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1.
Generation of blood glucose curves is essential to monitor glycemic control in dogs and cats with diabetes mellitus. Up till now blood collection and blood glucose measurements could only be performed in a hospital. However, glucose concentrations measured in a hospital environment can markedly differ from concentrations measured at home, due to reduced appetite, different activity level and stressful handling. At the Clinic of Small Animal Internal Medicine, University of Zurich, a new method to collect capillary blood from the ear and to measure blood glucose by means of a portable glucose meter has been developed. This method enables owners of diabetic dogs or cats to determine blood glucose concentrations and generate blood glucose curves at home. Three cases demonstrate, how much blood glucose concentrations at home may differ from those in the hospital and how home monitoring can help to establish diabetic control in dogs and cats.  相似文献   

2.
Home-monitoring of blood glucose concentrations has recently been introduced to owners. The objectives of this study were to investigate the feasibility of home-monitoring of blood glucose in diabetic cats by owners, the problems encountered and to compare glucose concentrations at home with those measured in the hospital. Twelve of 15 cat owners were able to generate glucose curves over the study period of 4 months. Most problems were related to restraining the cat, generating negative pressure with the lancing device and producing a blood drop. In the majority of cases, these problems could be resolved during the study. Blood glucose concentrations in the clinic tended to be lower than at home; some of the differences were significant. No association between tolerance of the procedure and blood glucose concentrations measured at home was found. We, therefore, assume that the lower glucose levels in the hospital were caused by lack of food intake. In 38% of cases, treatment based on hospital curves would have been different from that based on home curves. Home-monitoring appears to be a valuable tool in the management of cats with diabetes mellitus. One of its major advantages is that it enables frequent generation of blood glucose curves, which is of particular importance in cats that are difficult to regulate.  相似文献   

3.
Recently a new method for capillary blood sampling from the ears of dogs and cats was described, which allows the measurement of glucose concentration by means of portable glucose meters. The authors of this report evaluated the suitability of this method for use by pet owners and the potential technical problems. The owners of seven healthy dogs and seven healthy cats were asked to perform two glucose curves (measuring blood glucose concentration every 2 hours for a total of 12 hours). All dog owners and three cat owners were able to perform a reliable blood glucose curve. The most frequently encountered problems were inadequate formation of a blood drop due to excessive digital pressure on the pinna, repeatedly depressing the plunger of the lancet device instead of allowing the negative pressure to slowly build up, and failure to fill the test strip up to the mark. The authors conclude that these steps of the procedure need to be stressed during technique demonstration and that home monitoring of blood glucose concentrations may serve as a new tool in the management of diabetic dogs and cats.  相似文献   

4.
Many owners are able and willing to perform home monitoring of blood glucose concentrations in diabetic cats. Once owners are familiar with the technique, they appreciate its advantages and show long-term compliance. The success of home monitoring hinges greatly on careful preparation and instruction of the owner. Owners must have ready access to veterinary support if needed. Initially, most owners call for advice, and several of them need repeated explanation or demonstration of the procedure. The frequency of re-evaluations of the diabetic cats by veterinarians is not affected by home monitoring. One of its major advantages is that it enables frequent generation of blood glucose curves. In complicated cases, more than one curve can, therefore, be performed at home before a treatment decision is made. According to preliminary data cats managed with home monitoring may have better glycaemic control than those managed without. However, those results need to be confirmed in a large group of cats.  相似文献   

