Subclinical bacteriuria (SB) and pyuria (SP) are recognized in companion animals, yet their prevalence and comorbidities in those without signs of lower urinary tract disease (LUTD) remain underexplored.

Determine SB and SP prevalence, identify associations, and compare species differences.

Two hundred eighty-seven cats and 533 dogs without LUTD signs.

Prospective cross-sectional study with retrospective analysis of medical records.

Subclinical bacteriuria prevalence was 6.67% in cats and 9.81% in dogs. Subclinical pyuria was rarer in cats (1.05%) than in dogs (2.88%). Concurrent SB and SP occurred in 0.3% of cats and 2.5% of dogs (P = .0275), highlighting species-specific patterns. Higher urinary white blood cell levels were associated with higher urine bacterial levels (P < .001). In cats, key multivariable logistic regression associations increasing the composite outcome variable (SP, SB, or SP and SB) odds included previous diagnoses of lower urinary tract infection (LUTI; odds ratio [OR] 5.6 [95% confidence limit or 95CL 2-15.6), diabetes mellitus (OR 6.5 [95CL 1.4-30.3]), hyperthyroidism (OR 9.6 [95CL 1.2-77]), and current diagnosis of acute kidney injury (AKI; OR 7.5 [95CL 2.1-27]); in dogs, a previous diagnosis of AKI (OR 9.9 [95CL 1.3-76.9]), and current diagnoses of AKI (OR 9.9 [95CL 2.3-43.5]) and LUTI (OR 23.3 [95CL 12.5-43.5]). Machine learning revealed additional associations, including hypercortisolism in dogs.

These findings underscore distinct risk profiles between species, suggesting tailored diagnostic approaches in veterinary practice. The rarity of concurrent SB and SP, unlike in humans, questions the application of human guidelines to animals.

Diabetes mellitus (DM) in cats is commonly managed with insulin injections and glycemic control is assessed with glucose monitoring systems. Automated insulin delivery (AID) systems, which integrate a continuous glucose monitoring system with an insulin pump controlled by a set algorithm, are successful in managing type 1 DM in humans but have not been reported in cats until now. Here, the use of an AID system is described in an 11-year-old cat with DM. After an initial 6 days of treatment with twice daily administration of protamine zinc insulin and insulin glargine, the AID was applied and managed by the cat owner. The system rapidly improved glycemic control and remission of DM was achieved. Throughout the application period, the AID system was well tolerated by the cat. This case suggests that AID systems can be used in diabetic cats and that they might improve glycemic control.

A 7-year-old spayed female mixed-breed dog was diagnosed with acute pancreatitis and received supportive care for 2 weeks, after which the dog developed diabetes mellitus (DM). Insulin therapy was initiated (insulin glargine 300 U/ml) at 0.2 U/kg subcutaneously (SQ) every 12 hours with no dose adjustments required. After 2 months, insulin therapy was discontinued because of a suspected hypoglycemic episode and persistently normal interstitial glucose concentrations. Nineteen months after diagnosis, the dog remained euglycemic with normal hemoglobin A1c, consistent with diabetic remission. Diabetic remission is rare in dogs and is reported only in the context of insulin-resistance caused by excess progesterone or glucocorticoids and in a single case report with no obvious cause of insulin-resistance. The case reported here demonstrates that even in pancreatitis-related DM, remission is possible in a dog.

Hypersomatotropism (HST) in cats has predominantly been associated with diabetes mellitus (DM) and HST in nondiabetic cats is poorly described.

To describe the clinical presentation, clinicopathologic findings, and outcome of nondiabetic cats with presumed HST.

Twenty-eight client-owned cats.

Multi-site retrospective study based on medical records of nondiabetic cats seen at 10 institutions between 2014 and 2024 with presumed HST (elevated serum insulin-like growth factor-1 [IGF-1] ± clinical signs compatible with acromegaly ± documented pituitary enlargement). Clinical presentation, diagnostic findings, and survival times were reviewed.

Twenty-eight cats with HST were included. Twenty-six cats were males, and 2 cats were females; mean age was 9.5 years (±SD 3.5 years); mean body weight was 7.1 kg (±SD 2.1 kg). The median serum IGF-1 concentration was 1236 ng/mL (range 704-2455 ng/mL). Nineteen of 28 cats (68%) had clinical signs possibly related to acromegaly: prognathia inferior (13/28), weight gain (12/28), broad facial features (10/28), abdominal enlargement (10/28), respiratory stridor (9/28), polyphagia (9/28), and signs of neurological disease (3/28). The most common clinicopathological abnormalities were hyperproteinemia (12/28), serum creatinine above the reference interval (RI) (10/28), and urinary specific gravity below the RI (9/28). Hypertrophic cardiomyopathy phenotype was identified in 8/17 cases. The most common comorbidity was chronic kidney disease (10/28). The median survival time after diagnosis was 24 months (range 1-103 months).

