Diabeetus
What is diabetes mellitus?
Diabetes mellitus is a condition where the body cannot convert glucose into energy due to issues producing or regulating the hormone insulin.
Name 3 clinical signs of diabetes in pets
Polyuria, polydipsia, weight loss, dehydration, sudden cataract formation in dogs, plantigrade posture in cats. More ill patients may also show lethargy, anorexia, weakness, and vomiting.
Name 2 types of insulin (human or veterinary)
Vetsulin, ProZinc, NPH, Glargine
Senvelgo (Velagliflozin) and Bexacat (bexagliflozin)
What is a normal blood glucose level in dogs and cats?
Dogs: 60-120mg/dL
Cats: 70-150mg/dL
Name 2 symptoms of hypoglycemia
Lethargy, weakness, ataxia, tremors, seizures
Should insulin be given if the pet isn't eating?
How do these medications work?
The SGLT2 protein in the kidneys reabsorb glucose back into the bloodstream. These medications inhibit that protein leading to increased glucose excretion in the urine and decreased glucose reabsorption in the bloodstream
How can we further evaluate stress hyperglycemia versus diabetes?
Run a fructosamine. Fructosamine is a protein-bound glucose molecule that provides an average of a patient's blood sugar levels over the past 2 to 3 weeks for cats and 3 to 4 weeks for dogs
Define diabetic ketoacidosis (DKA)
In uncontrolled diabetes, the body starts breaking down fat for energy, this results in a buildup of acidic ketones in the blood.
Name the 2 types of insulin syringes and the difference between them?
U-40 (40 units/mL, pets) and U-100 (100 units/mL, humans)
Which species is this medication indicated for and why can't it be used in the other species?
These medications are used in cats. Dogs get insulin-dependent diabetes meaning they have little to no insulin, these medications would increase their risk of DKA.
What are the two types of Diabetes mellitus? Which species are typically each type?
Insulin-dependent (similar to type 1) - patients cannot produce their own insulin. Dogs.
Insulin-resistant (similar to type 2) - patients can produce insulin but not use it effectively. Cats
Name 2 symptoms of DKA?
Lethargy, weakness, anorexia, tachypnea, vomiting, acetone odor on breath
How should insulin be stored and handled?
What life threatening complication are we concerned about and how do we monitor?
DKA, monitor blood ketone level.
Define renal threshold and approximate levels in dogs and cats.
The renal threshold for glucose is the level at which the kidneys stop reabsorbing sugar and it begins spilling into the urine. 200mg/dL in dogs and 250-300mg/dL in cats.
Is diabetes curable?
Diabetes is lifelong. Some cats may be able to go into remission if treated early but should be monitored regularly.
What are two ways to monitor and why might one way be preferred?
In clinic glucose curve or freestyle libre. A libre may be preferred as a curve in hospital can be inaccurate for stressed patients and it doesn't allow a full 12 hour curve.
Name a reason a cat might not be a good candidate for this treatment?
They are on insulin, pancreatitis, CKD stage 3 or 4, DKA