5.
OBJECTIVE: To evaluate owner compliance with longterm home monitoring of blood glucose concentrations in diabetic cats and assess the influence of home monitoring on the frequency of reevaluation of those cats at a veterinary hospital. DESIGN: Retrospective study. ANIMALS: 26 cats with diabetes mellitus. PROCEDURE: Medical records of diabetic cats for which home monitoring was undertaken were reviewed, and owners were contacted by telephone. Signalment, laboratory test results, insulin treatment regimen, details of home monitoring, clinical signs during treatment, frequency of follow-up examinations, and survival times were evaluated. RESULTS: Monitoring of cats commenced within 12 weeks (median, 3 weeks) after initial evaluation; 8 owners were unable to perform home monitoring, and 1 cat was euthanatized after 1 week. In 17 cats, duration of home monitoring was 4.8 to 46.0 months (median, 22.0 months); 6 cats died after 7.0 to 18.0 months (median, 13.0 months). In 11 cats, home monitoring was ongoing at completion of the study (12.0 to 46.0 months' duration). Fourteen owners completed blood glucose curves every 2 to 4 weeks. Cats managed with home monitoring received higher dosages of insulin, compared with cats that were not monitored. Four of 17 cats managed by home monitoring had transient resolution of diabetes mellitus for as long as 1 year. Home monitoring did not affect the frequency of reevaluation at the veterinary hospital. CONCLUSIONS AND CLINICAL RELEVANCE: Owner compliance with long-term home monitoring appeared to be satisfactory, and home monitoring did not affect the frequency of reevaluation of patients by veterinarians.  相似文献   

6.
Home monitoring of blood glucose (HMBG) concentrations has been recommended in the monitoring of human diabetics for 3 decades. During the last number of years, it also gained popularity in long-term follow-up of diabetic cats and dogs. The aim of this retrospective study was to evaluate the practical feasibility of and identify the major problems encountered with HMBG in diabetic pets. A standard questionnaire was filled in by owners of 9 diabetic pets monitored with HMBG. The need for more than 1 puncture to obtain a blood drop, the creation of a sufficient blood drop, the need for assistance in restraining the pet, and the resistance of the pet were the most frequently encountered problems during HMBG. The major obstacles for the owners to start with HMBG were also identified. In conclusion, HMBG is a practical and simple technique for most owners and, overall, owners were satisfied.  相似文献   

7.
Two new methods for collection of capillary blood from the ear of dogs and cats for the measurement of blood glucose concentration using portable blood glucose meters (PBGMs) are described. The first method uses a lancing device after pre-warming the ear, while the second employs a vacuum lancing device. Both methods generated blood drops of adequate size, although the latter method was faster and easier to perform. Accuracy of the two PBGMs was evaluated clinically and statistically. Although assessment of statistical accuracy revealed differences between the PBGMs and the reference method, all of the PBGM readings were within clinically acceptable ranges. Measurement of capillary blood glucose concentration is easy to perform, inexpensive and fast. It may be used by owners to determine blood glucose concentrations at home, and could serve as a new tool for monitoring diabetic dogs and cats.  相似文献   

8.
The generation of a blood glucose curve is important for assessing the response to insulin therapy in diabetic dogs. Disadvantages of this technique include patient discomfort and the potential for missing transient hypo- or hyperglycaemic episodes. The aim of the current study was to evaluate a continuous glucose monitoring system (CGMS) for use in diabetic dogs. Interstitial fluid glucose concentrations were recorded in 10 diabetic dogs, every five minutes for up to 48 hours, using a subcutaneous sensor attached to the CGMS device. Blood glucose concentrations were measured simultaneously using a glucometer. The correlation between interstitial fluid and blood glucose values was 0.81 (P < 0.01). The largest discrepancies between the two sets of data were seen during the one- to three-hour period following feeding, suggesting that postprandial hyperglycaemia might not be reflected in the interstitial fluid. The authors conclude that the CGMS is a potentially valuable tool in the management of canine diabetic patients.  相似文献   

