Epidemiology of Diabetes Mellitus among 193,435 Cats Attending Primary‐Care Veterinary Practices in England

Abstract

BackgroundDiabetes mellitus (DM) is a common endocrine disease of cats. The prevalence of DM in cats in England is not well‐defined.Hypothesis/ObjectivesTo estimate the prevalence and identify risk factors for DM in a large population of cats attending primary‐care practices.AnimalsA cohort of 193,563 cats in the VetCompass Programme attending 118 primary‐care practices in England.MethodsCross‐sectional analysis of cohort clinical data. Data were extracted covering September 1st 2009 and August 31st 2014. Period prevalence of DM was calculated. Associations between risk factors and DM were assessed using logistic regression modelling.ResultsOf 1,128 DM cases were identified among 194,563 cats (period prevalence 0.58%; 95% confidence interval [CI] 0.54–0.61). Multivariable modelling indicated that Tonkinese (OR 4.1; 95% CI 1.8–9.6; P = .001), Norwegian Forest (odds ratio [OR] 3.5; 95% CI 1.3–9.6; P = .001) and Burmese (OR 3.0; 95% CI 2.0–4.4; P < .001) cats had increased odds of DM compared with crossbred cats. DM odds increased as bodyweight categories increased above 4 kg (P < .001), as cats aged beyond 6 years old (P < .001) and in insured cats (OR 2.0; 95% CI 1.6–2.4; P < .001) but sex was not significantly associated with DM.Conclusions and Clinical ImportanceDiabetes mellitus is an important component of the primary‐care practice caseload with 1‐in‐200 cats affected. An increased risk of DM in certain cat breeds supports a genetic predisposition. These results can guide future research and preventative healthcare.

Computed Tomographic Angiography of the Pancreas in Cats with Chronic Diabetes Mellitus Compared to Normal Cats

“…The only difference identified between groups was that DM‐affected cats weighed significantly more than did normal control cats. This finding is consistent with previously published reports of increased body weight being a risk factor for DM development …”

Associations of body condition score with health conditions related to overweight and obesity in cats

“…Adi ponectin has a negative dose-response association with type 2 diabetes mellitus in humans (Li et al 2009) and cats (Ishioka et al 2009, Tvarijonaviciute et al 2012, Zapata et al 2017. Sev eral studies found positive associations between diabetes mellitus and increased bodyweight or BCS (Scarlett & Donoghue 1998, Lund et al 2005, Prahl et al 2007, O'Neill et al 2016, Öhlund et al 2018. Interestingly, only cats with BCS of 8 of 9 had sig nificantly higher odds of diabetes mellitus compared to cats with BCS of 5 in the current study.…”

“…All the veterinarians who had practised in the clinic were trained to use the Purina 9point BCS chart (Fig 1). Assuming equal sample size for seven groups (BCS of 1/2, 3, 4, 5, 6, 7 and 8/9), 97 cats for each BCS group would be required to have 80% power to detect a prevalence of diabetes mellitus at 0•17, 0•29, 0•64, 1•03, 1•99, 4•24 and 5•16% in each group (O'Neill et al 2016), respectively, with a chisquared test (twosided, α=0•05). The extracted prevalence was based on the weight of cats instead of the BCS (O'Neill et al 2016).…”

“…In contrast, the evidence in feline medicine is not as strong and rather sparse. The health conditions reported to be positively associated with feline O&O include dermatological conditions (Scarlett & Donoghue 1998, Lund et al 2005, Öhlund et al 2018, lameness (Scarlett & Donoghue 1998), musculoskeletal disease (Öhlund et al 2018), hypertrophic cardiomyopathy (Freeman et al 2013, Payne et al 2015, respiratory conditions (Öhlund et al 2018), oral condi tions (Lund et al 2005), lower urinary tract (LUT) conditions (Lekcharoensuk et al 2001, Segev et al 2011, Pusoonthornthum et al 2012, Öhlund et al 2018) -particularly feline idiopathic cystitis (FIC; Cameron et al 2004, Defauw et al 2011, Lund et al 2016, neoplasia (Lund et al 2005) and diabetes mellitus (Scarlett & Donoghue 1998, Lund et al 2005, Haring et al 2012, O'Neill et al 2016, Öhlund et al 2018. The associa tion between diabetes mellitus and O&O is supported by more robust evidence than the other health conditions.…”

“…This study was conducted to screen the associations of 9point BCS in cats with various health conditions that have been shown to relate to O&O (as discussed above) (Scarlett & Donoghue 1998, Lekcharoensuk et al 2001, Cameron et al 2004, Lund et al 2005, Defauw et al 2011, Segev et al 2011, Haring et al 2012, Pusoonthornthum et al 2012, Freeman et al 2013, GarcíaGuasch et al 2014, Payne et al 2015, Lund et al 2016, O'Neill et al 2016, Öhlund et al 2018, dogs (Weeth 2016) and humans (Hubert et al 1983, Must et al 1999, Mokdad et al 2003, Asia Pacific Cohort Studies Collaboration 2006, Cheung & Wong 2007, Hersoug & Linneberg 2007, Wang et al 2008, Guh et al 2009, Lavie et al 2009, Chaffee & Weston 2010, Eslick 2012, Melo et al 2014, MouraGrec et al 2014, Park et al 2014, Aune et al 2015, Boulet 2015, Nascimento et al 2015, Papanas & Ziegler 2015, Zhang & Silverberg 2015. We also aimed to evaluate the associations in more detail by keeping as many of the 9point divisions of BCS as possible in the analyses.…”