Juvenile hyperinsulinism in a Maine Coon kitten
Case summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabo...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-11-01
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| Series: | Journal of Feline Medicine and Surgery Open Reports |
| Online Access: | https://doi.org/10.1177/20551169221136473 |
| _version_ | 1811186678592700416 |
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| author | Matthew Kornya Anthony Abrams-Ogg Dominique Comeau Jeff Caswell |
| author_facet | Matthew Kornya Anthony Abrams-Ogg Dominique Comeau Jeff Caswell |
| author_sort | Matthew Kornya |
| collection | DOAJ |
| description | Case summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabolism (ie, storage diseases and urea cycle disorders), infection or iatrogenic hypoglycemia were negative. An inappropriately high serum insulin level was noted in the face of marked hypoglycemia. The insulin:glucose ratio was 0.44 (<0.3) and the amended insulin:glucose ratio was 1268 (<30). Thoracic radiography and abdominal ultrasonography did not identify a cause for this elevated insulin level. Stabilization with a low, but adequate, blood glucose occurred with corticosteroid therapy, with further significant improvement with the addition of diazoxide. Peripheral neuropathy developed several months later, and concerns for quality of life led to humane euthanasia approximately 1 year after the initial diagnosis. Insulin levels remained high at the time of euthanasia. Necropsy found no gross lesions, though microscopic degeneration of the sciatic nerve and subjectively mildly increased size and number of pancreatic islets was noted. These findings were consistent with a diagnosis of congenital hyperinsulinism. Relevance and novel information This is the first reported case of congenital hyperinsulinism in a cat and may parallel the diffuse form of hypoglycemic hyperinsulinism reported in humans and a single dog. It should be considered a differential diagnosis in kittens presenting for refractory hypoglycemia. |
| first_indexed | 2024-04-11T13:50:32Z |
| format | Article |
| id | doaj.art-5c302e17b1244d0396c95c78a19e7bf9 |
| institution | Directory Open Access Journal |
| issn | 2055-1169 |
| language | English |
| last_indexed | 2024-04-11T13:50:32Z |
| publishDate | 2022-11-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Feline Medicine and Surgery Open Reports |
| spelling | doaj.art-5c302e17b1244d0396c95c78a19e7bf92022-12-22T04:20:40ZengSAGE PublishingJournal of Feline Medicine and Surgery Open Reports2055-11692022-11-01810.1177/20551169221136473Juvenile hyperinsulinism in a Maine Coon kittenMatthew KornyaAnthony Abrams-OggDominique ComeauJeff CaswellCase summary A 5.5 month-old intact male Maine Coon cat was presented to a referral hospital for a history of muscle fasciculations, lethargy and seizures associated with refractory hypoglycemia. Diagnostic testing for hypothyroidism, hyposomatotropism or hypoadrenocorticism, inborn errors of metabolism (ie, storage diseases and urea cycle disorders), infection or iatrogenic hypoglycemia were negative. An inappropriately high serum insulin level was noted in the face of marked hypoglycemia. The insulin:glucose ratio was 0.44 (<0.3) and the amended insulin:glucose ratio was 1268 (<30). Thoracic radiography and abdominal ultrasonography did not identify a cause for this elevated insulin level. Stabilization with a low, but adequate, blood glucose occurred with corticosteroid therapy, with further significant improvement with the addition of diazoxide. Peripheral neuropathy developed several months later, and concerns for quality of life led to humane euthanasia approximately 1 year after the initial diagnosis. Insulin levels remained high at the time of euthanasia. Necropsy found no gross lesions, though microscopic degeneration of the sciatic nerve and subjectively mildly increased size and number of pancreatic islets was noted. These findings were consistent with a diagnosis of congenital hyperinsulinism. Relevance and novel information This is the first reported case of congenital hyperinsulinism in a cat and may parallel the diffuse form of hypoglycemic hyperinsulinism reported in humans and a single dog. It should be considered a differential diagnosis in kittens presenting for refractory hypoglycemia.https://doi.org/10.1177/20551169221136473 |
| spellingShingle | Matthew Kornya Anthony Abrams-Ogg Dominique Comeau Jeff Caswell Juvenile hyperinsulinism in a Maine Coon kitten Journal of Feline Medicine and Surgery Open Reports |
| title | Juvenile hyperinsulinism in a Maine Coon kitten |
| title_full | Juvenile hyperinsulinism in a Maine Coon kitten |
| title_fullStr | Juvenile hyperinsulinism in a Maine Coon kitten |
| title_full_unstemmed | Juvenile hyperinsulinism in a Maine Coon kitten |
| title_short | Juvenile hyperinsulinism in a Maine Coon kitten |
| title_sort | juvenile hyperinsulinism in a maine coon kitten |
| url | https://doi.org/10.1177/20551169221136473 |
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