Page 582 - Problem-Based Feline Medicine

574 PART 8 CAT WITH ABNORMAL LABORATORY DATA

Burmese kittens are over-represented, but any breed Once hypertriglyceridemia resolves, many kittens can
may be involved. tolerate normal cat food.
Pathogenesis is unknown, but it is probably due to a Gemfibrozil (Lopid, Parke Davis, 7.5–10 mg/kg daily)
primary defect of lipid metabolism, if secondary causes may help reduce triglyceride values if dietary therapy
(diabetes nephrotic syndrome) have been eliminated. alone fails.
There is probably one phenotypic expression for many Marine (fish) oils which are rich in n-3 fatty acids may
different genetic mutations, which may involve the reduce plasma triglycerides by decreasing the synthesis
enzyme lipoprotein lipase or other essential molecules of VLDL. Dose at 10–30 mg/kg PO daily for cats that
in lipoprotein metabolism, e.g. apolipoproteins. are unresponsive to dietary fat restriction.
The pathogenesis of the concurrent clinical signs and Always check body weight at regular intervals if cats
anemia is unknown. are on a calorie-restricted or reducing diet to ensure
normal weight is maintained.
Clinical signs

There may be no clinical signs, just hyperlipidemia. DIABETES MELLITUS**
Alternatively, a variety of clinical signs may occur
Classical signs
including:
● Lipemia retinalis. ● Polyuria, polydipsia.
● Cutaneous xanthomata. ● Polyphagia or inappetance.
● Lipemic aqueous. ● Weight loss.
● Frequently associated with severe anemia (PCV ● Persistent hyperglycemia, glycosuria.
< 11%) in kittens around the time of weaning.
Kittens may present with acute lethargy, dyspnea See main references on page 236 for details (The Cat
and death within 48 h. Usually the entire litter has With Polyuria and Polydipsia).
severe fasting hypertriglyceridemia. Reported in
purebred (including Siamese, Persian, Burmese,
Pathogenesis
Oriental) and domestic shorthair breeds.
Hyperlipidemia occurs in some cats with diabetes
Diagnosis mellitus.

Confirmation of hypertriglyceridemia and/or hyper- Rarely, cats with diabetes have concurrent hyper-
cholesterolemia. adrenocorticism or acromegaly, conditions which result
in insulin-resistant diabetes mellitus.
Other diagnostic tests may indicate where the abnor-
mality of lipid metabolism is located by the relative dis- The hypertriglyceridemia results from a combination
tribution of the lipoproteins. of reduced lipoprotein lipase activity as insulin is
required for normal activity of this enzyme, increased
Treatment synthesis of VLDL due to poor regulation of hormone-
sensitive lipase, increased flux of non-esterified fatty
Severely anemic kittens need emergency treatment
acids to the liver and increased triglyceride synthesis.
with supplemental oxygen and a blood transfusion
to survive. The raised cholesterol concentrations reflect increased
hepatic synthesis, which leads to down-regulation of
The plasma triglyceride should be reduced to less
LDL receptor activity and increased LDL.
than 5.5 mmol/L (500 mg/dl), which minimizes the
risk of hyperlipidemia-associated signs.
Clinical signs
Feed either a homemade or commercial diet low in sat-
urated fats, calorie restricted, and high in fiber to Signs of diabetes mellitus (polyuria, polydipsia, weight
reduce lipid values. Wean kittens onto a low-fat diet. loss).