Diligent monitoring of blood glucose and ketones is imperative for dogs and cats diagnosed with diabetes mellitus. One of serious complications that can arise from unregulated diabetes mellitus is a condition known as diabetic ketoacidosis (DKA). DKA is often an interference of glucose metabolism due to insulin malfunction. The body, in exchange, turns to fatty and beta-oxidation for energy sources, which leads to increased production of ketone bodies, such as hydroxybutyrate, acetone, and acetoacetate. Thus, indications for DKA include high blood glucose level, high ketone level, and metabolic acidosis. Resulting electrolyte imbalance may pose serious harm, and if left untreated, it may become fatal for the affected pets.
What are some signs that I can look out for?
Since excess blood glucose and ketones from the breakdown of fatty acids will be removed through urine, increased urination will be a key sign of DKA. This increased excretion of fluid will then result in dehydration of the body, which may be presented by excessive thirst. Other common symptoms include lethargy/weakness, vomiting, decreased appetite/weight loss, and abdominal pain.
Immediate interventions include restoration of the fluid balance through the means of saline solution (0.9% NaCl fluid). Often, potassium supplementation is also necessary to restore electrolyte balance. An injection of fast-acting insulin is also likely to be administered both to quickly lower blood glucose level and to manage excessive ketone production.
DKA is frequently found to be accompanied by one or more illnesses. This is because insulin imbalance in DKA is often caused by physiological stress. These physiological stresses range from dehydration and drug therapy to bacterial infection, inflammation, and heart failure. In fact, a source published in 2017 reported that 90% of cats and 70% of dogs had concurrent illnesses with DKA. It is, therefore, important to examine and understand the underlying cause of DKA in the process of treatment.
-https://www.vin.com/apputil/content/defaultadv1.aspx?meta=Generic&pId=11196&id=3854239 Understanding Diabetic Ketoacidosis. World Small Animal Veterinary Association World Congress Proceedings, 2005.
-https://vcahospitals.com/know-your-pet/diabetic-ketoacidosis-in-dogs Diabetic Ketoacidosis in Dogs. VCA.
-https://www.medvetforpets.com/dka-dog-cats/#:~:text=Risk%20factors%3A%20Median%20age%208,UTI%20and%20hyperadrenocorticism%20most%20common). Diagnosis and Treatment of Diabetic Ketoacidosis (DKA) in Dogs and Cats. Medvet, 2017.
-http://www.diabeticcatinternational.com/knowledge/dka/?fbclid=IwAR0Cm4mfrFMNvO8QAwk5Du_LGFaDJug0_s4H3mzX3OdYCVvifQGqueJ65Cg DKA. Diabetic Cat International.