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What Is The Significance Of Vomiting In A Child Who Has Dka

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Urine Tests For Diabetes: Glucose Levels And Ketones

The human body primarily runs on glucose. When your body is low on glucose, or if you have diabetes and don’t have enough insulin to help your cells absorb the glucose, your body starts breaking down fats for energy. Ketones (chemically known as ketone bodies) are byproducts of the breakdown of fatty acids. The breakdown of fat for fuel and the creation of ketones is a normal process for everyone. In a person without diabetes, insulin, glucagon, and other hormones prevent ketone levels in the blood from getting too high. However, people with diabetes are at risk for ketone buildup in their blood. If left untreated, people with type 1 diabetes are at risk for developing a condition called diabetic ketoacidosis (DKA). While rare, it’s possible for people with type 2 diabetes to experience DKA in certain circumstances as well. If you have diabetes, you need to be especially aware of the symptoms that having too many ketones in your body can cause. These include: If you don’t get treatment, the symptoms can progress to: a fruity breath odor stomach pain trouble breathing You should always seek immediate medical attention if your ketone levels are high. Testing your blood or urine Continue reading >>

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  1. ClarkSavageJr

    ketogenic diets food for thought

    It seems to me that with seizure rates being 6% of the population of dogs, favoring the hunting and work breeds, perhaps we are missing some fundamental metabolic issues. This large % does not to me imply genetics. Those % are generally much lower and constant. I don't think that is what we are seeing here. We are seeing a gradual increase in incidences over time. That is not genetics and if it is, it is a recessive manifestation from a norm and that is simply not probable.
    I have an interest in African hunting dogs. They do not eat any vegetables only meat from kills. While the species is of course somewhat different having only four toes, they are essentially the essence of dog species globally. They are not noted for large epileptic numbers.
    The ketogenic diet is often used in refractory cases of human children. Taken to mean a high fat low carb low protein diet. Of course the African dog has a high fat, high protein, low carb diet. In fact, this was the standard diet of virtually all K9s prior to the advent of grain as the primary protein source for human beings. I don't want to get into huge detail about the health of man prior to this grain diet except to say, he may have been healthier prior to the advent of grain. Just in case there are any stalwarts in regard to grain and fiber. Let me say that there is not one single study in Medicine that confirms the use of a high grain diet to reduce colon cancer. An Asprin a day might work but not grain fiber.
    To me it seems illogical for the carnivores to move to mostly grain diets successfully. Since there has been sketchy research into hypoglycemia and thyroid, I would submit that these conditions are most often a result of long term abundant carbohydrates in human diets. The notion, for example that pasta has become the ultimate health food coresponds to the rise of diabetes in the human population.
    The ketogenic diet is about 30% successful in human epilepsy. This is a huge number. A Vet on the internet stated that he doubted that a dog could develop a metabolism run off ketones. Of course I find this absolutely absurd. The African dog literally must run off ketones. The conversion of proteins to glucose is a very restricted process when there is an abundance of fats in the diet. The heart and brain run nicely on ketones. The African dogs consume about 6 pounds of meat a day, broken down into two meals breakfast and dinner. Of course their metabolic needs and caloric metabolism is very very high. So the large meals are really a product of the calories needed. They can easily run fifty miles on any given day.
    My intuition tells me that meat eating species should in fact eat meat not grain based analog "meat" products. If it's cereal, it's cereal. There have never been any studies to this end aside from the grain producers promising ultimate nutrition to the dogs that eat these grain mixtures. It seems very centrocentric for man, an omnivore, to try to make carinvores eat what they eat. Even though a domesticated dog will eat this analog product, try putting a bowl of meat next to the gravy train and see what happens.
    I would suggest that any dog that suffers from k9 seizures, and granted there are many reasons not all applicable, should be at least tried on their ancient carnivorous diet, meat. I have heard all the rubbish about constipation etc. After a species has regained it's ability to eat meat, the microvili in the intestine will elongate. Constipation will not be an issue. This is more an issue of human projection of retentive problems.
    Whether a dog can survive on grain is not the issue. Under the bell curve I am sure many can survive, however many will not thrive and with typical statistics we have to allow for a percentage that will not do well. Again, I find it interesting that the breeds most noted for seizure are the hunters and work breeds, those which are more closely connected to the African dogs.
    Also, don't burn meat for a dog. Just put a bit of burger into the microwave and heat it though. I would suggest that raw meat is probaly better but of course there is E.coli. With longer microvili in the colon, the chances of diseases are reduced. It is not surprising that grain actually reduces the length of microvili and increases the amount of fecal waste. Again all of this nonsense is based on human myth, that somehow the shear volume of waste somehow protects bowel health. There are enough human diseases caused by grain and ergots that humans should not foist their myths on carnivores.
    My disclaimer. This is just food for thought. Ponder it, discuss it with your vet before you consider actually doing it primarily becasue some of the meds may have altered half-lives on a decent meat diet. It is certainly not harmful to feed carnivors meat, although I would avoid frying or flame grilling which has an association to cancer models. I think light microwaving and even raw if you have a good supplier or personal butcher is optimal.
    [This message has been edited by ClarkSavageJr (edited 05-14-2002).]

