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How To Treat Ketoacidosis In Dogs At Home

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 >>

Canine Diabetic Ketoacidosis (dka)

Canine Diabetic Ketoacidosis (dka)

Canine diabetic ketoacidosis, sometimes known as DKA, is a potentially fatal disease that most commonly occurs in dogs with uncontrolled diabetes mellitus, although in rare cases it has been known to appear in nondiabetic dogs. This condition symptomatically resembles that of diabetes but usually goes unnoticed until a near-fatal situation is at hand. For this reason, it is important to understand the causes, symptoms and treatment options. How Canine Diabetic Ketoacidosis Develops Under normal conditions, the pancreas is responsible for producing insulin, which helps to regulate the level of glucose in the blood cells. When the pancreas is ineffectively able to create enough insulin, a dog becomes diabetic. By default, a dog's body will begin looking for alternative fuel sources, such as fat. The problem is that when too much fat is consumed by the body, the liver then begins to produce ketones. This excessive level of ketones causes the condition known as canine diabetic ketoacidosis. There are two scenarios in which this can occur: in dogs with poorly controlled diabetes and in dogs with undiagnosed diabetes. Recognizing the Symptoms Because of the potentially deadly side effects, it is crucially important that dog owners be aware of the symptoms of canine diabetic ketoacidosis. One of the more common problems associated with this illness is the extreme similarity of the warning signs to a diabetic condition. While both conditions are harmful, canine diabetic ketoacidosis represents the last step taken by the body before it surrenders to the condition. The following are some of the recognizable symptoms of canine diabetic ketoacidosis: Drinking or urinating more than usual Sudden, excessive weight loss attributed to loss of appetite General fatigue Vomiting Sudden on Continue reading >>

Diabetic Dog: Tips To Manage His Diet

Diabetic Dog: Tips To Manage His Diet

So, your dog has diabetes. Take a deep breath. With good care, your companion can lead a long, healthy life. Like humans, when dogs have diabetes, staying trim is key. If your dog is overweight, losing some pounds can help his cells better use insulin, a hormone that keeps blood sugar levels in check. That makes it easier for his body to turn food into fuel. The goal for any pooch with diabetes is to keep blood sugar (or glucose) levels as close to normal as possible. This helps your dog feel good and makes it less likely he'll get diabetes-related complications, such as vision-clouding cataracts and urinary tract infections. Your veterinarian will determine how many calories your dog needs every day, based on his weight and activity level. Once you know that number, it's important to keep a close eye on what he eats and how much. Researchers are still exploring what diet is best for dogs with diabetes. Most vets recommend a high-fiber, low-fat diet. Fiber slows the entrance of glucose into the bloodstream and helps your dog feel full. Low-fat foods have fewer calories. Together, the diet can help your dog eat less and lose weight. But make sure your pooch drinks plenty of water. Fiber takes water from the body, and that can cause constipation and other problems. Most dogs do fine with food you can buy at the store. But your vet may recommend prescription dog food or a homemade diet developed by a veterinary nutritionist. Your vet can tell you the best way to go about changing your dog's food. Even the best diet won’t help if your dog doesn’t eat it, though -- and you can't give insulin to a dog on an empty stomach. It can make him very sick. If your dog isn't eating as much, it could be because he doesn't like the food. It could also mean he has another problem, or Continue reading >>

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Update On Insulin Treatment For Dogs And Cats: Insulin Dosing Pens And More

Authors Thompson A, Lathan P, Fleeman L Accepted for publication 19 February 2015 Checked for plagiarism Yes Peer reviewer comments 3 1School of Veterinary Science, The University of Queensland, Gatton, QLD, Australia; 2College of Veterinary Medicine Mississippi State University, Starkville, MS, USA; 3Animal Diabetes Australia, Melbourne, VIC, Australia Abstract: Insulin therapy is still the primary therapy for all diabetic dogs and cats. Several insulin options are available for each species, including veterinary registered products and human insulin preparations. The insulin chosen depends on the individual patient's requirements. Intermediate-acting insulin is usually the first choice for dogs, and longer-acting insulin is the first choice for cats. Once the insulin type is chosen, the best method of insulin administration should be considered. Traditionally, insulin vials and syringes have been used, but insulin pen devices have recently entered the veterinary market. Pens have different handling requirements when compared with standard insulin vials including: storage out of the refrigerator for some insulin preparations once pen cartridges are in use; priming of the pen to ensure a full dose of insulin is administered; and holding the pen device in place for several seconds during the injection. Many different types of pen devices are available, with features such as half-unit dosing, large dials for visually impaired people, and memory that can display the last time and dose of insulin administered. Insulin pens come in both reusable and disposable options. Pens have several benefits over syringes, including improved dose accuracy, especially for low insulin doses. Keywords: diabetes, mellitus, canine, feline, NPH, glargine, porcine lente Introduction Insulin the 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 >>

