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Scientific Research of the Union of Scientists in Bulgaria - Plovdiv, series G. Medicine, Pharmacy and Dental medicine, Vol. XVII, ISSN 1311-9427, International Conference of Young Scientists, 11 - 13 June 2015, Plovdiv
DIABETES MELLITUS IN 8 YEARS FEMALE ROTWIELLER-
CASE REPORT
Alexandar Avramov1, Stefan Dimitrievski1,Cvetanka Stojanovska1,Blagica Trajanoska1, Elena Buntevska1,Zhivko Davidovski1 1University St. KlimentOhridski - Bitola, Veterinary faculty, 7000 Bitola; ^Correspondence /e-mail: elena_buntevska@yahoo.com
ABSTRACT
Diabetes mellitus in dogs is not clearly separated disease, but represents a manifestation of various pathophysiological processes. The unique characteristic of these disorders is the presence of hyperglycemia in the presence of glycosuria, which is a result of absolute or relative insulin deficiency combined with absolute or relative excess of glucagon. Insulin and glucagon are peptides that are secreted in the p and a cells of pancreatic islets and their roles are opposite, but are focused on efficient depositing and mobilization of sugar. In our case, 8 years old female, Rottweiler demonstrate a clinical diagnosis of diabetes mellitus (body constitution 2, polydipsia, polyuria, lethargy and bilateral cataracts). The dog's owners noticed dehydration, weakening sharply, increased thirst 5 - 6 liters per day, chronic fatigue.
Key words: diabetes mellitus, Rottweiler, bilateral cataracts, insulin, glucagon
INTRODUCTION
In our case, was described diabetes mellitus, in 8 years female dog, from the breed rotweiller, with polydipsia, polyuria, lethargy, bilateral cataract, body condition 2, losing weight, hronic fatigue. The patient was treated with Humolog 2x 14 IN, tabl. Glucophage 850 mg 2 x 1 before the meal, special mode of food, dietal food and everyday exercieses.
Diabetes mellitus is one of the most common endocrine disorders in dogs, having apreva-lence of 0.3-0.6 %.(1,2). In many dogs the disease is similar to human type 1 diabetes, which is caused by autoimmune destruction of b-cells in genetically predisposed individuals. Antibodies against b-cells and several islet components (insulin, GAD65, IA2,insulin is produced and secreted solely by beta cells in the islets of Langerhans(3) have been demonstrated in the serum of dogs with newly diagnosed diabetes,suggesting that these antigens are involved in the autoimmune process.(4,5).
The observation that certain breeds of dogs are predisposed to diabetes 18 recently lead to genetic studies. The risk of diabetes was shown to be associated with certain dog leukocyte antigen (DLA) haplotypes. Since most dogs are middle-aged to elderly at the time of diagnosis, canine type 1 diabetes seems to correspond best to the subgroup of type 1 diabetes termed latent autoimmune diabetes in adults (LADA).(6-10). Diabetes typically occurs in middle-aged to elderly dogs, most being five or more years of age, and rarely occurs in dogs < 12 months of age. The proportion of females has decreased from more than 70 % to around 55 %, most probably because of more frequent early neutering and the consequent decrease in diestrus-associated diabetes (2,5) Samoyeds, various terrier breeds (Australian, Tibetan, cairn,West Highland white), miniature
schnauzers, beagles, and poodles (miniature and toy) are at increased risk for diabetes.The boxer, German shepherd dog, and golden retriever appear to be at low risk(11). Preliminary genetic studies have suggested a genetic component for both susceptibility and resistance to diabetes.(12,13)
The four typical symptoms of diabetes mellitus are polyuria,polydipsia, polyphagia, and weight loss. These are sometimes unnoticed until the dog develops blindness due to diabetic cataracts. About 50 % of diabetic dogs develop cataract within the first six months and about 80 % within 16 months after the diagnosis of diabetes.(14)Due to the potential danger of lens-induced uveitis, the eyes should be monitored closely during the course of diabetes. The risk of capsule rupture appears to be particularly high in dogs with rapidly progressing cataracts.(15)
The prognosis following early surgical intervention is usually good. Symptoms and signs other than cataract depend on the duration and severity of the diabetes and possible concurrent disease such as pancreatitis or infections. The diabetic dog maybe obese, of normal weight, or underweight. It's haircoat maybe dull and hepatomegaly may be palpable. Otherwise, the dog with so-called uncomplicated diabetes is usually inrelatively good physical condition. In contrast, dogs with diabetes complicated by ketoacidosis or the hyperosmolar nonketotic syndrome are usually presented with symptoms oflethargy, anorexia, reduced water intake, and vomiting.
The former serves to detect morning hypoglycemia, in which case the owner is instructed to contact the clinic.(16,17) There may be considerable day-to-day variability of blood glucose concentration(18) due to difference in insulin absorption and different levels of stress and exercise. Glucose is constantly transported across the beta cell membrane through glut-2/glut-1, which keeps extracellular and intracellular glucose concentrations similar (19). Individual curves may thus not reflect the true glycemic situation, regardless of whether they are obtained in the hospital or at home.
