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Cats Dka Guidelines

Feline Diabetes

Feline Diabetes

Lisa A. Pierson, DVM Introduction Warning: Before reading even the first sentence of this webpage, you must commit to reading past the STOP sign below. The first section of this paper discusses the detrimental impact of dietary carbohydrates on the blood glucose balance and insulin response of cats as a species – with pre-diabetic and diabetic patients being especially susceptible to the negative effects of high carbohydrate diets. However, if your cat is receiving insulin and you switch to a low carb diet –without lowering the insulin dosage – you will be putting your cat at significant risk for a hypoglycemic crisis. This is discussed under the STOP sign section below. I receive many emails each week asking for food recommendations for diabetic cats. Answers: 1) NO DRY FOOD but see Tips for Transitioning Dry Food Addicts to Canned Food if you are dealing with a dry food addict. All cats can be transitioned to an appropriate diet (no dry food) if the owner is patient enough. 2) See Cat Food Composition chart and stay below 10% carbohydrate calories (the third column). There are many suitable low carbohydrate choices available depending on your cat’s preference and your budget. Many cats do well on Friskies Classic Pates and Fancy Feast. Stay away from food with gravy – they are high in carbohydrates. The same is true for most food with sauces. Higher protein/lower fat is also the goal. However, you will note that most commercial foods are low in protein and high in fat. Why? Because protein is expensive and fat is cheap This is one of many reasons why I make my own cat food. 3) See Commercial Foods when you are ready to learn more about evaluating pet foods. Cats are obligate carnivores and are designed to eat other animals (meat, organs, etc.) – not grains Continue reading >>

Spilleautomater Dka Diabetes Cats

Spilleautomater Dka Diabetes Cats

Feline diabetic ketoacidosis is a buildup of ketones in the bloodstream of a cat's body. Ketoacidosis is a result of diabetes that has worsened or hasn't. The Secret of Nature treatment of dka in cats, Stop Searching Official ADA recommendation for someone with diabetes: Less than treatment of dka in cats. Stop Searching About dka treatment in cats! Stop wasting your time with unanswered searches. Diabetes is diagnosed by any one of the following. Now, what should your normal ranges be? As I have always recommended you (and it is dka cats also the recommendation of ADA for diabetes management), every diabetic. Diabetes Care Dka: : The 3 Step Trick that Reverses Diabetes Permanently in As Little as 11 Days. DIABETES CARE DKA The REAL cause of Diabetes (and. AAHA guidelines for Diabetes management in dogs and cats 2010 AAHA Diabetes Management Guidelines for Dogs Dogs and cats with DKA may show very elevated. Diabetic ketoacidosis (DKA) is a lifethreatening condition that develops when cells in the body are unable to get the sugar (glucose) they need for energy. Now, what should your normal ranges be? As I have always recommended dka treatment in cats you (and it is also the recommendation of ADA for diabetes management. The Secret of Nature. You can print your sugar chart and present it to your doctor to undertake the most appropriate actions for the best dka treatment in cats diabetes management. It solves the problem for you quickly. Is this what you are looking dka treatment cats? Stop Searching About dka diabetes cat! We collect what you are looking for here. Feline Diabetes: : Pre Diabetes Diabetic Dka Read Cats on the opposite hands have to have someone near the as well as family responsible to. If you want to take care of your health. You Want Something Special Ab 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 >>

Isfm Consensus Guidelines On The Practical Management Of Diabetes Mellitus In Cats

Isfm Consensus Guidelines On The Practical Management Of Diabetes Mellitus In Cats

Abstract Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently - unless hypoglycaemia is encountered. The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They repre Continue reading >>

