Pancreas

Question 0

Metabolic effects of insulin: (5)

Answer 0

Carbohydrate metabolism

Suppresses hepatic glucose production

Promotes glucose uptake my the liver, then stores it as glycogen

Stimulates glucose uptake into peripheral tissues

Decreases the breakdown of fat and prevents formation of ketones

Question 1

Pancreas Anatomy

Answer 1

Composed of tissue called islets of Langerhans which are composed of 4 cells

Alpha - secretes glucagon
Beta - secretes insulin
Delta - secretes somatostatin (inhibits GH)
F cells - pancreatic polypeptide

Question 2

Feline Diabetes Mellitus

Pathophysiology

Answer 2

Type 2

Resistant to insulin or not enough insulin

There’s and impairment of insulin action in the liver, muscle, and adipose tissue

B-cells are damaged by chronically high BC concentrations suppressing insulin secretions (glucotoxicity)

Severe pancreatitis maybe a trigger

Glucocorticoids and GH have strong diabetogenic actions

Question 3

Feline Diabetes Mellitus

Signalment

Answer 3

Mean age 10 years

Neutered males

Burmese

Question 4

Feline Diabetes Mellitus

Clinical signs/Physical exam

Answer 4

PU/PD
Polyphagia
Wt loss
Plantigrade posture

Glucose curves
No spot checks, because of the somogyi phenomenon

Question 5

Feline Diabetes Mellitus

Diagnostics

Answer 5

Based on persistent hyperglycemia and glucosuria

Fructosamine

Question 6

Feline Diabetes Mellitus

Treatment

Answer 6

Diet: low carbs and high protein

Insulin therapy: glargine and prozinc

Oral drugs

Question 7

Feline Diabetes Mellitus

Prognosis

Answer 7

Can go into remission
MST - 3 years
Depends on age, concurrent diseases, owner compliance

Question 10

Canine DM

Pathophysiology

Answer 10

Beta cell deficiency or destruction resulting in absolute insulin deficiency

Causes:
Immune-mediated
Pancreatitis
Cushing's
Acromegaly 
Gestational
Meds

Question 11

Canine DM

Signalment

Answer 11

Dogs 7 years or older

Females at increased risk

Terriers, toy poodles, schnauzers, Samoyeds, keeshonds, bichons, Huskies

Question 12

Canine DM

Clinical signs/physical exam

Answer 12

PU/PD, polyphagia, wt loss

Less common: lethargy, weakness, decreased vision

Question 13

Canine DM

Diagnostics

Answer 13

Hyperglycemia

Glucosuria

Question 14

Canine DM

Treatment

Answer 14

Insulin therapy: vetsulin or humulin-N

Question 15

DKA

Pathophysiology

Answer 15

Complication of DM

Insulin deficiency and excessive counter-regulatory hormones together cause hypoglycemia and the generation of ketones

Question 16

DKA

Clinical signs/physical exam

Answer 16

Depression, anorexia, vomiting, PU/PD

Recumbent, severely dehydrated, weak

Question 17

DKA

Diagnostics

Answer 17

Stress leukogram 
Hyperglycemia 
Elevated liver enzymes 
Elevated cholesterol and triglycerides 
Hypokalemia
Hypophosphatemia
Acid-base abnormalities 
Blood gas for metabolic acidosis
Glucosuria 
Ketonuria 
Urine culture

Question 18

DKA

Treatment

Answer 18

IV fluids for dehydration

Potassium and phosphorus supplementation

Insulin CRI or intermittent injections