Todayโs path rounds are on ๐๐ข๐๐๐๐ญ๐๐ฌ ๐ฆ๐๐ฅ๐ฅ๐ข๐ญ๐ฎ๐ฌ! No real reason, just thought it would be fun to get some pancreas up in here. This post is quite long, but hopefully itโs interesting!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
Diabetes mellitus is a ๐ฆ๐๐ญ๐๐๐จ๐ฅ๐ข๐ ๐๐ข๐ฌ๐๐๐ฌ๐, meaning that it impacts how the body processes certain materials. In diabetes mellitus, ๐ ๐ฅ๐ฎ๐๐จ๐ฌ๐ (the major sugar in our body) is not able to move through its normal metabolic cycle, causing it to accumulate in the blood stream causing ๐ก๐ฒ๐ฉ๐๐ซ๐ ๐ฅ๐ฒ๐๐๐ฆ๐ข๐ (too much glucose in the blood).
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
There are two basic underlying problems in diabetes mellitus, both relating to ๐ข๐ง๐ฌ๐ฎ๐ฅ๐ข๐ง, which is a hormone produced by the pancreas that allows glucose to move into your cells for them to produce energy.
In ๐๐ฒ๐ฉ๐ ๐ ๐๐ข๐๐๐๐ญ๐๐ฌ, there is inadequate production of insulin due to damage to the pancreas. Typically, this is ๐ข๐ฆ๐ฆ๐ฎ๐ง๐–๐ฆ๐๐๐ข๐๐ญ๐๐, meaning that the bodyโs immune system attacks the pancreas cells and destroys them. Why the body starts doing this is uncertain, but it definitely leads to problems for affected critters!
In ๐๐ฒ๐ฉ๐ ๐ ๐๐ข๐๐๐๐ญ๐๐ฌ, the tissues do not respond to insulin appropriately, and therefore do not take up glucose. In humans, there are strong correlations with development of Type 2 diabetes and obesity, inactivity, micronutrient imbalances and genetic factors. We havenโt fully confirmed what the predisposing factors are in animals, but they are likely similar!
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get this disease, however today we are going to focus on dogs and cats, as they are the main species that we see this condition in. Dogs tend to get Type 1 diabetes, while cats tend to get Type 2 diabetes.
๐๐๐ฅ๐ฅ ๐ฆ๐ ๐ฆ๐จ๐ซ๐ ๐๐๐จ๐ฎ๐ญ ๐๐จ๐ ๐ฌ ๐ฐ๐ข๐ญ๐ก ๐ฌ๐๐ ๐ฉ๐๐ง๐๐ซ๐๐๐ฌ๐๐ฌ!
As mentioned above, dogs tend to get Type 1 diabetes. The cause is most damage to the ๐ฉ๐๐ง๐๐ซ๐๐๐ญ๐ข๐ ๐ข๐ฌ๐ฅ๐๐ญ๐ฌ (where insulin is produced) due to previous disease in the pancreas. For example, dogs are prone to ๐ฉ๐๐ง๐๐ซ๐๐๐ญ๐ข๐ญ๐ข๐ฌ (inflammation in the pancreas), which is a topic for another day. But it can be an inciting cause of damage to the pancreas, leading to development of diabetes. Without having these islets working properly, there is not enough insulin production to encourage glucose to move into the cells, causing hyperglycemia. There are also cases of genetic-linked diabetes in Keeshonds, as well as cases of diabetes due to improper development of the pancreas.
๐๐ก๐๐ญ ๐๐๐จ๐ฎ๐ญ ๐๐๐ญ๐ฌ ๐ฐ๐ก๐จ๐ฌ๐ ๐๐๐ฅ๐ฅ๐ฌ ๐๐จ๐งโ๐ญ ๐ฅ๐ข๐ค๐ ๐ข๐ง๐ฌ๐ฎ๐ฅ๐ข๐ง ๐๐ง๐ฒ๐ฆ๐จ๐ซ๐?
Cats tend to get Type 2 diabetes, which means their cells no longer respond to insulin to allow glucose uptake. The exact cause of this ๐ข๐ง๐ฌ๐ฎ๐ฅ๐ข๐ง ๐ซ๐๐ฌ๐ข๐ฌ๐ญ๐๐ง๐๐ is not known, but it leads to increased glucose in the blood because it is not going where itโs supposed to: into the cells. This causes the pancreatic islets to boost insulin production, as they desperately try to get the glucose levels under control. This can lead to burnout of these cells, causing damage and leading to underlying Type 1 diabetes.
