Diabetes Mellitus Flashcards
What is the renal threshold after which results in glucosuria (and consequently PU/PD)?
200mg/dL (11.1mmol/L) in dogs
250-300mg/dL (13.8-16.6mmol/L) in cats
…leading to osmotic diuresis
What are the primary causes of diabetes mellitus in cats and dogs?
Dogs - insulin deficiency due to distruction of beta cells
Cats - insulin resistance leading to exhaustion of beta cells
What are the clinical signs of DKA?
Hypokalaemia, hypophosphataemia (potassium and phosphorus both lost via diuresis), PU/PD, dehydration, lethargy, anorexia/hyporexia, vomiting, weight loss, loss of muscle mass, increased resp rate, pear drops breath
Ovariohysterectomy in dogs can help control unregulated type II diabetes, true or false?
True - progesterone and GH(?) both counteract the action of insulin and can provoke development of type II (insulin resistant) diabetes.
BG is <100mg/dl - what course of action do you take?
Start dextrose 2.5-5% CRI at 1-2ml/kg/hr and monitor BG Q 30mins
BG is 100-200mg/dl - what course of action do you take?
Give ¼ insulin dose and start dextrose 2.5-5% 1-2ml/kg/hr and monitor BG Q30mins
BG is 200-300mg/dl - what course of action do you take?
Give 1/2 dose insulin and start dextrose 2.5-5% at 1-2ml/kg/hr if glucose drops below 150mg/dl and monitor BG Q 30mins.
BG is >300mg/dl - what course of action do you take?
Give full dose of insulin and monitor BG Q 30mins. Monitor for ketonuria if hyperglycaemia is persistent.
What abnormal blood results are associated with DKA?
Increased PCV/TS (due to dehydration), metabolic acidosis (low pH, increased anion gap, decreased bicarbonate), raised urea/creatinine.
Return to eating is a primary post-op concern for diabetic patients. How can this concern be mitigated?
Maropitant 1mg/kg SC 1 hour prior to opioids.
Should dexmedetomidine be administered as a sedative to aggressive diabetic feline patients?
This is contraindicated as dexmedetomidine can cause transient hyperglycaemia by suppressing insulin secretion.
What are the current AAHA fasting guidelines for diabetic patients prior to surgery?
4-6 hours
How can pain affect glycaemic control?
It can cause hyperglycaemia due to insulin inhibition
What is the difference between type I and II diabetes?
Type I is an autoimmune disease where the body attacks its own beta cells (dogs).
Type II is due to insulin resistance i.e. cells become less responsive to insulin (cats)
Where is glucagon produced and what is its function?
It is released by the alpha cells in the pancreas. Glucagon promotes glycogenolysis (conversion of glycogen in the liver into glucose) and gluconeogenesis in the liver and kidneys when when glycogen stores are low.
