Diabetes

Question 1

How does diabetes mellitus affect appetite and weight?

Answer 1

Increased appetite

Weight loss

Question 2

Do the different types of diabetes affect demeanour? (Mellitus, insipidus, ketoacidosis)

Answer 2

Diabetes mellitus - BAR
Diabetes insipidus - BAR
Diabetic ketoacidosis - lethargic

Question 3

How does diabetes mellitus affect:
Muscle
Liver size
Eyes (dogs)
Ortho (cats)?

Answer 3

Muscle atrophy
Hepatomegaly
Bilateral cataracts, lens induced uveitis, retinoneuropathy
Diabetic neuropathy - flat hocks

Question 4

What changes may be seen on biochemistry with diabetes mellitus?

Answer 4

Hypergylcaemia
Increased fructosamine
Hyperlipidaemia
Metabolic acidosis
Increased ALP

Question 5

What visual changes may be seen to blood serum with diabetes mellitus?

Answer 5

Lipaemic serum

Question 6

What changes may be seen on urinalysis with diabetes mellitus?

Answer 6

Glucosuria

Low USG

Question 7

What causes diabetes mellitus in dogs?

Answer 7

Immune mediated
Beta islet destruction
(Type 1)

Question 8

What causes diabetes mellitus in cats?

Answer 8

Obesity leading to insulin resistance

Type 2

Question 9

How is diabetes treated in dogs?

Answer 9

Caninsulin/lentinsulin BID (life long)
Lifestyle changes - diet high in fibre and carbs
Glipizide (oral anti-hyperglycaemic drug)

Question 10

How is diabetes treated in cats?

Answer 10

Caninsulin or prozinc BID (life long)

Lifestyle changes - weight loss, low carb diet

Question 11

If an animal with diabetes mellitus is not eating, what should be done to the insulin dose?

Answer 11

Reduce dose by 50%

Question 12

What is diabetic ketoacidosis? What causes it?

Answer 12

Complication of unregulated diabetes mellitus

Caused by stress, inadequate insulin or concurrent disease

Question 13

What are the clinical signs of diabetic ketoacidosis?

Answer 13

Vomiting
Inappetance
Dehydration
Weakness
Tachypnoea 
Acetone breath

Question 14

What haematological changes may be seen with diabetic ketoacidosis?

Answer 14

Anaemia
Stress leukogram (SMILE)

Question 15

What biochemistry changes may be seen with diabetic ketoacidosis?

Answer 15

Marked hyperglycaemia
Hypokalaemia
Acidosis

Question 16

What urinalysis changes may be seen with diabetic ketoacidosis?

Answer 16

Ketonuria
Glucosuria
Low USG
(Same as DM + ketonuria)

Question 17

How is diabetic ketoacidosis diagnosed?

Answer 17

Ketonuria + DM

Question 18

How is diabetic ketoacidosis treated?

Answer 18

IVFT
Insulin CRI
Supplement potassium
Dextrose supplementation?

Question 19

What are the clinical signs of diabetes insipidus?

Answer 19

Severe polydipsia >200ml/kg/day (PD = 100ml/kg/day)
Polyuria (PUPD)
Otherwise clinically normal!

Question 20

What changes may be seen with diabetes insipidus on urinalysis?

Answer 20

Hyposthenuria (USG <1.008)

Question 21

How is diabetes insipidus diagnosed?

Answer 21

Rule out other causes
Trial desmopression
Water deprivation test (last resort - requires close monitoring for dehydration)

Question 22

What is the treatment for diabetes insipidus?

Answer 22

Desmopressin

replaces low levels of vasopressin

Question 23

What are the two causes of diabetes insipidus?

Answer 23

Central - lack of ADH production in pituitary

Nephrogenic - lack of response to ADH (metabolic problem or renal)