Turkiye Klinikleri Journal of Veterinary Sciences

.: REVIEW
Akromegali Saptanan Kedilerde İnsülin Direnci: Geleneksel Derleme
Insulin Resistance in Cats with Acromegaly: Traditional Compilation
Sirvan Oshnouei MAHMOUDZADEHa , Lora KOENHEMSİa , Tandzhu Nailov MEHMEDOVb , Mehmet Erman ORa
aİstanbul Üniversitesi Cerrahpaşa Veteriner Fakültesi, Klinik Bilimler Bölümü, İç Hastalıkları AD, İstanbul, Türkiye
bUniversity of Forestry Faculty of Veterinary Medicine, Department Internal Non-infectious Diseases, Pathology and Pharmacology, Sofiya, Bulgaria
Turkiye Klinikleri J Vet Sci. 2024;15(2):72-6
doi: 10.5336/vetsci.2024-102056
Article Language: TR
Full Text
ÖZET
 Akromegali, büyüme plakları kapandıktan sonra bile hâlâ fazla miktarlarda salgılanan büyüme hormonundan (BH) kaynaklanan bir bozukluktur. Hastalık; bağ dokusu, kemik ve iç organların aşırı büyümesi ile karakterizedir. Kedilerde akromegali genellikle fonksiyonel bir hipofiz adenomdan kaynaklanır. Kedilerde hipofiz tümörü, dorsal olarak sella tursika'nın üzerine uzanan bir makro adenomdur. Kronik aşırı BH sekresyonunun katabolik ve anabolik etkileri vardır. Anabolik etkileri, artan insülin benzeri büyüme faktörü-1 konsantrasyonları ile kemik, kıkırdak ve yumuşak dokuların çoğalmasına neden olur ve böylece hayvanda organomegali (özellikle böbrek ve kalp) şekillenir. BH'nin katabolik etkileri insülin direncine ve zamanla diabet mellitusa neden olabilir. Poliüri, polidipsi, polifaji, vücut büyüklüğünde artış, karın ve başın genişlemesi, yüz genişlemesi, interdental alanın genişlemesi, inspiratuar stridor hastalığın önemli belirtileridir. Akromegali olan kedilerin çoğu orta yaşlı veya daha büyüktür (ortalama 10 yaş) ve %90'ı erkektir. Akromegalinin, insüline dirençli diyabetik kedilerin %30 kadarında mevcut olabileceği kabul edilmektedir. Geçmişte kedilerde akromegali, nadir görülen bir hastalık olarak düşünülmesine rağmen son çalışmalarda diyabetik kedilerde insülin direncinin nedenlerinden birinin de akromegali olabileceği daha çok saptanmaya başlanmıştır. Bu nedenle, insülin direnci olan diyabetik kedilerde, akromegali düşünülmeli ve değerlendirilmelidir. Bu makalenin amacı, diabetes mellitus ve akromegali arasındaki ilişki hakkında bilgi vermek ve insüline direnç gösteren diyabetik kedilerde akromegali tanısı için inceleme yapılması gerektiğini vurgulamaktır.

Anahtar Kelimeler: Akromegali; büyüme hormonu; insülin; diyabet
ABSTRACT
 Acromegaly is a disorder caused by excess growth hormone (GH) after the growth plates have closed. It is characterized by overgrowth of connective tissue, bones and internal organs. A functional pituitary adenoma usually causes acromegaly in cats .The pituitary tumor in cats is a macro adenoma that extends dorsally over the sella turcica. Chronic excessive GH secretion has catabolic and anabolic effects. The anabolic effects causes proliferation of bone, cartilage and soft tissues with increasing concentrations of Insulin-like growth factor-1, and organomegaly (especially in the kidney and heart) is formed. The catabolic effects of GH may cause insulin resistance and diabetes mellitus. Polyuria, polydipsia and polyphagia, increased body size, enlargement of the abdomen and head, facial enlargement, enlargement of the interdental area, inspiratory stridor are important symptoms of the disease. Most cats with acromegaly are middleaged or older (average age 10) and 90% are male. It is recognized that acromegaly may be present in up to 30% of insulin resistant diabetic cats. Although acromegaly in cats was thought to be a rare disease in the past, recent studies have begun to detect that acromegaly may be one of the causes of insulin resistance in diabetic cats. In diabetic cats with insulin resistance, acromegaly should be considered and evaluated. This article aims to provide information about the relationship between diabetes mellitus and acromegaly and to emphasize the need for examination to diagnose acromegaly in insulin-resistant diabetic cats.

