Key result
Fenofibrate, insulin CRI, and TPE normalize severe hypertriglyceridemia in a diabetic dog within 2 days.
Why the study?
Severe hypertriglyceridemia in juvenile diabetic dogs lacks documented multimodal treatment protocols including fenofibrate, insulin CRI, and manual TPE.
Does multimodal treatment including fenofibrate, insulin CRI, and manual TPE normalize severe hypertriglyceridemia in a diabetic dog?
Case Report (n=1)
Does multimodal treatment including fenofibrate, insulin CRI, and manual TPE normalize severe hypertriglyceridemia in a diabetic dog?
A multimodal treatment protocol including fenofibrate, insulin CRI, and manual TPE successfully normalized extreme hypertriglyceridemia in a juvenile diabetic dog.
May support multimodal therapy for severe hypertriglyceridemia in diabetic dogs; hypothesis-generating and requires prospective trials before practice change.
OBJECTIVE: To describe the therapeutic protocol used to normalize severe hypertriglyceridemia in a dog. CASE SUMMARY: A 7-month-old, 1.2-kg female Pomeranian presented with acute polyuria, polydipsia, and ocular discoloration. Diagnoses included diabetic ketosis, severe hypertriglyceridemia (>225 mmol/L [>20,000 mg/dl]), lipemia retinalis, and bilateral uveitis. The triglyceride concentration was near normal within 2 days of initiating treatment with fenofibrate, regular insulin constant rate infusion (CRI), manual therapeutic plasma exchange (TPE), and a low-fat diet. All clinical signs resolved. The dog has had no relapse of hypertriglyceridemia at the time of writing the manuscript, 6 months later, with continued treatment of diabetes mellitus. NEW OR UNIQUE INFORMATION PROVIDED: This is the first case report documenting the combination of fenofibrate, insulin CRI, and manual TPE for treatment of severe hyperlipidemia in a dog. Detailed protocols for manual TPE and a novel insulin CRI are provided. A discussion of multiple spurious biochemical and hematologic errors associated with the severe hypertriglyceridemia is also provided.
No takes yet. Share an insight, caveat, or question.
Guarino et al. (2022) conducted a case report in Diabetic ketosis and severe hypertriglyceridemia (n=1). Fenofibrate, regular insulin constant rate infusion (CRI), manual therapeutic plasma exchange (TPE), and a low-fat diet was evaluated on Triglyceride concentration normalization and resolution of clinical signs. A multimodal treatment including fenofibrate, insulin CRI, manual TPE, and a low-fat diet normalized severe hypertriglyceridemia (>20,000 mg/dl) in a diabetic dog within 2 days.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: