diabetestalk.net

My Cat Has Ketoacidosis

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 >>

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 >>

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 >>

Diabetic Ketoacidosis In Dogs

Diabetic Ketoacidosis In Dogs

My dog is diabetic. He has been doing pretty well overall, but recently he became really ill. He stopped eating well, started drinking lots of water, and got really weak. His veterinarian said that he had a condition called “ketoacidosis,” and he had to spend several days in the hospital. I’m not sure I understand this disorder. Diabetic ketoacidosis is a medical emergency that occurs when there is not enough insulin in the body to control blood sugar (glucose) levels. The body can’t use glucose properly without insulin, so blood glucose levels get very high, and the body creates ketone bodies as an emergency fuel source. When these are broken down, it creates byproducts that cause the body’s acid/base balance to shift, and the body becomes more acidic (acidosis), and it can’t maintain appropriate fluid balance. The electrolyte (mineral) balance becomes disrupted which can lead to abnormal heart rhythms and abnormal muscle function. If left untreated, diabetic ketoacidosis is fatal. How could this disorder have happened? If a diabetic dog undergoes a stress event of some kind, the body secretes stress hormones that interfere with appropriate insulin activity. Examples of stress events that can lead to diabetic ketoacidosis include infection, inflammation, and heart disease. What are the signs of diabetic ketoacidosis? The signs of diabetic ketoacidosis include: Excessive thirst/drinking Increased urination Lethargy Weakness Vomiting Increased respiratory rate Decreased appetite Weight loss (unplanned) with muscle wasting Dehydration Unkempt haircoat These same clinical signs can occur with other medical conditions, so it is important for your veterinarian to perform appropriate diagnostic tests to determine if diabetic ketoacidosis in truly the issue at hand Continue reading >>

Help Precious Fight Diabetic Ketoacidosis!

Help Precious Fight Diabetic Ketoacidosis!

The Story Precious is a 5 year old cat from Lomita, CA who was just diagnosed with feline diabetes mellitus complicated by ketoacidosis. She is currently hospitalized but doing well, and expected to come home by the weekend. Diabetes is very manageable and her prognosis is good, but a new diagnosis is expensive and she could really use your help! Diabetes mellitus occurs when a cat’s body is either not producing or not properly using insulin. This prevents glucose from entering the cells, leaving high levels of glucose in the blood. Diabetic ketoacidosis (DKA) occurs when the cells are deprived of glucose and begin breaking down fat for fuel, leaving toxic ketones in the body. Precious is in great hands with my regular vet, Dr. Drury at Bay Cities Pet Hospital. She is receiving IV fluids to help treat the DKA and dehydration. She was given an anti-nausea injection to make sure she has food in her belly as she starts insulin, and her appetite has already come back. Her doctor is doing a glucose curve to determine the proper insulin dose for her and regulate her blood sugar. We also had blood and urine samples sent to the lab and should have full results back by tomorrow (4/9). She will need insulin, syringes, testing supplies, and antibiotics to take home. As the parent of a diabetic cat, the scariest part for me was the bill that came with the initial diagnosis. When I found Remy he was very sick and needed treatment right away, but I wasn’t able to cover his bills out of pocket as I already had several fosters. Luckily, SO many animal lovers came through for him and sent donations, so all I had to worry about was getting him better. Similarly, Precious’ parents always donate their spare time and money to animal causes, and her dad has been out of work with an inj Continue reading >>