Glycemic Control Of Hospitalized Diabetic Patients

Glycemic Control Of Hospitalized Diabetic Patients

Thomas Schermerhorn, VMD, Diplomate ACVIM (Small Animal Internal Medicine) Kansas State University Glycemic control in diabetic dogs and cats may be jeopardized by hospitalization for treatment of diabetic or nondiabetic disorders or routine health care interventions, such as minor surgical procedures or dental prophylaxis. Thus, a major challenge for veterinarians caring for established diabetics in the hospital is to provide needed care while avoiding significant disruption of glucose control. This article provides useful strategies and techniques for in-hospital glucose management in established stable diabetics. GLUCOSE REGULATION Glucose homeostasis is subject to complex physiologic regulation.1 Glucose in the blood has 3 major sources. Digestion of dietary carbohydrates, which produces glucose that is absorbed into the blood following a meal. Glycogenolysis biochemically breaks down glycogen, a stored form of glucose. Hepatic gluconeogenesis produces glucose from precursors, such as amino acids and glycerol. The latter 2 processes occur between meals or during fasting. Each process is subject to physiologic regulation at multiple steps, which maintains blood glucose within precise physiologic limits. Regulation in Healthy Animals In healthy animals, euglycemia is maintained by interplay between hormones that adjust glucose levels in the blood. Insulin is released from pancreatic beta cells, and is the principal hormone responsible for lowering blood glucose. Precise coupling between changes in portal vein glucose concentration and insulin secretion permits exquisite minute-to-minute glycemic regulation. The rate and amount of insulin release is modulated by a myriad of physiologic substances, including neurotransmitters, paracrine factors, and hormones. The incret Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is an emergency. DKA develops due to: Long standing undiagnosed diabetes mellitus Insufficient insulin dose in treated diabetics Reduced insulin action - caused by obesity , concurrent illness or drugs. This is the cause of more than two-thirds of cases of DKA. What causes DKA? Due to a lack of insulin , glucose cannot be used by the body cells as an energy source. Instead fat is broken down to provide energy. When fat is used as an energy source, acids known as ketones are produced. Ketones circulating in the blood cause signs of DKA - anorexia, nausea and lethargy. Diagnosis The diagnosis of DKA is based on detecting ketones in the urine and sometimes in the blood along with signs of illness. See Urine Monitoring for more information. Treatment DKA is an emergency and treatment must be started as soon as possible. Your veterinary surgeon will administer intravenous fluids and insulin and correct any underlying disorders to stabilise your cat. Once your cat is stabilised it will be started on long term insulin therapy again. Continue reading >>

Monitoring Methods For Dogs And Cats With Diabetes Mellitus

Monitoring Methods For Dogs And Cats With Diabetes Mellitus

Go to: Abstract Effective monitoring is essential for the management of dogs and cats with diabetes mellitus. However, methods for evaluating glycemic control must be tailored to meet both the needs of the patient and the expectations of the owner. This article discusses the philosophies that drive blood glucose monitoring in veterinary diabetics and review common practices. The advantages and limitations of the various options are presented. Keywords: cat, diabetes mellitus, dog, glucometer, monitoring Diabetes mellitus is a common endocrinopathy in dogs and cats. Although the underlying etiologies differ for the two species, both are treated with exogenous insulin and require regular monitoring to ensure appropriate therapy.1 Successful patient management is widely defined by the maintenance of a stable body weight and mitigation of clinical signs such as excessive thirst, urination, and hunger, along with the avoidance of ketosis or hypoglycemia. The latter is particularly important for veterinary diabetics, as these patients cannot assist themselves if blood glucose (BG) concentrations drop precipitously. Achieving euglycemia (BG approximately 60–130 mg/dl) is not the goal of insulin therapy because dogs and cats are spared many of the complications associated with sustained hyperglycemia in human diabetes patients, such as retinopathy, vascular disease, and renal injury.1 Consequently, most canine and feline diabetics experience only short periods of euglycemia in the course of the day and instead live with mild to moderate hyperglycemia. The frequency of monitoring for diabetic dogs and cats is variable, although some form of evaluation is generally recommended every 4–12 weeks.1 Newly diagnosed patients are monitored more frequently, often every 7–14 days, Continue reading >>

