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What Causes Ketoacidosis In Dogs

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 >>

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 >>

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 >>

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 >>

Diabetic Ketoacidosis (dka)

Diabetic Ketoacidosis (dka)

Diabetic ketoacidosis is an acute metabolic complication of diabetes characterized by hyperglycemia, hyperketonemia, and metabolic acidosis. Hyperglycemia causes an osmotic diuresis with significant fluid and electrolyte loss. DKA occurs mostly in type 1 diabetes mellitus (DM). It causes nausea, vomiting, and abdominal pain and can progress to cerebral edema, coma, and death. DKA is diagnosed by detection of hyperketonemia and anion gap metabolic acidosis in the presence of hyperglycemia. Treatment involves volume expansion, insulin replacement, and prevention of hypokalemia. Diabetic ketoacidosis (DKA) is most common among patients with type 1 diabetes mellitus and develops when insulin levels are insufficient to meet the body’s basic metabolic requirements. DKA is the first manifestation of type 1 DM in a minority of patients. Insulin deficiency can be absolute (eg, during lapses in the administration of exogenous insulin) or relative (eg, when usual insulin doses do not meet metabolic needs during physiologic stress). Common physiologic stresses that can trigger DKA include Some drugs implicated in causing DKA include DKA is less common in type 2 diabetes mellitus, but it may occur in situations of unusual physiologic stress. Ketosis-prone type 2 diabetes is a variant of type 2 diabetes, which is sometimes seen in obese individuals, often of African (including African-American or Afro-Caribbean) origin. People with ketosis-prone diabetes (also referred to as Flatbush diabetes) can have significant impairment of beta cell function with hyperglycemia, and are therefore more likely to develop DKA in the setting of significant hyperglycemia. SGLT-2 inhibitors have been implicated in causing DKA in both type 1 and type 2 DM. 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 >>

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 >>

Emergency Situations With Diabetic Dogs

Emergency Situations With Diabetic Dogs

In diabetic dogs, the following emergency situations may arise: 1. Hypoglycaemia - extremely low blood sugar 2. Diabetic ketoacidosis or hyperglycaemic hyperosmolar non-ketotic syndrome HHNK syndrome) - caused by extremely high blood sugar CONTACT YOUR VETERINARIAN IMMEDIATELY for possible adjustment of the insulin dose or treatment of additional medical problems if your diabetic dog shows any of these signs: · Excessive drinking for more than 3 days · Excessive urination or inappropriate urination in the house for more than 3 days · Reduction in or loss of appetite · Weakness, seizures or severe depression · Behavioural change, muscle twitching or anxiety · Constipation, vomiting or diarrhoea · Signs of a bladder infection (passing frequent small amounts of urine, straining to urinate, blood in the urine) Swelling of the head or neck Hypoglycaemia in treated diabetic dogs One of the most important complications seen in diabetic dogs on insulin treatment is an unduly low blood glucose level, called hypoglycaemia. Situations that may lead to hypoglycaemia are: 1. Your dog receives the normal dose of insulin but has not received its normal quantity of food - it does not eat, vomits up the meal or has diarrhoea. 2. Your dog is abnormally active, leading to abnormally high energy (glucose) use. 3. Your dog accidentally receives a dose of insulin that is too high. 4. Your dog's insulin requirement has naturally fallen. Signs of low blood glucose Low blood glucose can be fatal, so it is extremely important that you recognize these signs, which are often subtle in the early stages: · restlessness · trembling or shivering · unusual movements or behaviour - some animals become very quiet and stop eating. · muscle twitching · coma What to do If any of the above signs Continue reading >>

Treatment Of Diabetic Ketoacidosis In Dogs By Continuous Low-dose Intravenous Infusion Of Insulin.

Treatment Of Diabetic Ketoacidosis In Dogs By Continuous Low-dose Intravenous Infusion Of Insulin.

Abstract In a prospective clinical trial, low-dose, continuous, IV infusion of insulin (dosage, 2.2 U/kg of body weight, q 24 h) was used to treat 21 dogs with diabetic ketoacidosis. Mean (+/- SD) blood glucose concentration at the onset of treatment was 550 +/- 150 mg/dl and after 6 hours, was 350 +/- 106 mg/dl, with a mean decline of 34 +/- 16 mg/dl/h. By 12 hours, mean blood glucose was 246 +/- 85 mg/dl, with a mean decline of 28 +/- 14 mg/dl/h during the second 6 hours of treatment. Mean duration of treatment required to reach a blood glucose concentration < or = 250 mg/dl was 10 +/- 4 hours, with a range of 4 to 24 hours. Ketonuria was observed for 26 +/- 14 hours (range, 6 to 72 hours). Hypoglycemia developed in 3 of 21 dogs during treatment, but responded to IV administration of a glucose solution and to a reduction in rate of insulin delivery. Potassium supplementation was required in 15 of 21 dogs. Mean bicarbonate concentration was 11.6 +/- 3.4 mEq/L before treatment and was 18.2 +/- 0.7 mEq/L after 24 hours. Fifteen of 21 dogs (71%) survived to be discharged. Mean duration of treatment with the insulin infusion was 50 +/- 30 hours (range, 7 to 124 hours). In this series of dogs, continuous, low-dose, IV infusion of insulin provided a gradual and consistent reduction in blood glucose concentration while ketoacidosis, electrolyte balance, and dehydration were corrected.(ABSTRACT TRUNCATED AT 250 WORDS). 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 >>

