Extended patient care report for an unstable acromegalic cat with hypoglycaemia

The patient presented to the hospital collapsed and unresponsive. He was a known diabetic patient, and was already undergoing treatment for his diabetes.

Species: Feline

Breed: Domestic Long Haired

Age: 14 years 3 months

Gender: Male (neutered)

Weight: 4.8 kg

The patient had previously been diagnosed with insulin dependent diabetes mellitus (IDDM). He had been confirmed as acromegalic (with a high insulin-like growth factor 1 concentration), and had also been noted to have a heart murmur, and International Renal Interest Society stage 2 chronic kidney disease (IRIS, 2013). He was found collapsed in the morning by his owner who, suspecting hyperglycaemia, administered a subcutaneous insulin glargine (Lantus, Sanofi Aventis) injection and presented him to the practice.

The cat presented collapsed, comatose and hypothermic with a temperature of 32.2°C (reference range: 37.8–39.0°C), and constricted pupils. He had a gallop rhythm with a grade 1/6 systolic murmur and pulse deficits, although he had good pulse quality with a heart rate of 180 beats per minute (reference range: 140–220 bpm). He had no other abnormalities detected on physical examination with the veterinary surgeon (VS). Thoracic auscultation was clear with a respiratory rate of 28 breaths per minute (brpm) (reference range: 20–30 brpm), pink and tacky mucous membranes with a capillary refill time of 1–2 seconds (reference range: 1–2 seconds).