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Ketonuria Dog

Ketonuria

Ketonuria

Ketonuria in dogs is defined as the presence of ketones (acetone, acetoacetate, and beta-hydroxybutyrate) in the urine. In many dogs, glycosuria is also present and cystitis is a common sequela. This condition is mostly observed in dogs with diabetes mellitus and ketoacidosis. Continue reading >>

Urinalysis: Testing A Urine Sample

Urinalysis: Testing A Urine Sample

There are many valuable pieces of information that your veterinarian can obtain from analyzing a urine sample. As with any other procedure, it is important to remember that we need to look at the whole picture, not just one value, before we attempt to draw any conclusions from the testing. Test results always need to be interpreted in light of the history, physical exam, possible blood work, and further testing such as x-rays, ultrasound, etc. Obtaining a urine sample There are several different ways to obtain a urine sample from a pet. The most common way to catch a sample in a larger pet, such as a dog, is to use a clean, dry container, such as an aluminum pie pan, plastic dish, etc. A litter box can be washed, rinsed well to eliminate all traces of detergent or disinfectant, and allowed to dry. Then use special litter available from your veterinarian, or clean styrofoam packing peanuts instead of regular litter. After the pet has urinated, the styrofoam is removed and the sample is poured into a clean container. To minimize changes in the urine, always collect the urine sample in a clean, dry container, and take it to your veterinarian's office immediately. If there will be a wait, refrigerate the sample. If the temperature is warm, consider placing the urine in a cooler during transportation. DO NOT FREEZE A URINE SAMPLE. If a sterile sample is needed, your veterinarian may recommend that you bring your animal to the veterinary clinic for a procedure called "cystocentesis," in which a small needle is placed directly into the bladder through the body wall. This procedure does not take very long, and should provide a sample that has not been contaminated by debris or bacteria from outside the bladder. Your veterinarian may also use a urinary catheter to obtain a urine Continue reading >>

Why Is There Ketone In My Dog's Urine ?

Why Is There Ketone In My Dog's Urine ?

Why Is There Ketone In My Cat's Urine ? To see what normal blood and urine values are for your pet, go here For an explanation of causes of most abnormal blood and urine tests go here To see how tests are often grouped, go here Ron Hines DVM PhD Lots of my articles are plagiarized and altered on the web to market products and services. There are never ads running or anything for sale with my real articles. Try to stay with the ones with in the URL box or find all my articles at ACC.htm. Ketone In Your Pet’s Urine Ketonuria Most of the thin in-office test strips that veterinarians use to analize a sample of your pet’s urine contain a portion that changes color when ketones are present. There should not be any. When there is, it is usually evidence that your pet is burning its stored fat for energy instead of glucose sugar. That often occurs when pets refuse to eat, or when diabetes prevents them from utilizing their blood sugar properly. Reasons Why Your Pet Might Have Ketone (ketone bodies, ketosis) In Its Urine : Unmedicated or poorly controlled diabetes in dogs and cats, malnutrition andr starvation are the most common causes. Of course, any disease that prevents or makes pets uninterested in eating; particularly it is young and its nutritional demands for growth are high, will also "throw" them into ketosis (ketoacidosis). Occasional, false-positive test results do occur. But those are usually low or borderline-positive color changes on the urine test strips. Complementary Tests : A urine and blood BHB (ß-Hydroxybutyrate) assay to confirm the positive urine ketone result, CBC/WBC and blood chemistry panels and then secondary tests depending on those results .................... DxMe 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 >>

