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Canine Ketoacidosis Prognosis

What Causes High Ketones In A Canine?

What Causes High Ketones In A Canine?

A dog with a high level of ketones in his urine suffers from a condition known as ketonuria, usually resulting from a buildup of these substances in the dog's blood. A ketone is a type of acid, which, if allowed to accumulate in the blood, can lead to ketoacidosis, a potentially fatal condition. The main health conditions that can cause high ketone levels in a canine are starvation and diabetes. A dog's body breaks down the food that he eats into sugars, also called glucose, that the cells of the body use for energy. The dog's pancreas then produces the hormone insulin to regulate the amount of glucose that the body will absorb. If the insulin to regulate the glucose is insufficient, typically due to chronic diabetes mellitus, the body breaks down alternate sources of fuel for its cells; a dog's body that is starved of nutrition will do the same. One of these sources is the fat stored in the dog's body. When the body breaks down this fat, it produces as a by-product toxic acids known as a ketones. These ketones then build up in the dog's blood and also his urine, leading to ketoacidosis. Always consult an experienced veterinarian regarding the health and treatment of your pet. A dog suffering from high ketone levels in his blood and urine exhibits symptoms of weight loss, vomiting, increased thirst, decreased appetite, increased urination, lethargy, low body temperature and yellowing of the skin and gums, according to PetMD. The dog's breath may also have a sweet, fruity smell due to the presence of acetone caused by ketoacidosis, says VetInfo. To properly diagnose high ketone levels and ketoacidosis in your dog, a veterinarian will take blood tests and a urinalysis, which will also check your dog's blood glucose levels. Depending on the dog's physical condition, hospit Continue reading >>

Testing For Diabetic Ketoacidosis Symptoms In Dogs

Testing For Diabetic Ketoacidosis Symptoms In Dogs

Diabetic ketoacidosis is an extreme form of hyperglycemia, during which ketones build up in the bloodstream. Ketoacidosis can be fatal, so it’s essential to contact your veterinarian as soon as symptoms arise. Symptoms can include vomiting, weakness, rapid breathing and the odor of acetone on the breath. Your veterinarian will perform a variety of tests to determine if your diabetic dog is suffering from ketoacidosis, including blood testing and urine dipsticks. Your dog might need to stay at the vet for around-the-clock monitoring. Blood Testing for Ketoacidosis Your veterinarian performs a blood test to determine if your dog is suffering from diabetic ketoacidosis. He collects a small amount of blood, testing it for high circulating blood sugar levels and blood pH levels, as well as phosphorus and potassium levels. Electrolyte levels can fluctuate, so he might perform several tests over a period of time to create a record of imbalances, as well as determine which intravenous fluids would best benefit your dog. Blood tests continue until your dog shows significant improvement. Urine Dipstick Test for Ketones While caring for your pet, the vet places a catheter inside the dog to collect urine. He tests the urine with a dipstick to perform a routine urinalysis, which he's likely to repeat many times during your dog’s emergency care stay. When a urine dipstick no longer reads positive for ketones, your dog is well on his way to recovery. Around-the-Clock Monitoring and Fluid Therapy During ketoacidosis, your dog’s cells experience a severe loss of glucose. This can be dangerous, so early detection is best. If possible, get your dog into a 24-hour care facility as soon as you notice symptoms. The vet closely monitors your dog, ensuring he is treated for any infection Continue reading >>

Preventing And Treating Canine Diabetes

Preventing And Treating Canine Diabetes

The growing diabetes epidemic is not limited to people—diabetes mellitus is increasing among dogs as well. Researchers estimate that one in 200 dogs will develop the disease. Fortunately, treatment has made huge strides in recent years, and as a result, dogs with diabetes are living longer, healthier lives. The mechanism of diabetes is relatively simple to describe. Just as cars use gas for fuel, body cells run on a sugar called glucose. The body obtains glucose by breaking down carbohydrates in the diet. Cells then extract glucose from the blood with the help of insulin, a hormone made by the pancreas in specialized cells called beta cells. (The pancreas, an organ situated behind the stomach, produces several hormones.) In diabetes mellitus, cells don’t take in enough glucose, which then builds up in the blood. As a result, cells starve and organs bathed in sugary blood are damaged. Diabetes is not curable, but it is treatable; a dog with diabetes may live many happy years after diagnosis. Kinds of Diabetes Humans are subject to essentially three kinds of diabetes. By far the most common is Type 2, followed by Type 1 and gestational diabetes. Type 2 diabetes has typically been a disease of middle and old age (though it is being seen increasingly in young people), and has two causes: The beta cells don’t make enough insulin, or muscle cells resist insulin’s help and don’t take in enough glucose (or both). As a result, blood glucose levels climb. Type 1 diabetes usually occurs when the immune system attacks and destroys the beta cells, cutting off insulin production; the reason for this attack is thought to be a combination of genetic predisposition plus exposure to a trigger (research into possible triggers is ongoing). Glucose then stays in the blood and, aga Continue reading >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. Continue reading >>