Keywords: Acromegaly; growth hormone; insulin; diabetes
REFERENCES:
  1. Peterson ME. Diagnosis and management of insulin resistance in dogs and cats with diabetes mellitus. Vet Clin North Am Small Anim Pract. 1995;25(3):691-713. [Crossref]  [PubMed] 
  2. Randolph JF, Peterson ME. Acromegaly (growth hormone excess) syndromes in dogs and cats. JD Bonagura and RW Kirk eds. Philadelphia WB Saunders. 1992;322-7. [Link] 
  3. Schwedes CS. Transient diabetes insipidus in a dog with acromegaly. J Small Anim Pract. 1999;40(8):392-6. [Crossref]  [PubMed] 
  4. Eigenmann JE, Eigenmann RY, Rijnberk A, van der Gaag I, Zapf J, Froesch ER. Progesterone-controlled growth hormone overproduction and naturally occurring canine diabetes and acromegaly. Acta Endocrinol (Copenh). 1983;104(2):167-76. [Crossref]  [PubMed] 
  5. Lichtensteiger CA, Wortman JA, Eigenmann JE. Functional pituitary acidophil adenoma in a cat with diabetes mellitus and acromegalic features. Vet Pathol. 1986;23(4):518-21. [Crossref]  [PubMed] 
  6. Norman EJ, Mooney CT. Diagnosis and management of diabetes mellitus in five cats with somatotrophic abnormalities. J Feline Med Surg. 2000;2(4):183-90. [Crossref]  [PubMed] 
  7. Niessen SJ, Petrie G, Gaudiano F, Khalid M, Smyth JB, Mahoney P, et al. Feline acromegaly: an underdiagnosed endocrinopathy? J Vet Intern Med. 2007;21(5):899-905. [Crossref]  [PubMed] 
  8. Peterson ME. Acromegaly in cats: are we only diagnosing the tip of the iceberg? J Vet Intern Med. 2007;21(5):889-91. [Crossref]  [PubMed] 
  9. Daughaday WH, Rotwein P. Insulin-like growth factors I and II. Peptide, messenger ribonucleic acid and gene structures, serum, and tissue concentrations. Endocr Rev. 1989;10(1):68-91. [Crossref]  [PubMed] 
  10. Karila TA, Karjalainen JE, Mäntysaari MJ, Viitasalo MT, Seppälä TA. Anabolic androgenic steroids produce dose-dependant increase in left ventricular mass in power atheletes, and this effect is potentiated by concomitant use of growth hormone. Int J Sports Med. 2003;24(5):337-43. [Crossref]  [PubMed] 
  11. Rosenfeld RG, Wilson DM, Dollar LA, Bennett A, Hintz RL. Both human pituitary growth hormone and recombinant DNA-derived human growth hormone cause insulin resistance at a postreceptor site. J Clin Endocrinol Metab. 1982;54(5):1033-8. [Crossref]  [PubMed] 
  12. Hansen I, Tsalikian E, Beaufrere B, Gerich J, Haymond M, Rizza R. Insulin resistance in acromegaly: defects in both hepatic and extrahepatic insulin action. Am J Physiol. 1986;250(3 Pt 1):E269-73. [Crossref]  [PubMed] 
  13. Bolinder J, Ostman J, Werner S, Arner P. Insulin action in human adipose tissue in acromegaly. J Clin Invest. 1986;77(4):1201-6. [Crossref]  [PubMed]  [PMC] 
  14. Abrams-Ogg AC, Holmberg DL, Stewart WA, Claffey FP. Acromegaly in a cat: diagnosis by magnetic resonance imaging and treatment by cryohypophysectomy. Can Vet J. 1993;34(11):682-5. [PubMed]  [PMC] 
