title: Longitudinal evaluation of serum pancreatic enzymes and ultrasonographic findings in diabetic cats without clinically relevant pancreatitis at diagnosis.
abstract: BACKGROUND
  Cats with diabetes mellitus can have subclinical pancreatitis but prospective studies to confirm this are lacking. Metabolic control of diabetic cats with pancreatitis is difficult.
  
  
  OBJECTIVE
  Subclinical pancreatitis occurs in diabetic cats at the time diabetes is diagnosed or might develop during the follow-up period, hampering diabetic remission.
  
  
  METHODS
  Thirty cats with newly diagnosed diabetes without clinical signs of pancreatitis on admission.
  
  
  METHODS
  Prospective study. On admission and 2 and 6 months later, serum Spec fPL and DGGR-lipase were measured and the pancreas underwent ultrasonographic examination. Pancreatitis was suspected if serum markers were increased or ≥2 ultrasonographic abnormalities were detected. Cats were treated with insulin glargine and diabetic remission was defined as euglycemia ≥4 weeks after discontinuation of insulin. Nonparametric statistical tests were used for analysis.
  
  
  RESULTS
  Subclinical pancreatitis at the time of diagnosis was suspected in 33, 50, and 31% of cats based on Spec fPL, DGGR-lipase and ultrasonography, respectively; and in 60% when diagnostic criteria were combined. During the follow-up period, suspected pancreatitis developed in additional 17-30% cats. Only 1 cat had transient clinical signs compatible with pancreatitis. Seventeen of the 30 cats (57%) achieved remission. Frequency of abnormal Spec fPL and DGGR-lipase and abnormal ultrasonographic findings did not differ in cats achieving remission and those who did not. Cats achieving remission had significantly lower Spec fPL at 2 months (P < .001).
  
  
  CONCLUSIONS
  Based on laboratory and ultrasonographic measurements, many cats with diabetes might have pancreatitis, although without clinical signs. Cats with high Spec fPL might have a reduced chance of diabetic remission; however, this topic needs further studies in large cohorts of diabetic cats.
authors.affiliation: Clinic for Small Animal Internal Medicine, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland; Department of Animal Medicine, Production and Health, University of Padova, Legnaro, PD, Italy; Istituto Veterinario di Novara, Granozzo con Monticello, NO, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Zini
authors.forename: M
authors.initials: M
authors.lastname: Hafner
authors.forename: P
authors.initials: P
authors.lastname: Kook
authors.forename: T A
authors.initials: TA
authors.lastname: Lutz
authors.forename: S
authors.initials: S
authors.lastname: Ohlerth
authors.forename: C E
authors.initials: CE
authors.lastname: Reusch
mesh_terms: D000818:Animals; D002371:Cat Diseases / Q000097:blood* / Q000000981:diagnostic imaging; D002415:Cats; D003920:Diabetes Mellitus / Q000097:blood / Q000473:pathology / Q000662:veterinary*; D005260:Female; D005977:Glutarates / Q000737:chemistry; D008049:Lipase / Q000097:blood / Q000737:chemistry; D008297:Male; D010078:Oxazines / Q000737:chemistry; D010179:Pancreas / Q000000981:diagnostic imaging / Q000201:enzymology*; D010195:Pancreatitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000662:veterinary*; D011446:Prospective Studies; D014463:Ultrasonography
chemical_list: C501502:1,2-o-dilauryl-rac-glycero glutaric acid-(6'-methyl resorufin) ester; D005977:Glutarates; D010078:Oxazines; D008049:Lipase
keywords: DGGR-lipase; Endocrinology; Feline; Gastroenterology; Spec fPL
references.citation: Gut. 2014 May;63(5):818-31
references.pmid: 23929695
references.citation: Vet Clin Pathol. 2012 Sep;41(3):312-24
references.pmid: 22861648
references.citation: Res Vet Sci. 2010 Aug;89(1):20-6
references.pmid: 20132955
references.citation: J Vet Intern Med. 1998 Jan-Feb;12(1):1-6
references.pmid: 9503353
references.citation: J Vet Intern Med. 2010 Nov-Dec;24(6):1314-21
references.pmid: 20840299
references.citation: J Gastroenterol. 2007 Apr;42(4):291-7
references.pmid: 17464458
references.citation: J Vet Intern Med. 2013 Sep-Oct;27(5):1077-82
references.pmid: 23888903
references.citation: J Vet Intern Med. 2004 Nov-Dec;18(6):807-15
references.pmid: 15638263
references.citation: J Feline Med Surg. 2008 Oct;10(5):480-7
references.pmid: 18639478
references.citation: J Vet Intern Med. 2014 Nov-Dec;28(6):1753-9
references.pmid: 25312554
references.citation: Diabetes Care. 2009 May;32(5):834-8
references.pmid: 19208917
references.citation: Vet Pathol. 2007 Jan;44(1):39-49
references.pmid: 17197622
references.citation: Vet Radiol Ultrasound. 2005 May-Jun;46(3):238-42
references.pmid: 16050283
references.citation: J Feline Med Surg. 2007 Oct;9(5):351-8
references.pmid: 17449313
references.citation: Top Companion Anim Med. 2012 Aug;27(3):140-7
references.pmid: 23148855
references.citation: Prev Vet Med. 2005 Apr;68(1):19-33
references.pmid: 15795013
references.citation: J Am Vet Med Assoc. 2014 May 1;244(9):1060-5
references.pmid: 24739116
references.citation: J Am Vet Med Assoc. 2013 May 1;242(9):1238-43
references.pmid: 23600780
references.citation: J Vet Intern Med. 2008 Nov-Dec;22(6):1326-32
references.pmid: 19000245
references.citation: J Vet Intern Med. 2013 Jul-Aug;27(4):913-8
references.pmid: 23731243