Diabetes In Cats

Diabetes In Cats

This article is about diabetes mellitus in cats. For other uses, see Diabetes (disambiguation). Diabetes mellitus is a chronic disease in cats, whereby either insufficient insulin response or insulin resistance lead to persistently high blood glucose concentrations. Diabetes could affect up to 1 in 230 cats,[1] and may be becoming increasingly common. Diabetes mellitus is less common in cats than in dogs. 80-95% of diabetic cats experience something similar to type-2 diabetes, but are generally severely insulin-dependent by the time symptoms are diagnosed. The condition is treatable, and treated properly, the cat can experience a normal life expectancy. In type-2 cats, prompt effective treatment may lead to diabetic remission, in which the cat no longer needs injected insulin. Untreated, the condition leads to increasingly weak legs in cats, and eventually malnutrition, ketoacidosis and/or dehydration, and death. Symptoms[edit] Cats will generally show a gradual onset of the disease over a few weeks or months, and it may escape notice for even longer.[citation needed] The first outward symptoms are a sudden weight loss (or occasionally gain), accompanied by excessive drinking and urination; for example, cats can appear to develop an obsession with water and lurk around faucets or water bowls. Appetite is suddenly either ravenous (up to three-times normal) or absent. These symptoms arise from the body being unable to use glucose as an energy source. A fasting glucose blood test will normally be suggestive of diabetes at this point. The same home blood test monitors used in humans are used on cats, usually by obtaining blood from the ear edges or paw pads. As the disease progresses, ketone bodies will be present in the urine, which can be detected with the same urine stri Continue reading >>

Care Of Diabetic And Diabetic Ketoacidotic Patients (proceedings)

Care Of Diabetic And Diabetic Ketoacidotic Patients (proceedings)

Diabetes mellitus is the condition of hyperglycemia (high blood glucose) and glucosuria (glucose in the urine) caused by absence of the hormone insulin, or failure of the cells of the body to be able to respond to insulin. Diabetes mellitus is the condition of hyperglycemia (high blood glucose) and glucosuria (glucose in the urine) caused by absence of the hormone insulin, or failure of the cells of the body to be able to respond to insulin. Diabetes mellitus in veterinary patients can most often be compared to human adult onset diabetes (type 2), and juvenile onset diabetes is rare in veterinary patients. Patients may present with few clinical signs, in relatively good health (uncomplicated diabetes mellitus), or may be weak and dehydrated with severe electrolyte abnormalities (ketoacidotic diabetes mellitus). The most common clinical signs include weight loss, polyuria/polydipsia, increased or decreased appetite, unkempt hair coat, dandruff, sudden onset blindness (in dogs from cataract formation secondary to diabetes), and hind limb weakness (from diabetic neuropathy in cats) . In dogs and cats that have progressed to diabetic ketoacidosis, vomiting, anorexia, and lethargy are common complaints. Physical examination findings can reveal thin body condition, cataracts (dogs), dehydration, and mental dullness. Animals with recent onset diabetes mellitus can have a relatively normal examination. Laboratory testing to diagnose diabetes mellitus is relatively straightforward, and diagnosis can be confirmed at the time of evaluation in some cases with in-house testing. Elevated blood glucose is the mainstay of diagnosis; however keep in mind that hyperglycemia may be from diabetes, or secondary to a stress response, especially in cat. Handheld glucometers that are used by h 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 must be swiftly and aggressively treated. Diagnosis Diagnosis is based on the presence of ketonuria with clinical signs. Management guidelines Goals of treatment for diabetic ketoacidosis include correcting fluid deficits and acid-base and electrolyte imbalances, reducing blood glucose and ketonuria, initiating insulin therapy, and treating concurrent diseases. The use of intravenous fluid therapy with isotonic fluids to correct fluid deficits and acid-base and electrolyte imbalances is recommended. Many protocols for treatment of DKA exist but IV fluids and rapid-acting insulin (regular) must be administered first to quickly decrease hyperglycemia. Once the blood glucose has decreased to 250 mg/dL using regular insulin, it is important to add dextrose to the fluids and continue with regular insulin until the cat is no longer vomiting, is eating, and no longer has ketones in the urine. At this point, the regular insulin along with the dextrose in the fluids can be discontinued and Vetsulin® (porcine insulin zinc suspension) therapy can be initiated. 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 to adjust the Vetsulin dose. 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 you suspect rebound hyperglyc Continue reading >>

