Companion animal endocrinology has benefited from international standardisation of disease terminology for diabetes mellitus, Cushing's syndrome, and hypoadrenocorticism through Project Agreeing Language in Veterinary Endocrinology (ALIVE). A group of 14 experts and one chair convened for the third cycle of Project ALIVE, focusing on thyroid disease terminology. The cycle employed the modified Delphi approach from previous cycles, augmented by procedural refinements-such as inclusion of an off-site chair and stricter adherence to timelines -to improve efficiency and flexibility. Novel in this round was the integration of feedback from a previous cycle, which resulted in updated definitions for diabetes mellitus originally developed in ALIVE Cycle 1. Outcomes: A 100% consensus was achieved among panellists and 91.4-100% among 105 members of international veterinary endocrinology societies (32% of total memberships) over 78 thyroid-related terminology items and five revised definitions pertaining to diabetes mellitus. These standardised definitions are expected to facilitate clearer communication and education, enhance diagnostic consistency, support research comparability, and improve clinical care in feline and canine endocrine diseases.

A substantial number of cats develop diabetes mellitus (DM), a serious endocrine disorder that can lead to other physiologic complications. While DM management can be complex, successful control that alleviates the patient's clinical signs and avoids hypoglycemia is achievable in most cats. Diabetic remission is also possible. The 2026 AAHA Diabetes Management Guidelines for Cats retain clinically relevant information from the 2018 AAHA Diabetes Management Guidelines and present new findings and expert opinions. Subjects such as pathophysiology, diagnosis, how to treat and monitor cats receiving SGLT2 inhibitors, various insulin options for cats, how to monitor cats receiving insulin, diet and physical activity recommendations, advantages and disadvantages of at-home glucose monitoring devices, diagnosing and treating diabetic ketoacidosis, and client education are all discussed. The guidelines also cover how to identify patients who are at risk of developing DM and how to differentiate DM from transient or mild hyperglycemia.

OBJECTIVE:To investigate safety and effectiveness of velagliflozin oral solution as sole therapy in naïve and previously insulin-treated diabetic cats. ANIMALS:252 client-owned cats receiving ≥ 2 doses of velagliflozin; 214 (85%) naïve diabetics and 38 (15%) insulin-treated diabetics. PROCEDURES:Prospective, baseline-controlled, open-label clinical field trial. Cats received velagliflozin orally, once daily. Physical examinations and blood collections were performed days 0, 3, 7, 30, 60, 120, and 180. RESULTS:Data are median (range). Screening blood glucose (BG) was 436 mg/dL (272 to 676 mg/dL). On days 30, 60, 120, and 180, single BG after receiving velagliflozin was 153 mg/dL (62 to 480 mg/dL), 134 mg/dL (64 to 414 mg/dL), 128 mg/dL (55 to 461 mg/dL), and 125 mg/dL (77 to 384 mg/dL), respectively. Screening fructosamine was 538 µmol/L (375 to 794 µmol/L). On the same recheck days, fructosamine was 310 µmol/L (204 to 609 µmol/L), 286 µmol/L (175 to 531 µmol/L), 269 µmol/L (189 to 575 µmol/L), and 263 µmol/L (203 to 620 µmol/L). At day 180, 81% of 158 cats remaining had BG and/or fructosamine within reference ranges; 88.6% (124 of 140) and 87.7% (121 of 138) showed improvement in polyuria and polydipsia, respectively. Ketonuria developed in 35 cats (13.9%), including 18 (7.1%) that had ketoacidosis. Ketoacidosis was less common in naïve diabetic cats (11 of 214 [5.1%]) compared to insulin-treated diabetic cats (7 of 38 [18.4%]). At ketoacidosis diagnosis, 14 of 18 cats (77.8%) were euglycemic (ie, BG < 250 mg/dL). Most episodes of ketosis or ketoacidosis (30 of 35 [85.7%]) occurred within the first 14 days of treatment. Insulin-treated diabetic cats were less likely to complete the trial. No clinical hypoglycemia occurred. CLINICAL RELEVANCE:Velagliflozin improved glycemic parameters and clinical signs in diabetic cats. Velagliflozin provides an alternative to insulin as a stand-alone treatment of diabetic cats.

