Canine diabetes mellitus: assessing risk factors to inform preventive measures

Pöppl, Álan Gomes

doi:10.1002/vetr.3078

Cited by 2 publications

(4 citation statements)

References 31 publications

(67 reference statements)

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“…An often-asked question by the owners of diabetic pets is “Why did my pet become diabetic?”, and due to the heterogeneity of the CDM, the answer is usually “we don’t know” [ 123 ]. Notwithstanding, the main characteristic of IRD cases is the potential for remission after the identification and resolution of the target-tissue disorder causing insulin resistance [ 1 , 19 ].…”

Section: How To Best Manage Progesterone-related Diabetes Mellitus?mentioning

confidence: 99%

“…Within a diabetic Elkhound population composed exclusively of females with PRDM (10.4% being pregnant), previous obesity was shown as a relevant risk factor, as well as age [ 64 ]. In these ways, the knowledge regarding PRDM risk factors allows simple recommendations that can potentially reduce the risk of DM development in an entire female [ 123 ]. These may include rational use of glucocorticoids especially in older, breed-predisposed, and overweight entire bitches [ 6 ], feeding balanced commercial dog food as the main (>90%) daily source of energy and nutrients [ 5 , 7 , 64 , 90 ], and preventing overweight development based on promoting the owner’s education, adequate feeding recommendations, and regular physical activity [ 64 , 185 , 186 ].…”

Section: How To Best Manage Progesterone-related Diabetes Mellitus?mentioning

confidence: 99%

“… Hypothetical causal diagram for P4-related diabetes mellitus in dogs [ 2 , 5 , 64 , 123 ]. The arrows represent evidence obtained from studies with dogs, but also from studies with humans, animal models, and cell cultures.…”

Section: Figurementioning

confidence: 99%

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Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Pöppl,

Lopes,

Nogueira

et al. 2024

Animals

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Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. This narrative review aims to provide relevant detailed information on (1) the canine estrus cycle and its impact on canine diabetes mellitus (CDM) etiology and management, (2) the role of pyometra as a further cause of insulin resistance, and (3) useful individual therapeutic and preventive strategies. PRDM is recognized due to diestrus, exogenous progestogen exposure, pregnancy, and P4-production ovarian dysfunction. Pyometra represents additional inflammatory and septic negative influence on insulin sensitivity, and its diagnosis associated with CDM is therapeutically challenging. The estrus cycle’s hormone fluctuations seem to modulate peripheric insulin sensibility by influencing insulin receptor (IR) affinity and its binding capacity, as well as modulating tyrosine kinase activity. Pyometra was shown to negatively influence IR compensatory mechanisms to insulin resistance causing glucose intolerance. Spaying and pregnancy termination may cause diabetes remission in PRDM cases in a median time of 10 days (1–51). Pharmacological annulment of progesterone effects may benefit patients unable to undergo surgery; however, remission chances are virtually null. The ALIVE (Agreeing Language in Veterinary Endocrinology) project proposed new criteria for CDM diagnoses and subclinical diabetes recognition. These new concepts may increase the frequency of a PRDM diagnosis and, even more, its relevance. Spaying represents a preventive measure against pyometra and PRDM that should be individually assessed in light of its recognized benefits and harms.

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Section: How To Best Manage Progesterone-related Diabetes Mellitus?mentioning

confidence: 99%

Section: How To Best Manage Progesterone-related Diabetes Mellitus?mentioning

confidence: 99%

See 1 more Smart Citation

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Pöppl,

Lopes,

Nogueira

et al. 2024

Animals

Self Cite

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“…An often-asked question by the owners of diabetic pets is "Why did my pet become diabetic? ", and due to the heterogeneity of the CDM, the answer is usually "we don't know" [123]. Notwithstanding, the main characteristic of IRD cases is the potential for remission after the identification and resolution of the target-tissue disorder causing insulin resistance [1,19].…”

Section: Initial Patient Evaluationmentioning

confidence: 99%

Estrus Cycle, Pyometra, and Insulin-Resistant Diabetes in the Bitch: What is Known and Why it is Relevant?

Pöppl,

Lopes,

Nogueira

et al. 2024

Preprint

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Correlations among estrus cycle, pyometra, and canine diabetes mellitus (CDM) have been described since the late 1950s, and substantial progress in understanding mechanisms beyond was achieved nowadays. Progesterone-related diabetes mellitus (PRDM) in dogs is known for its particular potential for diabetes remission. Thus, a deep understanding of the physiopathological aspects involved is crucial to postulate treatment guidelines to improve the PRDM remission rate, as well as to inform preventive measures. This narrative review aims to provide relevant detailed information on 1) canine estrus cycle and its impact on CDM etiology and management, 2) the role of pyometra as a further cause of insulin resistance, and 3) useful individual therapeutic and preventive strategies. Pharmacological annulment of progesterone effects, as well as inflammatory and progesterone-related conditions resolution in association with adequate exogenous insulin therapy, and residual beta cell function, are key aspects to achieve remission, or at least to improve diabetic clinical control. In this way, spaying should be considered mandatory in most PRDM cases. Preventive measures against CDM can include spaying recommendations; however, individual-based recommendations should be considered since castration may be associated with some long-term health issues.

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Canine diabetes mellitus: assessing risk factors to inform preventive measures

Cited by 2 publications

References 31 publications

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

Estrus Cycle, Pyometra, and Insulin-Resistant Diabetes in the Bitch: What is Known and Why it is Relevant?

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