Difference between revisions of "Feline Medicine Q&A 04"

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'''A water deprivation test followed by an ADH response test has been performed in a cat with clinical signs and initial assessment consistent with diabetes insipidus. The water deprivation test was stopped after 8 hours as the cat was noted to be clinically de- hydrated. Results are shown graphically (19). Following ADH administration the USG increased to 1.020.'''
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'''A water deprivation test followed by an ADH response test has been performed in a cat with clinical signs and initial assessment consistent with diabetes insipidus. The water deprivation test was stopped after 8 hours as the cat was noted to be clinically dehydrated. Results are shown graphically. Following ADH administration the USG increased to 1.020.'''
  
 
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The absence of change in USG following water deprivation is consistent with diabetes insipidus. The response to ADH is diagnostic of central diabetes insipidus.
 
The absence of change in USG following water deprivation is consistent with diabetes insipidus. The response to ADH is diagnostic of central diabetes insipidus.
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|l1=Diabetes Insipidus#Diagnosis
 
|q2=What are the treatment options?
 
|q2=What are the treatment options?
 
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*As long as constant access to water is ensured so that the cat does not become dehydrated, and the owner is happy to live with a very polydipsic and polyuric cat, treatment is not mandatory.  
 
*As long as constant access to water is ensured so that the cat does not become dehydrated, and the owner is happy to live with a very polydipsic and polyuric cat, treatment is not mandatory.  
 
:*The owner should be informed of the risk of rapid, life-threatening dehydration which can occur if access to water is restricted or illness (e.g. vomiting or diarrhoea) occurs.<br><br>
 
:*The owner should be informed of the risk of rapid, life-threatening dehydration which can occur if access to water is restricted or illness (e.g. vomiting or diarrhoea) occurs.<br><br>
*Treatment with DDAVP, a synthetic analogue of ADH. DDAVP is available as oral, parenteral, and intranasal preparations licensed for human use.  
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*Treatment with desmopressin, a synthetic analogue of ADH. Desmopressin is available as oral, parenteral, and intranasal preparations licensed for human use.  
 
:*A starting dose of 1–5 μg per cat once to twice a day is recommended; in general higher doses are required when oral dosing is used (e.g. 50 μg per cat twice daily).  
 
:*A starting dose of 1–5 μg per cat once to twice a day is recommended; in general higher doses are required when oral dosing is used (e.g. 50 μg per cat twice daily).  
 
:*The intranasal preparation can be administered by the conjunctival route and comprises 100 μg/ml (one drop corresponds to 1.5–4 μg).  
 
:*The intranasal preparation can be administered by the conjunctival route and comprises 100 μg/ml (one drop corresponds to 1.5–4 μg).  
 
:*The dose is modified to produce remission of clinical signs.  
 
:*The dose is modified to produce remission of clinical signs.  
:*In some cases, severe polydipsia is not completely controlled by DDAVP alone and non-hormonal treatment may be added to the regime.  
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:*In some cases, severe polydipsia is not completely controlled by desmopressin alone and non-hormonal treatment may be added to the regime.  
 
:*Chlorpropamide (40 mg/day) potentiates the renal tubular effects of ADH and can help to stabilize cats with central or partial central diabetes insipidus. It should be used with some caution in view of the fact that in humans it is a potent hypoglycaemic.  
 
:*Chlorpropamide (40 mg/day) potentiates the renal tubular effects of ADH and can help to stabilize cats with central or partial central diabetes insipidus. It should be used with some caution in view of the fact that in humans it is a potent hypoglycaemic.  
 
:*Thiazide diuretics can also be used in this situation and have a paradoxical effect to reduce polyuria.
 
:*Thiazide diuretics can also be used in this situation and have a paradoxical effect to reduce polyuria.
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|l2=Diabetes Insipidus#Treatment
 
|q3=What is the prognosis?
 
|q3=What is the prognosis?
 
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*Central diabetes insipidus has been reported following CNS trauma and may improve/resolve with time.  
 
*Central diabetes insipidus has been reported following CNS trauma and may improve/resolve with time.  
 
*Where central diabetes insipidus is associated with neoplasia, the prognosis is dependent on the rate of progression of the tumour.
 
*Where central diabetes insipidus is associated with neoplasia, the prognosis is dependent on the rate of progression of the tumour.
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|l3=Diabetes Insipidus#Prognosis
 
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Latest revision as of 07:56, 1 October 2011


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A water deprivation test followed by an ADH response test has been performed in a cat with clinical signs and initial assessment consistent with diabetes insipidus. The water deprivation test was stopped after 8 hours as the cat was noted to be clinically dehydrated. Results are shown graphically. Following ADH administration the USG increased to 1.020.


Question Answer Article
What is the diagnosis? Link to Article
What are the treatment options? Link to Article
What is the prognosis? Link to Article


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