Equis ISSN 2398-2977

Pancreas: chronic pancreatitis - diabetes mellitus

Contributor(s): Christopher Brown, Janice Sojka, Han van der Kolk, Vetstream Ltd

Introduction

  • Syndrome secondary to pancreatic disease; primary diabetes mellitus as seen in human and dog but extremely rare in the horse.
  • Cause: deficiency in circulating insulin - chronic pancreatitis; lack of insulin effect - endocrinopathies due to neoplasia.
  • Diabetes mellitus with hyperinsulinemia due to an insulin antagonist producing tumor is relatively common in aged horses.
  • Signs: weight loss, polyphagia (or normal appetite), polydipsia/polyuria   Polydipsia / polyuria  , hyperglycemia; similar to hyperadrenocorticism.
  • Diagnosis: blood biochemistry, oral glucose absorption test    .
  • Treatment: if shock - oral or IV glucose; routine insulin therapy.
  • Prognosis: guarded; poor if neoplasia.

Pathogenesis

Etiology

Pathophysiology

  • Insulin dependent:
    • Idiopathic destruction of insulin secreting cells.
    • Chronic inflammation   →   destruction of beta islet cells   →   absolute deficiency of insulin.
    • Damage from parasite migration has been presumed to be the inciting cause.
  • Non-insulin dependent:
    • Insulin-receptor anomalies, eg hypophyseal adenoma   →   increased release of somatotrophin and/or cortisol    →   decreased glucose utilization + peripheral tissue insensitivity to insulin due to endocrine modification   →   insulin-resistant hyperglycemia.

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.
  • Johnson P J, Wiedmyeyer C E & Messer N T (2009)Conditions of the equine pancreas.Equine Vet Educ21(1), 26-29 VetMedResource.
  • Johnson P Jet al(2005)Diabetes mellitus in a domesticated Spanish Mustang.JAVMA226(4), 584-588 PubMed.
  • Furr M O & Robertson J (1992)Two cases of equine pancreatic disease and a review of the literature.Equine Vet Educ4, 55-58 Wiley Online Library.
  • Church S, West H J & Baker J R (1987)Two cases of pancreatic adenocarcinoma in horses.Equine Vet J19, 77-79 PubMed.


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