Diabetes Flashcards
Signalment for canine DM
middle aged - older (5-12y), though seen in juveniles rarely
females may be more prone
Type 1 diabetes cause and species
failure of pancreatic beta cells, more common in dogs
type 2 diabetes cause and species
insulin resistance and beta cell burnout, more common in cats
Signs of DM in dogs
PU/PD/PP and weight loss
Signs of DM in cats
no typical presentation
Causes of feline insulin resistance?
obesity/diet, chronic hyperglycaemia, endocrinopathies
6 factors that complicate DM
obesity, infectious (UTI, pyelonephritis), chronic illness (pancreatitis), hyperthyroidism, hyperadrenocorticism, acromegaly
most common cause of UTI
E. Coli
What is acromegaly?
functional pituitary resulting in excess GH
What is transient diabetes?
diabetic remission
What is DKA??
Diabetic ketoacidosis
What are signs of DKA?
dehydration, hypovolemia, metabolic acidosis, hypotension, weakness, dullness, vomiting, anorexia, ketone breath, collapse, death
Which is false regarding the neuropathies involved with DM?
A) plantigrade posture when standing or walking
B) sensorimotor neuropathy in pelvic and thoracic limbs
C) Axonal degeneration
D) marked decreases in nerve fructose
D - there are marked increases in nerve glucose
T/F there is significant association between presence of abnormal pulmonary histopathology and DM
True - congestion and edema, pneumonia, smooth muscle hypertrophy, fibrosis
2 ocular changes that can be seen due to DM
retinal or cataracts
Clinical signs of a “healthy diabetic”
PU/PD, weight loss, PP, dry, flaky skin, plantigrade stance
2 initial diagnostics for DM
blood glucose (hyperglycaemia) and urine dipstick (glucosuria)
Lab abnormalities seen in DK patient?
hyperglycaemia, glycosuria, ketonuria, metabolic acidosis, decreased Na, Cl, K, P, Mg
Therapy for healthy diabetic
insulin therapy diet, oral hypoglycaemics? monitoring, long term care
T/F: regular insulin is short acting
true
Which insulin types are intermediate acting? A) regular B) NPH C) Lente D) PZI
NPH and Lente!
Which insulin types are long acting? A) NPH B) Lente C) PZI D) Ultralente
PZI and ultralente
Which of the following insulins is not U-40 formulation?
A) Vetsulin
B) PZI vet
C) Glargine
C - glargine, is U100 formulation
Starting insulin therapy
1/4 to 1/2 unit/kg body weight BID
lower dose if obese
first dose is test dose
Which is FALSE regarding mechanisms of oral hypoglycaemic agents?
A) stimulate insulin release from pancreas
B) increase hepatic glucose production
C) reduce glucose absorption form GI tract
D) increase peripheral glucose uptake
B - it decreases hepatic glucose production
T/F: oral hypoglycaemic agents are effective when used alone in treating DM cats
false
An owner calls you because he just checked the urine of his diabetic cat and it was positive for ketones. What do you suggest?
client probably needs an appointment and should come in
A client calls you because her DM cat has had high glucose the past few days. What do you suggest
bring cat in for PE and potential insulin adjustment
Two things that falsely lower fructosamine levels
marked hypoproteinemia
hyperthyroidism
How often should you recheck a well controlled DM cat
3-4m
How do you treat a “complicated” DM cat?
treat concurrent diseases
attempt to control DM clinical signs with therapy
consider quality of life
requires long-term commitment of owner and DVM
Which insulin is preferred by our professor?
NPH! intermediate acting and cheap
