Case
A 6-year-old spayed hound crossbreed is presented for poorly regulated diabetes mellitus (DM). She was diagnosed 6 months prior, at which time insulin lente (0.25 U/kg SC every 12 hours) was initiated and a balanced dry kibble adult maintenance diet was continued. The insulin dose has been steadily increased to 1.6 U/kg SC every 12 hours based on clinical signs and continuous interstitial glucometer readings, but polyuria and polydipsia are still present and blood glucose concentrations remain >250 mg/dL (reference interval, 60-135 mg/dL). The patient’s body weight has increased from 71.9 lb (32.6 kg) to 81.1 lb (36.8 kg).
On physical examination, the patient is subdued with a BCS of 7/9, bilateral cataracts, and a puffy face with thickened skin and drooped upper eyelids (Figure 1). No other dermatologic changes are noted.
FIGURE 1 Facial appearance of a 6-year-old spayed hound crossbreed with poorly regulated DM
CBC reveals a normocytic, nonregenerative anemia and a stress leukogram, and serum chemistry profile reveals hyperglycemia, hypertriglyceridemia, hypercholesterolemia, and increased ALP activity (Table 1). Urine obtained via cystocentesis has a specific gravity of 1.025, pH of 7, and glucose concentration of 1,000 mg/dL (ie, 3+ on urine dipstick). Occasional rod-shaped bacteria are noted in the sediment. Results of endocrine testing are shown in Table 2.