Management Of Feline Diabetic Ketoacidosis

Management Of Feline Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus with concurrent and often severe metabolic derangements associated with hyperglycaemia, glucosuria, metabolic acidosis, ketonaemia +/- ketonuria. Patients with ketonaemia/ketosis are usually still bright, eating and maintaining their hydration. Those with ketoacidosis are dehydrated, clinically unwell (e.g., anorexia, vomiting, lethargy) and typically require hospitalisation and intensive management. DKA is distinguished from uncomplicated diabetes mellitus (DM) by a relative insulin lack and increased counter-regulatory hormones. The latter are thought to occur secondary to intercurrent disease. Concurrent disease has been documented in approximately 90% of cats with DKA, with the most common being hepatic lipidosis, chronic kidney disease, acute pancreatitis, bacterial or viral infections and neoplasia (Bruskiewicz et al. 1997). Heinz bodies, neutrophilia with a left shift, increased ALT and azotaemia is common. Most cats presenting with DKA are newly diagnosed diabetics or recently diagnosed but poorly controlled diabetics. Diagnosis Hyperglycaemia, Glucosuria, Metabolic Acidosis Plus Ketones in Plasma and/or Urine Traditionally DKA has been diagnosed using urinary ketone dipsticks, which detect acetoacetate but not beta-hydroxybutyrate. However as the latter is the principle ketone body in DKA, measuring serum beta-hydroxybutyrate is a more sensitive indicator of DKA. In humans portable meters that measure beta-hydroxybutyrate in whole blood have largely superseded urine dipsticks. These ketone meters have recently proven useful in diagnosing DKA in cats, although they tend to underestimate beta-hydroxybutyrate at higher values (Zeugswetter, Rebuzzi 2012; Weingart et al. 2012). In the absence of a ke Continue reading >>

Isfm Consensus Guidelines On The Practical Management Of Diabetes Mellitus In Cats

Isfm Consensus Guidelines On The Practical Management Of Diabetes Mellitus In Cats

Diabetes mellitus (DM) is a common endocrinopathy in cats that appears to be increasing in prevalence. The prognosis for affected cats can be good when the disease is well managed, but clinical management presents challenges, both for the veterinary team and for the owner. These ISFM Guidelines have been developed by an independent, international expert panel of clinicians and academics to provide practical advice on the management of routine (uncomplicated) diabetic cats. Although the diagnosis of diabetes is usually straightforward, optimal management can be challenging. Clinical goals should be to limit or eliminate clinical signs of the disease using a treatment regimen suitable for the owner, and to avoid insulin-induced hypoglycaemia or other complications. Optimising bodyweight, feeding an appropriate diet and using a longer acting insulin preparation (eg, protamine zinc insulin, insulin glargine or insulin detemir) are all factors that are likely to result in improved glycaemic control in the majority of cats. There is also some evidence that improved glycaemic control and reversal of glucose toxicity may promote the chances of diabetic remission. Owner considerations and owner involvement are an important aspect of management. Provided adequate support is given, and owners are able to take an active role in monitoring blood glucose concentrations in the home environment, glycaemic control may be improved. Monitoring of other parameters is also vitally important in assessing the response to insulin. Insulin adjustments should always be made cautiously and not too frequently – unless hypoglycaemia is encountered. The Panel has produced these Guidelines after careful review of the existing literature and of the quality of the published studies. They represent a Continue reading >>

