Page 6 - Clinical Connections - Autumn 2019

RVC RESEARCH STUDY VETERINARY SERVICES RVC.AC.UK
The RVC’s Diabetes Research Journey
Lucy Davison, Professor of Veterinary Clinical Genetics and MRC Clinician Scientist Fellow, outlines contributions
Vets, nurses and researchers at the RVC have devoted the last 20 years (see timeline below) to improving our understanding of the pathogenesis of canine and feline diabetes mellitus, as well as searching for improvements in the way these conditions are managed.
Diabetes in dogs usually occurs as a result of destruction of insulin-producing pancreatic beta cells, meaning that dogs require insulin injections to survive. In cats, the situation is different, and in some ways is more similar to human type 2 diabetes, where bodyweight and diet play a significant role. Sometimes a change in diet and weight loss is enough to reverse the disease, but many cats still require insulin.
Hypersomatotropism in cats, where the pituitary gland in the brain produces too much growth hormone, can also lead to diabetes.The diagnosis and surgical management of this condition has been pioneered at the RVC.
In addition to clinical and genetics
research at the RVC, our understanding of canine and feline diabetes has benefitted from the RVC’s VetCompass project, especially in improving our understanding of risk factors associated with diabetes.
As well as offering medical and surgical expertise in diabetes management at RVC Small Animal Referrals and the Beaumont Sainsbury Animal Hospital, the RVC is now using the latest technologies in genomics to advance healthcare in pets.
Until very recently, genetic analysis of
the entire DNA code of an animal (whole genome sequencing) was out of reach for veterinary researchers due to very high
costs involved. With the development of new sequencing technologies and ‘big data’ analysis tools, however, things have changed. The whole genome of a patient can now be sequenced for under £1,500. Researchers can identify the smallest variants in dog and cat genomes and determine which of these may be contributing to disease.
The 20-year collection of clinical diabetes
samples and data from patients has allowed researchers at the RVC to take advantage of new technologies to answer questions that have been puzzling them for years, such as: • Why do so many Samoyeds become
diabetic?
• Why do we never see diabetes in boxers? • Why do the breeds which are protected
from diabetes sometimes develop
pancreatic tumours (insulinoma)?
• Why are Burmese cats more likely to get
diabetes than other cats?
• Why are some breeds, such as the
Labrador retriever, predisposed to developing diabetes at less than six months of age?
Using funding from a range of sources, including the PetPlan Charitable Trust,
the MRC, the ECVIM-CA Clinical
Studies Fund,The Samoyed Association, The Burmese Cat Club and BSAVA PetSavers, and with the support of industrial partner Dechra Veterinary Products, RVC researchers are beginning to discover the
2006
The first paper describing genetic susceptibility to diabetes in dogs is published, using samples from the RVC archive, in collaboration with the University of Manchester
2014
A paper is pub- lished by RVC researchers out- lining the utility of the IGF-1 ELISA in diagnosis of hy- persomatotropism in diabetic cats, as well as a study of diagnostic imaging findings in hyper- somatotropism
2004
A landmark paper on IGF-1 in diabetic cats is published by the RVC, laying the foundations for future work in hyperso- matotropism (acromegaly)
2000
The UK Canine Diabetes Register and Archive is established at the RVC, and is still running – see: http://rvc.uk.com/ caninediabetesre- search
2008
The RVC publishes a paper describing the immune response to different types of insulin in diabetic dogs
2012
The first surgical hypophysectomy is performed on a diabetic cat with hypersoma- totropism at RVC Small Animal Referrals
2010
A Quality-of-Life tool for diabetic patients and their owners is developed and published by RVC researchers
2000 2003 2004 2005 2006 2007 2008 2010 2012 2013
2003
The RVC publishes the first paper to demonstrate clinical use of continuous glucose monitoring in canine diabetic patients
2005
In collaboration with the University of Cambridge, the RVC publishes a paper describing breed predispositions to diabetes in dogs and the epidemiology of the condition in UK practice
2007
Feline acromegaly is increasingly recognised as a cause of diabetes in cats, highlighted by an RVC publication
2008
The RVC publishes the first evidence for the presence of autoantibodies in canine diabetes mellitus
2012
In collaboration with the Universi- ty of Newcastle, a proof-of-prin- ciple study
is published, demonstrat- ing that gene therapy may be feasible in canine diabetes
2013
The RVC publishes further genetic evidence for the role of the immune system in canine diabetes
6 Autumn 2019