Juvenile diabetes mellitus with exocrine pancreatic insufficiency in a Thai Bangkaew dog: a case report

Abstract

An 8-month-old intact male Thai Bangkaew bred dog presented with polyuria, polydipsia, polyphagia, exercise
intolerance and weight loss over 2 weeks. The serum biochemistry profiles revealed hyperglycemia, glycosuria and
high serum fructosamine concentrations indicating the development of diabetes mellitus. The dog had a good response
to a half-dose of intermediate-insulin injection twice daily monitored by the improvement of clinical signs and serum
fructosamine. This was supposed to be due to the partial destruction of islets of Langerhans. Two months later,
voluminous diarrhea with greasy stools, dry coat hair and generalized alopecia were observed. However, the clinical
signs of diabetes mellitus, such as polyuria and polydipsia were not noticed. The levels of canine-trypsin-like immunereactivity and cobalamin were below the normal range. This suggested exocrine pancreas loss of function. To determine
the etiology, serum insulin was measured revealing a very low level. On the other hand, serum canine pancreas-specific
lipase and C-reactive protein were in the normal range. Using ultrasonography, immune-mediated pancreatic fibrosis
was suspected while pancreatitis was a lesser possibility. Successful treatment was achieved with a combination of lowdose insulin, pancreatic enzymes and methylcobalamin promoting weight gain and exercise tolerance. This case was a
report of juvenile diabetes mellitus concurrent with exocrine pancreatic insufficiency in a Thai Bangkaew dog, which
had not been well recognized. Additional to the Thai Bangkaew breed, this report might be an important piece of
scientific knowledge that might be of potential hereditability and economic importance in the future.