Canis ISSN: 2398-2942

Diabetes insipidus

Synonym(s): DI

Contributor(s): David Bruyette

Introduction

  • Cause: absolute or relative deficiency of anti-diuretic hormone (ADH).
  • Two forms:
    • Hypothalamic-hypohyseal DI (HDDI).
    • Nephrogenic DI (NDI).
  • Signs:
    • Polyuria/polydipsia.
    • Urine: low SG/osmolarity.
  • Diagnosis: urinalysis, hematology, biochemistry.
  • Treatment: various chemotherapies.
  • Prognosis: varies.

Pathogenesis

Etiology

Central form

  • Partial or total failure to synthesize or release ADH.
  • Rare.

May be

  • 1° - idiopathic.
  • 2° to:
    • Head trauma.
    • Neoplasia 1°/2°.
    • Inflammatory/vascular damage.

Nephrogenic form

  • Head trauma.
  • Neoplasia 1°/2°.
  • Inflammatory/vascular damage.
  • Failure of distal renal tubules to respond to ADH (renal tubule insensitivity).

May be

  • 1° - rare (inherited in man but no evidence for this in dogs).
  • 2° (acquired):
    • Non-specific condition - includes many conditions with impaired ADH action.
    • Renal + metabolic disorder → loss of ability to respond to ADH.
    • Most of these may be distinguished by typical history/signs/laboratory findings.
  • May be caused by:
    • Hyperadrenocorticism.
    • Hypercalcemia.
    • Hypoadrenocorticism.
    • Renal insufficiency.
    • Pyometra.
    • Hypokalemia.
    • Hepatic insufficiency.
    • Hyperthyroidism.
    • Iatrogenic.
    • Post-obstructive ureteral diuresis.

Specific

Central form

  • Neoplasia.
  • Trauma.
  • Inflammation.
  • Idiopathic.

Nephrogenic form

  • Renal medullary fibrosis, tubular necrosis.
  • Hypercalcemia.
  • Idiopathic.

Pathophysiology

  • Absolute or relative deficiency of ADH → marked polyuria and resultant polydipsia.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Ramsey I D, Dennis R & Herrtage M E (1999) Concurrent central diabetes insipidus and panhypopituitarism in a German shepherd dog. JSAP 40 (6), 271-274 PubMed.
  • Schwedes C S (1999) Transient diabetes insipidus in a dog with acromegaly. JSAP 40 (8), 392-396 PubMed.
  • Haberer B & Reusch C E (1998) Glycated haemoglobin in various pathological conditions - investigations based on a new, fully automated method. JSAP 39 (11), 510-7 PubMed.
  • Takemura N (1998) Successful long-term treatment of congenital nephrogenic diabetes insipdus in a dog. JSAP 39 (12), 592-594 PubMed.


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