9.
OBJECTIVE: To evaluate day-to-day variability in blood glucose curves (BGCs) generated at home and at the clinic for cats with diabetes mellitus. DESIGN: Prospective study. ANIMALS: 7 cats with diabetes mellitus. Procedures-BGCs generated at home on 2 consecutive days and within 1 week at the clinic were obtained twice. On each occasion, insulin dose, amount of food, and type of food were consistent for all 3 BGCs. Results of curves generated at home were compared with each other and with the corresponding clinic curve. RESULTS: Differences between blood glucose concentration determined after food was withheld (fasting), nadir concentration, time to nadir concentration, maximum concentration, and mean concentration during 12 hours had high coefficients of variation, as did the difference between fasting blood glucose and nadir concentrations and area under the curve of home curves. Differences between home curve variables were not smaller than those between home and clinic curves, indicating large day-to-day variability in both home and clinic curves. Evaluation of the paired home curves led to the same theoretical recommendation for adjustment of insulin dose on 6 of 14 occasions, and evaluation of home and clinic curves resulted in the same recommendation on 14 of 28 occasions. Four of the 6 paired home curves in cats with good glycemic control and 2 of the 8 paired home curves in cats with poor glycemic control led to the same recommendation. CONCLUSIONS AND CLINICAL RELEVANCE: Considerable day-to-day variability was detected in BGCs generated at home. Cats with good glycemic control may have more reproducible curves generated during blood collection at home than cats with poorer control.  相似文献   

10.
Use of continuous glucose monitoring in veterinary medicine is gaining popularity. Through use of a commercially available continuous glucose monitor system, insights into daily glucose changes in dogs and cats are achievable. The continuous glucose monitoring system measures glucose concentrations in the interstitial fluid of the subcutaneous space by use of a small, flexible probe. When placed in the subcutaneous tissue, the probe is connected to a recording device that is attached to the animal and records the interstitial fluid glucose concentration every 5 minutes (288 readings per 24 hours). Once attached and properly calibrated, the instrument can remain in place for several days, hospitalization of the patient is not necessary, and the normal daily routine of the animal can be maintained. The data from the recording device are then downloaded and a very detailed picture of the interstitial fluid glucose concentration over that time period can be obtained. Subcutaneous interstitial fluid glucose concentrations have a good correlation to blood glucose concentrations within a defined range. The continuous glucose monitoring system has distinct advantages over traditional blood glucose curves and is a valuable tool for managing diabetic dogs and cats. In addition, other clinical uses for continuous glucose monitoring are being developed. This review is designed to outline the technology behind the continuous glucose monitoring system, describe the clinical use of the instrument, provide clinical examples in which it may be useful, and discuss future directions for continuous glucose monitoring in dogs and cats.  相似文献   

11.
Management of diabetic dogs and cats requires a tremendous cooperative effort between the practitioner and the client. Consistency in the handling, availability, and formulations of the different insulins will improve client compliance. In addition to insulin therapy, successful management of the diabetic animal includes the client's perceptions of the animal's health, maintenance of the animal's body weight, consistency in water consumption, and monitoring serial blood glucose concentrations. Serial blood glucose determinations improve the practitioner's ability to identify and address problems associated with insulin therapy, and thereby delay or minimize the complications of long-term diabetes.  相似文献   

12.
The objective of this study was to evaluate the safety and efficacy of a purified porcine insulin zinc suspension for treating dogs with uncomplicated diabetes mellitus. Fifty-three dogs were treated for 60 days after an initial dose determination period. The means of the blood glucose concentrations during 12-hour glucose curves and the means of the blood glucose nadir concentrations during 12-hour glucose curves for all dogs were determined before beginning insulin therapy (time 0), at the end of the dose determination period (time 1), 30 days after time 1 (time 2), and 60 days after time 1 (time 3). Presence of polyuria, polydipsia, and ketonuria was determined at each time point. Adequacy of control of hyperglycemia was based on 12-hour blood glucose curves and improvement in clinical variables (results of physical examinations, historic information, polyuria, polydipsia, and ketonuria). Safety was evaluated by questionnaire, performance of physical examination, CBC, serum chemistry profile, and urinalysis. The means of the blood glucose concentrations during 12-hour glucose curves and the means of the blood glucose nadir concentrations during 12-hour glucose curves for all dogs at times 1, 2, and 3 were significantly lower compared with time 0 (P < .0001). There was a reduction in the proportion of dogs with polyuria, polydipsia, and ketonuria of 82, 86, and 80%, respectively. All of the dogs had adequate glycemic control at time 1, 66% at time 2, and 75% at time 3. At time 3, 66% of dogs required insulin injections q12h. Other than hypoglycemia, there were no important adverse effects of insulin administration. The insulin, was safe and efficacious for reducing blood glucose and clinical signs in dogs with diabetes mellitus.  相似文献   

