Page 213 - ONLINE PROCEEDING BOOK WSAVA 2017
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14 times higher odds of development of diabetes compared to those whose glucose is less than 135 mg/ dL (7.5 mmol/L). Mild persistently increased fasting blood glucose is therefore likely to be an indicator or risk factor for diabetes in other groups of predisposed cats, such as senior obese or Burmese cats.
It is strongly recommended that for diabetic cats, assessment of glycaemic control is performed
using home glucose monitoring to avoid stress hyperglycaemia. Spot checks in hospital should not be used to adjust insulin dose. If home glucose monitoring is not possible, admit the cat to the clinic in the early morning, so that the nadir glucose concentration
would be expected to occur after resolution of stress hyperglycaemia, as this is the most critical measurement. If the nadir glucose concentration is affected by stress hyperglycaemia, it can result in the clinician making an inappropriate increase in insulin dose.
In summary, based on the increased incidence of diabetes in cats 8 years of age or older, we recommend all senior cats have a screening blood glucose measured at each health check using a screening blood sample obtained from a pad or ear sample prior to physical examination and measured with a glucose meter calibrated for feline blood. This is especially important
in cats with one or more additional risk factors for diabetes such as obesity, Burmese breed, male sex
or glucocorticoid therapy. Measuring blood glucose in capillary blood from the ear or paw is easy and rapid to perform, and is less labour intensive and better tolerated than traditional methods of venous sampling. Cats with suspected stress hyperglycaemia should be retested 3-4 hours later using an ear or pad sample, minimizing stress and struggling. In cat without signs of diabetes, if blood glucose is still increased, hospitalize the cat overnight and withhold food. Retest measuring a fasting glucose and performing a glucose tolerance test. Diabetic cats should wherever possible have home glucose monitoring to adjust insulin dose and in-hospital spot tests should not be used.
References
Reeve-Johnson MK; Rand J; Vankan D Anderson S; Marshall R., Morton JM. Diagnosis Of Prediabetes In Cats: Glucose Concentration Cutpoints For Impaired Fasting Glucose And Impaired Glucose Tolerance Dom Anim Endo 2016; 57: 55-62
Mia K. Reeve-Johnson B Vet Med; Jacquie S. Rand BVSc, DVSc; Dianne Vankan BVSc, PhD; Stephen T. Anderson BSc, PhD; Rhett Marshall BVSc, PhD; John M. Morton BVSc PhD. Cutpoints for screening blood glucose concentrations in healthy senior cats J Feline Med Surg. 2017 Feb. doi: 10.1177/1098612X16685675.
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