Endocrine pancreas (Yr 4) Flashcards
what are some causes of diabetes mellitus in dogs?
infection, pancreatitis, immune mediated disease, hormones/drugs causes loss of islets
what are some predisposing factors for diabetes mellitus in dogs?
obesity
endocripnopathy
hyperlipaemia
what is the pathogenesis of diabetes mellitus in cats?
insulin resistance (type II diabetes) with possible insulin deficiency
what can exacerbate diabetes mellitus in cats?
obesity
growth hormone
pancreatitis
what biochemical processes will be influenced by lack of insulin?
increased glucagon
increased gluconeogenesis
decrease cellular uptake of glucose
osmotic diuresis
fatty acid metabolism (ketoacids produced)
what are the main clinical signs of diabetes mellitus?
PUPD
polyphagia
weight loss
what are the findings on haematology and biochemistry that indicate diabetes mellitus?
hyperglycaemia
elevated ALT, ALKP
hypertriglycidaemia
urinary ketones
what findings on urinalysis are indicative of diabetes mellitus?
low USG
glycosuria
ketonuria
sediment
how is diabetes mellitus diagnosed?
clinical signs with persistant fasting hyperglycaemia and glycosuria
how is diabetes mellitus treated?
lifelong insulin, diet and routine
(cats can go into remission)
how much insulin should a dog be given for diabetes mellitus?
twice daily (give half daily ration of food then a dose of insulin)
how are cats with diabetes mellitus treated?
twice daily injections of insulin (can go into remission)
what are the features of a diabetes mellitus diet for dogs?
high fibre and complex carbohydrates
with consistent feeding/exercise
what are the features of a diabetes mellitus diet for cats?
low carbohydrates and high protein
with constant feeding/exercise
what should be monitored in diabetes mellitus cases?
clinical signs (thirst, appetite, weight gain)
urine glucose
glucose curves and fructosamine (weekly)
what are the signs of an insulin overdose in diabetes mellitus patients?
ataxia, collapse, seizures
how are insulin overdoses of diabetes mellitus patients treated?
feed immediately and give sugar substance under tongue
should therapy for diabetes mellitus be continued if an animal isn’t eating?
yes as basal insulin is always needed to control glucose entry into cells
give a half dose (don’t stop!!)
what is the nadir of a glucose curve?
the lowest point on the curve
what should the nadir of the glucose curve stay between?
4.5-9mM
how is blood glucose measured to get a glucose curve?
skin prick on lip/ear then glucose monitor
can also use wireless monitoring using a patch
what are some problems that may effect the accuracy of a blood glucose curve?
depends how active the animal is being
depends on appetite of patient
depends how stressed the patient is
what are some chronic complications of untreated diabetes mellitus?
ketoacidosis
infections
lens induced uveitis
diabetic neuropathy
cataracts
diabetic retinopathy
what is type 1 diabetes mellitus?
patients pancreas doesn’t make enough insulin meaning they have very high blood glucose
what causes overswing of glucose curves in diabetes mellitus patients?
insulin causes massive drop (too low) in blood glucose this trigger glucagon, epinephrine and cortisol which causes a massive increase in blood glucose (too high)
why do patients with diabetes mellitus get ketoacidosis?
insulin deficiency/resistance causes an increase in lipolysis and fat oxidation (not being inhibited by insulin) leading to increased ketones in blood which get into urine and cause an osmotic diuresis
osmotic diuresis leads to loss of water/sodium and reduced kidney perfusion which causes an azotaemia and cells become dehydrated
what are the clinical signs of ketoacidosis from diabetes mellitus?
vomiting
depression
dehydration
weakness
tachypnoea
how can diabetic ketoacidosis be diagnosed?
ketonuria along with being a diagnosed diabetic
how is diabetic ketoacidosis treated?
provide adequate insulin
restore water/electrolyte loss (potassium, phosphate, bicarbonate)
correct acidosis
treat concurrent illnesses (pancreatitis…)
should you always hospitalise patients with diabetic ketoacidosis?
if patient is clinically well they can be managed at home
what is an insulinoma?
insulin producing tumour of pancreatic beta cell (leads to hypoglycaemia)
what are the clinical signs of an insulinoma?
weakness, trembling, ataxia, seizures
weight gain
neurological signs
often episodic
(all signs of hypoglycaemia)
