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How To Treat Ketoacidosis In Cats

'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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious complication of diabetes mellitus. Before the availability of insulin in the 1920s, DKA was a uniformly fatal disorder. Even after the discovery of insulin, DKA continued to carry a grave prognosis with a reported mortality rate in humans ranging from 10% to 30%. However, with the expanding knowledge regarding the pathophysiology of DKA and the application of new treatment techniques for the complications of DKA, the mortality rate for this disorder has decreased to less than 5% in experienced human medical centers (Kitabchi et al, 2008). We have experienced a similar decrease in the mortality rate for DKA in our hospital over the past two decades. DKA remains a challenging disorder to treat, in part because of the deleterious impact of DKA on multiple organ systems and the frequent occurrence of concurrent often serious disorders that are responsible for the high mortality rate of DKA. In humans, the incidence of DKA has not decreased, appropriate therapy remains controversial, and patients continue to succumb to this complication of diabetes mellitus. This chapter summarizes current concepts regarding the pathophysiology and management of DKA in dogs and cats. • Diabetic ketoacidosis (DKA) is a severe form of complicated diabetes mellitus that requires emergency care. • Acidosis and electrolyte abnormalities can be life threatening. • Fluid therapy and correction of electrolyte abnormalities are the two most important components of therapy. • Concurrent disease increases the risk for DKA and must be addressed as part of the diagnostic and therapeutic plan. • Bicarbonate therapy usually is not needed and its use is controversial. • About 70% of treated dogs and cats are discharged from the hospital after 5 to 6 days Continue reading >>

How To Treat Cat Diabetes At Home With These Top 5 Holistic Options.

How To Treat Cat Diabetes At Home With These Top 5 Holistic Options.

Cat diabetes is increasingly being diagnosed, and currently it affects more than 1 in 400 cats. Diabetes is very treatable, and does not need to shorten your cat’s life span. This article will go over the signs of diabetes in cats, along with the various suspected causes. I will review the most common solutions, focusing on the lesser know natural solutions that you can use to treat your cat for diabetes at home. Most pet owner’s first suspect that their cat has diabetes as their cat is drinking and urinating much more than normal. This may be accompanied by increased appetite, but also weight loss. Occasional there is noticeable leg weakness, or dropping down on the rear legs. Some people notice a sweet smell to the breath. If not noticed early, your cat may become very ill with a condition called Ketoacidosis. This requires immediate veterinary treatment. Diabetes is a result of the pancreas not producing enough insulin to allow the body to utilize blood glucose (sugar). This results in high blood sugar levels causing increased drinking and urination. Some cats are genetically at risk of developing diabetes. Cats that are obese typically are on a high carbohydrate dry cat food, are at higher risk. If you suspect your pet is diabetic, have this confirmed by your veterinarian. Most cats begin with insulin, but with some diet alterations may come off insulin therapy. Ask your veterinarian about Glargine (brand name Lantus) Insulin – it is longer acting and better at regulating difficult to better at regulating difficult to regulate diabetic cats. The insulin injections can be given at home, and at the same time each day. Your veterinarian will show you how to give injections – they are not painful and usually not even noticed. The proper type of insulin, dose, an 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 >>

Diabetes With Ketone Bodies In Cats

Diabetes With Ketone Bodies In Cats

Diabetes Mellitus with Ketoacidosis in Cats The term “ketoacidosis” refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies.” Meanwhile, diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. 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. Typically, the type of condition affects older cats; in addition, female cats are more prone diabetes with ketoacidosis than males. 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 cat'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 cat’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 (azotemia), low sodium levels Continue reading >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

