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DMod3 Pt6 Endocrine Disease > DM3 Pt6-2 Diabetes mellitus > Flashcards

DM3 Pt6-2 Diabetes mellitus Flashcards

1
Q

What is the estimated incidence of feline diabetes mellitus in the UK?

A

Nearly 1 in 200 cats are diabetic.

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2
Q

What type of diabetes mellitus is most common in cats?

A

Type 2 diabetes mellitus, characterized by insulin resistance and impaired insulin secretion.

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3
Q

What are the three current treatment goals for managing feline diabetes mellitus?

A

Early detection, aggressive treatment early in the course of the disease, and aiming for transient diabetes with temporary insulin use.

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4
Q

What is transient diabetes mellitus in cats?

A

Transient diabetes refers to a temporary state where the cat may no longer need exogenous insulin after initial treatment, though it may revert to insulin dependence later.

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5
Q

In what percentage of cats may diabetes mellitus be transient?

A

Diabetes mellitus may be transient in 50-60% of cats if diagnosed early and treated appropriately.

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6
Q

What factor plays a significant role in the development of feline diabetes mellitus?

A

Obesity is a major factor contributing to the development of diabetes in cats.

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7
Q

How can appropriate weight management impact diabetic cats?

A

Weight loss can significantly reduce insulin requirements and may even reverse the need for exogenous insulin.

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8
Q

What is the role of veterinary nurses in managing feline diabetes?

A

Nurses play a vital role in preventing diabetes through obesity management, early detection, educating owners, and increasing treatment compliance.

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9
Q

What can trigger a return to insulin dependence in cats with transient diabetes?

A

Cats may revert to an insulin-dependent state due to factors like obesity or corticosteroid treatment.

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10
Q

When does transient diabetes most commonly occur in diabetic cats?

A

Transient diabetes typically occurs within 1-3 months of initiating insulin treatment.

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11
Q

At what age are cats most commonly at risk of developing diabetes mellitus?

A

Cats in the “mature adult” life stage (7-10 years old) are most commonly affected, though diabetes can occur at any age.

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12
Q

What are some risk factors for feline diabetes mellitus?

A

Male neutered cats, Burmese cats, indoor sedentary cats, obese cats (>5kg), and cats receiving corticosteroid or progestogen treatment.

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13
Q

What is the increased risk for Burmese cats of developing diabetes?

A

Burmese cats in the UK have a 1 in 53 chance of developing diabetes.

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14
Q

Why is routine screening important for at-risk cats?

A

Routine screening allows for earlier detection of diabetes, which can increase the likelihood of transient diabetes mellitus.

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15
Q

How can client education help in preventing diabetes in at-risk cats?

A

Educating owners about managing obesity and promoting exercise can help prevent diabetes in at-risk cats.

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16
Q

What is the risk associated with diabetogenic drugs like corticosteroids?

A

Cats receiving diabetogenic drugs are at risk of developing diabetes and should be monitored regularly.

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17
Q

How often should urinalysis be performed in cats to detect diabetes mellitus early?

A

Annual urinalysis should be performed in all cats aged 7 years and older, and every 3-6 months for at-risk cats.

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18
Q

What special considerations should be made for diabetic screening in Burmese, obese, indoor cats, or those on diabetogenic drugs?

A

Increased frequency of urinalysis, every 3-6 months, and vigilance in cats with 2 or more risk factors.

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19
Q

What can be used for home urine sampling in cats?

A

Non-absorbent litter like Katkor, Mikki litter, or aquarium gravel can be used for home urine sampling.

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20
Q

What test should follow-up a high blood glucose or glucosuria result?

A

A serum fructosamine measurement should be performed to confirm or rule out diabetes.

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21
Q

What clinical steps can be taken to help detect feline diabetes earlier in practice?

A

Adding blood glucose measurement to the pre-anaesthetic protocol for cats over 7 years old and regular weight monitoring and body condition scoring.

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22
Q

What key topics should a nurse cover when educating a client about feline diabetes?

A

Client education on the disease, addressing additional concerns (e.g., obesity), insulin storage, drawing up doses, administering insulin, monitoring for hypoglycaemia, urine sampling, dietary management, follow-up appointments, and home monitoring.

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23
Q

Why is it important for owners to understand diabetes and its implications?

A

Understanding diabetes helps improve compliance with treatment and long-term disease management.

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24
Q

What is an important tip for administering insulin injections in cats?