Diabetic Ketoacidosis In Dogs: Symptoms, Causes, & Treatments

Diabetic Ketoacidosis In Dogs: Symptoms, Causes, & Treatments

Diabetic ketoacidosis in dogs, sometimes shortened to DKA, is a deadly medical emergency that happens when there is not enough insulin in the body to regulate levels of blood sugar known as glucose. It is a complication of diabetes mellitus that requires immediate medical treatment before it becomes fatal. When insulin levels drop, the body can’t use glucose properly, so glucose builds up in the blood while the liver produces ketone bodies to act as an emergency fuel source. When ketone bodies are broken down, they cause the body’s pH balance to shift and become more acidic. Dogs can’t maintain their fluid and electrolyte balance, which results in deadly symptoms. If your dog shows signs of diabetic ketoacidosis, especially if they have been diagnosed with diabetes, it is important that you see an emergency veterinarian right away for treatment. Here is what you should know about the symptoms, causes, and treatments for diabetic ketoacidosis in dogs. Symptoms Of Diabetic Ketoacidosis In Dogs Sometimes dogs that suffer from diabetic ketoacidosis only show mild symptoms, but the majority of affected animals get very sick within a week of the start of the illness. The symptoms of diabetic ketoacidosis can resemble the warning signs of a diabetic condition, which also requires medical attention. The difference is that diabetic ketoacidosis is the body’s final effort at survival before succumbing to diabetes. Here are several symptoms of diabetic ketoacidosis in dogs. Excessive thirst or urination Sweet breath Sudden weight loss Muscle loss Loss of appetite Fatigue Unhealthy, rough coat Rapid breathing Dandruff Weakness Vomiting Sudden impaired vision Causes Of Diabetic Ketoacidosis In Dogs The main cause of diabetic ketoacidosis in dogs is ultimately insulin depende Continue reading >>

Diabetic Ketoacidosis (dka) In Dogs

Diabetic Ketoacidosis (dka) In Dogs

Overview Diabetic Ketoacidosis (DKA) in Dogs Diabetic ketoacidosis (DKA), the most severe form of Diabetes Mellitus in dogs, results in severe changes in blood chemicals including imbalances in small, simple chemicals known as electrolytes. Diabetes mellitus (DM) is a chronic condition in which a deficiency of the hormone insulin impairs the body’s ability to metabolize sugar. It is one of the most common endocrine (hormonal) diseases of dogs. For more information on the basics of diabetes, go to Diabetes mellitus in dogs DKA is a life-threatening condition caused by diabetes mellitus resulting from insulin deficiency that leads to excess production of ketoacids by the liver. Subsequent changes in the blood result that includes metabolic acidosis, electrolyte abnormalities producing severe signs of systemic illness. DKA condition can occur in pets with new diabetes or in current diabetics that decompensate. Secondary diseases and/or infections can cause diabetics to decompensate and develop DKA. What to Watch For with Diabetic Ketoacidosis (DKA) Signs associated with DKA depend on the individual pet and the length of time they have been ill. Signs may consist of the classic signs of diabetes including: Increased thirst Increased frequency of urination Weight loss despite a good appetite Sudden blindness Additional signs of DKA include: Lethargy Vomiting Weakness Dehydration Some pets will have a strong smell of acetone from their breath Diagnosis of Diabetic Ketoacidosis (DKA) in Dogs Diagnostic tests for DKA in dogs may include: Complete medical history and thorough physical examination. Serum biochemical profile to determine the blood glucose concentration and to exclude other potential causes of the same symptoms such as pancreatitis. Elevated blood glucose is the Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Studies show that female dogs (particularly non-spayed) are more prone to DKA, as are older canines. Diabetic ketoacidosis is best classified through the presence of ketones that exist in the liver, which are directly correlated to the lack of insulin being produced in the body. This is a very serious complication, requiring immediate veterinary intervention. Although a number of dogs can be affected mildly, the majority are very ill. Some dogs will not recover despite treatment, and concurrent disease has been documented in 70% of canines diagnosed with DKA. Diabetes with ketone bodies is also described in veterinary terms as diabetic ketoacidosis or DKA. It is a severe complication of diabetes mellitus. Excess ketone bodies result in acidosis and electrolyte abnormalities, which can lead to a crisis situation for your dog. If left in an untreated state, this condition can and will be fatal. Some dogs who are suffering from diabetic ketoacidosis may present as systemically well. Others will show severe illness. Symptoms may be seen as listed below: Change in appetite (either increase or decrease) Increased thirst Frequent urination Vomiting Abdominal pain Mental dullness Coughing Fatigue or weakness Weight loss Sometimes sweet smelling breath is evident Slow, deep respiration. There may also be other symptoms present that accompany diseases that can trigger DKA, such as hypothyroidism or Cushing’s disease. While some dogs may live fairly normal lives with this condition before it is diagnosed, most canines who become sick will do so within a week of the start of the illness. There are four influences that can bring on DKA: Fasting Insulin deficiency as a result of unknown and untreated diabetes, or insulin deficiency due to an underlying disease that in turn exacerba Continue reading >>