About Diabetes Mellitus

About Diabetes Mellitus

If your dog or cat has been diagnosed with diabetes mellitus, it's easy to feel alone—but you're not. It is estimated that 1 out of every 100 dogs that reaches 12 years of age will develop diabetes.1 In cats, it's estimated that between 1 in 50 and 1 in 500 will develop diabetes mellitus.2 Diabetes mellitus occurs when your dog or cat has stopped producing insulin, has inadequate levels of insulin, or has an abnormal response to insulin. Learn more about what insulin is. In dogs, diabetes mellitus is common in middle-aged to older animals, especially in females, but it is also seen in young dogs of both sexes. When seen in younger animals, it can be a sign that your cat or dog is genetically predisposed to diabetes—this can mean that related animals may also be predisposed.3 Certain breeds of dogs also experience above-average rates of diabetes. These include4: In cats, diabetes mellitus is more common in middle- to older-aged animals as well, and also in cats that are overweight. Also, neutered males are at a greater risk than females. Certain breeds, such as Siamese cats, experience an above-average rate of diabetes. Some drugs, when used long-term, may interfere with insulin and lead to diabetes mellitus in your pet. These include glucocorticoids (cortisone-type drugs) and hormones that may be used to control heat cycles in female dogs.3 It is important to note the difference between diabetes mellitus and diabetes insipidus. Diabetes insipidus, also known as water diabetes, occurs when the kidneys are unable to regulate fluids in the body, and large amounts of dilute urine are produced. This condition is far less common than diabetes mellitus. Diabetes insipidus is caused by problems in part of the brain or in the kidneys, and there is no glucose (sugar) present 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 >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Also see Pet Diabetes Wiki: Ketoacidosis A Ketone Primer by an FDMB user What are Ketones? Ketones or ketone bodies (acetone, acetoacetic acid, and beta-hydroxybutyric acid) are waste products of fatty acid breakdown in the body. This is the result of burning fat, rather than glucose, to fuel the body. The body tries to dispose of excess ketones as quickly as possible when they are present in the blood. The kidneys filter out ketones and excrete them into the urine. Should you care about ketones? YES! If they build up, they can lead to very serious energy problems in the body, resulting in diabetic ketoacidosis, a true medical emergency. If the condition is not reversed and other systemic stresses are present, ketones may continue to rise and a condition known as diabetic ketoacidosis (DKA) may occur. This condition can progress very quickly and cause severe illness. It is potentially fatal even when treated. Recognition of DKA and rapid treatment by your veterinarian can save your cat's life. Signs of Diabetic Ketoacidosis (DKA) Drinking excessive amounts of water OR no water Excessive urination Diminished activity Not eating for over 12 hours Vomiting Lethargy and depression Weakness Breathing very fast Dehydration Ketone odor on breath (smells like nail-polish remover or fruit) Causes of Diabetic Ketoacidosis (DKA) Insulin dependent diabetes mellitus Inadequate insulin dosing or production Infection Concurrent diseas that stresses the animal Estrus Medication noncompliance Lethargy and depression Stress Surgery Idiopathic (unknown causes) Risk Factors for DKA Any condition that causes an insulin deficiency History of corticosteroid or beta-blocker administration Diagnosis Laboratory tests performed by your vet are necessary for diagnosis. Depending on how sick your c Continue reading >>

Ketoacidosis In Cats – Causes, Symptoms & Treatment

Ketoacidosis In Cats – Causes, Symptoms & Treatment

Ketoacidosis in cats at a glance Ketoacidosis is a serious complication of diabetes in which ketones and blood sugar levels build up in the body due to insufficient levels of insulin which is required to move glucose into the cells for energy. As a result, the body uses fat as an alternate energy source which produces ketones causing the blood to become too acidic. Common causes include uncontrolled diabetes, missed or insufficient insulin, surgery, infection, stress and obesity. Symptoms of ketoacidosis include increased urination and thirst, dehydration, nausea, diarrhea, confusion, rapid breathing which may later change to laboured breathing. What is diabetic ketoacidosis? Diabetic ketoacidosis (DKA) is a life-threatening complication of diabetes characterised by metabolic acidosis (increased acids in the blood), hyperglycemia (high blood glucose) and ketonuria (ketones in the urine). It is caused by a lack of or insufficient amounts of insulin which is required to move glucose from the bloodstream and into the cells to be used for energy. When this occurs, the body begins to search for alternate sources of energy and begins to break down fat. When fat is broken down (metabolised) into fatty acids, waste products known as ketones (acetoacetate, beta-hydroxybutyrate, acetone) are released from the liver and accumulate in the bloodstream (known as ketonemia). This causes the blood to become too acidic (metabolic acidosis). As well as metabolic acidosis, ketones also cause central nervous depression.The body will try to get rid of the ketones by excreting them out of the body via the urine, increased urine output leads to dehydration, making the problem worse. Meanwhile, the unused glucose remains in the bloodstream, resulting in hyperglycemia (high blood sugar).Insulin Continue reading >>

Diabetic Ketoacidosis In Dogs And Cats

Diabetic Ketoacidosis In Dogs And Cats

Ketoacidosis is a complication of diabetes in pets, and is one of the most severe side effects that can accompany the condition. Finding your pet seriously ill and receiving a diagnosis of diabetic ketoacidosis can be a big shock to the pet owner, as most presentations of the condition occur in animals that were not actually known to be diabetic in the first place. This is of course extremely worrying for the pet owner, as they will have to face not only the very serious and possibly life-threatening immediate issue of diabetic ketoacidosis itself, but have to face the reality that assuming their pet survives, they will have to deal with the serious and potentially expensive diagnosis of diabetes as well. What is ketoacidosis? Ketoacidosis occurs when the animal’s metabolism is thrown severely out of whack, as part of the development of diabetes in the pet. Usually, an additional trigger such as an inflammation, infection or condition such as pancreatitis is also required to trigger ketoacidosis, as any of these things can interfere with the way that the body regulates and processes glucose. Ketoacidosis starves the body’s cells of glucose, despite the fact that sufficient glucose is present within the blood. The diabetic element of this is that sufficient natural insulin is not being made available to the body to allow the glucose in the blood to enter the cells, as glucose requires insulin in order to metabolise. The body responds to this issue by metabolising all of the fat stores and other sources of fuel available to it, breaking down the very structure of the body itself. This process causes the production of ketones, which the body then attempts to burn as fuel, which is not a normal healthy process. In turn, the burning of ketones by the body leads to a dang 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 >>