  15. Berg RI, Nelson RW, Feldman EC, Kass PH, Pollard R, Refsal KR. Serum insulin-like growth factor-I concentration in cats with diabetes mellitus and acromegaly. J Vet Intern Med. 2007;21(5):892-8. [Crossref]  [PubMed] 
  16. Campbell J, Rastogi KS. Growth hormone-induced diabetes and high levels of serum insulin in dogs. Diabetes. 1966;15(1):30-43. [Crossref]  [PubMed] 
  17. Young FG. The growth hormone and diabetes. Recent Progress in Hormone Research. 10th ed. New York: Academic Press; 1953.
  18. Moller DE, Flier JS. Insulin resistance-mechanisms, syndromes, and implications. N Engl J Med. 1991;325(13):938-48. [Crossref]  [PubMed] 
  19. Feldman EC, Nelson RW. Acromegaly and hyperadrenocorticism in cats: a clinical perspective. J Feline Med Surg. 2000;2(3):153-8. [Crossref]  [PubMed] 
  20. Peterson ME, Taylor RS, Greco DS, Nelson RW, Randolph JF, Foodman MS, et al. Acromegaly in 14 cats. J Vet Intern Med. 1990;4(4):192-201. [Crossref]  [PubMed] 
  21. Chang-DeMoranville BM, Jackson IM. Diagnosis and endocrine testing in acromegaly. Endocrinol Metab Clin North Am. 1992;21(3):649-68. [Crossref]  [PubMed] 
  22. Clemmons DR, Van Wyk JJ, Ridgway EC, Kliman B, Kjellberg RN, Underwood LE. Evaluation of acromegaly by radioimmunoassay of somatomedin-C. N Engl J Med. 1979;301(21):1138-42. [Crossref]  [PubMed] 
  23. Hanaire-Broutin H, Sallerin-Caute B, Poncet MF, Tauber M, Bastide R, Rosenfeld R. Insulin therapy and GH-IGF-I axis disorders in diabetes: impact of glycaemic control and hepatic insulinization. Diabetes Metab. 1996;22(4):245-50. [PubMed] 
  24. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic complications of acromegaly: epidemiology, pathogenesis, and management. Endocr Rev. 2004;25(1):102-52. [Crossref]  [PubMed] 
  25. Mauldin GN, Burk RL. The use of diagnostic computerized tomography and radiation therapy in canine and feline hyperadrenocorticism. Probl Vet Med. 1990;2(4):557-64. [PubMed] 
  26. Giustina A, Casanueva FF, Cavagnini F, Chanson P, Clemmons D, Frohman LA, et al.; Pituitary Society and the European Neuroendocrine Association. Diagnosis and treatment of acromegaly complications. J Endocrinol Invest. 2003;26(12):1242-7. [Crossref]  [PubMed] 
  27. Niessen SJ. Feline acromegaly: an essential differential diagnosis for the difficult diabetic. J Feline Med Surg. 2010;12(1):15-23. [Crossref]  [PubMed] 
  28. Kaser-Hotz B, Rohrer CR, Stankeova S, Wergin M, Fidel J, Reusch C. Radiotherapy of pituitary tumours in five cats. J Small Anim Pract. 2002;43(7):303-7. [Crossref]  [PubMed] 
  29. Goossens MM, Feldman EC, Nelson RW, Theon AP, Koblik PD, Elliott DA, et al. Cobalt 60 irradiation of pituitary gland tumors in three cats with acromegaly. J Am Vet Med Assoc. 1998;213(3):374-6. [Crossref]  [PubMed] 
  30. Brearley MJ, Polton GA. Coarse Fractionated Radiation Therapy for Pituitary Tumours in Cats: A Retrospective Study of 10 Cases. Veterinary and Comparative Oncology. (2005;3(1):38-9. [Crossref] 

.: Up To Date

.: Process List

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com