Diabetes In Dogs: Symptoms, Causes, & Treatment

Diabetes In Dogs: Symptoms, Causes, & Treatment

Diabetes is a chronic disease that can affect dogs and cats and other animals (including apes, pigs, and horses) as well as humans. Although diabetes can’t be cured, it can be managed very successfully. Diabetes mellitus, or “sugar diabetes,” is the type of diabetes seen most often in dogs. It is a metabolism disorder. Metabolism refers to how the body converts food to energy. To understand what diabetes is, it helps to understand some of this process. The conversion of food nutrients into energy to power the body’s cells involves an ongoing interplay of two things: • Glucose: essential fuel for the body’s cells. When food is digested, the body breaks down some of the nutrients into glucose, a type of sugar that is a vital source of energy for certain body cells and organs. The glucose is absorbed from the intestines into the blood, which then transports the glucose throughout the body. • Insulin: in charge of fuel delivery. Meanwhile, an important organ next to the stomach called the pancreas releases the hormone insulin into the body. Insulin acts as a “gatekeeper” that tells cells to grab glucose and other nutrients out of the bloodstream and use them as fuel. What is diabetes? With diabetes, the glucose-insulin connection isn’t working as it should. Diabetes occurs in dogs in two forms: • Insulin-deficiency diabetes—This is when the dog’s body isn’t producing enough insulin. This happens when the pancreas is damaged or otherwise not functioning properly. Dogs with this type of diabetes need daily shots to replace the missing insulin. This is the most common type of diabetes in dogs. • Insulin-resistance diabetes—This is when the pancreas is producing some insulin, but the dog’s body isn’t utilizing the insulin as it should. The ce Continue reading >>

Diabetes In Dogs (diabetes Mellitus)

Diabetes In Dogs (diabetes Mellitus)

Diabetes in dogs is a common disorder and is similar to juvenile diabetes in people in which the pancreas cannot produce sufficient amount of insulin. This page looks at the symptoms, health risks, and treatment of this disease. It also discusses how to use some natural remedies such as herbs and supplements to help dogs with diabetes. Diabetes mellitus (sugar diabetes) is a common autoimmune disorder in both cats and dogs. Pets that are obese, as well as neutered male cats and unspayed female dogs are more prone to the disease. Most dogs that have diabetes are between 7 to 9 years old, although it can occur to very young dogs as well. Sugar diabetes is divided into Type I and Type II. Type I diabetes (similar to juvenile diabetes in people) occurs when the body attacks the pancreatic cells that make insulin. When your dog's body does not have enough insulin, the body is unable to properly utilize or store blood sugar, resulting in increased sugar levels. The excessive sugar spills over into the urine and is removed from the body. As a result, the body tissues do not have enough blood sugar to sustain a consistent energy level. This is the most common form of diabetes in dogs and is frequently referred to as insulin dependent diabetes (IDDM). In type II diabetes mellitus, insulin is still produced, but it is either not adequately produced, or the cells are not as sensitive to it as they should be. If the cells are not sensitive enough, then even though insulin is present, glucose cannot enter the cells. Type II diabetes is associated with obesity, and in many cases can be cured with weight loss and exercise. This form is uncommon in dogs and is frequently referred to as non-insulin dependent diabetes (NIDDM). If left untreated, diabetes in dogs will lead to kidney failu Continue reading >>