Your Cat And Diabetes: Everything You Need To Know

Your Cat And Diabetes: Everything You Need To Know

Diabetes is a very serious issue – and not just in people either. That’s right, this chronic and potentially debilitating condition also affects cats (and dogs). And while it’s difficult to know the exact incidence of diabetes in cats, best estimates put it somewhere in the range of 1 cat in every 100-200 cats will become diabetic. What’s even sadder is that this incidence seems to be on the increase. Fortunately, armed with some good information, important tips, and a good working relationship with your veterinarian, you can give your cats the best chance at avoiding this frustrating condition. And if they’ve already developed it, know that these same tools can help you best manage your cat’s diabetic state; avoiding the potential complications and perhaps even getting them into diabetic remission. What is diabetes? In the most basic sense, diabetes mellitus is a disorder where blood sugar, or glucose, cannot be effectively utilized and regulated within the body. There are several hormones within the body that play important roles in glucose metabolism. Insulin is one of the most important, if not the most important, and it’s the hormone most central to the development and control of the diabetic state. Glucose fuels the body and insulin is the hormone that helps to get it into most cells within the body. Diabetes is often easily diagnosed and controllable. However, when undiagnosed or poorly managed, diabetes can be devastating. Diabetes can absolutely be managed and your cat can still lead a long and happy life. Routine veterinary care and evaluation are important, as is achieving and maintaining an appropriate weight in your cat and feeding him an appropriate diet. There are two types of diabetes – Type I and Type II. In Type I diabetes, the pancreas Continue reading >>

Diabetic Ketoacidosis Is A Dire Diagnosis

Diabetic Ketoacidosis Is A Dire Diagnosis

Michelle Gerhard Jasny, V.M.D. has been practicing veterinary medicine on the Vineyard since 1982 and writing the Visiting Vet column for more than 25 years. She lives and works in West Tisbury. She can be reached at [email protected] Yves had always been a cat who liked to eat. A seasonal resident, I saw him every summer. When he was four years old, I suggested reducing the amount he was being fed. At six, I advised a prescription weight loss diet. It was a difficult regimen for his owners to maintain. Yves lived strictly indoors and didn’t get much exercise, and the other cat in the household had different health problems, requiring different food. By 11 years old, Yves was tipping the scale at 21 pounds. “He’s at risk for all kinds of diseases, especially diabetes,” I said, not unsympathetically, considering how many years I have struggled with my own battle of the bulge. His family committed again to helping him lose weight and last winter we sent them off with more diet food, recommending monthly weigh-ins with their winter veterinarian. Spring arrived. Seasonal folks began returning. Memorial Day weekend, Yves’s mother called. “We’ve been here two weeks,” she said. Yves had been fine until yesterday. “I am worried he might have some kind of blockage. He’s been vomiting and crying and he’s not eating.” “He’s still an indoor cat?” I asked. Cats who go out have greater risk of ingesting things that may upset their tummies, anything from mice to antifreeze, but Yves never ventured to the great outdoors. “Any flowers like lilies in the house?” I asked. Ingestion of houseplants is a common cause of gastroenteritis for indoor cats and lilies in particular are extremely toxic to cats, leading to potentially fatal kidney failure. “No, Continue reading >>

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Diabetes Complications In Dogs And Cats: Diabetes Ketoacidosis (dka)

Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease: Diabetes Mellitus (Sugar Diabetes) in Dogs Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it! What is DKA? When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body. Symptoms of DKA Clinical signs of DKA include the following: Weakness Not moving (in cats, hanging out by the water bowl) Not eating to complete anorexia Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal) Weight loss (most commonly over the back), despite an overweight body condition Excessively dry or oily skin coat Abnormal breath (typically a sweet “ketotic” odor) In severe cases DKA can also result in more significant signs: Abnormal breathing pattern Jaundice Ab Continue reading >>

Diabetic Ketoacidosis (dka) In Cats

Diabetic Ketoacidosis (dka) In Cats

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

More in ketosis