Hypersomatotropism can present without DM and should be considered in cats with signs suggestive of growth hormone excess or a pituitary tumor.

Hypophysectomy provides the most favorable long-term outcome for cats with hypersomatotropism (HST) and concurrent diabetes mellitus (DM).

Assess owner perceptions of quality of life (QoL) of their diabetic cats pre- and post-hypophysectomy for HST.

Client-owned cats (27 retrospectively, 13 prospectively).

Owners whose cats had undergone hypophysectomy between 2012 and 2022 for the management of HST with DM were identified. Owner telephone interviews were performed to formulate questions addressing points of view regarding HST and hypophysectomy. The DIAQoL-Pet questionnaire was adjusted to include newly formulated questions and distributed to owners. The questionnaire also was distributed to owners of cats with HST with DM pre-hypophysectomy (T0) and at least 3 months post-hypophysectomy (T1) between March 2023 and November 2024. Item-weighted impact score (IWIS) and an average-weighted impact score (AWIS) were calculated. The AWIS and IWIS at T0 and T1 for prospectively recruited cases were compared using the Wilcoxon signed rank test.

Nearly 92% (22 out of 24) of retrospective group respondents and 100% (10 out of 10) of prospective group respondents would definitely request hypophysectomy again. For paired prospective group responses, IWIS were significantly less negative postoperatively for "worry" (P = .02), "pet unwell" (P = .03), "worry hypoglycemia" (P = .01), and "worry vision" (P = .04). The median AWIS before (2.16; IQR, -4.23 to -1.17) and after (-1.27; IQR, -2.06 to -0.39) hypophysectomy were significantly less negative (P = .02).

Most owners perceive hypophysectomy to be a beneficial intervention for their QoL and that of their cat.

The FreeStyle Libre 3 (FSL3) continuous glucose monitoring system (CGMS) is accurate in diabetic people, and its smaller size could be advantageous in veterinary patients.

Assess the clinical and analytical accuracy, sensor lifespan, and frequency of complications of the FSL3 in diabetic cats.

Twenty client-owned diabetic cats.

Interstitial glucose concentrations (IG) measured using the FSL3 were compared to blood glucose concentrations (BG) measured using the AlphaTRAK2. Skin reactions at the application site and sensor lifespan were recorded. Spearman's correlation coefficient, Bland-Altman test, and Parkes error grid analysis (EGA) were used to evaluate correlation, bias, and clinical accuracy, respectively. Analytical accuracy was assessed using the mean absolute relative difference (MARD).

Median sensor lifespan was 11 days (range, 4-14). After sensor removal, 4 cats had a mild erythema at the application site. A total of 288 paired IG-BG measurements were recorded, the majority of which (279/288, 97%) were in the euglycemic (70-180 mg/dL) and hyperglycemic (>180 mg/dL) ranges. A strong positive correlation was observed between IG and BG readings (rs = 0.95; < 0.0001). Comparison of IG and BG measurements resulted in a MARD of 13.6% and an overall negative bias of -19.4 ± 46.0 mg/dL. Clinical accuracy was demonstrated, with 99.7% (287/288) of the results in zones A + B of the Parkes EGA.

FreeStyle Libre 3 provides clinically accurate measurements in the euglycemic and hyperglycemic ranges in diabetic cats. The smaller size of the FSL3 may improve adherence and long-term use of CGMS in diabetic cats.

Chat Generative Pre-trained Transformer's (ChatGPT) ability to generate client educational materials for use in practice is unknown.

To assess the educational quality of ChatGPT-generated client handouts for common internal medicine diseases. We hypothesized that ChatGPT can be used to efficiently generate easy-to-understand, accurate handouts for client education.

Small Animal Internal Medicine (SAIM) diplomates and pet owners were administered 2 separate electronic surveys.

Client handouts on diabetes mellitus (DM) and immune-mediated hemolytic anemia (IMHA) in dogs and inflammatory bowel disease (IBD) in cats were generated by using a standardized prompt in ChatGPT-3.5. Electronic surveys were distributed to both pet owners and American College of Veterinary Internal Medicine (ACVIM)-SAIM diplomates.

Pet owners (n = 50) reported a greater understanding of each disease process after reading the handouts for DM (Z = 5.865, P < .001), IMHA (Z = 5.953, P < .001), and IBD (Z = 5.508, P < .001). Median pet owner satisfaction scores (reported on a scale of 0 to 5, with 0 indicating poor satisfaction and 5 indicating maximal satisfaction) were 4 for DM, 4 for IMHA, and 5 for IBD. Many diplomates reported that they would use the handout on DM (n = 48/67; 71%), IBD (n = 47/62; 76%), and IMHA (n = 32/64; 50%) with either "minor" or "minimal to no" revisions.

Although some refinement is warranted, ChatGPT-3.5 was able to successfully generate client educational handouts for common internal medicine diseases.

This study aimed to identify the differences in the profile of mild cognitive impairment (MCI) among inpatients with type II diabetes mellitus (T2DM) by using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).