Diabetes With Ketone Bodies In Dogs

Diabetes With Ketone Bodies In Dogs

Diabetes Mellitus with Ketoacidosis in Dogs Diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. The term “ketoacidosis,” meanwhile, refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies”. In diabetes with ketoacidosis, ketoacidosis immediately follows diabetes. It should be considered a dire emergency, one in which immediate treatment is required to save the life of the animal. This condition typically affects older dogs as well as females. In addition, miniature poodles and dachshunds are predisposed to diabetes with ketoacidosis. Symptoms and Types Weakness Lethargy Depression Lack of appetite (anorexia) Muscle wasting Rough hair coat Dehydration Dandruff Sweet breath odor Causes Although the ketoacidosis is ultimately brought on by the dog's insulin dependency due to diabetes mellitus, underlying factors include stress, surgery, and infections of the skin, respiratory, and urinary tract systems. Concurrent diseases such as heart failure, kidney failure, asthma, cancer may also lead to this type of condition. Diagnosis You will need to give a thorough history of your dog’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count (CBC). The most consistent finding in patients with diabetes is higher than normal levels of glucose in the blood. If infection is present, white blood cell count will also high. Other findings may include: high liver enzymes, high blood cholesterol levels, accumulation in the blood of nitrogenous waste products (urea) that are usually excreted in the urine (azo Continue reading >>

Ketoacidosis

Ketoacidosis

Ketones in the urine, as detected by urine testing stix or a blood ketone testing meter[1], may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels combined with certain other systemic stresses. DKA can be fixed if caught quickly. Diabetics of all species therefore need to be checked for ketones with urine testing stix, available at any pharmacy, whenever insulin level may be too low, and any of the following signs or triggers are present: Ketone Monitoring Needed: Little or no insulin in last 12 hours High blood sugar over 16 mmol/L or 300 mg/dL (though with low insulin, lower as well...) Dehydration (skin doesn't jump back after pulling a bit gums are tacky or dry)[2] Not eating for over 12 hours due to Inappetance or Fasting Vomiting Lethargy Infection or illness High stress levels Breath smells like acetone (nail-polish remover) or fruit. Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. Possible False Urine Ketone Test Results Drugs and Supplements Valproic Acid (brand names) Depakene, Depakote, Divalproex Sodium[3] Positive. Common use: Treatment of epilepsy. Cefixime/Suprax[4] Positive with nitroprusside-based urine testing. Common use: Antibiotic. Levadopa Metabolites[5] Positive with high concentrations[6]. Tricyclic Ring Compounds[7][8] Positive. Commo Continue reading >>

Canine Diabetic Ketoacidosis

Canine Diabetic Ketoacidosis

Use this algorithm to diagnose and treat diabetic ketoacidosis in dogs. CANINE DIABETIC KETOACIDOSIS • Alice Huang & J. Catharine Scott-Moncrieff Material from Clinician’s Brief may not be reproduced, distributed, or used in whole or in part without prior permission of Educational Concepts, LLC. For questions or inquiries please contact us. Continue reading >>

What Are The Treatments For Ketoacidosis In Dogs?

What Are The Treatments For Ketoacidosis In Dogs?

