ISSN 2398-2969      

Diabetic ketoacidosis

icanis

Synonym(s): DKA


Introduction

  • Diabetic ketoacidosis (DKA) is a life-threatening metabolic crisis, characterized by hyperglycemia, metabolic acidosis and dehydration.
  • Patients may decompensate quickly and prompt intervention is needed.
  • Causes:
    • Undiagnosed insulin-dependent diabetes mellitus Diabetes mellitus.
    • Inappropriately low insulin dosages in treated dogs.
    • Impaired insulin action and/or resistance caused by concurrent illness or drugs (around 2/3 of dogs with DKA have one or more concurrent problems).
      Follow the diagnostic tree for Canine Diabetic Ketoacidosis Canine Diabetic Ketoacidosis.

Pathogenesis

Etiology

  • Relative or absolute insulin deficiency → excessive lipolysis → production of ketone bodies in liver.
  • Excessive ketosis results in metabolic acidosis Acid base imbalance.

Predisposing factors

General

Pathophysiology

  • Lipolysis: non-esterified fatty acids released from adipose tissue → converted to ketone bodies by the liver → ketosis and acidosis.
  • Impaired utilization of ketone bodies by peripheral tissues.
  • Excess of diabetogenic hormones, fasting and dehydration → increased gluconeogenesis and ketogenesis.
  • Increased production and decreased utilization of ketone bodies → accumulation of ketones in the blood → development of metabolic acidosis.

Timecourse

  • Diabetic ketoacidosis develops within a few days of absolute insulin deficiency.

Diagnosis

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to obtain ten tokens to view any ten Vetlexicon articles, images, sounds or videos, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Di Tommaso M, Aste G, Rocconi F et al (2009) Evaluation of a portable meter to measure ketonemia and comparison with ketouria for the doagnosis of canine diabetic ketoacidosis. JVIM 23, 466-471 PubMed.
  • Fall T, Hamlin H H, Hedhammar A et al (2007) Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival and breed distribution. JVIM 21, 1209-1216 PubMed.
  • Hume D Z, Drobatz K J & Hess R S (2006) Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). J Vet Intern Med 20, 547-555 PubMed.
  • Macintire D K (1993) Treatment of diabetic ketoacidosis in dogs by continuous low-dose intravenous infusion of insulin. JAVMA 202, 1266-1271 PubMed.

Other sources of information

  • Boysen S R (2008) Fluid and electrolyte therapy in endocrine disorders: Diabetes mellitus and hypoadrenocorticism. Vet Clin North Am Small Anim Pract 38, 699-717 PubMed.

Can’t find what you’re looking for?

We have an ever growing content library on Vetlexicon so if you ever find we haven't covered something that you need please fill in the form below and let us know!