Diabetic nephropathy, obesity, arterial stiffness, inappropriate activation of the renin–angiotensin–aldosterone system and sympathetic nervous system, mitochondrial dysfunction and oxidative stress leading to increased intracellular reactive oxygen species that worsen arterial stiffness, and proinflammatory systemic and cardiovascular cytokines have all been implicated in the pathophysiology of SH in DM in humans.11 Currently there are no data to suggest that DM is a risk for SH in cats. The gene discussed is REN; the disease is obesity due to melanocortin 4 receptor deficiency.