Transient hyperglycaemia in a prediabetic dog treated with prednisone and cyclosporin A

Abstract

A dog with immune-mediated haemolytic anaemia developed transient hyperglycaemia and glucosuria requiring insulin therapy in association with prednisone and cyclosporin A therapy. Following short-term therapy with insulin and cyclosporin A, the dog remained on prednisone therapy but required no further insulin therapy for 12 weeks, at which time the dog became permanently diabetic. We hypothesise that prednisone and cyclosporin A contributed to insulin resistance in a prediabetic dog with suboptimal endogenous insulin concentration and that the degree of insulin resistance decreased when cyclosporin A therapy was discontinued.

Cutaneous nocardiosis in two dogs receiving ciclosporin therapy for the management of canine atopic dermatitis

“…Diabetes mellitus has been reported in a dog suspected to be prediabetic receiving prednisolone and ciclosporin for management of immune‐mediated anaemia . Ciclosporin suppresses insulin secretion and can cause β‐cell destruction, and may accelerate the development of diabetes in predisposed dogs . In case 1, ciclosporin was administered for 4 months, and the patient developed permanent diabetes mellitus despite ciclosporin drug withdrawal.…”

In this issue – September 2009

“…The authors of this case report speculate that prednisone and cyclosporin A contributed to insulin resistance in a dog 3 …”

“…The authors of this case report speculate that prednisone and cyclosporin A contributed to insulin resistance in a dog. 3 The dog had immune-mediated haemolytic anaemia, which was treated with prednisone and cyclosporin A, and it subsequently developed transient hyperglycaemia and glucosuria that required insulin therapy. After short-term therapy with insulin and cyclosporin A, the dog remained on prednisone therapy, but required no further insulin therapy for 12 weeks, at which time it became permanently diabetic.…”

Ciclosporin A therapy is associated with disturbances in glucose metabolism in dogs with atopic dermatitis

“…Ciclosporin A has been shown to inhibit insulin secretion in in vitro assays containing canine pancreatic islets 24 and in vivo assessment of islet pancreatic β‐cell function in dogs 18,25,26 . Despite the fact that overt diabetes mellitus has been only rarely described following CsA treatment in dogs, 3,27–31 a study of pancreatic β‐cell function 32 revealed that after 3 weeks of CsA administration at 20 mg/kg, dogs remained normoglycaemic, but retrieved islet tissue showed a significantly lower total insulin output than that of control animals 32 …”