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What Is Ketoacidosis In Cats

Diabetes With Ketone Bodies In Cats

Diabetes With Ketone Bodies In Cats

Diabetes Mellitus with Ketoacidosis in Cats The term “ketoacidosis” refers to a condition in which levels of acid abnormally increased in the blood due to presence of “ketone bodies.” Meanwhile, diabetes is a medical condition in which the body cannot absorb sufficient glucose, thus causing a rise the blood sugar levels. In diabetes with ketoacidosis, ketoacidosis immediately follows diabetes. It should be considered a dire emergency, one in which immediate treatment is required to save the life of the animal. Typically, the type of condition affects older cats; in addition, female cats are more prone diabetes with ketoacidosis than males. Symptoms and Types Weakness Lethargy Depression Lack of appetite (anorexia) Muscle wasting Rough hair coat Dehydration Dandruff Sweet breath odor Causes Although the ketoacidosis is ultimately brought on by the cat's insulin dependency due to diabetes mellitus, underlying factors include stress, surgery, and infections of the skin, respiratory, and urinary tract systems. Concurrent diseases such as heart failure, kidney failure, asthma, cancer may also lead to this type of condition. Diagnosis You will need to give a thorough history of your cat’s health, including the onset and nature of the symptoms, to your veterinarian. He or she will then perform a complete physical examination, as well as a biochemistry profile and complete blood count (CBC). The most consistent finding in patients with diabetes is higher than normal levels of glucose in the blood. If infection is present, white blood cell count will also high. Other findings may include: high liver enzymes, high blood cholesterol levels, accumulation in the blood of nitrogenous waste products (urea) that are usually excreted in the urine (azotemia), low sodium levels Continue reading >>

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment

Diabetic Ketoacidosis In The Cat: Recognition And Essential Treatment

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

Hat You Should Know When Your Cat Has Diabetes

Hat You Should Know When Your Cat Has Diabetes

W - Care Of Your Diabetic Cat - If You Would Like To See How Diabetes Effects My Body, Click Here. Controlling diabetes in your cat is considerably harder than doing so in us humans. Keeping your cat at a healthy weight is essential . Read a 2014 article about how really difficult it can be here. Never allow a glucose meter to be used on more than one pet . The meters are hard to disinfect(ref) 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. Some Information About Your Cat’s Pancreas Your cat’s pancreas is a small, pinkish organ that is nestled in the folds of its small intestine. You can see it if you enlarge the fanciful image I put at the top of this page. Although it is quite small, the pancreas has two very important functions. One is to produce enzymes that allow your cat to digest food. The other is to produce a hormone (insulin) that regulates how your cat’s body utilizes sugar (glucose). Glucose is the main fuel of all animal cells. Most of it is manufactured in the pet’s liver or released from recent carbohydrate meals. The process by which the pancreas regulates your cat’s blood sugar level is actually much more complicated than my explanation and not yet fully understood. But my explanation should do for this article. Should you wish to know more, go here . Many types of cells form the pancreas. The ones that are important in understanding diabetes occur in small islands scattered throughout the pancreas (islets of Langerhans). These particular insulin-secreting cells are called ß (beta) cells. What Is Diabetes? There are several forms of diabetes. But Continue reading >>

