15225 Jefferson Hwy

Baton Rouge, LA 70817 US

225-755-3838

Open mobile navigation

Diabetic Ketoacidosis

By Wendy C. Brooks, DVM, DipABVP 
Educational Director, VeterinaryPartner.com

Ketoacidosis is one of the most extreme complications of diabetes mellitus that can be experienced. Unfortunately, most cases of ketoacidosis are in patients that were not previously known to be diabetic so the owner (and pet) must deal with two serious diagnoses: one acutely life-threatening and expensive and the other requiring on-going commitment and daily treatment.

Ketoacidosis represents an extreme metabolic derangement. Stress of some sort, usually some kind of infection, inflammatory disease, or pancreatitis creates a severe loss of glucose regulation. The cells are starving for glucose and, even though there is plenty of glucose in the blood, without insulin this glucose cannot enter the cells. In response to the starving body, all stored fuels are mobilized including fats. The extreme fat burning situation leads to the production of ketone bodies. When ketone bodies are burned for fuel, pH and electrolyte imbalances occur and the patient’s life is at risk. Shock and dehydration are only part of this body-wide crisis.

Nausea and appetite loss with marked listlessness is typically what the owner notices; prior signs of diabetes (excess thirst, appetite and weight loss) may have been ignored or unnoticed but at this point the pet is clearly very ill. Blood glucoses are typically extremely high, and ketones can usually be detected in the urine.

What to Expect in the Hospital

The sooner the crisis is noticed, the faster treatment can be instituted. Because electrolytes can change moment by moment, blood testing is necessary throughout the day to keep track and keep the imbalances corrected. A facility that offers 24-hour care is ideal. Aside from the monitoring required to manage the ketoacidosis, testing to determine the precipitating stress is necessary as well.

In dogs, the most common precipitating/concurrent conditions are: pancreatitis, urinary tract infection and Cushing's disease.

Intravenous Fluids

Fluid therapy is felt to be the key to treatment of this condition. The patient is invariably dehydrated from the high circulating blood sugar levels, which cause excess fluid loss in urine, as well as from vomiting and/or diarrhea, which are common in ketoacidosis. Aside from simply providing fluids, the IV fluid provides a vehicle by which other metabolic derangements can be repaired.

Insulin
Blood sugar must be controlled if treatment is to be successful but to prevent brain damage, blood sugar levels must be dropped slowly. To achieve this, “regular insulin” (typically Humulin R®) is used, given either as multiple intramuscular injections or as a continuous drip. This type of insulin is short acting and wears off quickly, which allows it to provide small adjustments. It is not until the patient is eating and nausea has been controlled that maintenance insulins can be started.

Potassium
Patients in ketoacidosis are greatly depleted in potassium. While insulin is needed to control blood sugar, insulin makes the problem worse by driving potassium into the body’s cells and out of the bloodstream. Typically, high amounts of potassium must be supplemented in the intravenous fluid solution.

Phosphorus
Low levels of phosphorus also accompany diabetic ketoacidosis and if levels drop too low, the patient’s red blood cells will begin to burst and be unable to maintain integrity. Phosphorus is also supplemented through the intravenous fluid solution.

Blood pH
The term ketoacidosis implies that the blood pH is overly acidic. If the situation is severe enough, sodium bicarbonate must be added to the intravenous therapy.

All these aspects require regular monitoring, which means lab work perhaps four times daily or more. Patients in diabetic ketoacidosis require close monitoring and intensive care.

When urine dipsticks no longer test positive for ketones and the patient is eating well and in good spirits, he or she is able to go home and be managed as a regular diabetic. Diet, monitoring, insulin etc. will be on-going concerns. Ideally, Ketostix, obtainable from any drug store, will be used at home to monitor for ketones to head off problems before they become extreme in the future.

We care for all animals!

"We believe that all animals deserve compassionate veterinary care."

Call today for more information
225-755-3838

New patients welcome!

Hours:
Monday/Wed/Fri 7 am to 5 pm
Tues/Thurs 8am to 5pm
Saturday 8 am - noon





Download PetPro Connect app here.

imgimg

Office Hours

Monday:

7:00 am-5:00 pm

Tuesday:

8:00 am-5:00 pm

Wednesday:

7:00 am-5:00 pm

Thursday:

8:00 am-5:00 pm

Friday:

7:00 am-5:00 pm

Saturday:

8:00 am-12:00 pm

Sunday:

Closed

Location

Find us on the map

Featured Articles

Read about interesting topics

  • Fish

    If you’re thinking of getting a pet fish, you should know that your veterinarian has a lot of good advice about pet ownership. Fish can be very rewarding as pets, and you just may be surprised about how much fish actually interact with their owners. Here’s more valuable information about choosing ...

    Read More
  • Caring for Senior Cats

    Thanks to advancements in veterinary care, today’s cats can live well into their teen years. It is not uncommon for cats to live to be 18 or even older. However, in order for cats to live a long full life, they need proactive veterinary care to stay healthy. As cats age, they are at greater risk for ...

    Read More
  • Feline Stomatitis: Treatments

    Cats rarely display their pain, but cats with feline stomatitis are often the exception. If your cat appears to have mouth pain, is reluctant to eat, doesn't want to groom, is drooling, and doesn't want you to open its mouth, it may be suffering from this debilitating, degenerative oral condition, and ...

    Read More
  • Feline Leukemia Virus: What You Need to Know

    Feline leukemia (FeLV) is a virus that weakens your cat's immune system. Unfortunately, when the immune system does not function properly, your cat may be more likely to develop other diseases, such as cancer and blood disorders. How Cats Contract Feline Leukemia Cats get feline leukemia from other cats. ...

    Read More
  • Family Cats and Pregnant Women: Take Measures to Prevent Toxoplasmosis Infection

    Nothing must spoil the joys of becoming a new parent. Not even your pets. But family cats with normal, every day habits can pose a risk to expectant women. Women's immune systems can be disturbed by a parasite carried in fecal matter. If you're the primary caretaker of your family's feline friend it ...

    Read More
  • Create an Environment Your Cat Will Love

    The Journal of Feline Medicine and Surgery confirms that feline emotional wellbeing, behavior and physical health are a result of how comfortable they are in their environment. Understanding how our cats interact with their environment can help us create a space for owners and cats to mutually thrive ...

    Read More
  • Catnip: Why Cats Love It

    Few things stimulate a cat's pleasure faster than catnip. Exposure to this simple herb can reveal a new side to their feline personality. Many cats will go crazy at the smell of this plant. Catnip has a reputation of being a feline drug and many cat owners wonder if it is safe to give it to their pet. ...

    Read More
  • Zoonosis

    Zoonosis refers to diseases that can be transmitted to humans from animals. In particular, they occur when an infected animal passes on bacteria, parasites, fungi or viruses to humans through scratches, saliva, feces and urine. Vectors (e.g., organisms like fleas and ticks) can also carry zoonotic diseases ...

    Read More
  • Sugar Gliders

    Thinking of getting a sugar glider? These tiny marsupials are energetic and friendly, making them popular choices as pets. Though they weigh less than a half-pound, they're more closely related to kangaroos than they are flying squirrels. If you think a sugar glider would make an ideal pet for your family, ...

    Read More
  • Epilepsy

    Epilepsy (often referred to as a seizure disorder) is a chronic neurological condition characterized by recurrent unprovoked seizures. It is commonly controlled with medication, although surgical methods are used as well. Epileptic seizures are classified both by their patterns of activity in the brain ...

    Read More

Newsletter Sign Up