Research review: Usefulness of serum fructosamine concentration on diabetic cats

Continuous interstitial glucose concentration monitoring (CGM) is a valuable tool for managing diabetes in cats. However, not all cats tolerate the procedure, and problems with affordability and owner reluctance or inability to engage with the technology involved might also present.

Serum fructosamine concentration can also be used to monitor diabetic status, but little data exists on the correlation of the two methods. Tobin et al¹ performed a prospective cohort study to evaluate whether serum fructosamine concentration correlates with mean interstitial glucose concentration.

A dozen cats with poorly controlled diabetes mellitus treated with insulin were included in the study. Each cat was monitored with CGM and serum fructosamine for a 6 to 12-week period. Mean interstitial glucose concentration was calculated over the 3 days around the time of the fructosamine measurement, which were taken at baseline, at 3 to 6 weeks and at 9 to 12 weeks.

A strong correlation between serum fructosamine and interstitial glucose concentration was found, with significant overlap between the groups when categorising serum fructosamine on reference intervals and physiologically relevant cut-off points.

The authors concluded that serum fructosamine concentration trends can be useful to monitor cats with diabetes when CGM is not available.

Bronchomalacia

Bronchomalacia is an important and hard to manage respiratory disease. However, little data exists on prognosis and risk factors for progression of the disease.

Chang et al² performed a prospective observational cohort study to assess the clinical course and risk factors for the condition. A total of 70 dogs with bronchomalacia confirmed with bronchoscopy were included in the study.

The median survival time after diagnosis was 998 days for all-cause mortality and 1,323 days for cardiorespiratory mortality. Roughly two-thirds of deaths were thought to be due to cardiorespiratory causes. One-third of the cases had pulmonary hypertension and pneumonia or pneumonitis.

Being older, having inflammatory airway disease treated with corticosteroids, and pulmonary hypertension were associated with the development of pneumonia/pneumonitis. Pulmonary hypertension, being older and severe bronchomalacia were associated with increased all-cause mortality.

High-grade tracheal collapse, pulmonary hypertension and inflammatory airway disease treated with corticosteroids were associated with increased cardiorespiratory mortality.

The authors concluded that bronchomalacia in dogs is associated with marked mortality. Knowledge of risk factors may help inform management choices.

Urethral catheterisation

Urethral catheterisation is a vital technique most commonly used to relieve urethral obstruction in male cats, often as an emergency. However, this is not always straightforward, and has the potential to cause urethral trauma.

The authors of the following study noted that reference texts do not always describe the technique in sufficient detail for it to be carried out optimally; that is, manipulating the penis to straighten the urethral flexure.

Various ancillary techniques have been described to aid the ease of the procedure, such as caudal epidural, but these have variable efficacy and none have been shown to increase the speed of catheterisation.

Locke et al³ described a novel technique involving stay sutures placed in the preputial fold to aid in the correct positioning of the penis. A group of 20 cats with urethral obstruction were assigned to have the procedure performed with the novel technique or the conventional technique, by final-year vet students or interns that had never catheterised a cat before.

The novice vets were allowed 30 minutes to complete the procedure. The mean time for successful catheterisation was 9.5 minutes for the novel technique compared to 14.6 minutes for the conventional technique, although this difference was not statistically significant.

However, all 10 cases catheterised by the novel technique were successfully completed in the 30 minutes allotted, compared to only 7 out of 10 of the cases catheterised by the conventional technique.

The authors concluded that this technique was easily learned, did not increase time compared to the conventional technique, and could improve the ease with which obese cats could be catheterised.

Congestive heart failure

Electrolyte disturbances in heart failure are associated with activation of the renin-angiotensin-aldosterone system (RAAS), and hyponatraemia has been linked with poor survival in acute congestive heart failure (CHF).

Hypochloraemia has also been associated with a poorer prognosis and diuretic resistance.

Lavigne et al⁴ performed a retrospective study including 84 cats that had stable CHF at least one week after being hospitalised. A total of 15 cats were found to be hypochloraemic, and these cats were found to have a higher risk of death and a shorter survival time.

In multivariate analysis, pimobendan use was independently associated with a higher risk of death and normal blood urea was associated with a lower risk of death.

The authors concluded that it might be important to attempt to normalise chloride levels in cats with CHF.

Adrenocortical hormone levels

Abnormalities in adrenocortical hormone levels can lead to changes in blood pressure. Runde et al⁵ performed a study to assess the relationship between systolic blood pressure (SBP) and adrenocortical hormones.

A group of 10 normotensive control dogs were compared to 84 dogs with clinical features of hyperadrenocorticism but normal post-ACTH stimulation test results. These were classified as normotensive, prehypertensive and hypertensive.

Other hormones including progesterone and aldosterone were also measured. Many of the baseline hormones were increased in the ill dogs compared to the controls.

No significant difference was reported in the baseline or post-ACTH hormone levels between the blood pressure groups. An increased risk of higher blood pressure in the ill dogs that had increased non-cortisol adrenocortical hormones was noted. However, an increase in adrenocortical sex hormones in normotensive controls was also found, which could not be explained.

Meningioma

Meningioma is one of the most common spinal cord tumours in dogs. Radiotherapy can be an effective treatment for this neoplasm, but data on complications of treatment and prognosis remains limited.

Uno et al⁶ reported a case series that aimed to evaluate the outcomes of surgery and radiotherapy in 10 dogs with spinal meningiomas.

All cases underwent surgery and had histopathological confirmation of the diagnosis. Three out of four cases that had surgical margins assessed had incomplete resections. Nine cases had postoperative adjunctive radiotherapy, and one had radiotherapy after tumour recurrence; six cases had local recurrence at between 95 and 1,086 days. The median survival time was 568 days with a range of 165 to 1,823 days. One dog had late onset worsening limb paralysis, which was suspected to be due to radiation, but no other cases had acute or late radiation-related adverse events.

Radiotherapy may, therefore, be a safe and effective adjunctive treatment for spinal meningioma in dogs.

Multimorbidity

It is known that multimorbidity – that is, the presence of two or more conditions – is associated with an increased risk of death as people and animals get older. However, the effects of multimorbidity are hard to assess in laboratory animals. By contrast, older dogs that are medically managed individually, and share a similar environment, physiology and genetic diversity to humans, could serve as an animal model for multimorbidity studies.

Foreman et al⁷ used owner-reported data from more than 50,000 dogs in the Dog Aging Project (DAP) to help assess how diagnoses accumulate over time and which diagnoses are most prevalent and associated with risk. The data analysis showed that accumulating conditions increased risk of death in dogs. The study also showed an increased risk of future conditions being reported if previous conditions had already been reported.

Increased age appeared to be the most important factor behind developing these diseases. The individual diseases appeared to have either a synergistic effect, or one condition predominated.

Osteoarthritis, being overweight, and cancer were found to be highly prevalent.

The authors concluded that, in line with previous work, the DAP highlighted the utility of the companion dog for informing the science of human ageing.

• Use of some of the drugs in this article is under the veterinary medicine cascade.
• This article appeared in Vet Times (4 August 2026), Volume 56, Issue 31, Pages 14-15