Management Of The Complicated Diabetic

Management Of The Complicated Diabetic

Proceeding of the NAVC North American Veterinary Conference Reprinted in the IVIS website with the permission of the NAVC Close window to return to IVIS Small Animal - Endocrinology Debra L. Zoran, DVM, PhD, Diplomate ACVIM Texas A&M University College Station, TX INTRODUCTION Diabetes mellitus is a common endocrinopathy in dogs and cats, and in most animals presents as a problem that is readily recognized and managed with routine diagnostic and therapeutic approaches. However, there are always exceptions to every rule, and this true for diabetes as well. This manuscript will review the recognition and management of insulin resistance, diabetic ketoacidosis, and the very uncommon, but challenging problem of nonketotic, hyperosmolar diabetes. The Complicated Diabetic – Insulin Ineffectiveness or Insulin Resistance? There are a number of factors that must be assessed in a dog or cat with diabetes that does not have adequate glycemic control. The first step is to determine whether the patient is an uncontrolled diabetic because of ineffective insulin or because of insulin resistance. There are many recognized causes of insulin ineffectiveness, and these include: • inactive insulin • diluted insulin • improper administration technique • inadequate dose • somogyi effect • inadequate frequency of insulin administration • impaired insulin absorption (especially long acting insulins) • anti-insulin antibody Insulin effectiveness should be assessed first, as it is the simplest group of problems to recognize and treat. Insulin ineffectiveness can be caused by inactive insulin, which is most often due to improper handling (e.g. insulin was damaged by heat or being dropped, shaken, etc). This problem is easily assessed by re-ev Continue reading >>

Guidelines To Bg Interpretation

Guidelines To Bg Interpretation

Due to the individual responses each pet has to insulin, differences in regulation levels being sought, and management style, it is important to review these guidelines with your vet and write down exactly what he/she wants you to do. Blood Glucose Goals for Diabetics Non-Diabetic Normal BG Cats Between 100 mg/dL and 300 mg/dL approximately 65-135 mg/dL Dogs without cataracts Between 100 mg/dL and 200 mg/dL approximately 70-150 mg/dL Dogs already blind from cataracts Between 100 mg/dL and 250 mg/dL approximately 70-150 mg/dL Timing is important: Always interpret your BG level in terms of where it occurs in the insulin and food cycle. You will need to have the results of at least one curve on the present insulin to know how your pet responds throughout the insulin and food cycle, and approximately when peak occurs. Until you know your pet's usual response at a given point in the cycle, you don't know if their BGs are expected to drop farther or if they are probably on the way up. The seriousness and degree of intervention needed can be very different for the same BG reading, based on whether BGs are usually falling or rising at the time of the BG test. Until you have enough experience with testing to be confident that your technique is consistent, your readings may vary due to procedural inconsistencies, rather than real changes in blood glucose levels. It is generally safer for your pet to have a somewhat higher BG than to run the risk of Hypoglycemia, though dogs risk developing cataracts and blindness at high BG levels (cats eyes are not affected this way). A single insulin dose may be reduced substantially or skipped entirely with minor repercussions (higher BG levels at next pre-shot). If ketones are present, especially if Ketoacidosis has developed, some insulin (a Continue reading >>

Blood Sugar Guidelines

Blood Sugar Guidelines

Absolute numbers vary between pets, and with meter calibrations. The numbers below are as shown on a typical home glucometer while hometesting blood glucose, not necessarily the more accurate numbers a vet would see (though many vets use meters similar to those used in hometesting). For general guidelines only, the levels to watch are approximately: mmol/L mg/dL(US) <2.2 <40 Readings below this level are usually considered hypoglycemic when giving insulin, even if you see no symptoms of it. Treat immediately[1] 2.7-7.5 50-130 Non-diabetic range[2] (usually unsafe to aim for when on insulin, unless your control is very good). These numbers, when not giving insulin, are very good news. 3.2-4.4 57-79 This is an average non-diabetic cat's level[3][4], but leaves little margin of safety for a diabetic on insulin. Don't aim for this range, but don't panic if you see it, either. If the number is not falling, it's healthy. 5 90 A commonly cited minimum safe value for the lowest target blood sugar of the day when insulin-controlled. 7.8 140 According to the American Association of Clinical Endocrinologists (AACE)[5], threshold above which organ and pancreatic dysfunction may begin in hospitalized humans[6] and the maximum target for post-meal blood glucose in humans.[7] 5.5-10 100-180 Commonly used target range for diabetics, for as much of the time as possible. <10-15 <180-270 "Renal threshold" (varies between individuals, see below), when excess glucose from the kidneys spills into the urine and roughly when the pet begins to show diabetic symptoms. See Hyperglycemia for long-term effects of high blood glucose. 14 250 Approximate maximum safe value for the highest blood sugar of the day, in dogs, who are more sensitive to high blood sugar. Dogs can go blind at this level. Cats Continue reading >>

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