LONG-TERM COMPLICATIONS OF DIABETES-MELLITUS .1. RETINOPATHY, NEPHROPATHY, NEUROPATHY

The late complications of diabetes mellitus are a significant cause of morbidity and mortality in the human diabetic population. Yet, diabet ic retinopathy, nephropathy, and neuropathy are uncommon in dogs and c ats with diabetes. The main explanation for this is the time elapsed b efore clinical manifestations of these syndromes are recognized, which usually occurs many years after the onset of the diabetic state. In f act, the main risk factor shared by these three complications in the h uman population is the duration of diabetes.(58) Small animals, especi ally the dog, have a relatively short life span (2-5 years) after the diagnosis of diabetes(25); this can be attributed to the shorter life span of domestic animals in general when compared with humans and the limitations present in veterinary medicine with respect to control of the hyperglycemic state. These factors put small animals at a lesser r isk for developing late complications of diabetes. However infrequent, late complications have been reported in dogs and cats with both spon taneous and experimentally induced diabetes. As advances in veterinary medicine are made regarding the management of diabetes and diabetic a nimals consequently live longer, it is possible that late complication s of diabetes will become more common. Accurate diagnosis will depend partly on the practitioners knowledge of these syndromes. This article discusses the pathogenesis of the late complications in general, and then discusses retinopathy, nephropathy, and neuropathy in greater det ail with respect to what is known about the syndromes in veterinary me dicine, comparisons to their human counterpart, etiology, and treatmen t.