Sugar High: Petplan Pet Insurance On Diabetic Ketoacidosis In Pets

Sugar High: Petplan Pet Insurance On Diabetic Ketoacidosis In Pets

We’ve discussed diabetes before--it’s a condition in cats and dogs caused by either a relative or absolute lack of insulin, which leads to high blood sugar. Blood sugar that is too high for too long results in a serious condition called diabetic ketoacidosis. We see diabetic ketoacidosis (or DKA, for short) in patients who are being under treated for diabetes and in patients whose diabetes was previously undiagnosed. These patients often come into the office on an emergency basis because of severe illness--they are vomiting, lethargic, dehydrated, and sometimes semi-comatose. High levels of glucose (or sugar) are found in both the blood and the urine due to insufficient insulin, and ketones are also present in the urine. In addition to high blood sugar levels, an insulin deficiency also affects the metabolism of fat, resulting in an increase in free fatty acids. These are converted to ketones. When insulin is low, ketones cannot be adequately utilized, so they build up in the body, causing ketosis. Ketosis causes acidosis (or acidifying of the blood), vomiting, dehydration, and sometimes neurological problems. In short, they make your diabetic pet feel pretty terrible. Not all animals with DKA show physical signs of illness. If ketones are present in your diabetic pet’s urine, then she also has ketoacidosis, even if she doesn’t appear to be sick. Non-sick ketoacidotic animals need to have their insulin doses re-evaluated to make sure the diabetes is adequately controlled. DKA can be life threatening, so treatment requires hospitalization. Fluid therapy is an important part of treatment to correct dehydration and addresses electrolyte imbalances. Short-acting insulin is administered frequently to decrease blood sugar levels quickly. Once blood glucose levels are Continue reading >>

Care Of Diabetic And Diabetic Ketoacidotic Patients (proceedings)

Care Of Diabetic And Diabetic Ketoacidotic Patients (proceedings)

Diabetes mellitus is the condition of hyperglycemia (high blood glucose) and glucosuria (glucose in the urine) caused by absence of the hormone insulin, or failure of the cells of the body to be able to respond to insulin. Diabetes mellitus is the condition of hyperglycemia (high blood glucose) and glucosuria (glucose in the urine) caused by absence of the hormone insulin, or failure of the cells of the body to be able to respond to insulin. Diabetes mellitus in veterinary patients can most often be compared to human adult onset diabetes (type 2), and juvenile onset diabetes is rare in veterinary patients. Patients may present with few clinical signs, in relatively good health (uncomplicated diabetes mellitus), or may be weak and dehydrated with severe electrolyte abnormalities (ketoacidotic diabetes mellitus). The most common clinical signs include weight loss, polyuria/polydipsia, increased or decreased appetite, unkempt hair coat, dandruff, sudden onset blindness (in dogs from cataract formation secondary to diabetes), and hind limb weakness (from diabetic neuropathy in cats) . In dogs and cats that have progressed to diabetic ketoacidosis, vomiting, anorexia, and lethargy are common complaints. Physical examination findings can reveal thin body condition, cataracts (dogs), dehydration, and mental dullness. Animals with recent onset diabetes mellitus can have a relatively normal examination. Laboratory testing to diagnose diabetes mellitus is relatively straightforward, and diagnosis can be confirmed at the time of evaluation in some cases with in-house testing. Elevated blood glucose is the mainstay of diagnosis; however keep in mind that hyperglycemia may be from diabetes, or secondary to a stress response, especially in cat. Handheld glucometers that are used by h Continue reading >>

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 >>

Diabetic Ketoacidosis In Cats And Dogs

Diabetic Ketoacidosis In Cats And Dogs

Over the last few days the signs have been getting worse. Your pet isn’t doing well; it is depressed, isn’t eating, and may even be vomiting. You thought it would get better, but it hasn’t and in fact your pet looks really sick. So you decide to take your pet into the veterinarian, who runs a bunch of tests. It is most likely that the animal will be whisked away to a treatment room after the veterinarian confirms a diagnosis of diabetic ketoacidosis. What is diabetic ketoacidosis (DKA)? You didn’t even know that your pet was diabetic, so how could it have this problem? Diabetic ketoacidosis most commonly develops in animals with undiagnosed diabetes. However, animals with diabetes can develop this problem as well, if their diabetes gets out of control. The reason that your pet will be quickly taken to the treatment room is because DKA is an emergency. These animals look sick because their whole body is being affected by the problem. If the situation is not addressed quickly, DKA can cause irreversible damage. This doesn’t mean that your pet will be fixed overnight. Even uncomplicated, mild cases of DKA often stay in the hospital for two or three days. Before we explain DKA, let’s review the meaning of diabetes. Diabetes is a situation where the body does not have enough insulin. Insulin is needed for cells to absorb glucose (which is crucial for normal cell function) from the blood stream. When cells don’t have insulin, they don’t absorb enough glucose and the cells starve. This starvation causes the liver to release more glucose into the blood stream. But without insulin, cells cannot absorb the glucose that is in the blood, and they continue to starve. This is how the vicious circle goes on. Usually diabetes is caught at this point, and the pet is star Continue reading >>

Diabetic Ketoacidosis In Dogs

Diabetic Ketoacidosis In Dogs

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

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