Diabetic ketosis and ketoacidosis in cats: 42 cases (1980-1995)
Bruskiewicz, K.A.; Nelson, R.W.; Feldman, E.C.; Griffey, S.M.
Journal of the American Veterinary Medical Association 211(2): 188-192
1997
ISSN/ISBN: 0003-1488 PMID: 9227749 Document Number: 479415
Medical records of 42 cats with diabetic ketosis (DK) or diabetic ketoacidosis (DKA) identified between January 1980 and December 1995 at the University of California-Davis Veterinary Medical Teaching Hospital were reviewed. In 26 cats, diabetes was newly diagnosed; in 16, diabetes had been diagnosed previously and cats had been treated with insulin (14 cats) or sulfonylurea drugs (2). Common clinical findings were lethargy, anorexia, polyuria, polydipsia and weight loss. Common laboratory findings were hyperglycaemia, hyponatraemia, hypochloraemia, hypokalaemia, hypocalcaemia, hypophosphataemia, low total CO2 content, hyperosmolality, high serum alanine transaminase activity, azotaemia, glycosuria, and ketonuria. Concurrent disorders were identified in 39 cats and included hepatic lipidosis, cholangiohepatitis, pancreatitis, chronic renal failure, urinary tract infection and neoplasia. Treatment of DK and DKA included administration of regular crystalline (34 cats), NPH (6) or ultralente (2) insulin, i.v. or s.c. administration of fluids and administration of antibiotics. Complications during treatment included abnormalities in serum electrolyte concentrations (27 cats), haemolytic anaemia (4), hypoglycaemia (3), and neurological abnormalities unrelated to hypoglycaemia (2). 11 cats died or were killed during the initial hospitalization period for treatment of DK or DKA. Azotaemia, metabolic acidosis, and hyperosmolality were more severe in cats that died than in cats that survived. Differences in regard to treatment or complications were not apparent between cats that died and cats that survived. The 31 cats that survived were discharged 1 to 16 days (median, 5 days) after initiation of insulin treatment. DK or DKA recurred in 13 (42%) of these cats.