Miguel Campos

Companion animal endocrinology has benefited from international standardisation of disease terminology for diabetes mellitus, Cushing’s syndrome, and hypoadrenocorticism through Project Agreeing Language in Veterinary Endocrinology (ALIVE). A group of 14 experts and one chair convened for the third cycle of Project ALIVE, focusing on thyroid disease terminology. The cycle employed the modified Delphi approach from previous cycles, augmented by procedural refinements—such as inclusion of an off-site chair and stricter adherence to timelines —to improve efficiency and flexibility. Novel in this round was the integration of feedback from a previous cycle, which resulted in updated definitions for diabetes mellitus originally developed in ALIVE Cycle 1. Outcomes: A 100% consensus was achieved among panellists and 91.4–100% among 105 members of international veterinary endocrinology societies (32% of total memberships) over 78 thyroid-related terminology items and five revised definitions pertaining to diabetes mellitus. These standardised definitions are expected to facilitate clearer communication and education, enhance diagnostic consistency, support research comparability, and improve clinical care in feline and canine endocrine diseases.

Cats with diabetic ketosis or ketoacidosis DK(A) require intensive glucose monitoring. The aim of this study was to assess the agreement between a portable blood glucose meter (PBGM) and a flash glucose monitoring system (FGMS; FreeStyle Libre 2.0 Abbott^®) measuring interstitial glucose in cats with DK(A). Ten client-owned cats with naturally occurring DK(A) were prospectively enrolled. Glucose concentrations were assessed with both methods every 1–3 h until resolution of DK(A), and every 4–8 h thereafter. While the median FGMS measured glucose concentration (14.3 mmol/L) was significantly lower than the median PBGM measured glucose concentration (19 mmol/L) (p < 0.001), the overall correlation between the FGMS and PBGM was high (r = 0.88; p < 0.001). In the Parkes error grid analysis, 98.3% of measurements fell in zones A and B. Bland–Altman plot analysis demonstrated that in the low glycaemic range (BG < 5.5 mmol/L), 50% of FGMS measurements deviated more than ±0.83 mmol/L, and in the high glycaemic range (BG > 5.5 mmol/L), 81% of results deviated >15% from the PBGM measurements. There was significant inter-individual variation in the difference between glucose concentrations measured by the FGMS and PBGM (p < 0.001). In spite of being more easily tolerated and easier to use, currently this method cannot be recommended for routine monitoring of cats with DK(A).