Changes

Problems include history of polyuria/polydipsia, anorexia and weight loss, azotemia, cystitis, dehydration, ketonuria, hyperglycemia.

Problems include history of polyuria/polydipsia, anorexia and weight loss, azotemia, cystitis, dehydration, ketonuria, hyperglycemia.

|l1=

|l1=Diabetic Ketoacidosis

|q2=Describe your initial treatment plan for this cat.

|q2=Describe your initial treatment plan for this cat.

|a2=

|a2=

*culture urine and begin bactericidal antibiotic effective against Gram-positive cocci that get high urine concentration (e.g. amoxicillin, ampicillin).  

*culture urine and begin bactericidal antibiotic effective against Gram-positive cocci that get high urine concentration (e.g. amoxicillin, ampicillin).  

*Begin s/c insulin (NPH, Lente, or P21) once glucose rises again and cat is eating.

*Begin s/c insulin (NPH, Lente, or P21) once glucose rises again and cat is eating.

|l2=

|l2=Diabetic Ketoacidosis#Treatment

|q3=What other electrolytes must you evaluate, and why?

|q3=What other electrolytes must you evaluate, and why?

|a3=

|a3=

Hypokalemia should be anticipated once insulin therapy is initiated, and potassium must be supplemented.

Hypokalemia should be anticipated once insulin therapy is initiated, and potassium must be supplemented.

|l3=

|l3=Diabetic Ketoacidosis

|q4=What are potential complications?

|q4=What are potential complications?

|a4=

|a4=

Complications include severe acidosis, arrhythmias, altered mentation, acute renal failure, hypernatremia, dehydration, hypophosphatemia, hypoglycemia from therapy, hypokalemia, thromboemboli and infections.

Complications include severe acidosis, arrhythmias, altered mentation, acute renal failure, hypernatremia, dehydration, hypophosphatemia, hypoglycemia from therapy, hypokalemia, thromboemboli and infections.

|l4=

|l4=Diabetic Ketoacidosis

|q5=Would you use sodium bicarbonate? Why or why not?

|q5=Would you use sodium bicarbonate? Why or why not?

|a5=

|a5=

Overzealous bicarbonate therapy can lead to alkaline overshoot, hypokalemia, hypocalcemia, paradoxical CSF acidosis, hypernatremia and hyperosmolality, and shift of the oxyhemoglobin dissociation curve.

Overzealous bicarbonate therapy can lead to alkaline overshoot, hypokalemia, hypocalcemia, paradoxical CSF acidosis, hypernatremia and hyperosmolality, and shift of the oxyhemoglobin dissociation curve.

|l5=

|l5=Diabetic Ketoacidosis#Treatment

|q6=You are treating the cat and have brought the glucose to within normal range. However, there is now 4+ ketonuria. Explain the increase in ketones on the urine dipstick.

|q6=You are treating the cat and have brought the glucose to within normal range. However, there is now 4+ ketonuria. Explain the increase in ketones on the urine dipstick.

|a6=

|a6=

Therefore, it appears as though there is an increase in ketones.

Therefore, it appears as though there is an increase in ketones.

|l6=

|l6=Diabetic Ketoacidosis#Diagnosis

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