13.
Clinical measurements, including a subjective clinical score and water intake, and biochemical measurements, including blood glucose, fructosamine, beta-hydroxybutyrate, cholesterol, triglycerides, triglycerides corrected for free glycerol, glycerol and urine glucose were compared for monitoring diabetic cats treated with porcine insulin zinc suspension. The data were grouped by subjective clinical score and the sensitivity of each measurement in differentiating the grouped data was assessed. None of the measurements was able to differentiate between the ranked clinical score groups, but two-hourly measurements of blood glucose over 24 hours, water intake, urine glucose and fructosamine were useful in differentiating cats that subjectively had the water and food consumption and general appearance of a normal cat from cats in which the signs of diabetes were less well controlled. Measurements of plasma lipids were not well correlated with the other measurements. The measurements that were most closely correlated with apparently perfect clinical control were the J index, water intake and maximum and mean blood glucose concentrations. In practice, water intake, maximum blood glucose concentration, mean blood glucose concentration and urine glucose would be the most useful indicators of clinical control in diabetic cats treated with porcine insulin zinc suspension.  相似文献   

14.
The aim of this study was to evaluate the accuracy of serum beta-hydroxybutyrate (beta-OHB) measurements for the diagnosis of diabetic ketoacidosis (DKA) in dogs. One hundred sixteen diabetic dogs were prospectively enrolled in the study: 18 insulin-treated (IT) diabetic dogs that had a positive urine ketone test and 88 untreated, newly diagnosed diabetic dogs. Venous blood gas tensions and pH, serum glucose and urea nitrogen (SUN), and electrolyte (Na+, Cl-, and K+) and urine acetoacetate (AA) concentrations were measured concurrently with serum beta-OHB concentrations. On the basis of laboratory findings, the patients were assigned to I of 3 groups: diabetic ketoacidosis (n = 43); diabetic ketosis (DK, n = 41); and nonketotic diabetes (NDK, n = 31). Serum beta-OHB concentrations differed significantly (P < .001) among the study groups. Although marked differences in beta-OHB concentrations were found, a considerable overlap exists between the distributions of dogs with DK and those with DKA. The overall accuracy of beta-OHB determination as a diagnostic test for DKA, determined by the area under the receiver operating characteristic (ROC) curve, was 0.92. In the 1.9- to 4.8-mmol/L range, serum beta-OHB determination sensitivity varied from 100 to 35.7%, whereas specificity varied from 39 to 100%. The cutoff value of 3.8 mmol/L showed the best equilibrium between specificity (95%), sensitivity (72%), and likelihood ratio (14.8). We concluded that the quantitative measurement of serum beta-OHB may be a potential tool for diagnosing and monitoring ketosis and ketoacidosis in diabetic dogs.  相似文献   