A

Advise owners to rotate the injection site to reduce the risk of reduced insulin absorption. The scruff of the neck can be divided into four, with the site changed daily.

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25
Q

How can nurses help reduce owners’ anxiety about injecting insulin into their cat?

A

Demonstrate the injection technique and allow the owner to practice, providing reassurance that using the same site occasionally is not harmful.

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26
Q

What should owners monitor to prevent complications from diabetes treatment?

A

Owners should monitor for signs of hypoglycaemia, obtain urine samples for testing, and use ketostix to check for ketones.

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27
Q

Why is dietary management important for diabetic cats?

A

Proper diet helps regulate blood glucose levels and manage obesity, which can impact insulin requirements.

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28
Q

What is the nurse’s role in follow-up appointments for diabetic cats?

A

Explain what will be monitored (e.g., blood glucose curves), why it’s important, and the procedure for follow-up appointments.

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29
Q

How does insulin licensing vary across countries?

A

In some countries, Glargine (a human insulin) is frequently used with a tight regimen that typically includes home blood testing.

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30
Q

What should owners be taught about insulin storage?

A

Insulin should be stored properly, typically in the refrigerator, to maintain its effectiveness.

31
Q

What is the role of home monitoring in managing feline diabetes?

A

Home monitoring allows for better glucose control, helps detect hypoglycaemia early, and may include blood glucose testing.

32
Q

Why is insulin therapy unpredictable in cats?

A

Cats can respond unpredictably to insulin, and no single type or dosing regimen is suitable for all cats.

33
Q

How often should insulin doses be increased for diabetic cats?

A

Insulin doses should be increased by no more than 0.5 IU per injection, and no more frequently than every 3-5 days.

34
Q

What dosing regime is generally more effective for diabetic cats?

A

Twice daily insulin dosing is usually more effective.

35
Q

What should owners do if they cannot strictly adhere to a twice-daily insulin dosing schedule?

A

It is better to have a less strict regime, such as 5 days of twice daily dosing and 2 days of once daily dosing, than to euthanize the cat due to worry about dosing.

36
Q

What type of diet is recommended for diabetic cats of any body weight?

A

A high-protein, low-carbohydrate diet is recommended for diabetic cats of any body weight.

37
Q

Why are wet diets preferable for diabetic cats?

A

Wet foods tend to contain lower proportions of carbohydrates compared to dry foods, which leads to better glycaemic control.

38
Q

What are some recommended prescription diets for diabetic cats?

A

High protein, low carbohydrate diets like Nestle Purina DM are recommended.

39
Q

What should owners look for in supermarket diets if prescription diets are not an option?

A

Owners should look for the lowest carbohydrate and highest protein proportions in supermarket diets.

40
Q

Is it necessary to have a strict insulin administration schedule related to feeding?

A

No, cats do not develop significant post-prandial hyperglycaemia, so a strict feeding and insulin administration schedule is not necessary.

41
Q

When is the most practical time to administer insulin to cats?

A

During or after feeding, to ensure the cat has eaten before insulin is given.

42
Q

How should the feeding regime be managed for cats that graze throughout the day?

A

Cats that graze can continue this regime as long as they are not gaining weight, and the amount of food eaten daily should be monitored.

43
Q

What dietary consideration should be made for diabetic cats with concurrent chronic renal disease?

A

A diet with lower protein content may be considered if chronic renal disease is present.

44
Q

What high-protein treats are recommended for diabetic cats if the owner insists on giving treats?

A

Chicken or fish are good high-protein treat options for diabetic cats.

45
Q

What key parameters should owners record to monitor diabetic control in cats?

A

Weight, body condition score, demeanour, appetite, thirst, coat condition, urination, blood glucose (if monitored), and urinalysis.

46
Q

What should owners track regarding their cat’s urination to monitor diabetes?

A

Owners can weigh the litter tray regularly to subjectively monitor changes in urination patterns.

47
Q

Why is it important for owners to keep a diary when monitoring their diabetic cat?

A

A diary helps track clinical signs and changes, allowing for better assessment of diabetic control.

48
Q

What role does urinalysis play in monitoring diabetic cats?

A

Urinalysis can check for remission (absence of glucose) or the presence of ketones, which may indicate ketoacidosis.

49
Q

Why should insulin doses not be adjusted based solely on urine glucose levels?

A

Urine glucose is not a reliable indicator for adjusting insulin doses, and frequent measurement may lead to owners making inappropriate dose adjustments.

50
Q

When can monitoring urine for glucose be useful in diabetic cats?