Also known as: DKA Severe diabetic ketoacidosis is a medical emergency and requires prompt treatment to correct dehydration, electrolyte disturbances and acidosis. It is a complication of insulin dependent Diabetes Mellitus. DKA is the result of marked insulin deficiency, and ketonaemia and ketoacidosis occur approximately 15 days after insulin concentrations are suppressed to fasting levels. Marked insulin suppression occurs on average 4 days after fasting glucose levels reach 30mmol/L. Many cats with DKA have other intercurrent conditions which may precipitate the condition including: infection, pancreatitis or renal insufficiency. Pathophysiology Insulin deficiency leads to increased breakdown of fat that releases fatty acids into the circulation. Free fatty acids are oxidised in the liver to ketones that are used by many tissues as an energy source instead of glucose. This occurs when intracellular levels of glucose are insufficient for energy metabolism as a result of severe insulin deficiency. In the liver, instead of being converted to triglycerides, free fatty acids are oxidised to acetoacetate, which is converted to hydroxybutyrate or acetone. Ketones are acids that cause central nervous system depression and act in the chemoreceptor trigger zone to cause nausea, vomiting and anorexia. They also accelerate osmotic water loss in the urine. Dehydration results from inadequate fluid intake in the face of accelerated water loss due to glucosuria and ketonuria. Dehydration and subsequent reduced tissue perfusion compounds the acidosis through lactic acid production. There is whole body loss of electrolytes including sodium, potassium, magnesium and phosphate and there is also intracellular redistribution of electrolytes following insulin therapy which may compound p Continue reading >>

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment

Review Article Diabetic ketoacidosis (DKA) is a not uncommon emergency in both newly diagnosed and poorly regulated diabetic cats. When there is a heightened metabolic rate and energy requirement due to concurrent illness, an increase in the release of glucose counter-regulatory hormones causes insulin receptor resistance, lipolysis, free fatty acid release and ketogenesis. This necessitates not only treatment to eliminate the ketosis and control blood glucose, but also investigation of concurrent illnesses. Continue reading >>

Diabetic Ketoacidosis In Cats

Diabetic Ketoacidosis In Cats

Diabetic ketoacidosis requires urgent veterinary treatment. With ketoacidosis, the lack of insulin causes the body to burn fat and muscle creating ketones. The kidneys are unable to filter all of the ketones from the blood. As a result, these ketones build up in the bloodstream, turning the blood extremely acidic. This is a dangerous stage of diabetes that causes blood chemical and blood sugar imbalances, and also impairs brain function. Left untreated, diabetic ketoacidosis can lead to diabetic coma and death. Understanding Diabetes Mellitus Diabetes mellitus is more commonly referred to as diabetes. With this disease, the feline's pancreas fails to properly regulate the flow of insulin within the body. Without the proper levels of insulin, the cat eats more, but fats and protein break down into energy, so the cat loses weight. Sugar levels within the blood skyrocket and are released in the urine. Cats often require insulin injections to maintain healthy blood sugar levels. With non-insulin dependent diabetes, diet, weight loss and exercise may be enough to keep blood sugar levels down. If a cat's blood sugar levels are properly monitored, a cat with diabetes is unlikely to face any serious health issues. If diabetic ketoacidosis does occur, call your vet immediately. Signs of Diabetic Ketoacidosis The most common signs of ketoacidosis in cats are excessive thirst and frequent urination. However, you should also watch for: Breath smells of nail polish remover/acetone Excessive appetite Vision changes/blindness Vomiting Weakness Weight loss Ketoacidosis can occur with an infection or illness. It can also happen if the insulin amounts need altering. Your vet will find a cause and create a new treatment plan you will follow at home. Diagnosis and Treatment When you bring Continue reading >>

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment.

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment.

Abstract Practical relevance: Diabetic ketoacidosis (DKA) is a not uncommon emergency in both newly diagnosed and poorly regulated diabetic cats. When there is a heightened metabolic rate and energy requirement due to concurrent illness, an increase in the release of glucose counter-regulatory hormones causes insulin receptor resistance, lipolysis, free fatty acid release and ketogenesis. This necessitates not only treatment to eliminate the ketosis and control blood glucose, but also investigation of concurrent illnesses. Clinical challenges: A number of metabolic derangements can occur with DKA, requiring a comprehensive diagnostic evaluation, elimination of ketones, careful correction of glucose, electrolyte and acid base abnormalities, and close monitoring. AUDIENCE: Any veterinarian that cares for cats in urgent and emergency situations should understand the pathophysiology of DKA in order to address an individual's clinical signs and metabolic derangements. Evidence base: This review draws evidence from the peer-reviewed literature as well as the author's personal clinical experience. 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 >>