15.
A scale to assess the severity of pruritus in dogs was further validated. Comparison of the scale with one containing visible numerical markings demonstrated that owners were heavily influenced by the presence of numbers, resulting in a loss of the scale's ability to generate continuous data. The presence of a traditional visual analogue scale was therefore essential. The scale was tested on 713 owners who presented their dogs for veterinary attention. Pruritus scores in 408 dogs with skin disease covered the full range of possible values (0 to 10). In 305 dogs with no skin disease, 90 owners gave a score greater than zero. Comparison of the scores seen in pruritic dogs, and dogs with no evidence of skin disease, allowed a 'normal range' of 0–1.9 to be established. The scale was able to discriminate between conditions typically regarded as pruritic or non-pruritic. When the scale was assessed for its ability to detect changes in pruritus score following treatment, a median reduction of 4.4 points was observed. The scale was also used to determine what magnitude of response owners would expect following treatment of their pruritic dogs. Only 12% would have been satisfied with a 50% reduction, a figure that is typically quoted as a satisfactory response in clinical trials of anti-pruritic drugs. As a result, alternative methods of assessing clinical trials are proposed. This study has shown the scale to be a valuable tool for clinical assessment of patients, and for monitoring treatment responses in clinical trials.  相似文献   

16.
OBJECTIVE: To evaluate day-to-day variability of serial blood glucose concentration curves in dogs with diabetes mellitus. DESIGN: Prospective clinical study. ANIMALS: 10 dogs with diabetes mellitus. PROCEDURE: Paired 12-hour serial blood glucose concentration curves performed during 2 consecutive days were obtained on 3 occasions from each dog. Dogs received the same dose of insulin and meal every 12 hours on both days. For each pair of curves, comparison was made between the results of days 1 and 2. RESULTS: Mean absolute difference (without regard to sign) between days 1 and 2 for each parameter was significantly > 0, disproving the hypothesis that there is minimal day-to-day variability of serial blood glucose concentration curves when insulin dose and meals are kept constant. Coefficient of variation of the absolute difference between days 1 and 2 for each parameter ranged from 68 to 103%. Evaluation of the paired curves led to an opposite recommendation for adjustment of the insulin dose on day 2, compared with day 1, on 27% of occasions. Disparity between dosage recommendations was more pronounced when glucose concentration nadir was < 180 mg/dL (10 mmol/L) on 1 or both days. In this subset of 20 paired curves, an opposite recommendation for dosage adjustment was made on 40% of occasions. CONCLUSIONS AND CLINICAL RELEVANCE: There is large day-to-day variation in parameters of serial blood glucose concentration curves in diabetic dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control.  相似文献   

17.
OBJECTIVE: To evaluate the reliability of history and physical examination findings for assessing control of glycemia in insulin-treated diabetic dogs. DESIGN: Retrospective study. ANIMALS: 53 insulin-treated dogs with diabetes mellitus. PROCEDURE: Medical records of insulin-treated diabetic dogs from June 1995 to June 1998 were reviewed, and information on owner perception of their dog's response to insulin treatment, physical examination findings, body weight, insulin dosage, and concentrations of food-withheld (i.e., fasting) blood glucose (FBG), mean blood glucose (MBG) during an 8-hour period, blood glycosylated hemoglobin (GHb), and serum fructosamine was obtained. Owner's perception of their dog's response to insulin treatment, physical examination findings, and changes in body weight were used to classify control of glycemia as good or poor for each dog. The FBG, MBG/8 h, blood GHb, and serum fructosamine concentrations were compared between well-controlled and poorly controlled insulin-treated diabetic dogs. RESULTS: Presence or absence of polyuria, polydipsia, polyphagia, lethargy, and weakness were most helpful in classifying control of glycemia. Mean FBG and MBG/8 h concentrations, blood GHb concentrations, and serum fructosamine concentrations were significantly decreased in 25 well-controlled diabetic dogs, compared with 28 poorly controlled diabetic dogs. Most well-controlled diabetic dogs had concentrations of FBG between 100 and 300 mg/dl, MBG/8 h < or = 250 mg/dl, blood GHb < or = 7.5%, and serum fructosamine < or = 525 mumol/L, whereas most poorly controlled diabetic dogs had results that were greater than these values. CONCLUSIONS AND CLINICAL RELEVANCE: Reliance on history, physical examination findings, and changes in body weight are effective for initially assessing control of glycemia in insulin-treated diabetic dogs.  相似文献   

