Mollie Gunning^1,2, Ian Ramsey¹

¹University of Glasgow, Glasgow, United Kingdom. ²University of Cambridge, Cambridge, United Kingdom

Objectives

To investigate associations between previous (exogenous and endogenous) glucocorticoid exposure with ketosis and glycaemic control markers at diagnosis, and survival outcomes in dogs with diabetes mellitus.

Methods

Single centre retrospective case-controlled study of diabetic dogs attending a UK university hospital between 2019 - 2026. Cases were split into 3 groups: glucocorticoid treatment documented 6 weeks before DM diagnosis (GC group), hypercortisolism diagnosed before or within 6 months of DM (HC group), and those not exposed to excess glucocorticoids (N group). The presence of ketonaemia (>1mmol/L) or ketonuria and HbA1c/serum fructosamine concentrations at diagnosis, and survival were compared.

Results

Eighty-nine dogs were included in the study, 17 dogs in the GC group, 11 in the HC group and 61 in the N group. There was a significant difference (p = 0.03) in the proportion of dogs that were ketotic on presentation when GC, but not HC, were compared with N. There were no significant differences in glycaemic markers at diagnosis. The median survival time for GC dogs was 254 days (95% confidence interval (CI) = 19d - infinity), compared to 768 days for the HAC dogs (95% CI 149d - infinity), and 1,381 days for the N group (95% CI 801d – 1,681d). The Kaplan-Meier survival curves for the three groups were significantly different (p = 0.02).

Statement: Impact/ Clinical Significance

Previous glucocorticoid treatment has an influence (directly or indirectly) on the presentation and outcome of canine DM. This effect may be more severe than that reported with hypercortisolism.