A

It is useful in detecting transient diabetes when insulin requirements are reducing, indicated by the absence of glucosuria.

51
Q

How should owners monitor their cat’s thirst for diabetic control?

A

A subjective assessment (e.g., drinking less, more, or the same) is valuable, as measuring exact water intake is often impractical.

52
Q

What can the absence of glucose in the urine suggest in a diabetic cat?

A

The absence of glucose may indicate remission or improved glycaemic control.

53
Q

What should owners monitor for to detect early stages of ketoacidosis?

A

Periodic checks for urine ketones can help detect developing ketoacidosis before the cat becomes clinically unwell.

54
Q

Why is it important for veterinary nurses to be supportive when monitoring diabetic cats?

A

Providing a sympathetic and supportive ear to clients can greatly improve compliance and ensure successful long-term management.

55
Q

What are two key challenges when hospitalizing diabetic cats?

A

Stress-induced hyperglycaemia and stress-related anorexia, both of which can complicate blood glucose interpretation.

56
Q

What principles should be followed to reduce stress in hospitalized diabetic cats?

A

Following “Cat Friendly Practice” principles can reduce stress and improve management outcomes for diabetic cats.

57
Q

What minimally invasive blood sampling technique is often better tolerated by diabetic cats?

A

The ear vein technique is less invasive and may be better tolerated by diabetic cats.

58
Q

What is a benefit of home blood glucose monitoring in diabetic cats?

A

It allows for accurate readings without the stress of hospitalization, making it easier to manage difficult-to-stabilize cats.

59
Q

What is the goal of performing a blood glucose curve (BGC) in a diabetic cat?

A

To identify the nadir blood glucose concentration, evaluate the duration of insulin effect, and check for Somogyi overswing.

60
Q

How is a blood glucose curve (BGC) performed?

A

After giving the cat its usual breakfast and insulin dose, blood glucose levels are checked every 1-2 hours over a 12-24 hour period.

61
Q

What is the target blood glucose range for diabetic cats during a BGC?

A

The target blood glucose concentration is between 5-14 mmol/L.

62
Q

How is the peripheral ear vein sampling performed in diabetic cats?

A

Warm the ear, apply Vaseline to prevent blood from running, hold the ear firmly, and pierce the peripheral ear vein with a needle or lancet to collect blood.

63
Q

Why is Vaseline applied to the ear during ear vein sampling?

A

To prevent the blood from running into the cat’s hair coat, making the sample easier to collect.

64
Q

What tool is used to measure the blood glucose concentration in diabetic cats?

A

A glucometer is used, either directly applied to the blood sample or using a test strip.

65
Q

How often should stabilized diabetic cats be reassessed?

A

Every 3-6 months.

66
Q

What minimum checks should be performed during a diabetic reassessment?

A

Discussion with the owner about the diabetic diary, full physical exam, weight and body condition scoring, serum fructosamine measurement.

67
Q

What additional tests are useful during diabetic reassessments?

A

Blood pressure measurement, full urinalysis (including UPC and culture), routine haematology, and serum biochemistry.

68
Q

Why is the owner’s diabetic diary important during check-ups?

A

The diary provides valuable insights into clinical signs, dietary changes, and trends that help manage the cat’s diabetes.

69
Q

What signs may indicate that a diabetic cat no longer needs exogenous insulin?

A

Low blood glucose (<10mmol/L) before insulin administration, low/normal fructosamine concentration, persistent absence of glucosuria.

70
Q

Why is client education important at the initial consult for diabetic cats?

A

Providing sufficient information about the disease, expected stabilization time, and insulin needs helps set realistic expectations and improve compliance.

71
Q

How can nurses support owners in managing diabetic cats?

A

By offering advice on insulin administration, answering questions, providing tips on home monitoring, and discussing concerns to reduce owner anxiety about handling insulin.

72
Q

What is the importance of being flexible with feeding and insulin schedules?

A

Flexibility helps owners manage treatment, and missing occasional insulin doses is better than not treating the cat at all.

73
Q

What are potential signs of transient diabetes in cats?

A

A drop in blood glucose levels, normal fructosamine, and absence of glucosuria can indicate that a cat no longer needs insulin.

74
Q

What is diabetic neuropathy, and how is it managed in cats?

A

Diabetic neuropathy is nerve damage caused by prolonged high blood sugar, and it may not recover even after blood glucose control is achieved.

DMod3 Pt6 Endocrine Disease (6 decks)

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