Management Of Feline Diabetic Ketoacidosis

Management Of Feline Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus with concurrent and often severe metabolic derangements associated with hyperglycaemia, glucosuria, metabolic acidosis, ketonaemia +/- ketonuria. Patients with ketonaemia/ketosis are usually still bright, eating and maintaining their hydration. Those with ketoacidosis are dehydrated, clinically unwell (e.g., anorexia, vomiting, lethargy) and typically require hospitalisation and intensive management. DKA is distinguished from uncomplicated diabetes mellitus (DM) by a relative insulin lack and increased counter-regulatory hormones. The latter are thought to occur secondary to intercurrent disease. Concurrent disease has been documented in approximately 90% of cats with DKA, with the most common being hepatic lipidosis, chronic kidney disease, acute pancreatitis, bacterial or viral infections and neoplasia (Bruskiewicz et al. 1997). Heinz bodies, neutrophilia with a left shift, increased ALT and azotaemia is common. Most cats presenting with DKA are newly diagnosed diabetics or recently diagnosed but poorly controlled diabetics. Diagnosis Hyperglycaemia, Glucosuria, Metabolic Acidosis Plus Ketones in Plasma and/or Urine Traditionally DKA has been diagnosed using urinary ketone dipsticks, which detect acetoacetate but not beta-hydroxybutyrate. However as the latter is the principle ketone body in DKA, measuring serum beta-hydroxybutyrate is a more sensitive indicator of DKA. In humans portable meters that measure beta-hydroxybutyrate in whole blood have largely superseded urine dipsticks. These ketone meters have recently proven useful in diagnosing DKA in cats, although they tend to underestimate beta-hydroxybutyrate at higher values (Zeugswetter, Rebuzzi 2012; Weingart et al. 2012). In the absence of a ke 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 >>

Using Glargine For Diabetic Ketoacidosis

Using Glargine For Diabetic Ketoacidosis

Using glargine intravenously for diabetic ketoacidosis Diabetic ketoacidosis results from prolonged inadequate insulin activity. The main aims of therapy are to supply exogenous insulin, restore hydration status and manage electrolyte disturbances. Ketoacidotic cats usually present severely dehydrated and as such, have reduced absorption from subcutaneous tissue (from reduced blood flow). Until hydration is restored, insulin must be administered either intravenously or intramuscularly. For many years, the insulin of choice for treating ketoacidosis has been regular insulin due to its rapid onset, potent glucose lowering effect and predictably short duration of action. Glargine has almost identical properties to that of regular insulin when used intravenously (Scholtz et al, 2003). Its actions are so similar that glargine can simply be substituted for regular insulin (for all your current protocols just draw glargine up instead of regular insulin). There are no reported clinical trials in the human literature assessing glargine administered intravenously as it was accepted to have no benefit over regular insulin. Regular insulin is used solely to treat diabetic ketoacidosis and many veterinary clinics chose not to stock it (or use it well after the expiry date) as the disease is seen so infrequently and most of the vials are wasted. Glargine on the other hand, can be used in DKA as well as maintenance therapy and most clinics have it on hand for diabetic cats. We mix glargine with normal saline, hartmann’s or 2.5% glucose solution. It is uncertain how long it will stay active in these solutions so suggest a new solution is made every 24hrs. Glargine can be administered to ketoacidotic cats by: infusing intravenously at a rate of 0.05-0.1 U/kg/hr and rate adjusted to ma Continue reading >>

When And How To Check For Them

When And How To Check For Them

Information provided about specific medical procedures or conditions is for educational purposes to allow for educated, on-going discussion with your vet and is not intended to replace veterinary advice. Diabetic Cat Care Ketones Many of us have heard of ketogenic diets; used often by bodybuilders, or to help with weight loss. The science is that by keeping the body in a ketone producing state, fat stores will be used by the body, weight will drop off much more quickly. That may be fine for humans, but producing ketones is the last state we want our diabetic cats to be in. Ketones occur when the body cannot access blood glucose for energy. Left untreated, ketones build up in the system and can lead to a life threatening situation called Diabetic Ketoacidosis, also known as DKA. While development of ketones is not an "immediate emergency", the progression of excessive ketones which develop into diabetic ketoacidosis IS a very real emergency situation requiring immediate veterinary care and very aggressive treatment. Catching ketones at low levels, before they get out of control, and then taking immediate and appropriate action can save your cat’s life. Ketones are a direct result of hyperglycemia (high BG). Ketones can develop because of not enough insulin, illness, infection, and/or anorexia. In humans, ketones can be produced when the body burns too much fat storage for energy. While practicing TR it is very rare for a cat to produce ketones once the BG is well regulated. That said, at the start of TR, right after diagnosis, if your cat is sick, or when making an insulin switch, its strongly recommended as a precaution to test for ketones if your cat is over renal threshold (225/12.5) for longer than a day. For those cats prone to quick ketone production, checking fo 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 >>