If your dog has diabetes mellitus, a common ailment in the canine realm, then diabetic ketoacidosis is a hazardous possibility. Ketoacidosis is a metabolic disorder that's related to extreme hyperglycemia. When diabetic dogs develop ketoacidosis, ketones, a type of acid, accumulate in their blood. Veterinary care is vital for dogs with this condition. Diabetic Ketoacidosis Background When insufficient amounts of insulin bring upon the liver's inordinate manufacturing of ketoacids, ketoacidosis arises. Numerous factors can cause diabetic ketoacidosis in canines. The primary cause of the condition is reliance on insulin, although ketoacidosis is also linked to things such as urinary tract infections and skin infections. Dogs frequently experience diabetic ketoacidosis when their diabetes mellitus hasn't yet been identified or managed. Key Diabetic Ketoacidosis Symptoms If you notice any unusual symptoms in your diabetic pet, get him to the veterinarian for treatment immediately. Diabetic ketoacidosis is an urgent condition. Common symptoms of the ailment are throwing up, nausea, appetite loss, dandruff, fatigue, feebleness, dehydration, fast breathing, depression, decreased body temperature, frequent urination, inordinate thirst, weight loss and unusual-smelling breath: If your dog's breath has an odor that's reminiscent of nail polish remover, diabetic ketoacidosis could be the culprit. Since diabetic ketoacidosis is a medical emergency in dogs, immediate care is of the essence, no matter the time of day or night. If you notice these symptoms in your pet overnight, take him to a 24-hour veterinary hospital. Female dogs are particularly susceptible to the condition, as are elderly dogs. Treatment Options Some dogs with diabetic ketoacidosis need hospitalization, others do Continue reading >>

68..............................................................................................................................................................................navc Clinician’s Brief / April 2011 / Diagnostic Tree

68..............................................................................................................................................................................navc Clinician’s Brief / April 2011 / Diagnostic Tree

1. IV Isotonic Crystalloid Therapy • Shock fluid therapy is warranted if cardiovascular instability is present: Full shock dose of fluids is 90 mL/kg; start with ¼ to 1/3 dose and reassess until stable • Correct dehydration, provide maintenance needs, and replace ongoing losses over 6 to 24 hours: - % dehydration × body weight (kg) × 1000 plus - 20 mL/kg/day (insensible losses) plus - 20 to 40 mL/kg/day (maintenance sensible losses) plus - Account for vomiting, diarrhea, & polyuria (ongoing sensible losses) Alice Huang, VMD, & J. Catharine Scott-Moncrieff, Vet MB, MS, MA, Diplomate ACVIM & ECVIM Purdue University Canine Diabetic Ketoacidosis D i a gno s t i c Tre e / ENDOCRINOLOGY Peer Reviewed Physical Examination • Polyuria • Weight loss • Polydipsia • Vomiting • Polyphagia • Lethargy Patient may have only 1 or more of these signs. Laboratory Results • Blood glucose (BG): Hyperglycemia (> 200 mg/dL) • Blood gas (venous or arterial): Metabolic acidosis • Urine dipstick: Glucosuria; ketonuria or ketonemia Serum ketones can be measured if urine is unavailable. Diabetic Ketoacidosis Treatment 2. Electrolyte Supplementation (see Table 1, page 70) • Monitor serum potassium Q 4–6 H until within reference interval and stable; then Q 12–24 H • Monitor serum phosphorus Q 4–6 H until > 1.5; then Q 6–24 H • When supplementing potassium and phosphorus concurrently, take into account the amount of potassium contained in the potassium phosphate • Consider magnesium supplementation in instances of refractory hypokalemia 3. Regular Insulin • Continuous rate infusion (CRI) protocol:1 - Add 2.2 U/kg of regular insulin to 250 mL of 0.9% saline - Allow 50 Continue reading >>

