Veterinary Medicine - June 2008 - (Page c18)

Figure 4. Follow-up blood glucose curve Two units of glargine were administered at time 0. Blood glucose concentration (mg/dl) 300 250 200 150 258 197 147 121 100 50 0 0 2 4 6 8 10 12 60 Hours after insulin injection concern for both sta and patient safety, blood glucose curves were no longer attempted. Client observations along with a serum fructosamine concentration and physical exam every three to four months, while not optimal, have allowed me to adequately monitor Scamper. signs, urine cultures are advised to semiannually identify occult urinary tract infections. The best method of monitoring a diabetic cat depends on both the cat and the client. Not every cat can be monitored in an identical fashion.Tailor the method to the cat and the client.You must also use good clinical judgment when interpreting any test. Do the numbers t with what you are seeing and how the patient is behaving? Remember: Keep it simple. Even though diabetes is a complicated disease, most clients need simplicity.While this principle may not result in ideal regulation and maintenance, it may be adequate and result in less patient loss due to owner concerns about the ongoing management of diabetes. References 1. Zoran D. Feline diabetes: What’s up with insulin, in Proceedings. American Association of Feline Practitioners, Fall 2005 Conference. 2. Rand J. Understanding feline diabetes and its management: Part II, in Proceedings. ACVIM, 2002. 3. Reusch C, Kley S, Casella M, et al. Home monitoring of the diabetic cat. J Feline Med Surg 2006;8:119-127. 4. Greco D. Methods for monitoring diabetic cats, in Proceedings. Western Veterinary Conference, 2002. 5. Greco D. Monitoring diabetics, in Proceedings. Atlantic Coast Veterinary Conference, 2002. 6. Sirois M. Monitoring insulin therapy, in Proceedings. ACVIM, 2003. 7. Schaer M. Monitoring glycosuria in diabetic cats, in Proceedings. Western Veterinary Conference, 2003. 8. Sirois M. Advances in clinical chemistry, in Proceedings. ACVIM, 2002. 9. Feldman E. Successful management of non-responsive diabetic cats, in Proceedings. Waltham Feline Medicine Symposium, 2002. 10. Schermerhorn T. Treatment of diabetes mellitus in dogs and cats. Clinician’s Brief 2008;6:35-39. 11. Wilson S. Management of feline diabetes and the Somogyi phenomenon. VIN AAFP Rounds, July 10, 2005. 12. Melendez L, Lorenz M. Feline insulin resistance and diabetes mellitus, in Proceedings. Western Veterinary Conference, 2002. 13. Nelson R. Poorly controlled diabetes in a cat. Clinician’s Brief 2007;5:68-71. 14. Mayer-Roenne B, Goldstein RE, Erb HN, et al. Urinary tract infections in cats with hyperthyroidism, diabetes mellitus and chronic kidney disease. J Feline Med Surg 2007;9:124-132. Summary In my opinion, the blood glucose curve remains the gold standard for monitoring diabetic cats and is critical during the rst one to four months for newly diagnosed diabetic cats.Training clients to observe pertinent home behaviors and to monitor their cat for changes in these behaviors is also an integral part of monitoring.9 It can take one to four months to stabilize a newly diabetic cat, so be patient and avoid over-adjusting the insulin.2 Checking the serum fructosamine concentration every three months, along with a physical examination (including determination of body weight), and midday blood glucose concentration checks may be adequate for monitoring purposes in established, stable diabetic cats.4 For successful diabetic management, you must identify—and resolve —any concurrent diseases. Even in the absence of clinical 18 Additional Resource: markNtime. How to test your diabetic cat’s blood sugar at home. Available at: www.youtube.com/watch?v=_zE124fVn8. Accessed March 17, 2008. http://www.youtube.com/watch?v=_zE12-4fVn8 http://www.youtube.com/watch?v=_zE12-4fVn8

Table of Contents Feed for the Digital Edition of Veterinary Medicine - June 2008

Veterinary Medicine - June 2008 Contents Leading Off Clinical Exposures Idea Exchange A Challenging Case: Conjunctival Lymphoma in a Cat Updates on Canine Hypoadrenocorticism Product Preview CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller Clinical Edge - June 2008 Table of Contents Managing Diabetes Mellitus in Cats: What Makes it Work? Porcine Insulin Zinc Suspension in the Management of Feline Diabetes Mellitus Monitoring Diabetes Mellitus in Diabetic Cats Feline Diabetes Mellitus: Important Client Communication Points

Veterinary Medicine - June 2008

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