Diabetes Mellitus

Question 1

What 3 changes would you see on a biochem panel with DM?

Answer 1

1. Hyperglycemia
2. Hypercholesterolemia
3. Hypertriglyceridemia

Question 2

What changes would you see in the urine with DM?

Answer 2

Glucosuria (which falsely increases the USG 0.008-0.010)

Question 3

___% of dogs with DM had bacterial UTIs.

Answer 3

24%

Question 4

True or False: DM is dogs is dependent on insulin.

Answer 4

TRUE

Question 5

What are the 2 Neutral Protamine Hagedorn (NPH) products?

Answer 5

1. Humulin-N

2. Novolin-N

Question 6

The NPH insulin class is _____ - acting.

Answer 6

Intermediate acting

Question 7

What is the name of the Lente Insulin product?

Answer 7

Vetsulin

Question 8

Lente Insulin is a combination of 30% short-acting ____ and 70% long-acting ____ insulin.

Answer 8

Lente Insulin is a combination of 30% short-acting AMORPHOUS and 70% long-acting CRYSTALLINE insulin.

Question 9

Lente insulin is derived from where?

Answer 9

Porcine

Question 10

True or False: Vetsulin is not FDA approved yet for use in dogs and cats.

Answer 10

FALSE - FDA approved

Question 11

Protamine Zinc Insulin has more ____ than NPH, resulting in a prolonged duration.

Answer 11

Protamine

Question 12

What is the name of the Protamine Zinc Insulin product?

Answer 12

ProZinc

Question 13

True or False: ProZinc is approved for use in dogs and cats.

Answer 13

FALSE - FDA approved for use in cats.

Question 14

What is the name of the glargine product available?

Answer 14

Lantus

Question 15

What is the name of the detemir product available?

Answer 15

Levemir

Question 16

What dose of insulin would you use to initiate therapy in a diabetic dog?

Answer 16

0.25 - 0.5 U/kg SC q. 12 hr.

Question 17

Which 2 insulins would you choose from to initiate insulin therapy in a dog?

Answer 17

1. NPH

2. Lente

Question 18

What dose of insulin would you use to initiate therapy in a diabetic cat?

Answer 18

1 U/kg SC q. 12 hr.

Question 19

What 3 insulins would be your first choice in initiating insulin therapy in a cat?

Answer 19

1. PZI
2. Lente
3. Glargine

Question 20

What is the name of the oral hypoglycemic drug available for use in diabetic cats?

Answer 20

Glipizide

Question 21

Glipizide is successful in only ____% of cats.

Answer 21

33%

Question 22

In the diabetic cat, a ___-protein, ___-carbohydrate diet is ideal.

Answer 22

HIGH protein

LOW carbohydrate

Question 23

True or False: Meal feeding at the time of insulin administration is NOT essential in the diabetic cat.

Answer 23

TRUE

Question 24

True or False: In diabetes, remission is equivalent to a cure.

Answer 24

FALSE

Question 25

Remission in diabetic cats usually occurs within the first ___ months of treatment.

Answer 25

3 months

Question 26

Why do ketone bodies develop?

Answer 26

In states of glucose deficiency, ketone bodies can be used as an energy source.

Question 27

As ketone bodies increase in the vascular space, they exceed the renal threshold. What does this cause?

Answer 27

Osmotic diuresis

Question 28

Urine dipsticks measure what 2 ketones?

Answer 28

1. Acetoacetic acid | 2. Acetone

Question 29

Which ketone is not measured by a urine dipstick?

Answer 29

Beta-hydroxybutyrate

Question 30

____ + ____ = diabetic ketoacidosis

Answer 30

Ketosis + metabolic acidosis

Question 31

With diabetic ketoacidosis, what changes would you expect on a CBC?

Answer 31

1. Non-regenerative anemia 2. Inflammatory leukogram 3. Hemoconcentration (due to dehydration)

Question 32

With diabetic ketoacidosis, what changes would you expect on biochem profile?

Answer 32

1. Hyperglycemia 2. Hypercholesterolemia 3. Hypertriglyceridemia 4. Azotemia 5. High anion gap

Question 33

With diabetic ketoacidosis, what changes would you expect on a urinalysis?

Answer 33

1. Glucosuria 2. Ketonuria 3. Bacteriuria

Question 34

Dextrose can be supplemented as needed to keep blood glucose between ____ and ____ mg/dL.

Answer 34

100 and 250 mg/dL

Question 35

With DKA, you may need to supplement phosphorous. Phosphorous < ____ mg/dL can can hemolysis.

Answer 35

< 1.5 mg/dL

Question 36

Serum potassium may increase or decrease following insulin therapy?

Answer 36

Decrease

Question 37

What are your 2 fluid choices for re-hydrating a DKA patient?

Answer 37

1. 0.9% NaCl | 2. Buffered crystalloid solution (Plasmalyte A, LRS)