How to manage difficult-to-control diabetic cats (Proceedings)

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How to manage difficult-to-control diabetic cats (Proceedings)

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Apr 01, 2010

I. Pathogenesis
      A. Insulin-dependent (rare)
      B. Non-insulin dependent
      C. Transient
      D. How do you distinguish
      E. Does it matter?

II. Diagnosis
      A. Clinical signs
      B. Persistent hyperglycemia
      C. Glucosuria
      D. Stress-related hyperglycemia
      E. Insulin-dependent versus non-insulin dependent
           1. difficult to separate
           2. often diagnosed by clinical presentation or in retrospect

III. Patient Evaluation
      A. Stable versus non stable
           1. ketotic
           2. acidotic
           3. hyperosmolar
           4. hydration status
           5. eating/drinking
      B. Concurrent disease
           1. urinary tract infection
           2. concurrent endocrinopathies: cushing's disease, hyperthyroidism
           3. pancreatitis
           4. infections
           5. pregnancy
           6. reproductively intact
      C. Testing
           1. CBC
           2. Chemistry
                a. ketonemia
           3. Urinalysis
                a. ketonuria
                b. bacteriuria
                c. pyuria
           4. Urine culture
           5. abdominal ultrasound
           6. feline pancreatic lipase immunoreactivity (fPLI)
           7. insulin-dependent versus non-insulin dependent (?) – no good way to differentiate