Difference between revisions of "Diabetes Mellitus"
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*Predisposed to [[Pancreas - inflammatory|pancreatitis]] and may also have [[EPI|pancreatic insufficiency]] | *Predisposed to [[Pancreas - inflammatory|pancreatitis]] and may also have [[EPI|pancreatic insufficiency]] | ||
*Persistent [[Pancreas - endocrine#Glucagonoma|increase in glucagon]] may cause hyperglycaemia | *Persistent [[Pancreas - endocrine#Glucagonoma|increase in glucagon]] may cause hyperglycaemia | ||
+ | *More common in mature dogs, twice as common in females than in males | ||
===Aetiology=== | ===Aetiology=== | ||
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*Fatty change is consistently present in the liver and kidneys | *Fatty change is consistently present in the liver and kidneys | ||
*The lens in the eye is often opaque due to deposition of sorbitol causing it to swell (glucose is converted into sorbitol once the glycolytic pathway is saturated) | *The lens in the eye is often opaque due to deposition of sorbitol causing it to swell (glucose is converted into sorbitol once the glycolytic pathway is saturated) | ||
+ | *In immune-mediated isletitis - progressive lymphoplasmacytic infiltration and selective destruction of islet cells |
Revision as of 14:17, 8 August 2007
Diabetes mellitus
- Clinically significant glucose intolerance
- Chronic disease caused by absolute or relevant deficiency of insulin and therefore disorders of carbohydrate metabolism
- Occurs in most species, most commonly in dog and cat
- Predisposed to pancreatitis and may also have pancreatic insufficiency
- Persistent increase in glucagon may cause hyperglycaemia
- More common in mature dogs, twice as common in females than in males
Aetiology
Can be caused by
- Absolute deficiency of insulin due to degenerative changes in beta cells
- Antagonism of insulin by hormones from the adrenal and thyroid glands, anterior pituitary causing high levels of blood glucose
- Complication of pancreatic fibrosis
- Insulin binding antibodies, insulinase and plasma antagonists imbalance
- Chronic insulin resistance results in hyperinsulinism leading to islet exhaustion
Clinical signs
- Hyperglycaemia
- Polyuria
- Polydypsia
- Polyphagia
- Weight loss
- Muscle wasting (but some animals may present obese)
- Hepatomegaly
- Cataracts (dogs)
- Later stages when becoming ketoacidotic
- Dehydration
- Depression
- Inappetance
- Vomiting
- Diarrhoea
- Ketotic breath
- Ketonuria
- Metabolic acidosis
- Reduced cardiac output (due to loss of water and sodium), reduced blood pressure and renal flow causing circulatory collapse, coma and death
Pathology
- Pancreas appers normal or reduced in size due to fibrosis
- In cats, amyloidosis is sometimes present in the islets
- Fatty change is consistently present in the liver and kidneys
- The lens in the eye is often opaque due to deposition of sorbitol causing it to swell (glucose is converted into sorbitol once the glycolytic pathway is saturated)
- In immune-mediated isletitis - progressive lymphoplasmacytic infiltration and selective destruction of islet cells