Managing Diabetes Complicated By Ketoacidosis

Managing Diabetes Complicated By Ketoacidosis

Go to site For Pet Owners Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus that has to be aggressively treated. Diagnosis The diagnosis is based on the presence of ketonuria with signs of systemic illness. Management guidelines Goals of treatment include the correction of fluid deficits, acid-base balance and electrolyte balance, reduction of blood glucose and ketonuria, and beginning insulin therapy and treatment of concurrent diseases. Many protocols for treatment exist but rapid-acting insulin (regular) must be administered first, as decreases in the hyperglycemia must be achieved quickly. When blood sugar levels are lowered and maintained at 200−250 mg/dL for 4−10 hours, then Vetsulin® (porcine insulin zinc suspension) can be used. Evaluation of treatment When evaluating the regulation of insulin therapy, it is important to consider several areas including the evaluation of glycemia, urine monitoring, routine rechecks and glycated protein evaluations. Evaluation of the glycemia Creating a blood glucose curve is the most accurate way to evaluate glycemia in order to adjust the dose of Vetsulin. Indications for creating a blood glucose curve are: First, to establish insulin dose, dosing interval, and insulin type when beginning regulation. Second, to evaluate regulation especially if problems occur. Third, when rebound hyperglycemia (Somogyi effect) is suspected. Contraindications for creating a blood glucose curve are: Concurrent administration of drugs affecting glycemia. Presence of a known infection or disease. Stressed animal. The procedure is as follows: The most accurate way to assess response to management is by generating a blood glucose curve. Ideally, the first sample should be taken just prior to feeding Continue reading >>

's Experience With Ketoacidosis.

's Experience With Ketoacidosis.

Signs Treatment Zama's experience Diabetic ketoacidosis is caused by a lack of insulin or an insufficient amount of insulin. Since the lack of insulin means that glucose in not able to be used, the body searches for a new source of energy. In this condition, the diabetic breaks down body fat (lipolysis) to use as energy. During lipolysis, waste products called ketones are produced. Ketones are eliminated in the urine and through the lungs. Under normal conditions, the body can tolerate and eliminate ketones. But in diabetic ketoacidosis, fats are being broken down at such a high rate that the body can not eliminate the ketones fast enough and they build up in the blood. In high amounts, ketones are toxic to the body. They cause the acid-base balance to change and serious electrolyte and fluid imbalances result. Some of the signs of ketoacidosis include polyuria polydipsia lethargy anorexia weakness vomiting dehydration There will probably be ketones in the urine (ketonuria) The breath may have a sweet chemical smell similar to nail polish remover. However, some owners have said that even during documented ketoacidosis, their pet's breath did NOT have any unusual odor. Treatment Mildly ketoacidotic animals can be alert and well hydrated. After your pet is stabilized, your pet can return home and be treated with proper diabetes management techniques including insulin therapy, diet, and exercise. "Sick" ketoacidotic animals require intensive medical management in the vet hospital. This is a life-threatening emergency that requires complex medical management and monitoring. It may take several days for the animal to be out of danger. Treatment involves injections of regular insulin, intravenous fluids, electrolytes, and frequent monitoring of blood glucose, blood chemistry, Continue reading >>

Diagnosis And Treatment Of Diabetic Ketoacidosis (dka) In Dogs And Cats

Diagnosis And Treatment Of Diabetic Ketoacidosis (dka) In Dogs And Cats

What is DKA in Dogs and Cats? Diabetic Ketoacidosis (DKA) is a serious and life-threatening complication of diabetes mellitus that can occur in dogs and cats. DKA is characterized by hyperglycemia, ketonemia, +/- ketonuria, and metabolic acidosis. Ketone bodies are formed by lipolysis (breakdown) of fat and beta-oxidation when the metabolic demands of the cells are not met by the limited intracellular glucose concentrations. This provides alternative energy sources for cells, which are most important for the brain. The three ketones that are formed include beta-hydroxybutyrate, acetoacetate and acetone. Beta-hydroxybutyrate (BHB) and acetoacetate are anions of moderately strong acids contributing most to the academia (low blood pH). Acetone is the ketone body that can be detected on breath. In a normal animal, glucose enters the cell (with help of insulin) – undergoes glycolysis to pyruvate within cytosol – pyruvate moves into mitochondria (energy generating organelle in the cell) to enter the TCA cycle and ATP is formed. ATP is the main energy source of the body. When glucose cannot enter the cell, free fatty acids are broken down (lipolysis) and move into the cell to undergo beta-oxidation (creation of pyruvate). The pyruvate then moves into the mitochondria to enter the TCA cycle (by conversion to Acetyl-CoA first). However, when the TCA cycle is overwhelmed, the Acetyl-CoA is used in ketogenesis to form ketone bodies. Summary Diabetic Ketoacidosis (DKA) in Dogs and Cats When there is no insulin the body cannot utilize glucose and there is no intracellular glucose. The body then uses ketone bodes as an alternate source. When there is decreased insulin and increased counterregulatory hormones fatty acids are converted to AcCoA and then ketones. In the non-diabetic Continue reading >>

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