Understanding And Treating Diabetic Ketoacidosis

Understanding And Treating Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a serious metabolic disorder that can occur in animals with diabetes mellitus (DM).1,2 Veterinary technicians play an integral role in managing and treating patients with this life-threatening condition. In addition to recognizing the clinical signs of this disorder and evaluating the patient's response to therapy, technicians should understand how this disorder occurs. DM is caused by a relative or absolute lack of insulin production by the pancreatic b-cells or by inactivity or loss of insulin receptors, which are usually found on membranes of skeletal muscle, fat, and liver cells.1,3 In dogs and cats, DM is classified as either insulin-dependent (the body is unable to produce sufficient insulin) or non-insulin-dependent (the body produces insulin, but the tissues in the body are resistant to the insulin).4 Most dogs and cats that develop DKA have an insulin deficiency. Insulin has many functions, including the enhancement of glucose uptake by the cells for energy.1 Without insulin, the cells cannot access glucose, thereby causing them to undergo starvation.2 The unused glucose remains in the circulation, resulting in hyperglycemia. To provide cells with an alternative energy source, the body breaks down adipocytes, releasing free fatty acids (FFAs) into the bloodstream. The liver subsequently converts FFAs to triglycerides and ketone bodies. These ketone bodies (i.e., acetone, acetoacetic acid, b-hydroxybutyric acid) can be used as energy by the tissues when there is a lack of glucose or nutritional intake.1,2 The breakdown of fat, combined with the body's inability to use glucose, causes many pets with diabetes to present with weight loss, despite having a ravenous appetite. If diabetes is undiagnosed or uncontrolled, a series of metab Continue reading >>

How I Treat Electrolyte Disturbances In Diabetic Ketoacidosis

How I Treat Electrolyte Disturbances In Diabetic Ketoacidosis

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 – Critical Care Nishi Dhupa, BVM, DACVIM, DACVECC College of Veterinary Medicine Cornell University, Ithaca, NY INTRODUCTION Diabetic ketoacidosis (DKA) results from an absolute or relative insulin deficiency in conjunction with glucagon and stress hormone excess. It is crucial to identify underlying disease factors contributing to stress in these patients. Stress factors include changes in environment, dehydration and concomitant disease. Commonly associated diseases include renal disease, urinary tract and other infection, and pancreatitis; in cats, hepatic lipidosis is also commonly seen. DKA is characterized by hyperglycemia, dehydration, ketonemia, metabolic acidosis and multiple electrolyte abnormalities. Treatment must be intensive and directed towards the correction of fluid, electrolyte and acid-base abnormalities as well as the correction of abnormal carbohydrate metabolism. The treatment itself (particularly the correction of acid-base imbalance with sodium bicarbonate therapy and the use of insulin therapy) may exacerbate the electrolyte abnormalities, and careful monitoring and aggressive treatment of these abnormalities is critical. Without treatment, DKA is fatal and it should be considered a medical emergency. The mortality rate for DKA is 25-30 %, even with aggressive treatment. CLINICAL SIGNS Clinical signs seen in dogs and cats with ketoacidosis include polyuria, polydipsia, weight loss, anorexia, vomiting, diarrhea, lethargy, weakness, dehydration, obtundation and hyper- or hypoventilation. These clinical signs may develop in various combinations and are usually severe in the keto Continue reading >>

