Mable was very placid but she still required light general anaesthesia to aid the examination . She was placed in an induction chamber with isoflurane at 3 – 5 % for induction , which was dropped to 0.5 – 3 % and maintained with a tight-fitting mask . Normal inhouse biochemistry blood tests were undertaken to gain an overall picture of Mable ' s health and to rule out a urinary tract infection , which is another condition that can affect African pygmy hedgehogs .
Testing
To obtain urine for analysis in the practice , a free-catch sample is advised , if possible , as it is less invasive than other methods . Alternatively , for less cooperative African pygmy hedgehogs , manual expression of the bladder can be performed if their temperament allows , but caution is advised as their bladders are extremely delicate and at high risk of perforation . A urinary catheter can be passed under general anaesthesia or a cystocentesis performed . When analysing urine , particular attention should be paid to the levels of glucose and ketones , as these will provide a good indication of whether a urinary tract infection or DM is likely to be the diagnosis .
With this species , blood samples are usually taken under general anaesthesia . The jugular vein is used for larger volumes , and the cephalic , lateral saphenous or femoral veins are used for smaller volumes . A short , small-gauge ( 25G or 27G ) needle on a 1 ml or 2.5 ml syringe , is the
Table 2 . Mable ' s results , compared with the normal parameters for African pygmy hedgehogs . ALP = alkaline phosphatase ; ALT = alanine aminotransferase .
Mable ' s blood test results
Reference range for the African pygmy hedgehog
Sodium 138 mmol / l 131 – 159 mmol / l Potassium 4.07 mmol / l 3.50 – 6.70 mmol / l
Total protein
67.6 g / l 40.0 – 73.0 g / l
Albumin 30.8 g / l 14.0 – 43.0 g / l
Total globulin
36.8 g / l 15.0 – 47.0 g / l
Urea 8.6 mmol / l 4.1 – 18.4 mmol / l Creatinine 23 µ mol / l 7 – 71 µ mol / l Calcium 2.43 mmol / l 1.60 – 2.96 mmol / l Phosphate 1.69 mmol / l 0.89 – 3.30 mmol / l Cholesterol 4.6 mmol / l 2.1 – 6.3 mmol / l ALT 100 U / l @ 37 ° C 22 – 139 U / l @ 37 ° C ALP 40 U / l @ 37 ° C 9 – 95 U / l @ 37 ° C Glucose 18.0 mmol / l 0.7 – 7.6 mmol / l preferred size for this species [ 6 ] . Normal blood glucose levels in a healthy non-diabetic African pygmy hedgehog range from 4.0 to 6.5 mmol / l [ 7 ] . Normal urine parameters are based on those in dogs , cats and ferrets , due to the lack of well-documented veterinary findings for this species . Mable ' s results ( Table 2 ) showed a blood glucose range of 1 mmol / l to 40 mmol / l , so close monitoring of her blood glucose was advised .
Treatment / management
Insulin treatment
It was decided , in discussion with the VS , to trial the use of Caninsulin to manage Mable ' s DM . The VS advised beginning with a low dose and monitoring her closely . The starting dose was 0.5 iu BID , given 30 min after meals . Injections were administered subcutaneously , by pinching Mable ' s quills and gently pulling them up dorsally to reveal an area of skin between her quills that could be easily injected into . In Mable , the best injection site was the cranial midline area . Her skin was sensitive in more lateral areas , causing an increased reaction to injections in these sites .
Mable had a good temperament , so blood glucose curves could be performed successfully at home with paw pricks and an AlphaTrak 2 blood glucometer , which was configured on a feline setting . Mable ' s blood glucose was checked every 1 – 2 hours by taking a conscious sample from her paw pad . ( A sample could also be obtained via an ear prick , but the author had more success using a paw .) It would not be possible to test at home with a more aggressive African pygmy hedgehog or if blood samples for fructosamine assay were required .
Caninsulin 0.5 iu BID lowered Mable ' s blood glucose from 18.8 mmol / l to 4.6 mmol / l . ( At its highest , her blood glucose levels could reach up to 40.0 mmol / l ). She was best maintained at around 5 – 6 mmol / l , which was when her clinical signs were nearest to normal ; below this , she presented with ataxia , disorientation and lethargy . Mable was diagnosed with DM at around 8 months old and it was successfully managed with twice-daily injections until the end of her life at 5 years old .
Diet and weight management
Diet also played a role in the management of Mable ' s DM , as it does with canine or feline patients . Mable was fed normal cat food twice daily at the same time as her injections . In another case of an African pygmy hedgehog with DM ( in the USA ), the condition was well managed through diet alone . In that case , the patient displayed signs of polydipsia and polyuria , which prompted a visit to a VS . Once DM was diagnosed , the VS recommended Hill ' s Prescription Diet w / d ( for diabetic cats ) [ 5 ] , which controlled the patient ' s clinical signs from the diagnosis at around 1 year old until the end of her life at 4 years old .
34 Veterinary Nursing Journal