More common than in horses and cattle. Causes: pampered in diet,
sweets, liver, disease of pituitary body, or mostly of the liver.
Removal of pancreas. Brain and nervous lesions and reflex action.
Symptoms: pampered asthmatic subject, with dysuria and lameness,
dense, saccharine urine, bulimia, loss of weight, corneal ulcers,
cataracts, palsy, coma. Duration: 4 to 8 months, sugar may disappear
with complete liver degeneration. Diagnosis: by pampered condition,
asthma, thirst, diuresis, later by loss of weight, troubles of vision,
saccharine urine. Lesions: usually hypertrophied, fatty or caseated
liver, thickened capsule, disease of thyroid, heart and eye.
Treatment: skim or butter milk as sole diet, restricted diet of lean
meat clear of fat, warmth, dryness, pure air, sunshine, gentle
exercise only, cholagogues, sodium sulphate, or chloride, or
carbonate, or salicylate, salol, nitro-muriatic acid, antithermics,
ergot, codeine, bitters, mineral acids, derivatives.
Among domestic animals the dog has furnished the greatest number of
cases, yet even in this animal the disease appears to be far from
common.
_Causes._ The relative frequency of diabetes in the dog is probably
dependent on his life in human dwellings and on gourmandizing on dishes
prepared for man. Friedberger and Fröhner have produced the disease
artificially by feeding a great quantity of sugar and W. Williams has
met the disease in dogs fed exclusively and generously on liver.
Thiernesse records one case complicated by atrophy and steatosis of the
pituitary body, but in all other instances the appreciable lesions were
confined to the liver. In one case, reported by St. Cyr, the liver was
hypertrophied, yellow, mottled, marked by irregular elevations of
congested and hypertrophied hepatic tissue, and showing extensive
degeneration—mucous, caseous and fatty. Thiernesse found the liver of a
yellowish white color, and the seat of fatty degeneration implicating
the hepatic cells. Franzenberg in one case found fatty degeneration of
the liver, and Fröhner and Schindelki, in four cases, met with extensive
hepatic disease. The macroscopic lesions of the disease in dogs as in
horses appear to be mainly hepatic.
On the other hand the complete removal of the pancreas in the dog by
Mering, Minkowski, Thiroloix, Lancereaux and others was invariably
followed by mellituria, so that even in the absence of clinical
examples, we must recognize pancreatic lesions and functional disorders
as possible primary causative factors in glycosuria. In the light of
experimental medicine we must similarly recognize brain and nervous
lesions and reflex actions as possible causes, even if as yet
unsupported by clinical facts observed in the dog.
_Symptoms._ The disease usually appears in an old, fat, pampered dog,
affected with dyspnœa or asthma, with dysuria and lameness. The urine is
high colored, viscid, and of a high density (1055 to 1060, the normal
canine urine being about 1020), and charged with glucose. The subject
may have an enormous appetite but fails to gain in weight, and after a
time loses flesh and becomes badly emaciated. The pulse is small and
frequent, and the temperature which at the outset may reach 102°, falls
to the normal as the end approaches. Watering eyes, corneal ulcers, and
cataracts as well as hemiplegia and diabetic coma may precede death. The
amount of sugar has been found to vary in different cases from 3.2 to 12
per cent. of the urine.
_Course._ _Duration._ The dog may live from four to eight months and, as
in the horse, sugar may finally entirely disappear from the urine, in
connection with the progressive degeneration of the liver. If the
patient is unable to take exercise, the case reaches a more speedily
fatal issue.
_Diagnosis_ is deduced from the bulimia, pampered condition,
breathlessness, thirst, and diuresis, the subsequent loss of condition,
ocular troubles, and dropsy or coma, the whole being confirmed by the
dense, high colored, viscous, saccharine urine.
_Lesions._ As already noticed the most constant lesion is hypertrophy of
the liver, which is swollen unevenly, has thickened borders, is yellow
or red, very friable and often fatty, or caseated. The capsule of
Glisson is thickened and fibrous. Hypertrophy and fatty degeneration of
the thyroid have been found in different cases and in one instance
insufficiency of the mitral valve with systemic venous congestion.
Ocular troubles are constant.
_Treatment._ Put the patient on an exclusive diet of skim or butter milk
or if this is impossible it may be conjoined with lean meat—raw or
cooked—keep warm and dry, but give plenty of open air and sunshine.
Avoid fatigue and over exertion. Restricted diet is of great importance.
During the siege of Paris the short rations led to the disappearance of
glycosuria from many human patients.
Among medicinal agents, cholagogues come first, sulphate of soda with
chloride of sodium, bicarbonate of soda, salicylate of soda, salol,
nitro-muriatic acid, may be named. For the febrile condition,
antipyrine, acetanilid, or phenacetin may be employed, and iodoform,
ergot or codeine may be tried when other measures fail. Bitter tonics
and mineral acids may be beneficial, and lastly blisters to the region
of the liver may prove of service.