My Cat Has Diabetes :: Treatment

My Cat Has Diabetes :: Treatment

Living with a diabetic cat Each diabetic cat responds differently to different therapies. Some cats are easier to regulate; others require more complex types of treatment. Some cats can be treated successfully through changes in diet and with oral medications. In cats with more severe diabetes, insulin injections may be required for the remainder of their lives. In general, treatment for diabetes falls into three categories: Insulin injections Oral hypoglycemic medications Diet Home monitoring & testing Ongoing and frequent home monitoring of your cat's glucose level is important both for ensuring that diabetes is under control and the long-term health maintenance of your pet. Home monitoring usually results in less stress on the cat and allows for closer, more precise control of blood glucose levels on a regular basis, which helps avoid the risk of hypoglycemic episodes. Home testing of glucose levels can be done with a similar type of blood glucose monitor used by humans. This method requires a small sample of blood that is taken from the cat for testing and generally provides an immediate reading of your cat's blood glucose level. In addition to monitoring glucose levels through the blood, caretakers can use urine glucose monitoring. However, urine glucose monitoring is generally not as accurate due to the lag time for glucose to go from the blood to the urine in the cat's body. It is recommended to consult with your veterinarian on the best way to monitor your cat's glucose. They can also provide valuable advice on which type(s) of monitors work best in cats, as well as train you on how to use and interpret the test results. When at home, you also should continually be aware of your cat's appetite, water consumption and urine output to determine what is normal behav Continue reading >>

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

The Signs, Diagnosis & Types Of Diabetes Mellitus In Cats

There are certain signs or symptoms which are commonly seen in cats with diabetes mellitus. Unfortunately, these signs also occur in other diseases and conditions. Therefore, laboratory tests are necessary to diagnose diabetes mellitus in cats. The following article includes a discussion of how this diagnosis is made and the types of diabetes found in cats. What are the signs of diabetes mellitus in cats and why do they occur? Depending on how severely insulin production is impaired, there may be few signs of disease, or the signs may be severe. Dogs with diabetes often develop cataracts; cats do not. The most common signs of diabetes are: Increased thirst (polydipsia) and urination (polyuria) Change in appetite Weight loss Change in gait (walking) Decreased activity, weakness, depression Vomiting Increased Thirst and Urination: Because the glucose cannot enter the cells, the glucose levels in the blood become abnormally high (hyperglycemia). The glucose is filtered out by the kidneys and is found in the urine (glucosuria). When it is filtered out, it carries water with it. The animal, then, is losing more water through the urine than normal and has to make up for it by drinking more. Inappropriate Elimination: The increased urination may result in the cat not always urinating in the litter box. This inappropriate urination may be one of the first signs of diabetes in cats. In addition, cats with diabetes can often develop urinary tract infections, which may also result in inappropriate elimination. Change in Appetite: Some diabetic cats eat less, because frankly, they do not feel well. Other cats may have voracious appetites and eat a lot (polyphagia) because their hypothalamus keeps telling them they are hungry. Weight Loss: Because the cat cannot use the calories he Continue reading >>

Feline Diabetic Ketoacidosis

Feline Diabetic Ketoacidosis

Fall 2008 Ketoacidosis is a metabolic imbalance that is most commonly seen as a sequel to unmanaged or poorly regulated diabetes mellitus. It is caused by the breakdown of fat and protein in a compensatory effort for the need of more metabolic energy. The excessive breakdown of these stored reserves creates a toxic by-product in the form of ketones. As ketones build up in the blood stream, pH and electrolyte imbalances proceed. This condition is a potentially life-threatening emergency that requires immediate medical attention. Diabetes mellitus is a common endocrine disease in geriatric felines. It is caused by a dysfunction in the beta cells of the exocrine pancreas resulting in an absolute or relative deficiency of insulin. Insulin has been called the cells' gatekeeper. It attaches to the surface of cells and permits glucose, the cells' primary energy source, to enter from the blood. A lack of insulin results in a build up of glucose in the blood, physiologically causing a state of cellular starvation. In response to this condition the body begins to increase the mobilization of protein and fat storage. Fatty acids are released from adipose tissue, which are then oxidized by the liver. Normally, these fatty acids are formed into triglycerides. However, without insulin, these fatty acids are converted into ketone bodies, which cannot be utilized by the body. Together with the increased production and decreased utilization an abnormally high concentration of ketone bodies develop. These fixed acids are buffered by bicarbonate; however, the excessive amounts overwhelm and deplete the bicarbonate leading to an increase in arterial hydrogen ion concentration and a decrease in serum bicarbonate. This increase in hydrogen ions lowers the body's pH, leading to a metabolic ac Continue reading >>

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