CS: Thyroid disorders = endocrine

Question 1

Do glucose, ketones and proteins make urine acidic or alkaline?

Answer 1

all make urine acidic

Question 2

T/F: UTI can cause an alkaline urine pH

Answer 2

True

Question 3

T/F: you get hepatomegaly with DM

Answer 3

True

Question 4

Generally, which AB is good for UTI?

Answer 4

amoxicillin-clavulanate as becomes very concentrated in urine

Question 5

With stress-induced hyperglycaemia, do you expect glucosuria?

Answer 5

If hyperglycaemia started recently (e.g. last 2 hours d/t hospital visit), then no. If more chronic, then yes. Blood fructosamine level is not an unreasonable test to perform as cheap.

Question 6

When do you measure serum IGF-1 in a cat?

Answer 6

when diagnosed with DM (to check for feline acromegaly/ hypersomatotropism). Ensure before insulin is given. BUT must be some insulin in the system (and have been for a few days) at the time to interpret IGF1 correctly otherwise result invalid.

Question 7

What can massively high amylase (> 3 times baseline) indicate?

Answer 7

pancreatitis (also indicated by fasting lipaemia)

Question 8

How does lipaemic serum affect serum protein levels?

Answer 8

Lipaemic serum causes falsely high serum protein levels (thus high TSP and albumin)

Question 9

Why do you get bilirubinaemia with pancreatitis?

Answer 9

since bile duct runs through pancreas. Inflammation of pancreas –> obstructs pancreas –> bilirubinaemia.

Question 10

Can pancreatitis cause DM?

Answer 10

Yes

Question 11

Does pancreatitis explain V, D and inappetance?

Answer 11

Yes

Question 12

How can you confirm a dx of pancreatitis?

Answer 12

cPLI (2 tests - SNAP: at vets and Spec tests: to lab, 94% specificity)

Question 13

Diet - pancreatitis

Answer 13

• fat restricted (

Question 14

Causes - glucosuria d/t low renal threshold

Answer 14

• fanconi syndrome

- primary renal glucosuria

Question 15

What effect is insulin best at?

Answer 15

• best at reducing peripheral lipolysis
• least effective at increasing peripheral glucose uptake
• thus an animal with insulin deficiency and high blood glucose may not develop ketoacidosis if there is enough insulin to keep reducing peripheral lipolysis

Question 16

Why might an acidotic animal be hypOkalaemic?

Answer 16

• normally acidotic animals are hypErkalaemic
• in severe cases of V, PU and DM (insulin facilitates transport of K into cell), low K+ may be seen with acidosis
• risk of cardiac arrest

Question 17

Tx - diabteic ketoacidosis (DKA) crisis

Answer 17

• Tx = fluids with K+ supplementation:
o Rate of twice maintenance 150mg/kg/24 hr
o 0.45-0.9% NaCl
o 30-40mml/L of potassium as chloride or as mixture of potassium chloride and potassium phosphate.
o Don’t add phosphate to hartmann’s as causes K+ precipitation.
• Correct hypoglycaemia: soluble insulin (IM every hour or as CRI). Glucose will fall more quickly than ketones. Ok except risk of developing hypoglycaemia. As it is the ketoacidosis that is causing the inappetence….correct this. Then to avoid hypoglycaemia  almost paradoxically  lower rate of insulin infusion and start giving dextrose (24-72 hours until animal eating). Then manage as a standard diabetic.