Chronic pancreatitis with secondary diabetes mellitus treated by use of insulin in an adult California sea lion.
METHODS
A 21-year-old neutered male captive California sea lion developed chronic polyuria; polydipsia; polyphagia; accelerated development of existing cataracts; and frequent episodes of gastrointestinal upset including anorexia, signs of abdominal discomfort, diarrhea, and vomiting.


RESULTS
Chronic hypercholesterolemia, hypertriglyceridemia, hyperglycemia, and glucosuria were identified. During episodes of gastrointestinal abnormalities, transient hyperbilirubinemia and increased serum J-glutamyltransferase activities developed. Clinical findings strongly suggested chronic pancreatitis with secondary diabetes mellitus and intermittent cholestasis. Multiple diagnostic tests, including abdominal ultrasonography, serial hematologic and serum biochemical analyses, fecal examinations, urinalyses and bacteriologic culture of urine, measurement of serum fructosamine and insulin concentrations, and evaluation of thyroid and adrenal function, did not reveal any specific parasitic, endocrine, hepatic, or neoplastic etiologies.


RESULTS
For 1.5 years, the sea lion received once-daily administration of glargine insulin, gastrointestinal protectants, and a strict high-protein, low-fat diet. Daily monitoring of glucose regulation was achieved by training the sea lion to submit to blood and urine sampling. Glucose regulation ranged from fair to good, and clinical signs of diabetes mellitus lessened. Episodes of gastrointestinal upset still occurred, although the frequency and severity decreased. Ultimately, a severe episode developed, associated with diabetic ketoacidosis and sepsis, and the sea lion died. Severe fibrosing pancreatitis with exocrine and endocrine atrophy and abscesses arising from ectatic pancreatic ducts were found. Peripancreatic fibrosis caused stricture of the common bile duct, resulting in gallbladder distension without cholecystitis.


CONCLUSIONS
Diabetes mellitus can occur secondary to chronic pancreatitis in California sea lions and insulin therapy should be considered.
Meegan
Jenny M
JM
Mystic Aquarium and Institute for Exploration, Mystic, CT 06355, USA.
Sidor
Inga F
IF
Steiner
Jörg M
JM
Sarran
Delphine
D
Dunn
J Lawrence
JL
D000818:Animals; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000662:veterinary*; D017809:Fatal Outcome; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D050500:Pancreatitis, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D046070:Sea Lions
D007004:Hypoglycemic Agents; D007328:Insulin