2018 AAHA Diabetes Management Guidelines for Dogs and Cats*

Abstract

Diabetes mellitus (DM) is a common disease encountered in canine and feline medicine. The 2018 AAHA Diabetes Management Guidelines for Dogs and Cats revise and update earlier guidelines published in 2010. The 2018 guidelines retain much of the information in the earlier guidelines that continues to be applicable in clinical practice, along with new information that represents current expert opinion on controlling DM. An essential aspect of successful DM management is to ensure that the owner of a diabetic dog or cat is capable of administering insulin, recognizing the clinical signs of inadequately managed DM, and monitoring blood glucose levels at home, although this is ideal but not mandatory; all topics that are reviewed in the guidelines. Insulin therapy is the mainstay of treatment for clinical DM. The guidelines provide recommendations for using each insulin formulation currently available for use in dogs and cats, the choice of which is generally based on efficacy and duration of effect in the respective species. Also discussed are non-insulin therapeutic medications and dietary management. These treatment modalities, along with insulin therapy, give the practitioner an assortment of options for decreasing the clinical signs of DM while avoiding hypoglycemia, the two conditions that represent the definition of a controlled diabetic. The guidelines review identifying and monitoring patients at risk for developing DM, which are important for avoiding unnecessary insulin therapy in patients with transient hyperglycemia or mildly elevated blood glucose.

Histological and ultrastructural studies of the pancreas of native rabbits (Oryctolagus cuniculus)

“…The present study had discussed the normal morphological structure of rabbit pancreas with focusing on its endocrine part, because its functional significance and any disturbance to this function might cause sickness of diabetes. Recently, diabetes had become widespread disease encountered in both farm and wild animals which they were affected with this illness naturally and experimentally (9,10).…”

Starch sources influence lipidaemia of diabetic dogs

“…Dogs entered the experimental protocol after they were considered DM stabilized: at least 45 days without changes in insulin dosage due to absent manifestations of polyuria and polydipsia and blood glucose levels ranging from 5.0 to 16.7 mMol/L (90 to 300 mg/dL) [58]. During this stabilization period, all dogs had been eating the same basal (Ba) commercial dry extruded diet recommended for obese dogs 1 ( Table 3).…”

Insulinbehandlung beim Hund – Was gilt es zu beachten?

“…Die Hauptziele der Behandlung eines diabetischen Hundes sind ein Rückgang der klinischen Symptomatik sowie das Vermeiden von Komplikationen (z. B. Hypoglykämie, diabetische Ketoazidose) [5]. Die klinischen Symptome eines Diabetes werden in der Regel kontrolliert, wenn der Glukosespiegel unter der Nierenschwelle (beim Hund~12 mmol/l) bleibt, was nur durch Insulinverabreichung möglich ist.…”

“…Langzeitinsuline sind für den Hund nicht zugelassen. Bei der Katze ziehen die aktuellen Leitlinien [5,11] dagegen den Einsatz von Langzeitinsulinpräparaten gegenüber dem intermediären Caninsulin ® vor.…”