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 >>

Ketonuria

Ketonuria

Ketonuria Ketonuria is a common finding in sick ruminants and is seen in starvation; acetonemia of lactating dairy cattle; and pregnancy toxemia of ewes, does, and beef cattle. A small amount of ketonuria is normally present in dairy cows in early lactation. As a result, it is important that the assay method used to demonstrate ketonuria is appropriate for urine, because there may be a risk for false-positive reactions on some tests. The standard test is sodium nitroprusside, which turns an intense purple color in the presence of acetoacetate, one of the three keto acids. Sujoy Ghosh MD(General Medicine) DM(Endocrinology) MRCP(UK) MRCPS(Glasgow), Andrew Collier BSc MD FRCP(Glasgow & Edinburgh), in Churchill's Pocketbook of Diabetes (Second Edition), 2012 Ketonuria Ketonuria (in concert with hyperglycaemia) usually suggests the presence of a marked degree of insulin deficiency. In these circumstances, ketonuria results from: • accelerated breakdown of adipocyte triglycerides • preferential hepatic β-oxidation of the liberated fatty acids to ketone bodies (3-hydroxybutyrate and acetoacetate). Insulinopenia (absolute or, more commonly, relative) is primarily responsible for the acceleration of ketogenesis. Reduced ketone body clearance by peripheral tissues may also contribute as ketosis develops, and this too is influenced by insulin. Ketonuria in diabetes is sometimes erroneously attributed to fasting or decreased carbohydrate intake. Although ketonuria is a physiological response to fasting in non-diabetic individuals, the crucial distinction in the diabetic patient is the combination of ketonuria in concert with hyperglycaemia. In non-diabetic individuals, the plasma glucose concentration will be normal, or even marginally reduced, during fasting. In healthy subje Continue reading >>

Ketoacidosis

Ketoacidosis

Ketones in the urine or blood, 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 [2] combined with certain other systemic stresses. DKA can be fixed if caught quickly. Because of the hyperglycemia Cushing's disease creates, it's possible (but not frequent) to find ketones in the urine. [3] The three ketone bodies are acetone, acetoacetic acid, and beta-hydroxybutyric acid, with the predominating ketone body formed being beta-hydroxybutyrate acid. [4] Though they are referred to as "bodies" this is a misnomer as they are dissolved substances. [5][6] Ketones are produced by the liver as part of fat metabolism and are normally not found in sufficient quantity to be able to be measured in urine or blood (non-diabetics or well-controlled diabetics). [7] Since the body is set up to normally burn glucose as its fuel, when glucose isn't available as an energy source, (untreated/poorly treated diabetes and some other unrelated medical conditions), it begins to burn fat for energy instead. The result of the body turning to burning fat instead of glucose means more ketone production which is able to be measured when testing either urine or blood for them. [4][6] 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: 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 t Continue reading >>

Canine Urinalysis

Canine Urinalysis

Urinalysis is a critical tool for diagnosing kidney failure, diabetes, urinary tract tumors or infections, and many other diseases. Urinalysis is a screening test that may be helpful in diagnosing many diseases, but it is an especially important test to perform whenever any urinary tract disease or abnormality is expected. Abnormal appearing urine (cloudy or red colored), difficulty in urinating, abnormal frequency of urination, or abnormal flow are all indications for ordering a urinalysis. The test is noninvasive, relatively easy to interpret, and nearly every veterinary clinic has the reagents and instruments necessary to perform it. A Test of Kidney Function Urine is the end product of a process of filtration that removes waste products and metabolic end products from the blood serum. In addition, the kidneys help maintain fluid balance in the body by concentrating (or diluting) the kidneys’ filtrate. The functional unit of the kidney is the nephron, which is comprised of the glomerulus (with its attendant vascular bed that serves as a filtration unit) and the tubule, which modifies the filtrate. From the kidney the filtrate passes through the ureters into the storage organ, the bladder, where it remains until voided via the urethra and external genitalia. Analysis of the sediment of the urine reflects the health of all these structures and the cells that line them. A complete urinalysis will test the function of the nephrons; provide some indications of the current metabolic status of the animal; and demonstrate the relative fluid status of the body. In addition, the urinalysis evaluates substances in the urine that might indicate ongoing disease. Urine Analysis Fresh samples give the best results; samples should be analyzed within two hours, or up to six hours a Continue reading >>

