Diabetes Mellitus Flashcards
What are the 3 key clinical signs associated with diabetes mellitus? What is also seen in cats and dogs?
- PU/PD
- polyphagia
- weight loss
CATS = plantigrade stance
DOG = cataracts
How do most healthy diabetics present?
- PU/PD
- polyphagia + weight loss
- recurrent infections
- plantigrade stance from diabetic neuropathy
- cataracts
How do patients with diabetic ketoacidosis present?
- anorexia
- vomiting
- weakness
- severe metabolic acidosis
- blood glucose >500 mg/dl
What are the 2 major signs of diabetes mellitus on bloodwork? What are 2 other abnormalities?
- hyperglycemia >300 mg/dl - stress can cause this, particularly in cats
- glucosuria +/- ketonuria
metabolic acidosis + elevated liver enzymes/cholesterol
What test can be used to reflect a patient’s glycemic status over several weeks?
fructosamine and glycosylated hemoglobin (HbA1C)
What are 3 parts to treating a healthy diabetic?
- insulin injections - typically BID
- oral hypoglycemic - decrease insulin requirements or insulin resistance
- consistent high protein, low carbohydrate diet with high fiber and moderate fat restriction
What type of insulin should be used to treat diabetics?
intermediate and long-acting
- Vetsulin
- PZI
- NPH
- Lente/Ultralente
- Glargine
How should insulin usage be monitored when treating diabetes mellitus?
blood glucose curves –> see that the dose has sufficient potency and duration without cause a Somogyi effect from overdosage
What are some oral hypoglycemics that can be used to treat diabetes mellitus?
- Glipizide (Glucotrol)
- Metformin (Glucophage)
- Rosiglitazone (Avandia)
- Acarbose
efficacy is controversial
What are 3 parts to treating diabetic ketoacidosis?
- aggressive IV fluids - 0.9% saline with potassium and phosphate supplementation
- Regular insulin - fast-acting, given intermittently (q 6-8 hr) or by continuous IV infusion (monitor blood glucose!)
- bicarbonate - severe metabolic acidosis not improving with IVF
