Advancements in diagnostic, therapeutic, and monitoring options for canine and feline diabetes mellitus, canine hypoadrenocorticism, and canine hypercortisolism

This thesis presents advancements in diagnostic, therapeutic, and monitoring approaches for small animal endocrinopathies, focusing on canine and feline diabetes mellitus (DM), canine hypoadrenocorticism (HA), and canine hypercortisolism (HC). A prospective randomized crossover study assessed the effects of a homemade diet versus a commercial diet on glycemic control and variability in diabetic dogs, with the homemade diet showing superior glucose-lowering effects. Novel insulin analogs, including insulin glargine 300 U/mL and insulin degludec 100 U/mL, were evaluated for once-daily administration, offering practical alternatives to traditional twice-daily insulin protocols. Additionally, the thesis explored the effects of transmucosal glucagon powder (Baqsimi) on blood glucose concentrations in healthy cats, suggesting potential applications for managing hypoglycemic episodes in diabetic patients. The accuracy of the FreeStyle Libre 3 continuous glucose monitoring system (CGMS) was evaluated in diabetic and healthy cats, demonstrating good performance across a wide glycemic range. The Eversense XL, a novel CGMS with a lifespan of up to 180 days, was assessed in diabetic dogs, highlighting its potential to improve long-term adherence despite limitations such as sensor movement and calibration requirements. The thesis also presents the results of two prospective studies: one investigating the prevalence of canine eunatremic, eukalemic hypoadrenocorticism and the other examining the recovery timeline of the hypothalamic-pituitary-adrenal axis in dogs treated with intermediate-acting glucocorticoids. Furthermore, the diagnostic performance of urinary cortisol, urinary cortisol-to-creatinine ratio (UCCR), and low-dose dexamethasone suppression test were evaluated following a change in the Immulite 2000 antibody used for cortisol measurement. Finally, the thesis examined the impact of a therapeutic commercial diet formulated for calcium oxalate urolithiasis on calcium-phosphate homeostasis in dogs with HC treated with trilostane. In conclusion, this thesis provides valuable insights into endocrine diseases, aiding clinicians in improving the diagnosis and daily management of canine and feline DM, canine HA, and canine HC.