Canine and feline endocrinopathies reflect an endocrine gland disease or dysfunction with resulting hormonal abnormali ties that can variably affect the patient's wellbeing, quality of life, and life expectancy. These guidelines provide consensus recommendations for diagnosis and treatment of four canine and feline endocrinopathies commonly encountered in clini cal practice: canine hypothyroidism, canine hypercortisolism (Cushing's syndrome), canine hypoadrenocorticism (Addi son's disease), and feline hyperthyroidism. To aid the general practitioner in navigating these common diseases, a stepwise diagnosis and treatment algorithm and relevant background information is provided for managing each of these diseases. The guidelines also describe, in lesser detail, the diagnosis and treatment of three relatively less common endo crinopathies of cats: feline hyperaldosteronism, feline hypothyroidism, and feline hyperadrenocorticism. Additionally, the guidelines present tips on effective veterinary team utilization and client communication when discussing endocrine cases.

Diagnosis of thyroid and adrenal disease can be confusing. Whereas the definitive diagnosis of hyperthyroidism and hypoadrenocorticism are relatively straightforward, hypothyroidism and naturally occurring Cushing's syndrome (NOCS) are more complicated. In a patient with compatible clinical signs, a single increased tT 4 is enough to confirm hyperthyroidism, but a low tT 4 alone is never enough to confirm hypothyroidism. A flatline result (post-stimulation cortisol <2 ug/dL) on an ACTH stimulation test (ACTHst) confirms hypoadrenocorticism, but not all dogs with NOCS have increased ACTHst results. This article explains which diagnostics should be pursued for these endocrinopathies, and how to interpret them.

Glucocorticoids are used for a variety of purposes in veterinary medicine but often are associated with clinically important adverse effects. Polyuria and polydipsia are the most frustrating adverse effects noted by owners. To determine whether administration of desmopressin ameliorates polyuria and polydipsia associated with prednisolone administration. Seven healthy adult Walker Hounds. Prospective hypothesis testing study. Daily water intake and urine specific gravity (USG) were measured in dogs under 4 separate sequential conditions: no medications (C), prednisolone only (P), prednisolone and desmopressin (PD), and prednisolone after discontinuation of desmopressin (PAD). When compared to baseline, 6 of 7 dogs became polydipsic after administration of prednisolone (0.5 mg/kg PO q12h). When desmopressin (5 μg/dog SC q12h) was administered to dogs receiving prednisolone, significant decreases in water intake and serum sodium concentration occurred, and USG increased significantly. Administration of desmopressin to dogs receiving prednisolone significantly decreased water intake and serum sodium concentration, and increased USG. Our results suggest that, in some dogs, desmopressin ameliorates the most important adverse effect of prednisolone noted by owners, but that hyponatremia is an important complication associated with desmopressin use.

Abstract Background Glucocorticoids are used for a variety of purposes in veterinary medicine but often are associated with clinically important adverse effects. Polyuria and polydipsia are the most frustrating adverse effects noted by owners. Objective To determine whether administration of desmopressin ameliorates polyuria and polydipsia associated with prednisolone administration. Animals Seven healthy adult Walker Hounds. Methods Prospective hypothesis testing study. Daily water intake and urine specific gravity (USG) were measured in dogs under 4 separate sequential conditions: no medications (C), prednisolone only (P), prednisolone and desmopressin (PD), and prednisolone after discontinuation of desmopressin (PAD). Results When compared to baseline, 6 of 7 dogs became polydipsic after administration of prednisolone (0.5 mg/kg PO q12h). When desmopressin (5 μg/dog SC q12h) was administered to dogs receiving prednisolone, significant decreases in water intake and serum sodium concentration occurred, and USG increased significantly. Conclusions and Clinical Importance Administration of desmopressin to dogs receiving prednisolone significantly decreased water intake and serum sodium concentration, and increased USG. Our results suggest that, in some dogs, desmopressin ameliorates the most important adverse effect of prednisolone noted by owners, but that hyponatremia is an important complication associated with desmopressin use.

ABSTRACT A 4 mo old intact male Labrador retriever was referred to the authors’ institution for a 3 wk history of weight loss and progressive abdominal distension. Thoracic radiographs revealed sternal lymphadenopathy and a diffuse unstructured interstitial and bronchial pulmonary pattern. An abdominal ultrasound revealed multifocal lymphadenopathy, hepatosplenomegaly, and biliary duct dilation. Fine-needle aspirates of the spleen and liver revealed Histoplasma capsulatum organisms. Antifungal therapy was initiated with itraconazole and terbinafine. Repeat ultrasound examinations revealed resolving hepatosplenomegaly and resolving cystic duct dilation. Ultrasonographic findings mirrored a decrease in urine H capsulatum antigen levels. Histoplasmosis should be considered as a differential for unexplained biliary duct dilation or obstruction in dogs. Dogs with disseminated histoplasmosis should be monitored for this potential complication.

