ABSTRACT OF THE WEEK

The Canadian veterinary journal. La revue vétérinaire canadienne
Volume 64 | Issue 11 (November 2023)

Incidences of steroid-induced diabetes mellitus and congestive heart failure in cats given non-immunosuppressive doses of methylprednisolone acetate: 1042 cats.

Can Vet J. November 2023;64(11):1051 - 1057.

Wendy A Dutch¹, Gary D Norsworthy², Milton R Mayfield³, Jacqueline R Mayfield⁴, Connie W Schmitt⁵

¹ Alamo Feline Health Center, 16201 San Pedro Avenue, San Antonio, Texas 78232, USA (Dutch, Norsworthy); Texas A&M International University, 2101 Peach Blossom Street, San Antonio, Texas 78247, USA (M.R. Mayfield, J.R. Mayfield); Texas Veterinary Pathology, 1007 Wagon Wheel, Spring Branch, Texas 78070, USA (Schmitt).; ² Alamo Feline Health Center, 16201 San Pedro Avenue, San Antonio, Texas 78232, USA (Dutch, Norsworthy); Texas A&M International University, 2101 Peach Blossom Street, San Antonio, Texas 78247, USA (M.R. Mayfield, J.R. Mayfield); Texas Veterinary Pathology, 1007 Wagon Wheel, Spring Branch, Texas 78070, USA (Schmitt).; ³ Alamo Feline Health Center, 16201 San Pedro Avenue, San Antonio, Texas 78232, USA (Dutch, Norsworthy); Texas A&M International University, 2101 Peach Blossom Street, San Antonio, Texas 78247, USA (M.R. Mayfield, J.R. Mayfield); Texas Veterinary Pathology, 1007 Wagon Wheel, Spring Branch, Texas 78070, USA (Schmitt).; ⁴ Alamo Feline Health Center, 16201 San Pedro Avenue, San Antonio, Texas 78232, USA (Dutch, Norsworthy); Texas A&M International University, 2101 Peach Blossom Street, San Antonio, Texas 78247, USA (M.R. Mayfield, J.R. Mayfield); Texas Veterinary Pathology, 1007 Wagon Wheel, Spring Branch, Texas 78070, USA (Schmitt).; ⁵ Alamo Feline Health Center, 16201 San Pedro Avenue, San Antonio, Texas 78232, USA (Dutch, Norsworthy); Texas A&M International University, 2101 Peach Blossom Street, San Antonio, Texas 78247, USA (M.R. Mayfield, J.R. Mayfield); Texas Veterinary Pathology, 1007 Wagon Wheel, Spring Branch, Texas 78070, USA (Schmitt).

Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.

Abstract

OBJECTIVE:Corticosteroids are indicated to treat many feline diseases. However, side effects are a limiting factor in their use. The most concerning side effects are steroid-induced diabetes mellitus (SI-DM) and steroid-induced congestive heart failure (SI-CHF). This study aims to determine the incidences of these diseases in a large population of domestic cats seen at a privately-owned, feline-only practice.

ANIMALS:Cats in the study were client-owned patients of Alamo Feline Health Center in San Antonio, Texas. Control cats (controls) were examined as part of their routine health care.

PROCEDURES:The records of 732 cats that received methylprednisolone acetate (MPA) for various clinical indications were reviewed to determine how many developed SI-DM and SI-CHF. A similar record review of 310 controls was made to determine the incidence of spontaneous diabetes mellitus (Sp-DM) and spontaneous congestive heart failure (Sp-CHF). Control cats never received any oral or injectable corticosteroids.

RESULTS:Of the cats that received MPA, 28 developed SI-DM (3.83%) and 6 developed SI-CHF (0.82%). Of the controls, 22 developed Sp-DM (7.10%) and 6 developed Sp-CHF (1.90%).

CONCLUSION:The incidences of developing SI-DM and SI-CHF were 3.83% and 0.82%, respectively; and the risk was not increased even when repeated doses of MPA were given.

CLINICAL RELEVANCE:The authors consider the risk-benefit ratio sufficient to justify the use of MPA when it is indicated, especially if another drug cannot be substituted with the same therapeutic results.

PubMed Other Abstract

UNLABELLED:Incidences du diabète sucré et de l’insuffisance cardiaque congestive induits par les stéroïdes chez des chats ayant reçu des doses non immunosuppressives d’acétate de méthylprednisolone : 1042 chats.

OBJECTIF:Les corticoïdes sont indiqués pour traiter de nombreuses maladies félines. Cependant, les effets secondaires constituent un facteur limitant leur utilisation. Les effets secondaires les plus préoccupants sont le diabète sucré induit par les stéroïdes (SI-DM) et l’insuffisance cardiaque congestive induite par les stéroïdes (SI-CHF). Cette étude vise à déterminer l’incidence de ces maladies dans une large population de chats domestiques vus dans une pratique privée exclusivement féline.

ANIMAUX:Les chats de l’étude étaient des patients appartenant à des clients du Alamo Feline Health Center à San Antonio, au Texas. Les chats témoins (témoins) ont été examinés dans le cadre de leurs soins de santé de routine.

PROCÉDURES:Les dossiers de 732 chats ayant reçu de l’acétate de méthylprednisolone (MPA) pour diverses indications cliniques ont été examinés afin de déterminer combien d’entre eux ont développé du SI-DM et du SI-CHF. Un examen similaire des dossiers de 310 témoins a été réalisé pour déterminer l’incidence du diabète sucré spontané (Sp-DM) et de l’insuffisance cardiaque congestive spontanée (Sp-CHF). Les chats témoins n’ont jamais reçu de corticostéroïdes oraux ou injectables.

RÉSULTATS:Parmi les chats ayant reçu du MPA, 28 ont développé du SI-DM (3,83 %) et 6 ont développé du SI-CHF (0,82 %). Parmi les témoins, 22 ont développé du Sp-DM (7,10 %) et 6 ont développé du Sp-CHF (1,90 %).

CONCLUSION:Les incidences de développement de SI-DM et de SI-CHF étaient respectivement de 3,83 % et 0,82 %; et le risque n’a pas augmenté même lorsque des doses répétées de MPA ont été administrées.

PERTINENCE CLINIQUE:Les auteurs considèrent le rapport bénéfice/risque suffisant pour justifier l’utilisation du MPA lorsqu’il est indiqué, notamment si un autre médicament ne peut lui être substitué avec les mêmes résultats thérapeutiques.(Traduit par D^r Serge Messier).

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