Canine Ketoacidosis

Canine Ketoacidosis

Diabetic Ketoacidosis (DKA) is a condition that occurs in diabetic dogs. The diabetes deprives the body of much needed glucose, the energy source used by cells. Without energy from glucose, the body will look for alternative sources such as the fat that is stored in the body. Your dog's body will start to break down the fats causing small deposits to accumulate in the blood. These deposits are called ketones. The condition is called canine Ketoacidosis. Since the sugar cannot enter the cells it builds up in the blood causing a condition called hyperglycemia. Ketocacidosis can be caused by untreated diabetes or ineffective treatment of canine diabetes such as insulin therapy that is not working. Stress,medications, not drinking enough water and a bacterial infection can also cause the insulin to not work as planned. The disease is seen most often in females (up to 80%) and dogs older than 7 years of age. Breeds with a higher predisposition to the disease are poodles (miniature and toy), miniature schnauzers, Cairn Terriers and Beagles. When you go to the veterinarian it is common for dogs to be comatose or in shock. Symptoms of Canine Ketoacidosis Symptoms associated with ketoacidosis in dogs are related to both canine diabetes and DKA. Excessive thirst (polydipsia) Frequent urination (polyuria) Weakness Lethargy/Tired Behavior No appetite (anorexia) Weight Loss Vomiting Abdominal Pain Depression Coma Diagnosis of Canine Ketoacidosis Your veterinarian will ask if your dog is on other drugs such as glucocorticoids or any other illnesses that your dog is suffering from. During a physical exam your veterinarian will look for signs of dehydration, pain, high temperature, jaundice, low pulse and neurological problems. They will also look for muscle decline, weight loss, catar 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 >>

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 >>

Use Of Intravenous Insulin Aspart For Treatment Of Naturally Occurring Diabetic Ketoacidosis In Dogs

Use Of Intravenous Insulin Aspart For Treatment Of Naturally Occurring Diabetic Ketoacidosis In Dogs

Objectives To characterize the utility and safety of IV insulin aspart in the treatment of diabetes ketoacidosis (DKA) in dogs and to determine the times to resolution of hyperglycemia, ketonemia, and acidemia in dogs treated with IV insulin aspart.DesignProspective noncontrolled single arm study of dogs with DKA between February 2010 and March 2011.SettingUniversity teaching hospital.AnimalsSix dogs with spontaneous DKA and blood glucose (BG) concentration >13.8 mmol/L (250 mg/dL), pH between 7.0 and 7.35, and blood beta-hydroxybutyrate >2.0 mmol/L were treated with an IV continuous rate infusion (CRI) of aspart insulin. The time to biochemical resolution of DKA was defined as the time interval from when the IV CRI of aspart insulin began until marked hyperglycemia (BG concentration >13.8 mmol/L [250 mg/dL]), acidemia (venous pH <7.35), and ketonemia (beta-hydroxybutyrate concentration >2.0 mmol/L) resolved. Aspart insulin was administered as an IV CRI at an initial dose of 0.09 U/kg/h. The dose was adjusted according to a previously published protocol.Measurements and Main ResultsThe median time to biochemical resolution of DKA in dogs treated with insulin aspart was 28 hours (range, 20–116 h). Mean BG concentration decreased significantly from the time IV fluid resuscitation began (32.0 mmol/L [576 mg/dL]; range, 14.9–38.9 mmol/L [268–700 mg/dL]) until 6 hours later when IV aspart insulin CRI began (20.1 mmol/L [363 mg/dL]; range, 9.4–26.1 mmol/L [169–470 mg/dL], P = 0.03). No adverse effects were observed in association with IV insulin aspart administration. Median cost of hospitalization was US$3,477 (range, US$1,483–10,469). Median total units per kilogram of administered IV insulin aspart was 2.97 U/kg (range, 2.04–10.52 U/kg).Conclusions Intravenou Continue reading >>

