: 99%

“…Entire females and diestrus occurrence were identified as potential risk factors for CDM [ 5 , 6 ]. In regions where neutering is not a routine for the majority of the bitches, progesterone-related diabetes mellitus (PRDM) is probably the main form of CDM [ 6 , 7 , 8 , 9 ]. Less often, pregnancy may also trigger CDM [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Pöppl,

Lopes,

Nogueira

et al. 2024

Animals

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Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. This narrative review aims to provide relevant detailed information on (1) the canine estrus cycle and its impact on canine diabetes mellitus (CDM) etiology and management, (2) the role of pyometra as a further cause of insulin resistance, and (3) useful individual therapeutic and preventive strategies. PRDM is recognized due to diestrus, exogenous progestogen exposure, pregnancy, and P4-production ovarian dysfunction. Pyometra represents additional inflammatory and septic negative influence on insulin sensitivity, and its diagnosis associated with CDM is therapeutically challenging. The estrus cycle’s hormone fluctuations seem to modulate peripheric insulin sensibility by influencing insulin receptor (IR) affinity and its binding capacity, as well as modulating tyrosine kinase activity. Pyometra was shown to negatively influence IR compensatory mechanisms to insulin resistance causing glucose intolerance. Spaying and pregnancy termination may cause diabetes remission in PRDM cases in a median time of 10 days (1–51). Pharmacological annulment of progesterone effects may benefit patients unable to undergo surgery; however, remission chances are virtually null. The ALIVE (Agreeing Language in Veterinary Endocrinology) project proposed new criteria for CDM diagnoses and subclinical diabetes recognition. These new concepts may increase the frequency of a PRDM diagnosis and, even more, its relevance. Spaying represents a preventive measure against pyometra and PRDM that should be individually assessed in light of its recognized benefits and harms.

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L’insulinorésistance : causes et prise en charge chez le chien et le chat

Menard

2023

Le Nouveau Praticien Vét canine & féline

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Une insulinorésistance peut conduire au développement d’un diabète sucré et en compliquer la prise en charge. D’autres facteurs d’échec au traitement sont cependant possibles et doivent être recherchés (erreurs techniques, cinétique ou dose d’insuline inadéquates, etc.). Les principales maladies associées à une insulinorésistance chez le chien (syndrome de Cushing, imprégnation en progestérone lors du diœstrus chez la chienne non stérilisée) et le chat (sécrétion excessive d’hormone de croissance par un adénome hypophysaire) sont présentées dans cet article.

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Cushing’s Syndrome and Other Causes of Insulin Resistance in Dogs

Cited by 7 publications

References 33 publications

Spontaneous remission and relapse of diabetes mellitus in a male dog

Spontaneous remission and relapse of diabetes mellitus in a male dog

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

L’insulinorésistance : causes et prise en charge chez le chien et le chat

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