Diabète insipide : étude rétrospective des cas vus au ChuvA entre 2003 et 2022 et tentative de validation du dosage de la copeptine afin d'évaluer son intérêt dans l'exploitation d'une polyuro-polydipsie
Year: 2023
Type: dissertation
Abstract: Diabetes insipidus (DI) refers to a syndrome resulting from a deficiency in the sécrétion of antidiuretic hormone (ADH) or a failure of ADH action on its receptors located in the nephrons. This is respectively referred to as central diabetes insipidus (CDI) and nephrogenic diabetes insipidus (NDI). As a result, there is an inability to concentrate urine, excessive production of diluted urine, and increased thirst. In the first part, this work provides a synthesis of veterinary data on DI and a brief comparison with knowledge in human medicine. Few retrospective studies are available in veterinary medicine. Therefore, a second part will focus on a descriptive retrospective study of ten dogs and eight cats presented for consultation at the Veterinary Teaching Hospital of Alfort (CHUVA) between 2003 and 2022. The inclusion of dogs and cats in this study was based on the diagnosis of DI using a water deprivation test (WDT) or a therapeutic trial test. The objective of this part was to support veterinary data on DI and to study the evolution of diagnostic modalities for DI at CHUVA over the past twenty years. The results regarding the epidemiology and clinical and paraclinical presentation are consistent with established knowledge in veterinary medicine. Additionally, this part highlights a gradual abandonment of the WDT in favor of the therapeutic trial test. The tests required for the diagnosis of DI involve subjecting the animal to dehydration. Therefore, these tests are ethically questionable, potentially dangerous, time-consuming, and their interpretation can be difficult. These limitations are well documented in human medicine. That is why a diagnostic alternative is now commonly used: measuring copeptin, a fragment of the ADH precursor. Only one veterinary study mentions it but does not use it in the context of DI. The third part of this work is a prospective study aimed at validating one of the two available copeptin measurement kits in veterinary medicine, to investigate its usefulness in the diagnosis of DI. The linearity test conducted was not satisfactory, and as a result, this kit did not meet the necessary conditions for its utilisation. Further similar studies are needed to validate the other measurement kit. Furthermore, this part compares the ability of WDT and the hypertonic infusion test to induce ADH secretion in healthy dogs. The hypertonic infusion appears more promising in this regard, although it requires confirmation in animals with DI.
Source: HAL
Author: Regnard, Rémi
Language: English
Subfield: Small Animals
Field: Veterinary
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7018460298