Endocrine Emergencies Flashcards
What are endocrine diseases that can present with life-threatening complications
-Diabetic ketoacidosis (DKA)
-Hypoadrenocorticism
-Pheochromocytoma
-Thyrotoxicosis
-Myxedema
-Hyperglycemic hyperosmolar syndrome (HHS)
What will you see with DKA
Hyperglycemia
Glucosuria
Ketonemia
Ketonuria
Metabolic acidosis (low pH, low bicarbonate, and large negative base excess)
The progression to DKA or HHS requires what
both the lack of insulin as well as increasing concentrations of counterregulatory (or stress) hormones- including glucagon, epinephrine, cortisol, and growth hormone
What is the pathogenesis of HHS
Small amounts of insulin and hepati glucagon resistance inhibit lipolysis, preventing ketosis
What is common in cats with HHS
Renal failure and congestive heart failure
can also exacerbate hyperglycemia
What are the goals of therapy for HHS and DKA
1) Replace dehydration deficit and vascular volume
2) Manage electrolyte abnormalities
3) Initiate insulin therapy to help reduce glucose levels and reverse ketone production in DKA
4) Treat underlying diseases
Prognosis of DKA depends on
-severity of acidemia, type of severity of underlying disease, financial limitations, long-term treatment of diabetic pet
Does DKA or HHS tend to have higher mortality
HHS- due to severity of the metabolic derangement and underlying diseases
What are the clinical signs of insulinoma
1) Neurologic (neuroglycopenia)
2) Hypoglycemic signs
*Episodic signs precipiated by fasting, excitement, or exercise
How do you diagnose insulinoma
Normal or increased insulin concentration on the blood during hypoglycemic episode (glucose <60mg/dL)
What is the most rapid and effective treatment for animals with symptomatic hypoglycemic episodes
0.5-1ml/kg of 50% dextrose, diluted IV
What ratio might tell you a patient has Addisons
Na/K ration less than 27:1
70-89% specificity
