Feline Diabetes Mellitus : Literature review and prevalance study in city Niort (France)

Abstract

Diabetes mellitus is the second most commun endocrinological disease of cats. Eighty to 95% of cats may be affected by the later ailment. The compensated stage involves peripheral insulin resistance and consequent hyperinsulinemia. The decompensated stage is mainly triggered by amyloid depositions in 80% of the cats, chronic hyperinsulinemia, glucose toxicity, chonic hyperglycemia, and lipotoxicity, each of them leading to pancreatic beta-cells death and hypoinsulinemia. Predisposing factors for type 2 diabetes mellitus are obesity, physical inactivity, glucocorticoids treatment, male gender, Burmese breed, age above 7 years old, the absence of other companion animals, and neutering. Other well established causes of diabetes mellitus in cats include type 1 diabetes mellitus, pancreatic diseases, hyperthyroidism, and Cushing syndrom. Gestational diabetes and the recently identified human type 3 diabetes mellitus are not yet studied in cats. Diagnosis in cats is complicated by a less frequent observation of the classical triad (i.e. polyuria-polydypsia-polyphagia), and by the existence of significant stress hyperglycemia. This latter problem can be overcome by light restrain, repeated blood and urine glucose measurements, analysis of fructosamine and glycated hemoglobin, or detection of ketonuria. Life threatening complications of diabetes mellitus include ketoacidosis, hepatic lipidosis, and ketosis-hyperosmolar syndrome. Secondary diseases in cats include gastrointestinal disorders, infections, impaired blood rheology, neuropathy, nephropathy, retinopathy, cataract, heart failure and pulmonary lesions. Adequate treatment allows up to 90% remission rate. Low carbohydrate and fat diet is of outmost importance, together with high protein content. Some cats respond well to high fiber diet. First line medications include insulins and oral hypoglycemic agents, the choice depending on the experience of the veterinarian and the owner’s possibilities to treat the cat. Potential benefits may arise with the use of vanadium or troglitazone. One year mortality after diagnosis is high (42%), and the average survival time is around 3 years. Death occurs mainly due to co morbid diseases. We investigated the prevalence of feline diabetes mellitus in Niort, the main city of the rural Deux-Sèvres department in France. During 22 months, 2329 medical records were reviewed. Surprisingly enogh the prevalence (0.21%) was found lower than the lowest value given by the North American relevant literature, therefore tentative has been made to identify the underlying reasons. Repartition of predisposing factors among the cat population has been studied, showing a very young population (68.6% in the up to 5 year old age group), with a majority of female cats (60% from 6 to 10 year old age group, the critical age for the onset of the disease), few pure breed cats (4.1%, Burmese cats representing 0.3% of the overall population), high percentage of non neutered cats (32%), almost all of them having outdoor access (95%), and few overweighed cats (16%). After this, the question of the influence of the human cultural differences between North America and France was asked, therefore obesity rate in Niort were compared to previous French data, and they were found again lower. Hypothesis was drawn that the rural character of Deux-Sèvres could offer to cats a natural way of living, what on one hand exposes them to frequent life threatening dangers reducing their life expectancy, but on the other hand protects them against many predisposing factors of ailments such as diabetes mellitus.