Leading Science And Care For Animals

Leading Science And Care For Animals

be aware! Recent increased presentation of acquired Fanconi-like syndrome cases related to dried chicken and duck meat ingestion in the UK. A recent cluster of canine cases with PU/PD, glucosuria +/- ketonuria and without hyperglycaemia have been reported by number of referral practices and general practioners in the UK. This combination of findings is suggestive of a proximal tubular disorder and may also be associated with marked electrolyte and acid-base abnormalities. Where a dietary history has been available, the majority of these patients have been fed dried ‘jerky’ type dog treats (chicken and duck), of which many have been identified as originating from China. Acquired proximal tubular disease has previously been reported in Australia and the USA, as well as small numbers of cases in the UK and Europe in association with the ingestion of dried jerky treats. As yet, specific toxins have not been identified within these treats as a cause. Based upon previously published information, many pets presenting with these signs are responsive to discontinuation of treats alone when identified early in disease. However some patients with more significant acid-base and electrolyte disorders will require supportive medical therapy. A small percentage of cases are reported to die or are euthanased. Assessment of dietary history is key to identifying potential cases and where a compatible presentation is identified, should be considered in addition to testing for other causes of acquired proximal tubular disease. Based upon information available from other countries, some dogs may also present with PU/PD and hypophosphataemia alone, without glucosuria. We would urge veterinary surgeons throughout the UK to be aware of this potential presentation. References: Thompson et a Continue reading >>

Urine Samples To Monitor Diabetic Dogs And Cats

Urine Samples To Monitor Diabetic Dogs And Cats

Testing urine of diabetic dogs and cats can be used to look for: Hyperglycaemia in a stable diabetic patient Ketones Recurrent hypoglycaemia Glucosuria reflects hyperglycaemia in the past and does not indicate the current status or reflect hypoglycaemia. Glucosuria is not a very reliable method of monitoring diabetes mellitus and should not be used on its own to adjust an animal's insulin dose. Hyperglycaemia Urine monitoring can be used once an animal is known to have blood glucose concentrations in an acceptable range. In this case it is a quick and easy method of detecting hyperglycaemia. This should then be investigated further by measuring blood glucose concentrations. Ketones Urine monitoring is a quick and easy method of detecting ketones (ketonuria) and hence a potential emergency situation. See diabetic ketoacidosis. Hypoglycaemia In diabetic cats that are well controlled the urine should be free of glucose for most of each 24 hour period. Monitoring of urine for glucose can be useful in diabetic cats that are not yet stable and that have problems with recurrent hypoglycaemia. Here it is used to identify the absence of glucose. For example, a cat that has no glucose in morning samples may be at risk of hypoglycaemia and/or maybe going into diabetic remission. 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 >>

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 >>

Chemical Constituents

Chemical Constituents

Chemical constituents that are a part of a urinalysis include: pH, protein (Dipstick, SSA, Bence-Jones), protein-to-creatinine ratio, glucose, ketones, bilirubin and heme. pH Knowledge of the urine pH is important in interpreting urine sediment findings. Erythrocytes, leukocytes, and casts tend to disintegrate in alkaline urine (pH > 8.0). In addition, precipitation of urine crystals in supersaturated urine is highly dependent on urine pH (e.g. struvite will precipitate in alkaline not acidic urine). The reportable range of pH by the CLINITEK Advantus Urine Chemistry Analyzer used at Cornell University is from 5.0 to >9.0, in 0.5 unit increments. The table below illustrates the reportable pH results from the CLINITEK Advantus Urine Chemistry Analyzer used at Cornell University. pH 5.0 7.5 5.5 8.0 6.0 8.5 6.5 ≥ 9.0 7.0 Factors affecting the pH of urine Diet: Diet has a marked effect on urine pH. Grazing animals (herbivores) generally have alkaline urine except for young animals on a milk diet, where urine pH is more likely to be acidic. In contrast, carnivorous animals (dogs and cats) tend to have more acidic urine than adult herbivores, except straight after eating (called the post-prandial alkaline tide, due to increased secretion of HCl into the stomach). Renal hydrogen (H+) excretion and bicarbonate (HCO3–) resorption Pathologic abnormalities of systemic acid/base balance. Pathologic abnormalities of tubular function: Failure to excrete an acid load (e.g. H+ excretion in distal tubules) or failure to absorb bicarbonate in the proximal tubules. Age of urine specimen: Over time, loss of CO2 to the air occurs, raising the urine pH. Presence of contaminant or pathogenic bacteria: Some bacteria can alter the pH of urine. Urease-positive bacteria such as Streptococcus, Continue reading >>

