Biochemically diabetic, physically not! (cat)

RE: Biochemically diabetic, physically not! (cat)

Gillian Mostyn — Wed, 24 Feb 2016 22:12:25 GMT

[quote user="Linda Filshie"]he was a bit of a bugger to get a urine sample off in the first place.[/quote]

I find it is usually easy to get a cysto sample in diabetic cats....their bladders are always full!

RE: Biochemically diabetic, physically not! (cat)

Linda Filshie — Wed, 24 Feb 2016 20:36:51 GMT

Oh, and no proteinuria - negative on dipstick so not done P:Cr - is that something we would expect with acromegaly?

RE: Biochemically diabetic, physically not! (cat)

Linda Filshie — Wed, 24 Feb 2016 20:35:13 GMT

Thanks chaps - he was a bit of a bugger to get a urine sample off in the first place. Oh well, she's said she'll do "anything" for her cat so another sample or two should confirm her commitment!

I was wondering about acromegaly as well but he doesn't have that "look".

I'll definitely get a fasting BG before considering starting insulin and will ask for a repeat u/sample too- will be interesting to see how we go!

RE: Biochemically diabetic, physically not! (cat)

Kate Richardson — Wed, 24 Feb 2016 16:13:19 GMT

Hi Linda, I have a similar case- I repeated urine analysis on several occasions to check for persistent glycosuria and a fasting BG to confirm the diagnosis and started insulin. Owners have since reported that she is drinking and urinating less since starting insulin, and is also more of a grazer with respect to food now rather than clearing the bowl at every sitting, so she obviously did have subtle clinical signs. Also overweight. I have often found the SG to be in the 1.030-1.050 range with diabetics, even in ones that are overtly polydipsic, so I think the glucose in your case is artefactually elevating the SG, also consider if he is subclinically dehydrated as well.

RE: Biochemically diabetic, physically not! (cat)

Jenny Boyd — Wed, 24 Feb 2016 07:18:00 GMT

Yes the cat I was talking about I would put money on that he has acromegaly, o doesn't want tested as wouldn't do anything about it. Can't see how that would affect the USG. He had a whopping proteinuria- UPCr 3.96. Couldn't find any info about how acromegaly would cause this unless anyone knows differently?

RE: Biochemically diabetic, physically not! (cat)

Utlendigur — Tue, 23 Feb 2016 22:34:21 GMT

Could he have early acromegally? Just wondering given the lack of weight loss and the stiffness - although he could just be fat! Not sure whether it would affect the SG. Was there any proteinuria?

RE: Biochemically diabetic, physically not! (cat)

Jenny Boyd — Tue, 23 Feb 2016 22:08:46 GMT

I had one like this recently, and called the lab about it, although glycosuria can raise the USG it should only do so very marginally ie wouldn't raise it from 1.030 to 1.050. The chap I spoke to said it was an odd result and advised we got a repeat sample for USG

RE: Biochemically diabetic, physically not! (cat)

nikki — Tue, 23 Feb 2016 21:50:41 GMT

Glucose can artificially elevate the SG so given the biochemistry changes I'd be pretty happy to call that DM and start insulin therapy.

RE: Biochemically diabetic, physically not! (cat)

Martin Atkinson — Tue, 23 Feb 2016 19:06:37 GMT

How did you come to get results - a routine test or because there were at least some suspicious symptoms? I wouldn't be surprised by a raised urine SG with the glycosuria.

I suspect most of our diabetic patients have been compensating for some time before they finally come to us as PU/PD/PP so it may be you've caught this one early. IMO a good case for starting on Lantus Glargine and you may have a good chance of getting him into remission if you can get his weight down as well.