MATERIALS AND METHODS
Diabetes is diagnosed on the basis of appropriate symptoms and signs, persistent hyper-glygemia and glucosoria.
During clinical examination it was established reduced body mass, polyuria and polydip-sia, bilateral cataracts and lethargy.
In our case it was made complete blood count using special calibrated analyzer for dog blood which proved elevated levels of glucose. Blood glucose concentration may also be increased by anxiety and by other diseases, but this hyperglycemia is either mild or its cause (e.g. head trauma (20) or seizures) is readily apparent. Knowing this, we made one more blood count and urine analysis test for confirmation of our suspects.
Before setting the final diagnosis we had an attempt to therapy by using Glucophage a 850,0 (2x daily before meals) and the symptoms were minimized but not completely. For this purpose the successful therapy was achieved by using Humalog mix 75/25% 2 x 14 IU which shows the desired effects. Once-daily administration of a higher dose is not recommended because it increases the risk of hypoglycemia.(21,22) Effective treatment includes a high-fiber diet (> 8% fiber on a dry-matter basis).(23,24) Dog are fed with two meals of equal size.
RESULTS AND DISCUSSION
In preliminary analysis biochemical outcome shows the next values :
- Increased hematocrit;
- Leukocytosis;
- Reduced MCH (reduced volume of hemoglobin in the ER);
- Decreased MCHC (hemoglobin decreased volume in liter / erythrocytes);
- Elevated glucose 21,2 mmol / L (<14 mmol / L);
- An increased level of triglycerides 1,9 mmol / L (0,2-1,3 mmol / L);
- Increased level of alanine aminotransferase 121 U / L (8-57 U / L);
- Reduced iron 16,5 ^mol / L (46-241 ^mol / L).
Table 1 - Blood reslults and biohemical results before the therapy
Parameters Obtained values Reference values
WBC 9.6 6.0 - 17.0 x10 9/L
RBC 7.30 5.5 - 8.5 x 1012 /L
HGB 136 120 - 180 g/L
HCT 459 37.0 - 59.0
PLT 473 200 - 600 x 109/L
LYM % 33.3 12.0 - 30.0
MON % 4.2 2.0 - 9.0
GRA % 62.5 60.0 - 93.0
MCV 62.8 62.0 - 72.0 fL
MCH 18.6 20.0 - 25.0
MCHC 296 300 - 380 g/L
Glucose (mmol/L) 21.2 3.7 - 7.5 mmol/L
Triglycerides (mmol/L) 1.9 0.2-1.3 mmol/L
Cholesterol (mmol/L) 4.8 3.5-6.9 mmol/l
Urea 5.0 3.1 - 9.2
Creatinine 92.8 44 - 138
AST-GOT 49 9 - 49
ALT-GPT 121 8 - 57
Fe 16.5 46 - 241 |mol/L
In urinalysis was established glucosuria, leukocytosis and bacteriuria.
Presence of emphysematous cystitis.
Body weight: 28 kg; Body temperature: 38,1°C; Pulse: 130 / min; Breathing: 40 / min;
Degree of dehydration: dehydrated CRT < 2.
The patient has a reduced body mass, sharply weakening within 2-3 weeks, increased thirst (drinking 5-6 L of water per day), polydipsia, polyuria, chronic fatigue, lethargy, cataracts.
After two week therapy of our patient with Humalog Mix 75/25% 2x14 IU, we noticed significant improvement of the general condition of pacient from blood analysis results.
The analysis showed that the glucose return to normal levels, and weight of the patient is considerably improved. According to the results of the blood analysis, biochemical and general clinical examination of the patient shows very favorable outcome from the disease, but with significantly reduced vision (bilateral cataracts) because of high levels of glucose in the blood for longer period.
Table 2 Blood and biohemical results after two week therapy of our patient.
Parameters Obtained values Reference values
WBC 10 6.0 - 17.0 x10 9/L
RBC 7.50 5.5 - 8.5 x 1012 /L
HGB 159 120 - 180 g/L
HCT 167 37.0 - 59.0
PLT 445 200 - 600 x 109/L
LYM % 23.5 12.0 - 30.0
MON % 4.0 2.0 - 9.0
GRA % 67.5 60.0 - 93.0
MCV 64.9 62.0 - 72.0 fL
MCH 20.6 20.0 - 25.0
MCHC 356 300 - 380 g/L
Glucose (mmol/L) 7.0 3.7 - 7.5 mmol/L
Triglycerides (mmol/L) 1.1 0.2-1.3 mmol/L
Cholesterol (mmol/L) 3.6 3.5-6.9 mmol/l
Urea 5.7 3.1 - 9.2
Creatinine 92.0 44 - 138
AST-GOT 45 9 - 49
ALT-GPT 56.5 8 - 57
Fe 47.8 46 - 241 |mol/L
Body weight: 34 kg; Body temperature: 37,9°C; Pulse: 120 / min; Breathing: 20 / min; Degree of dehydration: normal CRT > 2.
Analysis of urine. Minimum presence of bacteria (emphysematous cystitis).
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