Ketonuria

Ketonuria

Ketonuria is a medical condition in which ketone bodies are present in the urine. It is seen in conditions in which the body produces excess ketones as an indication that it is using an alternative source of energy. It is seen during starvation or more commonly in type I diabetes mellitus. Production of ketone bodies is a normal response to a shortage of glucose, meant to provide an alternate source of fuel from fatty acids. Pathophysiology[edit] Ketones are metabolic end-products of fatty acid metabolism. In healthy individuals, ketones are formed in the liver and are completely metabolized so that only negligible amounts appear in the urine. However, when carbohydrates are unavailable or unable to be used as an energy source, fat becomes the predominant body fuel instead of carbohydrates and excessive amounts of ketones are formed as a metabolic byproduct. Higher levels of ketones in the urine indicate that the body is using fat as the major source of energy. Ketone bodies that commonly appear in the urine when fats are burned for energy are acetoacetate and beta-hydroxybutyric acid. Acetone is also produced and is expired by the lungs.[1] Normally, the urine should not contain a noticeable concentration of ketones to give a positive reading. As with tests for glucose, acetoacetate can be tested by a dipstick or by a lab. The results are reported as small, moderate, or large amounts of acetoacetate. A small amount of acetoacetate is a value under 20 mg/dl; a moderate amount is a value of 30–40 mg/dl, and a finding of 80 mg/dl or greater is reported as a large amount. One 2010 study admits that though ketonuria's relation to general metabolic health is ill-understood, there is a positive relationship between the presence of ketonuria after fasting and positive metabo Continue reading >>

Evaluation Of A Portable Meter To Measure Ketonemia And Comparison With Ketonuria For The Diagnosis Of Canine Diabetic Ketoacidosis.

Evaluation Of A Portable Meter To Measure Ketonemia And Comparison With Ketonuria For The Diagnosis Of Canine Diabetic Ketoacidosis.

Abstract BACKGROUND: The diagnosis of canine diabetic ketoacidosis (DKA) usually is based on measurement of urinary acetoacetate (ketonuria). In humans, this test is less sensitive and specific than blood 3-beta-hydroxybutyrate (ketonemia) evaluation. HYPOTHESIS: Ketonemia measurement using a portable meter is more accurate than ketonuria determination with a dipstick to diagnose canine DKA. ANIMALS: Seventy-two client-owned diabetic dogs with ketonemia, ketonuria, or both. METHODS: Prospective observational study. Based on blood bicarbonate concentration and anion gap, dogs were divided into 2 groups: patients with DKA (n= 25); patients with diabetic ketosis (n= 47). Sensitivity, specificity, and positive and negative likelihood ratio (LR) at different cut-off points were determined for both ketonemia and ketonuria. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of each diagnostic test to diagnose DKA. RESULTS: With regard to ketonemia, cut-off values of 2.3 and 4.3 mmol/L revealed 100% sensitivity and 100% specificity, respectively, whereas cut-off values of 2.8 and 3.5 mmol/L showed a -LR of 0.05 and a + LR of 13.16, respectively. With regard to ketonuria, a cut-off value of 1+ revealed 92% sensitivity, 40% specificity, and -LR of 0.20, whereas a cut-off value of 3+ revealed 44% sensitivity, 94% specificity, and +LR of 6.89. The areas under the ROC curves for the ketonemia and ketonuria tests were significantly different (0.97 and 0.81, respectively, P= .003). CONCLUSIONS AND CLINICAL IMPORTANCE: Measurement of ketonemia is accurate and more effective than measurement of ketonuria to diagnose canine DKA. Continue reading >>

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