Canis ISSN: 2398-2942

Diabetes mellitus: glomerulonephropathy

Contributor(s): Carmel Mooney

Introduction

  • A potentially serious complication of diabetes mellitus Diabetes mellitus (DM) but extremely rare in the naturally occurring canine disease.
  • In humans diabetic nephropathy is a leading cause of morbidity and mortality in chronically diabetic patients.

Pathogenesis

Pathophysiology

  • In humans it is characterized clinically as a triad of hypertension, proteinuria and eventually renal impairment:
    • Progressive stages are described as hyperfiltration (associated with elevated glomerular filtration rate), structural change (basement membrane thickening and mesangial expansion) without clinical effect, microalbuminuria, macroalbuminuria and eventually development of uremia and end stage renal disease.
  • In diabetic dogs proteinuria Proteinuria is relatively common but is not associated with hypertension Hypertension (also relatively common in diabetic dogs) or duration of diabetes nor does there appear to be an increased prevalence of chronic kidney disease Kidney: chronic kidney disease (CKD) in diabetic dogs:
    • The observed proteinuria in diabetic dogs may represent an alternate pathology to that described in diabetic human patients.

 

Timecourse

  • In humans usually takes at least 10-15 years to develop even if the diabetes is appropriately diagnosed and managed.
  • The long time lag before development of disease may explain the relative rarity of the disease in dogs compared with humans.

Diagnosis

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Treatment

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Herring I P, Panciera D L & Were S R (2014) Longitudinal prevalence of hypertension, proteinuria and retinopathy in dogs with spontaneous diabetes mellitus. J Vet Intern Med 28, 488-495 PubMed.
  • Mazzi A, Fracassi F, Dondi F, Gentilini F, & Famigli Bergamini P (2008) Ratio of urinary protein to creatinine and albumin to creatinine in dogs with diabetes mellitus and hyperadrenocorticism. Vet Res Commun 32, S299-S301 PubMed.

Other sources of information

  • Consensus statements:
    • IRIS Canine GN Study Group Diagnosis Subgroup, Littman M P, Daminet S, Grauer G F, Lees G E & van Dongen A M (2013)Consensus recommendations for the diagnostic investigation of dogs with suspected glomerular disease.J Vet Intern Med27, S19-S26PubMed.
    • IRIS Canine GN Study Group Standard Therapy Subgroup, Brown S, Elliott J, Francey F, Polzin D & Vaden S (2013)Consensus recommendations for the standard therapy of glomerular disease in dogs.J Vet Intern Med27, S27-S43PubMed.


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