Diabetic Ketoacidosis

Diabetic Ketoacidosis

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

Diabetes With Ketone Bodies In Cats

Diabetes With Ketone Bodies In Cats

Diabetic ketoacidosis is an extreme medical emergency that requires immediate veterinary attention. The condition can result in an accumulation of fluid in the brain and lungs, renal failure or heart failure. Affected animals that are not treated are likely to die. With timely intervention and proper treatment, it is likely that an affected cat can recover with little to no side effects. Diabetes mellitus occurs when the pancreas fails to produce sufficient insulin, creating an inability to efficiently process the sugars, fats, and proteins needed for energy. The resulting build-up of sugar causes extreme thirst and frequent urination. Since sugar levels help to control appetite, affected animals may experience a spike in hunger and lose weight at the same time due to the inability to properly process nutrients. In extreme cases, diabetes may be accompanied by a condition known as ketoacidosis. This is a serious ailment that causes energy crisis and abnormal blood-acid levels in affected pets. Cats affected with diabetic ketoacidosis are likely to present with one or more of the following symptoms: Vomiting Weakness Lethargy Depression Excessive Thirst Refusal to drink water Refusal to eat Sudden weight loss Loss of muscle tone Increased urination Dehydration Rough coat Dandruff Rapid breathing Sweet-smelling breath Jaundice The exact cause of diabetes in cats is unknown, but it is often accompanied by obesity, chronic pancreatitis, hormonal disease, or the use of corticosteroids like Prednisone. Ketoacidosis, the buildup of ketone waste products in the blood that occurs when the body burns fat and protein for energy instead of using glucose, is caused by insulin-dependent diabetes. Diabetic ketoacidosis is commonly preceded by other conditions including: Stress Surgery Continue reading >>

Understanding And Treating Diabetic Ketoacidosis

Understanding And Treating Diabetic Ketoacidosis

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

Feline Diabetes

Feline Diabetes

Insulin injections are the preferred method of managing diabetes in cats. Figure 1: To administer an injection, pull the loose skin between the shoulder blades with one hand. With the other hand, insert the needle directly into the indentation made by holding up the skin, draw back on the plunger slightly, and if no blood appears in the syringe, inject gently. Tips for Treatment 1. You can do it! Treating your cat may sound difficult, but for most owners it soon becomes routine. 2. Work very closely with your veterinarian to get the best results for your cat. 3. Once your cat has been diagnosed, it's best to start insulin therapy as soon as possible. 4. Home glucose monitoring can be very helpful. 5. Tracking your cat's water intake, activity level, appetite, and weight can be beneficial. 6. A low carbohydrate diet helps diabetic cats maintain proper glucose levels. 7. With careful treatment, your cat's diabetes may well go into remission. 8. If your cat shows signs of hypoglycemia (lethargy, weakness, tremors, seizures, vomiting) apply honey, a glucose solution, or dextrose gel to the gums and immediately contact a veterinarian. Possible Complications Insulin therapy lowers blood glucose, possibly to dangerously low levels. Signs of hypoglycemia include weakness, lethargy, vomiting, lack of coordination, seizures, and coma. Hypoglycemia can be fatal if left untreated, so any diabetic cat that shows any of these signs should be offered its regular food immediately. If the cat does not eat voluntarily, it should be given oral glucose in the form of honey, corn syrup, or proprietary dextrose gels (available at most pharmacies) and brought to a veterinarian immediately. It is important, however, that owners not attempt to force fingers, food, or fluids into the mouth of a 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 >>

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 >>

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 >>

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