The flash glucose monitoring system (FGMS) has recently become one of the most common monitoring methods in dogs and cats with diabetes mellitus. The aim of this study was to evaluate the impact of FGMS on the quality of life of diabetic pet owners (DPOs). Fifty DPOs were asked to answer a 30-question survey. More than 80% of DPOs considered FGMS easier to use and less stressful and painful for the animal compared to blood glucose curves (BGCs). Overall, 92% of DPOs reported that their pet had better diabetes control since using FGMS. The most challenging aspects of using the FGMS were ensuring proper sensor fixation during the wearing period (47%), preventing premature detachment (40%), and purchasing the sensor (34%). Moreover, 36% of DPOs reported that the device cost was difficult to afford in the long term. Comparing dogs and cats, a significantly higher number of dogs’ owners found the FGMS to be well-tolerated (79% vs. 40%), less invasive than BGCs (79% vs. 43%), and easier to maintain in situ (76% vs. 43%). In conclusion, FGMS is considered by DPOs to be easy to use and less stressful compared to BGCs, while enabling better glycemic control. Nevertheless, the costs related to its long-term use might be difficult to sustain.

A flash glucose monitoring system (FGMS) has been validated for use in diabetic dogs. However, it is unknown whether skin thickness affects FGMS measurements. The aim of this study was to evaluate whether FGMS accuracy is affected by skin thickness. Fourteen client-owned diabetic dogs on insulin treatment were prospectively enrolled in the study. The dogs were divided into two groups according to their ultrasound-measured skin thickness: dogs with skin thickness < 5 mm (Group 1) and dogs with skin thickness > 5 mm (Group 2). On days 1, 7 and 14, glucose curves were obtained simultaneously using the FGMS and a validated portable blood glucose meter. Paired measurements were used to calculate the mean bias and to determine accuracy according to ISO 15197:2013 criteria. The mean bias was significantly inversely correlated (p = 0.02; r = −0.6) with the mean skin thickness. Clinical accuracy was observed only in Group 2, with 99% of the results in zone A + B of the Parkes consensus error grid analysis. In conclusion, skin thickness seems to affect FGMS measurements, and the device is accurate in dogs with thicker skin (>5 mm); in dogs with thin skin (<5 mm), the clinical accuracy is low, and the results should be interpreted with caution.

Background: In dogs, duration of hypothalamic-pituitary-adrenal (HPA) axis suppression after systemic glucocorticoid treatment is reported to vary from a few days to up to 7 weeks after glucocorticoid discontinuation. These data are derived mainly from experimental studies in healthy dogs and not from animals with spontaneous disease. Hypothesis and Objective: To determine the timeline for recovery of the HPA axis in a group of ill dogs treated with intermediate-acting glucocorticoids (IAGCs). Animals: Twenty client-owned dogs that received IAGC for at least 1 week. Methods: Single-center prospective observational study. An ACTH stimulation test, endogenous ACTH concentration, serum biochemistry profile, and urinalysis were performed at T0 (2-6 days after IAGC discontinuation) and then every 2 weeks (eg, T1, T2, T3) until HPA axis recovery was documented (post-ACTH cortisol concentration > 6 μg/dL). Results: The median time of HPA axis recovery was 3 days (range, 2-133 days). Eleven of 20 dogs showed recovery of the HPA axis at T0, 6/20 at T1, and 1 dog each at T2, T5, and T9. Dose and duration of treatment were not correlated with timing of HPA axis recovery. Activities of ALT and ALP were significantly correlated with the post-ACTH cortisol concentration (rs = −0.34, P = .03; rs = −0.31, P = .05). Endogenous ACTH concentration was significantly correlated with pre (r = 0.72; P < .0001) and post-ACTH cortisol concentrations (r = 0.35; P = .02). The timing of HPA axis recovery of the dogs undergoing an alternate-day tapering dose was not different compared to dogs that did not (3.5 vs 3 days, P = .89). Conclusion and Clinical Importance: Most dogs experienced HPA axis recovery within a few days after IAGC discontinuation. However, 2/20 dogs required >8 weeks.

Background: Dogs with eunatremic, eukalemic hypoadrenocorticism (EEH) typically show signs of chronic gastrointestinal disease (CGD). Previous glucocorticoid administration (PGA) can give false-positive results on the ACTH stimulation test (ACTHst). Hypothesis/Objectives: To determine the prevalence of EEH in dogs with signs of CGD, and to identify clinical and clinicopathological features for EEH and PGA. Animals: One hundred twelve dogs with CGD (101 non-PGA and 11 PGA), 20 dogs with EEH. Methods: Multicenter prospective cohort study. Basal serum cortisol (BSC) concentration was measured in dogs with signs of CGD. When BSC was <2 μg/dL and in PGA dogs, ACTHst plus measurement of endogenous ACTH (eACTH) were performed. Records of dogs with EEH from 2009 to 2021 were reviewed. Results: The BSC concentration was 1250 pg/mL) than in non-PGA dogs (13.5, 7.3-46.6 pg/mL). Cortisol-to-ACTH ratio was lower (P < .0001 and P = .01, respectively) in EEH (0.002, 0.0002-0.2) than in non-PGA (0.1, 0.02-0.2) and PGA dogs (0.1, 0.02-0.2). Conclusions and Clinical Importance: The prevalence of EEH in dogs with signs of CGD was lower than previously reported. The clinical and clinicopathological features herein identified could increase the index of suspicion for EEH or PGA in dogs with an unclear history of glucocorticoid administration.

The novel Eversense XL continuous glucose monitoring system (Senseonics, Inc., Germantown, Maryland) has recently been developed for monitoring diabetes in humans. The sensor is fully implanted and has a functional life of up to 180 days. The present study describes the use of Eversense XL in three diabetic dogs (DD) with good glycemic control managed by motivated owners. The insertion and use of the device were straightforward and well tolerated by the dogs. During the wearing period, some device-related drawbacks, such as sensor dislocation and daily calibrations, were reported. A good correlation between the glucose values measured by the Eversense XL and those obtained with two commercially available devices, previously validated for use in DD, was found (r_s = 0.85 and r_s = 0.81, respectively). The life of the sensor was 180 days in two of the DD and provided high satisfaction. This innovative device might be considered a future alternative for home glucose monitoring in DD.