This case demonstrates remission of type III diabetes mellitus in a cat with hepatocellular carcinoma, suggesting potential for reversal of insulin resistance.
Diabetes mellitus (DM) is an endocrinopathy characterized by inefficient insulin secretion or action. In cats, DM may be classified as type I, type II, or type III (secondary). Feline DM has an estimated prevalence of 0.2–1% in veterinary hospitals, and most cases present as type II; however, type III DM can occur secondary to extrapancreatic disorders such as hepatic neoplasia, chronic pancreatitis, and acromegaly. Hepatocellular carcinoma (HCC) is uncommon in cats, but when resectable it can confer prolonged survival and, in selected situations, allow diabetes remission due to reversal of insulin resistance after removal of the inflammatory/obstructive focus. We report a case of remission of type III DM in a cat with pancreatitis secondary to compression by a hepatic mass. A 13-year-old mixed-breed male cat presented with prostration. Diagnostic testing revealed hyperglycemia (575 mg/dL). Insulin therapy was instituted, achieving partial glycemic control. Imaging demonstrated a mass in the right cranioventral region overlying the hepatic parenchyma. An exploratory celiotomy identified a 5.40 × 4.07 cm mass in the right hepatic lobe compressing the pancreas. A partial lobectomy was performed, and the specimen was submitted for histopathology, which confirmed well-differentiated trabecular hepatocellular carcinoma. After stabilization, insulin therapy was discontinued and remission of DM was observed.
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Hessel et al. (2025) studied this question.
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