The feline diabetic–friend or foe?(Proceedings)
Is the feline diabetic patient every veterinarian's nightmare? Since diabetes mellitus is one of the most common endocrinopathies in cats, it is likely you will face this disease many times in your veterinary career. The focus of this presentation will be to discuss the problems you may encounter with your feline diabetic foes using case studies to illustrate how these feline diabetics can be your friends.
Clinical signs – water consumption, urination habits, appetite, activity, weight gain/loss
Dose of insulin is 6-8U (cat) q.12h and all BG levels >300 mg/dl
Insulin resistance problems: The hunt for the problem(s) begins...
Insulin administration problems are the most common problems identified in poorly regulated diabetics. Over 80% of poorly regulated diabetic patients are due to administration issues...!
• Vary location of injection sites.
Every diabetic cat, especially those that are difficult to regulate, should have a full physical examination, complete diagnostic evaluation (CBC, biochemistry profile, serum T4, urinalysis), blood pressure measurement, and fructosamine level.
Imaging studies (radiographs, ultrasound) and more extensive testing may be needed to rule out concurrent diseases.
Don't forget to check for urine ketones.
Ketones are the end-product of rapid or excessive fatty-acid breakdown.
Glomeruli freely filter ketones and the tubules then resorb them completely. If the tubular resorptive capacity is saturated, then the ketones are incompletely resorbed, resulting in ketonuria. Ketonuria occurs quickly in younger animals and is more easily detected than ketonemia. Ketonuria does not signify renal disease, but rather excessive lipid or defective carbohydrate metabolism. Ketones will be present in the urine when the ketones in the blood go above a certain level.
The ketone present in the largest amount, beta-hydroxybutyrate, does not register on the urine dipstick. Dipstick tests are semiquantitative and only detect acetone and acetoacetic acid. Reagent strips contain nitroprusside that does not react with beta-hydroxybutyric acid. However, you can perform a simple chemistry maneuver to determine if any ketones are present. One drop of urine plus one drop of hydrogen peroxide will convert beta-hydroxybutyrate to acetoacetic acid which does register on the urine dipstick.