Page 882 - Small Animal Internal Medicine, 6th Edition

854 PART VI Endocrine Disorders

ulceration recur after antiulcer therapy is discontinued. mellitus: 53 cases (1995-1998). J Am Vet Med Assoc. 2000;217:
48.
A definitive diagnosis of gastrinoma requires histologic Cohen TA, et al. Evaluation of six portable blood glucose meters
VetBooks.ir and immunocytochemical evaluation of a pancreatic mass for measuring blood glucose concentration in dogs. J Am Vet
excised at surgery. A finding of increased baseline serum
Med Assoc. 2009;235:276.
gastrin concentrations from blood obtained after an over-
night fast increases the suspicion of gastrinoma. Additional Cohn LA, et al. Assessment of five portable blood glucose meters, a
point-of-care analyzer, and color test strips for measuring blood
differential diagnoses for increased serum gastrin concentra- glucose concentration in dogs. J Am Vet Med Assoc. 2000;216:
tions include gastric outflow tract obstruction, kidney failure, 198.
short-bowel syndrome, chronic gastritis, hepatic disease, and Davison LJ, et al. Study of 253 dogs in the United Kingdom with
animals receiving antacid therapy (e.g., H 2 -receptor antago- diabetes mellitus. Vet Rec. 2005;156:467.
nists, proton pump inhibitors). Baseline serum gastrin con- Davison LJ, et al. Anti-insulin antibodies in diabetic dogs before
centrations may vary, with occasional values in the reference and after treatment with different insulin preparations. J Vet
range in animals with gastrinoma. Provocative testing (e.g., Intern Med. 2008;22:1317.
secretin stimulation test, calcium challenge test) or explor- Davison LJ, et al. Autoantibodies to GAD65 and IA-2 in canine
atory laparotomy should be considered in dogs strongly sus- diabetes mellitus. Vet Immunol Immunopathol. 2008;126:83.
pected of having gastrinoma but with normal baseline serum Della Maggiore A, et al. Efficacy of protamine zinc recombinant
human insulin for controlling hyperglycemia in dogs with dia-
gastrin concentrations. (See Suggested Readings for more betes mellitus. J Vet Intern Med. 2012;26:109.
information on provocative testing.) Fall T, et al. Diabetes mellitus in a population of 180,000 insured
Treatment dogs: incidence, survival, and breed distribution. J Vet Intern
Med. 2007;21:1209.
Treatment should be directed at surgical excision of the Fall T, et al. Diabetes mellitus in Elkhounds is associated with dies-
tumor and control of gastric acid hypersecretion. Gastro- trus and pregnancy. J Vet Intern Med. 2010;24:1322.
intestinal tract ulceration can usually be managed by Ford SL, et al: Evaluation of detemir insulin in diabetic dogs
reducing gastric hyperacidity through administration of managed with home blood glucose monitoring, Proceedings,
H 2 -receptor antagonists (e.g., ranitidine, famotidine), proton ACVIM Forum, Anaheim, CA, 2010, p.442.
pump inhibitors (e.g., omeprazole), gastrointestinal tract Fracassi F, et al. Breed distribution canine diabetes mellitus in Italy.
Vet Res Commun. 2004;28:339.
protectants (e.g., sucralfate), or prostaglandin E 1 analogs Fracassi F, et al. Use of insulin glargine in dogs with diabetes mel-
(e.g., misoprostol). (See Chapter 28 for more information litus. Vet Rec. 2012;170:52.
on these gastrointestinal tract drugs.) Surgical resection of Guptill L, et al. Time trends and risk factors for diabetes mellitus
an ulcer may be required, especially if the ulcer has perfo- in dogs: analysisi of veterinary medical data base records
rated the bowel. Surgical resection of the tumor is necessary (1970-1999). Vet J. 2003;165:240.
to obtain a cure, although metastasis to the liver, regional Hofer-Inteeworn N, et al. Effect of hypothyroidism on insulin sen-
lymph nodes, and mesentery is common. Even if metastatic sitivity and glucose tolerance in dogs. Am J Vet Res. 2012;735:
disease is present, tumor debulking may enhance the success 529.
of medical therapy. Lorenzen FH. The use of isophane inulin for the control of diabetes
mellitus in dogs. Acta Vet Scand. 1992;33:219.
Prognosis Mazzi A, et al. Ratio of urinary protein to creatinine and albumin
The long-term prognosis for gastrinoma is guarded to poor. to creatinine in dogs with diabetes mellitus and hyperadrenocor-
ticism. Vet Res Commun. 2008;32:S299.
Evidence of metastasis was present in 76% of reported dogs Monroe WE, et al. Efficacy and safety of a purified porcine insulin
and cats at the time a gastrinoma was diagnosed. Reported zinc suspension for managing diabetes mellitus in dogs. J Vet
survival time in dogs and cats treated surgically, medically, Intern Med. 2005;19:675.
or both ranged from 1 week to 18 months (mean, 4.8 Mori A, et al. Comparison of glucose fluctuations between day- and
months). However, the short-term prognosis has improved night-time measured using a continuous glucose monitoring
with the advent of drugs that can reduce gastric hyperacidity system in diabetic dogs. J Vet Med Sci. 2013;75:113.
and protect and promote healing of the ulcers. Mori A, et al. Comparison of time-action profiles of insulin glargine
and NPH insulin in normal and diabetic dogs. Vet Res Commun.
Suggested Readings 2008;32:563.
Niessen SJM, et al. Evaluation of a quality-of-life tool for dogs with
Feldman EC, et al. Canine and feline endocrinology. ed 4. St. Louis: diabetes mellitus. J Vet Intern Med. 2012;26:953.
Elsevier; 2015. Palm CA, et al. An investigation of the action of neutral protamine
Johnston SA, Tobias KM. Veterinary surgery: small animal. St Louis: Hagedorn human analogue insulin in dogs with naturally occur-
Elsevier Saunders; 2018.
ring diabetes mellitus. J Vet Intern Med. 2009;23:50.
Canine Diabetes Mellitus Paul AEH, et al. Effect of hematocrit on accuracy of two point-
Beam S, et al. A retrospective-cohort study on the development of of-care glucometers for use in dogs. Am J Vet Res. 2011;72:
cataracts in dogs with diabetes mellitus: 200 cases. Vet Ophthal- 1204.
mol. 1999;2:169. Struble AL, et al. Systemic hypertension and proteinuria in dogs
Briggs C, et al. Reliability of history and physical examination with naturally occurring diabetes mellitus. J Am Vet Med Assoc.
findings for assessing control of glycemia in dogs with diabetes 1998;213:822.