๐๐ฎ๐ญ ๐ฐ๐ก๐ฒ ๐ข๐ฌ ๐ก๐ฒ๐ฉ๐๐ซ๐ ๐ฅ๐ฒ๐๐๐ฆ๐ข๐ ๐๐ง๐ ๐๐ข๐๐๐๐ญ๐๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
The primary issue with diabetes is that the cells no longer have an energy source! This can lead to a bunch of problems in a bunch of different tissues. To compensate, the body will begin to use up protein from the muscle and fat from various locations around the body to try and provide energy to the cells. This can lead to ๐ฆ๐ฎ๐ฌ๐๐ฅ๐ ๐ฐ๐๐ฌ๐ญ๐ข๐ง๐ (reduced muscle size and strength) and ๐ก๐๐ฉ๐๐ญ๐ข๐ ๐ฅ๐ข๐ฉ๐ข๐๐จ๐ฌ๐ข๐ฌ (excess fat in the liver, see our previous article!).
In terms of hyperglycemia, the body does some weird things when thereโs too much glucose floating around. There are way too many outcomes of hyperglycemia to discuss within this article, but one of the more interesting ones is production of ๐ฌ๐จ๐ซ๐๐ข๐ญ๐จ๐ฅ. Sorbitol is a particular form of sugar that is made when the body is trying to get rid of excess glucose that has a tendency to accumulate within cells, causing all kinds of issues! Here are two notable outcomes of sorbitol accumulation:
Dogs will frequently develop ๐๐๐ญ๐๐ซ๐๐๐ญ๐ฌ (clouding of the lens of the eye) due to diabetes, because of sorbitol accumulating within the lens. The body naturally wants to keep concentrations of different compounds in balance, so it attempts to dilute this massive amount of sorbitol with water, causing ๐๐๐๐ฆ๐ (excessive accumulation of fluid) within the lens, leading to cataracts.
Cats also have a special presentation of diabetes called ๐๐ข๐๐๐๐ญ๐ข๐ ๐ง๐๐ฎ๐ซ๐จ๐ฉ๐๐ญ๐ก๐ฒ. Similar to the cataracts in dogs, there can be excessive accumulation of sorbitol within the ๐ฆ๐ฒ๐๐ฅ๐ข๐ง ๐ฌ๐ก๐๐๐ญ๐ก๐ฌ(protective coverings) of various nerves. This can lead to damage to the nerve and prevent its normal conduction. This degenerative change can cause a ๐ฉ๐ฅ๐๐ง๐ญ๐ข๐ ๐ซ๐๐๐ ๐ฌ๐ญ๐๐ง๐๐in cats, meaning that they stand with their hocks on the ground. Weird!
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Animals with diabetes typically present with weight loss, ๐ฉ๐จ๐ฅ๐ฒ๐ฉ๐ก๐๐ ๐ข๐ (excessive hunger) and ๐ฉ๐จ๐ฅ๐ฒ๐ฎ๐ซ๐ข๐ (excessive urination). Based on initial suspicion, the veterinarian will likely run bloodwork to look for hyperglycemia, and a ๐ฎ๐ซ๐ข๐ง๐๐ฅ๐ฒ๐ฌ๐ข๐ฌ (assessment of the urine) to look for ๐ ๐ฅ๐ฎ๐๐จ๐ฌ๐ฎ๐ซ๐ข๐ (glucose in the urine). In fact, having glucosuria is where the name ๐ฆ๐๐ฅ๐ฅ๐ข๐ญ๐ฎ๐ฌ comes from! Mellitus means sweet in Latin, and supposedly doctors used to taste the urine of patients to diagnose this condition. Gross.
Based on this collection of clinical signs, veterinarians can often definitively diagnose diabetes mellitus, and begin treatment.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
Animals with diabetes mellitus are generally treated with injectable insulin. For Type 1 patients, this insulin replaces the insulin that their pancreas isnโt producing. For Type 2 patients, the insulin raises insulin levels in the blood, to hopefully overwhelm the cells with so much insulin they canโt ignore it anymore. This treatment is usually quite successful with proper lifestyle management and working closely with the veterinarian!
๐๐ก๐จ๐ญ๐จ๐ฌ
1) A histology photo showing ๐ฏ๐๐๐ฎ๐จ๐ฅ๐๐ซ ๐๐๐ ๐ง๐๐ซ๐๐ญ๐ข๐จ๐ง (excessive bubbling) of the pancreatic islets due to diabetes.
2) A liver with hepatic lipidosis.
3) A dog with cataracts in both eyes.
4) A cat with a plantigrade stance from diabetic neuropathy. QOTD: Can you name a species that is normally plantigrade? (Besides humans!)
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 2-3 courtesy of Noahโs Arkive.
Photo 4 courtsey of WikiVet/Manson Publishing.