  2. Ned Patterson DVM

    Clark,
    There is currently, a small scale, experimental study of a high fat ,low carbohydrate diet for dogs with refractory epilepsy. There are not yet any published results, but there will probably be some within the next year.
    Dogs, however, metablize fat much differently than people and most other species. They have much lower endogenous levels of ketones, because they presumably metabolize ketones more efficiently. There are 2 major theories as to why ketogenic diets are effective in some children.
    1. It is a direct ketone effects, and is directly related to the blood, and more specifically brain levels of ketones. Beta-hyroxybutyrate (one of the ketones) has a very similar stucture to GABA (one of the inhibitory neruotransmitters). If this is the mechanism it will probably be very very difficult to acheive the levels of ketones in dogs via a high fat, low carbohydrate diet that are effective for people due to the low starting point for dogs.
    2. That the mechanism of ketogenic diets is the increased energy utilization. If this is the case then similar diets might be effective for dogs with epilepsy.
    The ketogenic diet for people is very carefully calculated, and has to be strictly adhered to. Additionally there are some potentially side effects that of the diet.
    [This message has been edited by Ned Patterson DVM (edited 05-14-2002).]

  3. ClarkSavageJr

    Ned, thank you for your excellent post. Of course GABA receptors are inhibitory but there is no proof positive of the 3-hydroxybutyrate theory. In fact, that is why I avoided the subject entirely since the brain metabolism is extremely complex. Even the concepts of what precisely constitues a ketogenic state is murky.
    Remember that there are actually three ketones involved with the breakdown of Acetoacetyl CoA: acetoacetate, D3-hydroxybutyrate and acetone. These of course
    can be products of the pyruvate pathway via glycolysis to Acetyl CoA or can come from the Ketogenic Amino acids: Leucine, isoleucine, lysine, tryptophan, phenylanine and tyrosine. Thus the production of ketones comes from a number of sources but is generally associated with glycolysis and fatty acid metabolism.
    Nevertheless, the concept of the "ketogenic diet" shall we just call it a high fat low carb diet, in epileptic children has resulted in compelling results. I doubt sincerely that the human brain ever becomes ketogenic as long as there is one molecule of glucose. There are only several occasions when the brain actualy produces and used ketones in preference to glucose: nursing baby, diabetic, and starvation states. In fact, as long as some protein is onboard glycogenolysis is between 5 and 10 nmol/mg protein�min a value that is remarkably close to glucose utilization of the brain.
    Thus, I don't mind saying that I feel comfortable with the concept that a high fat diet, low carbs and in the humans low protein has resulted in a remarkable rate of seizure reduction in human children. But I am certainly not going to subscribe to one theory or get trapped into saying that ketogenic diets imply the exculsive use of ketones. I rather think it is a balance. Again this is pure speculation based on the biochemical understanding that any simple answer is probably incorrect.
    Perhaps I should have refrained from using the term ketogenic in that it might be misleading to other readers. I am talking about a diet composed of meat, a relatively high fat meat, in which the bulk of calories is provided by fats, specifically animal fats. This mimics the diet of the African dog. As you know, game meat is generally low in fat but the organs are high in fat.
