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The cat is monitored frequently during the first few months of treatment; The cat eats a diet low in carbohydrates and high in protein. Cats may present with type 2 (insulin-resistant) diabetes, at least at first, but hyperglycemia and amyloidosis, left untreated, will damage the pancreas over time and progress to insulin-dependent diabetes.
The causes of feline hyperesthesia syndrome are highly disputed, largely due to the unknown pathophysiology of the syndrome and the variation in responses to different treatment methods. [ 1 ] [ 3 ] [ 4 ] [ 8 ] There are three main theories on the cause of the syndrome, as outlined below:
The causes of the aging-related insulin resistance seen in obesity and in type 2 diabetes are uncertain. Effects of intracellular lipid metabolism and ATP production in liver and muscle cells may contribute to insulin resistance. [62]
Feline arterial thromboembolism (FATE syndrome) (German: Feline arterielle Thromboembolie) is a disease of the domestic cat in which blood clots block arteries, causing severe circulatory problems. Relative to the total number of feline patients, the disease is rare, but relatively common in cats with heart disease: about one-sixth of cats with ...
It may resolve with treatment of the diabetes. [8] The pathology of this condition in cats has been shown to be very similar to diabetic neuropathy in humans. [9] Distal symmetric polyneuropathy symptoms include atrophy of the distal leg muscles and the muscles of the head, and rear limb weakness. No treatment is known and the prognosis is poor.
Thiazolidinedione ligand dependent transactivation is responsible for the majority of anti-diabetic effects. The activated PPAR/RXR heterodimer binds to peroxisome proliferator hormone response elements upstream of target genes in complex with a number of coactivators such as nuclear receptor coactivator 1 and CREB binding protein, this causes upregulation of genes (for a full list see PPARγ):
Cats heterozygous for this gene (Mkmk) have shortened and thickened legs, because this gene causes dwarfism in cats. Cats with this mutation have lived naturally in feral populations worldwide. However, cats with this gene are also the basis for several intentionally selected breeds of dwarf cat.
The atrophied thyroid tissue will return to regular production of thyroid hormone which avoids the risk of iatrogenic hypothyroidism with other treatment options. [2] In one study after 4 years 84% of cats were euthyroid and 4% were hypothyroid. [6] Thyroid carcinomata are uncommon but difficult to diagnose and require higher dosage to treat.