A 6-year-old, spayed female, mixed breed boxer dog was presented for decreased appetite, polyuria and polydipsia, and lethargy 9 days after treatment with ketoconazole for Malassezia pododermatitis. Ketoconazoleinduced hypoadrenocorticism was confirmed with an adrenocorticotropic hormone (ACTH) stimulation test, and ketoconazole was discontinued. Clinical signs resolved 48 hours after initiation of prednisone, and resolution of glucocorticoid insufficiency was confirmed with a repeat ACTH stimulation test 48 hours after a 10-day course of prednisone. Glucocorticoid insufficiency after administration of a commonly used dermatological dose of ketoconazole has not been previously reported in veterinary medicine but should be considered in patients with adverse effects while receiving ketoconazole. Key clinical message: Iatrogenic hypoadrenocorticism may occur in dogs treated with commonly used dermatological doses of ketoconazole. The disease is likely transient, but steroid supplementation may be required in some patients to resolve clinical signs, especially in the presence of concurrent illness or stress.

Xylitol, a sugar substitute frequently used in sugar-free gum, is generally considered harmless to humans but it can be extremely toxic to dogs. Dog-owning customers are becoming increasingly aware of the risks associated with xylitol-containing chewing gums. However, there remains some uncertainty if these chewing gums are still dangerous to dogs after they have been partially consumed. In this work, a reliable low-cost analytical method has been developed to quantify the xylitol in sugar-free gum samples. Xylitol was extracted from gum samples using water as a solvent. Extractions were analyzed by GC-MS with direct aqueous injection (DAI). This method was successfully applied to over 120 samples including fresh gum and 5min, 15min, and 30min chewed gum samples.

Veterinary RecordVolume 184, Issue 1 p. 26-27 Research Thank you to our reviewers Patty Lathan, Corresponding Author Patty Lathan lathan@cvm.msstate.edu College of Veterinary Medicine, Mississippi State University, 240 Wise Center Drive, Mississippi State, MS, 39762 USAE-mail: lathan@cvm.msstate.eduSearch for more papers by this authorLinda Fleeman, Linda Fleeman Animal Diabetes Australia, 9-11 Miles St Mulgrave, VIC, 3170 AustraliaSearch for more papers by this author Patty Lathan, Corresponding Author Patty Lathan lathan@cvm.msstate.edu College of Veterinary Medicine, Mississippi State University, 240 Wise Center Drive, Mississippi State, MS, 39762 USAE-mail: lathan@cvm.msstate.eduSearch for more papers by this authorLinda Fleeman, Linda Fleeman Animal Diabetes Australia, 9-11 Miles St Mulgrave, VIC, 3170 AustraliaSearch for more papers by this author First published: 05 January 2019 https://doi.org/10.1136/vr.l8Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume184, Issue1January 2019Pages 26-27 RelatedInformation

A colorimetric scale has the potential to be very useful as a training tool for students in veterinary training programs. The authors of this report hypothesized that clinically active, graduate level veterinary students would assess mucous membrane color with greater consistency using an image-based system than with traditional word-based techniques. Third- and fourth-year veterinary students were asked to evaluate 10 canine gingival mucosa images and rate them with either an image-based scale designed by the authors or a word-based system. Although the mean absolute deviations from the median values were greater for the word scale (0.22) than for the image scale (0.20) indicating increased variation, mixed model analysis did not demonstrate these differences were significant ( p = .120). Based on this data it is possible that prior image and word-based instruction made it easier for the students to differentiate mucous membrane colors, or that the majority of the students were multimodal learners rather than single-type learners, making previous instruction techniques effective regardless of whether they were visual or read/write based. The authors recommend that future investigators both evaluate previous student instruction and consider administering visual, auditory, read/write, kinesthetic (VARK) tests when investigating potential learning aids in veterinary medicine.

Proficiency with instrumental analysis via GC-MS is an important skill for chemistry students. The application of analytical techniques and fundamental theoretical principles to real-world problems can be valuable learning exercises for undergraduates which can also improve their analytical thinking skills. Xylitol is generally considered safe for human consumption and is frequently used in sugar-free gum; however, it is extremely toxic to dogs. In this laboratory experiment, upper-level undergraduate chemistry students extract xylitol from both fresh and chewed gum sticks followed by direct aqueous injection GC-MS analysis. Students learn the proper steps and techniques required for sample extraction and preparation and GC-MS analysis, and they determine concentrations of xylitol present in gum samples. Identification and quantification of the chemical components in gum extract occurs via GC-MS analysis; however, other GC detectors could be used. Students also compare external and internal standard calibration methods for xylitol quantification. Upon quantification of xylitol in chewed and unchewed gum samples, students are able to calculate the level of hazard for dogs upon ingestion.

