26. Diabetes mellitus in dogs and cats Flashcards
If insulin decreases, what happens blood glucose
Increases
Type I DM
Insulin dependant
cause of Insulin dependant
decrease in secretion of insulin due to immune destruction of pancreatic beta cells, islet cell hypoplasia or pancreatic destruction
Pathogenesis of Insulin dependant
Autoimmune
Amyloidosis
Pancreatitis
Treatment of Insulin dependant
Insulin injecitons
which animal is more susceptible to Insulin dependant
Dogs > cats
Type II diabetes
Non Insulin dependant
Non Insulin dependant is due to
Insulin resistance due to diatobetogenic hormones or obesity
Secretion of insulin is normal but inefective
Delayed response in secreting insulin or the tissues are resistant
Which animal is more susceptible to Non Insulin dependant
Cats > dogs
Pathogenesis of Non Insulin dependant
Excess counterregulatory hormones
obesity
how can Non Insulin dependant become Insulin dependant
NIDDM –> Prolonged hyperglycaemia –> glucose toxicity of pancreatic cells –> destruction –> IDDM
Consequence of increased EC glucose
Glucosuria –> decreased blood K, Na, PO
IC dehydration –> hyperglycaemic coma
Glycation of proteins –> cataracts, neuropathy
Consequences of decreased IC glucose
Increased lipolysis
Ketonemia — ketouria, acidosis, ketoacidosis
Weight loss
Hyperlipidaemia
Increased gluconeogenesis –> weakness
Predisposed to DM in dogs
Middle/ old aged dogs
intact females
poodle, dachshund, terrier, puli, lab
Clinical signs of uncomplicated DM in dogs
PU/PD
weight loss
dehydration
hepatomegaly
dull coat
flaking skin
cystitis
cataracts
retinopathy
paresis
Clinical signs of complicated DM in dogs
all of uncomplicated as well as clinical signs associated with
diabetic ketoacidosis
hyperglycaemia hyperosmolar syndrome
pancreatitis
epi
cushing’s
Clinical signs of complicated DM in dogs associated with diabetic ketoacidosis
Kussmaul breathing
Anorexia
Acetone-smelling breath
Vomiting
Lethargy
Coma
Weakness
Clinical signs of complicated DM in dogs associated with hyperglycaemia hyperosmolar syndrome
restlessness
nystagmus
ataxia
convulsions
Clinical signs of complicated DM in dogs associated with pancreatitis
Abdominal pain
diarrhoea
vomiting
lethargy
Clinical signs of complicated DM in dogs associated with epi
poorly digested faeces
foul smelling faeces
flatulence
Clinical signs of complicated DM in dogs associated with cushing’s
acromegaly
Lab D of DM in dogs
increased; blood glucose, ALT, ALP, ALKP, BUN, creatinine, Amylase, lipase, cholesterol, progesterone, cortisol, GH
Urinalysis of DM in dogs
glucosuria >12mmol/l
Bacteriuria
Ketouria
fasting hyperglycaemia
blood glucose is measured on at least 2 occasions after >8hrs of fasting
Fructosamine levels
increase
used in cats as the levels are not affected by stress hyperglycaemia
Differentiation of NIDDM and IDDM
iv glucose tolerance test
DIagnosis of DM in dogs
History
physical exam
lab d
abdo US
Abdo US of DM in dogs
diffusse hepatomegaly
enlarged adrenal glands
pancreatitis
nephropathy
cystitis
ovarian cysts
uterine cysts
Insulin therapy
caninsulin
risks of caninsulin
anorexia or vomiting (give half dose)
excitement
falling convulsions
Weakness
tremor
coma
Blood glucose levels after 6 hrs post insulin
4-9mmol/l
Treatment of hypoglycaemia
Put honey on lips
Give an extra meal
skip following insulin dose
other non insulin treatments
ovariectomy - decrease risk of insulin resistance, and insulin demand
Diet - increase; protein, fibre, complex carbs
Treatment of ketoacidosis
Ringers & KCl
Regular insulin
K+ replacement
bicarbonate therapy
Clinical signs of DM in cats
PU/PD
Weight loss - polyphagia
cataracts
neuropathy
Lab D of DM in cats
Hepatic Lipidosis
Hypokalaemia
Hyperthyroidism - baseline serum T4 or serum free T4
stress hyperglycaemia
Insulin therapy of Type I DM of cats
glipizide, glargine
increased insulin secretion — Decreased blood glucose after 1-2 months
Insulin therapy of Type II DM of cats
diet
exercise
ovariohysterectomy