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

2010 Aaha Diabetes Management Guidelines For Dogs And Cats

Renee Rucinsky, DVM, ABVP (Feline) (Chair) | Audrey Cook, BVM&:S, MRCVS, Diplomate ACVIM-SAIM, Diplomate ECVIM-CA | Steve Haley, DVM | Richard Nelson, DVM, Diplomate ACVIM | Debra L. Zoran, DVM, PhD, Diplomate ACVIM | Melanie Poundstone, DVM, ABVP - Download PDF - Introduction Diabetes mellitus (DM) is a treatable condition that requires a committed effort by veterinarian and client. This document provides current recommendations for the treatment of diabetes in dogs and cats. Treatment of DM is a combination of art and science, due in part to the many factors that affect the diabetic state and the animal's response. Each animal needs individualized, frequent reassessment, and treatment may be modified based on response. In both dogs and cats, DM is caused by loss or dysfunction of pancreatic beta cells. In the dog, beta cell loss tends to be rapid and progressive, and it is usually due to immune-mediated destruction, vacuolar degeneration, or pancreatitis.1 Intact females may be transiently diabetic due to the insulin-resistant effects of the diestrus phase. In the cat, loss or dysfunction of beta cells is the result of insulin resistance, islet amyloidosis, or chronic lymphoplasmacytic pancreatitis.2 Risk factors for both dogs and cats include insulin resistance caused by obesity, other diseases (e.g., acromegaly in cats, hyperadrenocorticism in dogs), or medications (e.g., steroids, progestins). Genetics is a suspected risk factor, and certain breeds of dogs (Australian terriers, beagles, Samoyeds, keeshonden3) and cats (Burmese4) are more susceptible. Regardless of the underlying etiology, diabetic dogs and cats are hyperglycemic and glycosuric, which leads to the classic clinical signs of polyuria, polydipsia (PU/PD), polyphagia, and weight loss. Increased fat mobi Continue reading >>

Clinical Signs Of Diabetes Mellitus In Dogs And Cats

Clinical Signs Of Diabetes Mellitus In Dogs And Cats

Clinical signs are useful in the diagnosis and monitoring of canine and feline diabetes. Other laboratory tests are also necessary for diagnosis of Diabetes mellitus and the monitoring of treated diabetic pets. There are three distinct clinical pictures in diabetes mellitus: Uncomplicated diabetes mellitus The classical signs are polyuria,polydipsia, polyphagia, cachexia and increased susceptibility to infections (e.g. urinary tract infections). In long term diabetes complications due to protein glycosylation can be seen: cataracts (mainly in dogs) and peripheral neuropathy (mainly in cats). Diabetic ketoacidosis DKA develops due to long standing undiagnosed diabetes mellitus, insufficient insulin dose in treated diabetics and impaired insulin action and/or resistance, caused by obesity, concurrent illness or drugs. This is the cause of more than two thirds of cases of DKA. Due to the lack of insulin, glucose cannot be used as an energy source. Fats are broken down to provide energy. During lipolysis, high levels of ketones are produced. Ketosis and acidosis develop and are accompanied by electrolyte imbalances. Ketosis causes anorexia, nausea and lethargy. Treatment DKA is an emergency and treatment must be started as soon as possible. The goals of treatment are to correct fluid deficits, acid-base balance and electrolyte balance, lower blood glucose and ketone concentrations and recognize and correct underlying and precipitating factors. Therapy includes intravenous fluid therapy with isotonic fluids, e.g. 0.9% saline, and intravenous administration of rapid-acting insulin. If possible the electrolyte concentrations and acid-base balance should be measured and corrected. Caninsulin is an intermediate-acting insulin and is not suitable for intravenous administration. W 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 >>

Dog Diabetes: A Natural And Effective Alternative

Dog Diabetes: A Natural And Effective Alternative

56 Yet another human disease that also impacts dogs is diabetes. Diabetes is caused by either a lack of insulin or an insufficient response to the hormone. In a dog’s typical digestive process, the system breaks food down into components like glucose. Those components are carried to cells by pancreas-secreted insulin. When a dog doesn’t produce enough insulin or is unable to use it properly, glucose has nowhere to go. This elevates blood sugar levels, resulting in hyperglycemia and a number of associated health complications. The good news is that canine diabetes is adaptable; many diabetic dogs lead hale and hearty lives. Types of Diabetes There are two types of diabetes: Type I and Type II. Type I diabetes refers to the lack of overall insulin production and is the most common form of the disease. This happens because the pancreas fails to secrete sufficient levels of the stuff. Dogs with Type I diabetes, as you may have guessed, need insulin. Type II diabetes is more common in our feline friends and is a lack of “normal” reaction to insulin the body is already producing. Symptoms of Diabetes There are a number of symptoms of diabetes in dogs. Remember, though, that diabetes is identified through blood tests, a full medical examination and a urinalysis. Do not diagnose your own dog. Among the symptoms of diabetes in dogs are: Disproportionate thirst or a surge in consumption of water Loss of weight Increased levels of urination Fatigue Vomiting Forming of cataracts or attendant vision difficulties Skin infections Sweet-smelling or “fruity” breath Sticky urine Causes and Considerations The exact cause of diabetes in dogs is unknown. There are a number of contributing factors, including obesity and genetics, that play a role in how and if the disease develop Continue reading >>

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