endocrine pancreatic disorders Flashcards
what is DM
degree of insulin deficiency - clinically sig glucose intolerance caused by al absolute or relative lack of insulin
signs of DM
polyphagia, PU/PD, weight loss, cataracts? muscle wasting, hepatomegaly, ketoacidosis
diagnosis of DM
elevated ALP and ALT - secondary hepatic lipidosis, azotaemia? high cholesterol and TGs? cats may need to do fructosamine levels
tx of DM
insulin tx best d/t islet exhaustion - oral hypoglycaemics also an option (monitor)
best insulin substitutes
lente insulin - caninsulin, insuvet lente (given 2x/d)
longer lasting - insuvet PZI
synthetics - longer acting, peakless - determine/glargine (2x/d for grazing cats)
keys to feeding and exercise in DM patient
consistency! no snacks, feed 50-70kcals/kg, avoid high fat, exercise can lower insulin requirements, low carb, high protein diet?
pathophysiology of diabetic ketoacidosis
can be fatal - glucose deficiency d/t decreased insulin-mediated uptake - liver oxidises NEFAs, produces accept-acetate, beta-hydroxybutyrate and acetone = fat synthesis in liver, fat oxidation and mobilisation of FFA from fat tissue
approach to DKA
establish why now, decifer if ketoacidotic or ketotic
tx of DKA
FT - animal may be volume depleted promotes ketone excretion, correcting acidosis and can lower glucose + potassium supplementation esp when (preferably iv) insulin tx starts
signs of insulin secreting islet neoplasm
signs of hypoglycaemia on CNS and consequences of elevated catecholamines, waxes and wanes - worsened by exercise
dx of insulin secreting islet neoplasm
v high insulin in hypoglycaemia
tx of insulin secreting islet neoplasm
sx considered first, can tx w pred, chemo agent against beta cells, diazoxide to inhibit secretion and somatostatin analogue