Diabetes mellitus (DM) is a common disease encountered in canine and feline medicine. The 2018 AAHA Diabetes Management Guidelines for Dogs and Cats revise and update earlier guidelines published in 2010. The 2018 guidelines retain much of the information in the earlier guidelines that continues to be applicable in clinical practice, along with new information that represents current expert opinion on controlling DM. An essential aspect of successful DM management is to ensure that the owner of a diabetic dog or cat is capable of administering insulin, recognizing the clinical signs of inadequately managed DM, and monitoring blood glucose levels at home, although this is ideal but not mandatory; all topics that are reviewed in the guidelines. Insulin therapy is the mainstay of treatment for clinical DM. The guidelines provide recommendations for using each insulin formulation currently available for use in dogs and cats, the choice of which is generally based on efficacy and duration of effect in the respective species. Also discussed are non-insulin therapeutic medications and dietary management. These treatment modalities, along with insulin therapy, give the practitioner an assortment of options for decreasing the clinical signs of DM while avoiding hypoglycemia, the two conditions that represent the definition of a controlled diabetic. The guidelines review identifying and monitoring patients at risk for developing DM, which are important for avoiding unnecessary insulin therapy in patients with transient hyperglycemia or mildly elevated blood glucose.

Hypoadrenocorticism (HOAC; Addison's disease) is an endocrine condition seen in small animal practice. Dogs with this disease can present in a variety of ways from acute hypovolemic collapse to vague, chronic, waxing, and waning clinical signs. In the most common form of this disease, animals have both mineralocorticoid and glucocorticoid deficiency, resulting in hyponatremia and hyperkalemia, and signs of cortisol deficiency. The etiology may be immune-mediated destruction of the adrenal cortex, drug-induced adrenocortical necrosis (mitotane), enzyme inhibition (trilostane), or infiltrative processes such as neoplastic or fungal disease. Much less commonly, dogs have signs of cortisol deficiency, but no electrolyte changes. This is referred to as atypical HOAC. The veterinarian needs to have a clinical suspicion for HOAC to make a diagnosis in a timely manner. Treatment of dogs with an acute presentation prioritizes correcting the hypovolemia, hyperkalemia, acidosis, and hypoglycemia. Fluid therapy addresses most of these issues, but other directed therapies may be required in the most severe cases. For chronic management, all patients with Addison's disease will require replacement of glucocorticoids (usually prednisone), and most patients require replacement of mineralocorticoids with either desoxycorticosterone pivalate or fludrocortisone. Atypical Addisonians do not require mineralocorticoid supplementation, but electrolytes should be monitored in case the need arises in the future. The prognosis for dogs treated for HOAC promptly and appropriately is excellent; most patients die from other diseases. However, if the diagnosis is missed, patients may die as a consequence of HOAC. Thus, knowledge of the hallmarks of Addison's disease is imperative.

Veterinary RecordVolume 183, Issue 8 p. 260-261 Research Comparing lente insulin and NPH insulin for treating diabetic dogs Patty Lathan, Corresponding Author Patty Lathan lathan@cvm.msstate.edu College of Veterinary Medicine, Mississippi State University, 240 Wise Center Drive, Mississippi State, MS, 39762 USAE-mail: lathan@cvm.msstate.eduSearch for more papers by this authorLinda Fleeman, Linda Fleeman Animal Diabetes Australia, 9-11 Miles St Mulgrave, VIC, 3170 AustraliaSearch for more papers by this author Patty Lathan, Corresponding Author Patty Lathan lathan@cvm.msstate.edu College of Veterinary Medicine, Mississippi State University, 240 Wise Center Drive, Mississippi State, MS, 39762 USAE-mail: lathan@cvm.msstate.eduSearch for more papers by this authorLinda Fleeman, Linda Fleeman Animal Diabetes Australia, 9-11 Miles St Mulgrave, VIC, 3170 AustraliaSearch for more papers by this author First published: 01 September 2018 https://doi.org/10.1136/vr.k3636Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume183, Issue8September 2018Pages 260-261 RelatedInformation

This combined retrospective-prospective study evaluated the correlation between canine urine color (UC) and urine specific gravity (USG). Urine color was positively correlated with USG, but the relationship was not significantly improved by use of a UC chart. Urine color as an indicator of USG is limited as 20% of dark-yellow samples had a USG < 1.030.