Diabetes Mellitus in Dogs Flashcards
List the diseases that are a risk factor for developing diabetes mellitus in dogs
- HyperAdrenocoricism
- Hypertriglyceridemia
- Hypothyroidism
- Dental disease
- Systemic infection
- Pancreatitis
(Obesity and pregnancy too)
This would cause Type II diabetes (less common in dogs) bc Type I is due to a immune mediated attack/complete lack of insulin from a young age)
Clinical signs of diabetes mellitus in dogs occur once the BG exceeds the renal threshold of _________ mg/dL and glucosuria develops
BG > 200
List the clinical signs that can be seen in dogs with diabetes mellitus
- PU/PD
- Polyphagia
- Weight loss
- Cataracts
- Poor coat
- ABD pain (if pancreatitis)
- Increased fat metabolism (hepatic lipidosis, hepatomegaly, hypercholesterolemia)
A male neutered dog comes in with a BG of 250. You check the diet, medication history, and now you want to rule out concurrent endocrinopathies. What tests should you perform?
- MDB
- BP!! DM dogs @ risk for hypertension
- Electrolytes
- Triglycerides
- cPLI
- tT4
- Fructosamine
What can be evaluated on urinalysis in a dog with suspect DM?
- Glucose
- Ketones
- Bacteria, WBCs (DM patients get UTIs!)
A patient has a glucose of 350. How can you confirst persistent elevated glucose levels?
Fructosamine (tells the AVG BG from last 2 weeks)
What are the main Ddx for PU/PD in dogs
- DM
- HyperAdrenocoticism
- HypoT
- CKD
- Hypercalcemia
- Liver failure (due to no urea)
What eye changes can occur in dogs with DM?
- Cataracts (due to sugars in eye)
- Retinal hypertension
Which of the following is not a finding typically seen with diabetes mellitus?
A. Hypercholesterolemia
B. ↑ ALP
C. ↑ BP
D. Lymphocytosis
D. Lymphocytosis
Lymphopenia!! Stress leukogram!
What concurrent diseases can complicate stabilization of diabetes mellitus in dogs?
- HyperAdrenocorticism
- Renal dz
- Dental disease
What are the goals of managing a DM dog?
- Lower BG below renal threshold (<200)
- Treat UTI if needed
- Stop progression of concurrent diseases (Ex: pancreatitis, hypertension)
What is the 1st line insulin of choice in dogs?
U-40 pork lente
What is the starting dose of insulin in dogs?
0.25 IU/kg BID
Ex: 5 kg dog has a starting dose of 1.25IU BID
Which of the following are long acting insulins? Select all that apply.
A. U-40 pork lente
B. Glargine
C. Detemir
D. PZI
E. NPH
B. Glargine
C. Detemir
- long acting “peakless insulin”
- cumulative effect, given SID
True or False: Glipizide is an oral hypoglycemic that can be used in dogs and cats with diabetes mellitus
FALSE - can be used in cats not dogs
An overweight diabetic dog should aim for a _____% decrease in BW per week
1-2%
What is the diet of choice to treat an overweight dog with DM?
High fiber diet - improves glycemic control by reducing postprandial hyperglycemia
When should you consider switching the type of insulin?
- If uncontrolled despite adjusting dose
- If the duration of insulin is inappropriate (lasting < 10 hrs or > 12 hrs)
CS of hypoglycemia?
- Seizures
- Altered mentation
- Tremors
- Ataxia
- Impaired vision
(neuro stuff)
What concurrent condition can cause uncontrolled diabetes mellitus in mini schnauzers?
Hypertriglyceridaemia
What is somogyi?
Low BG (hypopglycemia) → triggers release of stress hormones (cortisol, epinephrine, glucagon) → rebound hyperglycemia
How long can somogyi last in dogs vs cats?
Dogs: 24 hrs
Cats: up to 72 hrs
If somogyi is present when performing a BG curve in a dog, how should the insulin therapy be tailored?
Decrease dose by 50%
What are the clinical signs of hypoglycemia?
- Seizures
- Muscle twitching
- Collapse
- Ataxia
- Altered mentation
- Impaired vision
An owner calls that their diabetic dog is showing signs of hypoglycemia. How can you direct the owner to treat at home before coming to the clinic?
- Give honey, corn syrup, or glucose syrup in the mouth
A diabetic dog comes in with signs of hypoglycemia after starting insulin last week. What is the treatment for hypoglycemia in the hospital?
- IV fluids: Dextrose diluted with saline
What concurrent disease in schnauzers is a risk factor for developing diabetes mellitus?
Hypertriglyceridemia
Which of the following insulin type can be given IV?
A. U-40 pork lente
B. Glargine
C. Detemir
D. PZI
E. NPH
E. NPH
What concurrent medications can cause uncontrolled diabetes mellitus in patients on insulin therapy?
- Steroids
- Megestrol acetate
- Cyclosporine
How often are samples taken during a BG curve and how long does the curve last?
BG taken every 2 hrs over 8-12 hrs
When taking a BG curve on a dog, what BG levels are acceptable to send the dog home?
If BG remains > 150 … Then repeat BG in 1 week
When doing a BG curve on a dog, what can be evaluated to determine if the insulin dose needs to be decreased?
If BG < 150, decrease dose of insulin by 10-25% and continue to monitor in hospital on decreased dose
When should the dose of insulin be decreased by 50%?
- If somogyi
- If showing CS of hypoglycemia
What is considered a normal blood glucose in dogs and cats?
80-120
(in diabetics should aim for 200, ideally 150)
