canine diabetic keto-acidosis

Re: canine diabetic keto-acidosis

Richard Carter — Mon, 27 Apr 2015 10:25:49 GMT

owners are ok, A few hours of my life are gone but I have found out after 27 years practice that dogs can get pregnancy keto-acidosis that is linked to growth hormone causing insulin resistance and not to the pups per se and that rather than abort, the bitch could end up in such a state with such severe multiple problems in just a few hours.

Re: canine diabetic keto-acidosis

Martin Atkinson — Mon, 27 Apr 2015 09:42:56 GMT

Sounds like the case from hell and you were on a hiding to nothing. I'm glad I didn't have to deal with it but I can't see what else you could have done. I hope they're not owners with unreasonable expectations as 'breeders' often are and appreciate you did the best you could under the circumstances.

Re: canine diabetic keto-acidosis

Michael Woodhouse — Mon, 27 Apr 2015 09:39:36 GMT

[quote user="Richard Carter"]How does one treat insulin resistance if (by definition) the body will not respond to insulin.[/quote]

By giving more insulin. The body is resistant to its effects not completely refractory. It's an issue of the pancreas being unable to sustain the higher requirement for insulin production. You then give the pancreas a 'rest' and it may well recover - particularly in this case when you had the pregnancy.

Re: canine diabetic keto-acidosis

Richard Carter — Mon, 27 Apr 2015 09:34:01 GMT

[quote user="Robin Grimmer"] Is there any other sort of cardiac arrest other than peracute?[/quote] probably not but she had got up, was a bit agitated, looked at her back end, keeled over and expired. CPR / adrenaline did nothing, not even 1 flicker of a beat

Re: canine diabetic keto-acidosis

Sammy82 — Mon, 27 Apr 2015 09:10:53 GMT

I'd still give Insulin, that's how they treat pregnancy diabetes in humans too. It'd call it pregnancy diabetes with ketoacidosis. Diabetes Typ2 (very rare in dogs otherwise) is being treated with insulin just the same, if diet/excercise and tablets like Metformin aren't enough. These drugs would probably be an option too in less severe cases, but spaying or aborting the pregnancy is probably the best solution. The problem will be to stabilise the dog enoug first of all to give it a chance to survive GA.

Re: canine diabetic keto-acidosis

Robin Grimmer — Mon, 27 Apr 2015 08:52:08 GMT

[quote user="Michael Woodhouse"]

[quote user="Robin Grimmer"]I don't think you'll be able to save the pups now, this bitch is very sick.[/quote]

Agreed

[quote user="Richard Carter"]she had a peracute cardiac arrest. - [/quote]

[/quote]

Oops my bad. Is there any other sort of cardiac arrest other than peracute?

Re: canine diabetic keto-acidosis

Richard Carter — Mon, 27 Apr 2015 07:24:26 GMT

yes possible re sodium levels- she was on a moderate fluid rate Hartmans (100ml/kg/hr) to try get some urine production, BUN top end / off scales, creat high but not ridiculous.

My problem is that this was pregnancy ketosis with hyperglycaemia complicated with hypocalcaemia and as she had been quite fine until a few days back, unlikely to be type 1 DM, May have been type 2 with pancreatic exhaustion, no sign of pancreatitis so if the texts are suggesting insulin resistance with the possibility of an excess of insulin already in the body, should one be giving more?

How does one treat insulin resistance if (by definition) the body will not respond to insulin.

Re: canine diabetic keto-acidosis

Michael Woodhouse — Mon, 27 Apr 2015 00:19:14 GMT

[quote user="Robin Grimmer"]I don't think you'll be able to save the pups now, this bitch is very sick.[/quote]

Agreed

[quote user="Richard Carter"]she had a peracute cardiac arrest. - [/quote]

Re: canine diabetic keto-acidosis

Robin Grimmer — Sun, 26 Apr 2015 23:50:22 GMT

I think the diabetes will be insulin resistant due to the progesterone levels. I would treat the electrolyte abnormalities and go for an emergency ovariohysterectomy and remove the source of progesterone. I don't think you'll be able to save the pups now, this bitch is very sick.

Re: canine diabetic keto-acidosis

Michael Woodhouse — Sun, 26 Apr 2015 20:58:40 GMT

Richard - put the sheep aside. The mechanism of preg tox in sheep is belly full of lambs, compress rumen, can't eat enough to keep up with demands. They are short of energy and hypoglycaemic (or sometimes normo-glycaemic).

I would have treated as a DKA - fluids, insulin and glucose if needed. We know pregnancy alters insulin resistance (think gestational diabetes). Making sure not to change sodium levels too quickly.