18.
Measurements of serum fructosamine, glycated hemoglobin, and glycated albumin (GA) complement serum glucose concentration for better management of diabetes mellitus (DM). Especially, the serum fructosamine test has long been used for diagnosing and monitoring the effect of treatment of DM in dogs. However, fructosamine tests are currently not performed in veterinary medicine in Japan. GA and fructoasmine levels have been shown to strongly correlate. However, the clinical implications of using GA remain to be elucidated. Therefore, the purpose of the current study was threefold: 1) Determine whether GA% is altered by acute hyperglycemia in normal dogs, simulating stress induced hyperglycemia; 2) Demonstrate that GA% does not dynamically change with diurnal variation of blood glucose concentration in diabetic dogs; and 3) Investigate whether GA% is capable of providing an index of glycemic control for 1–3 weeks in diabetic dogs as is the case with diabetic human patients. Our study demonstrated that serum GA% remains very stable and unaltered under acute hyperglycemic conditions (intravenous glucose injection) and in spite of diurnal variation of blood glucose concentration. Furthermore, serum GA% can reflect long-term changes (almost 1–3 weeks) in blood glucose concentration and the effect of injected insulin in diabetic dogs.  相似文献   

19.
Blood glycated hemoglobin evaluation in sick dogs.   总被引：1，自引：0，他引：1       下载免费PDF全文
Blood glycated hemoglobin concentration reflects long-term serum glucose levels in dogs. In this study, the effects of several diseases on blood glycated hemoglobin levels have been evaluated. For this study, blood samples were drawn from 93 unhealthy dogs. The animals were distributed into 10 groups according to pathological process (group 1, digestive problems; group 2, leishmaniasis; group 3, anemia; group 4, dermatological disorders; group 5, urinary problems; group 6, cardiorespiratory problems; group 7, diabetes mellitus; group 8, insulinoma; group 9, general diseases; group 10, control group). Blood glucose and glycated hemoglobin concentrations and hemoglobin and hematocrit values were analyzed in all the animals. In diabetic dogs, a strong increase in blood glycated hemoglobin was observed when compared with the other groups (P < 0.01). In contrast, dogs with insulinoma showed a decrease in blood glycated hemoglobin, though significant differences were not reported in all cases. No change in blood glycated hemoglobin concentrations were reported in dogs affected by other diseases. So, we can suppose that only the chronic alterations in glucose metabolism (chronic hyper- or hypoglycemia) can induce significant changes on the blood glycated hemoglobin concentrations in dogs.  相似文献   

20.
This study was conducted to evaluate the effect of camel milk in alloxan‐induced diabetic dogs and to follow this effect at three doses of milk. Firstly, three groups of dogs were used: two groups composed each of four diabetic dogs and receiving raw camel milk (treatment 1) or cow milk (treatment 2), and four healthy dogs getting raw camel milk (treatment 3) were used as control. Each animal was treated with 500 ml of milk daily. Secondly, we compared the effects of three amounts of camel milk: 100 ml, 250 ml and 500 ml to treat the diabetic dogs. After week 3, the dogs treated with camel milk showed a statistically significant decrease in blood glucose (from 10.88 ± 0.55 to 6.22 ± 0.5 mmol/l) and total protein concentrations (from 78.16 ± 2.61 g/l to 63.63 ± 4.43 g/l). For cholesterol levels, there was a decrease from week 2 (from 6.17 ± 0.5 mmol/l to 4.79 ± 0.5 mmol/l). There were no significant difference in blood glucose, cholesterol or total protein concentrations in dogs drinking 250 and 500 ml of camel milk. The dogs treated with 100 ml of camel milk did not show any significant decrease in blood glucose levels, and cholesterol and total protein concentrations. The investigation was not limited to the improvement in glycemic balance, lipids and proteins control in diabetic dogs getting camel milk, but we also noted a stability of this state after the dogs stopped to drink milk. This effect depended on the quantity of camel milk used to treat diabetic dogs.  相似文献   

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