    One of the great concerns of the government in regard to say hog feeds are the fact that corn meal and soy meal do not really stand up very well in the amino acid rankings. Corn meal for example is very low in Lycine. While you can take some of this grain and some of that, add some oils etc. and come up with a feed that meets nutritional demands on paper, you also end up with a large imbalance of the other amino acids out of proportion to say a natural diet. The simplest explaination is the fellow on the TV commercial that has to eat 20 bowls of corn flake to equal one bowl of Total.
    The problem herein with livestock is nitrogen and excessive waste, it's effect in the atmosphere and on the soil.
    The concepts of the "super grain" mixtures are great on paper if you are tying to feed 10 thousand head of hogs, but breakdown nicely when you examine the overall health and wellbeing of the livestock. Fortunately they have short lives so manifestations of advanced disease states are unually not evident.
    My issue is that intuitively I think feeding a carnivore a "grain based diet" is absurd. I am certain that the evolutionary metabolism of carnivore's is vastly different from say a ruminant. The physiological structures are not comparable. Why should anyone imagine that they should eat the same diet? Yet there are people who think nutrition is a matter of a combination of the white amino acid powders and essential fatty acids and sugars. This however does not address other biological factors like castles intrinsic factor to allow vitamin B12 to penetrate the stomach lining which is only available through a meat diet. Thus, vegetarians get pernicious anemias. The same feature exist with the thryoid. Iodine is in meat, but not vegetables. Thus, when one trys to understand any function of evolution and diet, oversimplification doesn't meet the mark.
    So very simply, let me state that carnivores which include canines, have millions of years of evolution on a meat and game diet. Their biological and biochemical functions have been evolved to make them efficient killers. In fact, they have evolved to be the kings of the jungle with a better than 70% kill rate on prey. This compares large to a lion's 50%! I find it impossible to imagine that man's mixing of grain feeds for carnivores can compare to the evolutionary perfection of the organism for meat and game and chase.
    In the medical fields we really get tunnel vision especially in the area of nutrition and evolution. Take for example the American Indian or Islander or Blacks for that matter. American Indians have absolutely the worst diabetes profile on the American diet. The Natives of Alaska used to eat a diet of raw fish and blubber. They now eat Burger King and their health state has disintigrated. Yet someone could conclude based on macro and micro nutritional content that the Burger King diet was healthier because it was lower in fat. Blacks eat salt and due to renin pathway disruption, thier intravascular volumes and blood pressure skyrocket. Thus the breeches of the evolutionary rules of original diets have generally consistant awful results. I have no reason to think that the departure of canines into the land of carbohydrates and grain based food analogs should yield anything but the same kinds of metabolic derangements. Since much of the focus on K9 epilepsy has centered around the thyroid function and bood sugar anomomolies, it may be time to consider a meat diet void of carbohydrates.
    Lastly Ned, I have read many of your board comments. You strike me as very well educated and concerned about this subject of K9 epilepsy. We are all more or less groping in the dark. For people with refractory cases, it seems to me they have nothing to lose by trying a few things like getting back to basics. A meat diet for a carinvore is about as basic as it gets.
    I don't have a great deal of time to post but will come back in a few months and see if anybody has tried the meat only diet, and this means smaller quantities, two feedings a day just like the African dogs. Your dog will be lean, happy and love dinner time.

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