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Ketoacidosis Starvation

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Ketoacidosis During A Low-carbohydrate Diet

To the Editor: It is believed that low-carbohydrate diets work best in reducing weight when producing ketosis.1 We report on a 51-year-old white woman who does not have diabetes but had ketoacidosis while consuming a “no-carbohydrate” diet. There was no family history of diabetes, and she was not currently taking any medications. While adhering to a regimen of carbohydrate restriction, she reached a stable weight of 59.1 kg, a decrease from 72.7 kg. After several months of stable weight, she was admitted to the hospital four times with vomiting but without abdominal pain. On each occasion, she reported no alcohol use. Her body-mass index (the weight in kilograms divided by the square of the height in meters) was 26.7 before the weight loss and 21.7 afterward. Laboratory evaluation showed anion-gap acidosis, ketonuria, and elevated plasma glucose concentrations on three of the four occasions (Table 1). She had normal concentrations of plasma lactate and glycosylated hemoglobin. Screening for drugs, including ethyl alcohol and ethylene glycol, was negative. Abdominal ultrasonography showed hepatic steatosis. On each occasion, the patient recovered after administration of intraven Continue reading >>

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Popular Questions

  1. StockDogLovr

    HELP - Emergency! Grain overload!

    I bought a 70 lb. bag of barley to supplement my new moms and moms to be. I had fed out maybe 10 lb. of that bag so far. This morning, my friend's kid let the sheep out of lock up for me. There is a side gate that goes to the feed storage barn, and he went into the barn to get hay out for them. He did not close the gate latch properly. This evening, when I arrived to lock everyone in, I found the gate wide open, and my entire herd except for one mom and her lamb were in the feed room. They had made a mess of the hay, and had binged on the barley such that there was maybe 15-20 lb left, so around 40 lb. This was shared among 12 adults (Barbs, a Kat ram, and some Kat/Barb crosses. So, each potentially ate 3.75 lb. Of course, I can't know who might have eaten more of it or less. It was raining when I arrived, and the one ewe with her lamb that was in the pasture had probably had her fill, and I worry that she was feeling punky which is why she was away from the rest.
    All I could think to do for the moment was drench everyone with bloat drench (for foamy bloat). I had this happen once before where the sheep ended up scouring but were otherwise fine, but I did lose one old ewe two days later and I now think this may have been from the bacteria toxin from over-eating. These sheep have had their CD/T; the new moms were revaccinated just a couple of weeks before they delivered.
    What more can I do? I have vitamin B injectable which I've heard can help mitigate the consumption of the body's B vitamins when the bacteria over-grows. I've also heard of giving penicillin injectible by mouth to kill the bacteria that produces the toxin that is so deadly. Should I go ahead and give these things tomorrow morning whether or not there are signs of illness. Everything I read says when they are really sick from this it is too late. But what can I do to mitigate their overeating before they get sick? I've also been told that milk of magnesia would be useful.
    Help!

  2. Bearfootfarm

    I'd just keep a close eye on them and only treat any that show signs of bloating.
    Throwing a lot of medications at them can cause problems too.
    If you HAVE to treat any, I'd give them vegetable oil and baking soda for bloat and acidosis.
    NO food other than hay until you see how their stools look

  3. StockDogLovr

    Thanks, Bearfootfarm - I just panicked because I knew they'd be going overnight without observation since I don't live where they are.
    I did have a similar thing happen once before, where the flock got into grain and alfalfa pellets, and everyone scoured but they were okay otherwise....except for one old ewe who died two days later. I didn't recognize that she was having any problems, and maybe she died coincidentally, but I worry that she died from the clostridium bacteria toxins...
    I will check everyone tomorrow AM. My friend's goats help themselves to baking soda free-fed, but will sheep do the same if offered baking soda? I've never provided it before.

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