Journal Scan: Survival data and prognostic factors in cats with newly diagnosed diabetes
Why they did it
Information about survival times and prognostic factors among cats with newly diagnosed diabetes will provide valuable information for clinicians to better educate owners about treatment expectations and outcomes.
What they did
Researchers retrospectively analyzed data from 114 cats in which diabetes mellitus had been newly diagnosed between January 2000 and July 2009. Data included the signalment, presence of concurrent disease, medication history (including use of corticosteroids or progestogens within the last six months), and physical examination findings as well as the presence of ketoacidosis and hematologic and serum chemistry profile information. All cats were reevaluated at regular intervals—typically at one week, two to three weeks, four to six weeks, eight to 12 weeks, and every three to six months as needed—and insulin type was recorded.
What they found
Researchers found that 95 out of the 114 cats (83.3%) survived to discharge and were treated with either insulin glargine (41.9%) or porcine insulin zinc suspension (58.1%). Ketoacidosis was present in 39 (34.2%) of cats at the time of diagnosis and was not associated with length of survival. Ketoacidosis developed in six cats after discharge—three of these had been diagnosed with ketoacidosis at initial examination. Five of these ketoacidotic cats died or were euthanized between 1 and 8 days after diagnosis.
The median survival of diabetic cats was 516 days (range = 1 to 3,468 days). Cats with an elevated creatinine concentration at the time of diagnosis had a 5% greater chance of dying for each 10-µg/dl increase in creatinine. Clinical remission was achieved in 45 cats (39.5%), and these cats were found to have a longer survival time than cats that were persistently diabetic. Overall, 70%, 64%, 59%, and 46% of cats lived longer than three, six, 12, and 24 months, respectively.
The researchers note that lack of diet information and incomplete records due to the retrospective nature of the study may have introduced bias into the results.
Diabetic cats with concurrent renal dysfunction at the time of diagnosis had a decreased survival time. The presence of ketoacidosis, on the other hand, may not negatively impact long-term survival, and cats that achieve clinical remission had a longer survival time than those that did not.
Callegari C, Mercuriali E, Hafner M, et al. Survival time and prognostic factors in cats with newly diagnosed diabetes mellitus: 114 cases (2000-2009). J Am Vet Med Assoc 2013;243(1):91-95.
Link to abstract: http://avmajournals.avma.org/doi/abs/10.2460/javma.243.1.91