This hospital-based cross-sectional study included consecutive T2DM in patients who were admitted to the Endocrinology Department of Xiangya Hospital Affiliated with Central South University from July 1, 2022, to December 31, 2022. Demographic characteristics, lifestyle information, medical history, and clinical features were collected using a standard questionnaire via face-to-face interviews by well-trained investigators. MCI was defined as the early stage of cognitive decline, and measured by MMSE and MoCA with education-specific cutoffs. Multivariate logistic regression analyses were used to determine factors associated with MCI detected by MMSE or MoCA.

A total of 474 participants were included. The prevalence of MCI detected by MMSE and MoCA was 18.4% and 51.9%, respectively. The MMSE had fair agreement with the MoCA for detecting MCI (kappa value = 0.287), and the MMSE score correlated significantly with the MoCA score (r_s = 0.82, P < 0.001). Age and diabetic nephropathy were associated with MCI by both MMSE and MoCA. Regular physical activity was only associated with MCI by the MMSE, educational level, household income, and stroke were only associated with MCI by the MoCA.

The MoCA was more sensitive than the MMSE in screening for MCI among inpatients with T2DM, as it detected more MCI patients. However, cautious should apply since this might come at the cost of specificity, given the lack of a gold-standard diagnosis in this study. In addition to age, diabetic nephropathy, regular physical activity, educational level, household income, and stroke status were considered modifiable factors for MCI among inpatients with T2DM, which provides important evidence for establishing intervention measures.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to atherosclerotic cardiovascular disease (ASCVD). Markers of arterial stiffness and subclinical atherosclerosis (carotid-femoral pulse wave velocity [cfPWV], and carotid-intima media thickness [CIMT]) and endothelial dysfunction (flow-mediated dilation [FMD], nitroglycerine-induced dilation [NID]) are potential ASCVD predictors. This study examined the correlation between vasculopathy and MASLD in type 1 diabetes (T1D).

We conducted cross-sectional vascular assessments in non-smoking adults with T1D without ASCVD. MASLD was determined by ultrasound and transient elastography. FIB-4 was calculated as a marker of fibrosis. ASCVD risk scores were assessed using the Steno Type 1 Risk Engine. Subjects were included in a 2:1 control-to-case ratio and matched for age and diabetes duration.

We examined 105 subjects, of whom 30 had MASLD. Mean age was 51.7 ± 15.7 years, mean diabetes duration was 29.9 ± 14.3 years. 50% were male, mean HbA1c was 55.1 ± 9.5 mmol/mol (7.2 ± 0.9%). MASLD was associated with lower NID (15.3 ± 6.3 vs. 20.1 ± 7.5%, p = 0.003). NID and cfPWV were more often impaired in people with MASLD (53.3% vs. 28.4%, p = 0.018, 56.7% vs. 35.1%, p = 0.043, respectively). In adjusted multivariable logistic regression, MASLD was associated with increased cfPWV (OR 8.30, 95% CI 1.25-55.2, p = 0.029), as was age, sex and mean arterial pressure. cfPWV and CIMT strongly correlated with 5-year ASCVD risk (cfPWV ρ = 0.76, CIMT ρ = 0.81, p < 0.001), as did FIB-4 (ρ = 0.74, p < 0.001). CIMT (0.93), cfPWV (0.88) and FIB-4 (0.88) yielded the highest AUROC to identify significant ASCVD risk.

cfPWV is the most robust vascular marker associated with MASLD in people with T1D. cfPWV, CIMT and FIB-4 correlated strongly to incident 5-year ASCVD risk. Sven Francque, Hilde Heuten and Christophe De Block have claimed equal senior authorship.

Maternal nutrition during pregnancy critically influences fetal programming, shaping the offspring's lifelong health and disease susceptibility. Both undernutrition and overnutrition affect fetal metabolism, predisposing offspring to obesity and cardiometabolic disorders in adulthood. This review examines current evidence on how maternal nutrition, particularly overnutrition and its complications, such as gestational diabetes mellitus (GDM) and obesity, affects offspring health. It also explores the biochemical and epigenetic mechanisms underlying aberrant fetal programming induced by an unfavorable intrauterine environment. Excess nutrient exposure in utero alters fetal metabolic pathways by modifying the expression of key metabolic genes and nutrient sensors, increasing susceptibility to metabolic syndrome later in life. Maternal obesity has additionally been linked to cognitive dysfunction, immune alterations, and elevated cancer-related mortality in the offspring. GDM exposure disrupts fetal hypothalamic development, impairing appetite regulation. Emerging evidence suggests that epigenetic changes induced by maternal overnutrition may be transmitted across generations and that paternal obesity may also contribute to fetal metabolic programming. Although lifestyle interventions during pregnancy have been tested, they show limited long-term benefits, whereas pre-pregnancy BMI remains the strongest predictor of offspring obesity, emphasizing the critical role of preconception care and the prevention of overweight in women of reproductive age.