Comparison of two insulin protocols for diabetic dogs undergoing cataract surgery

A comparison of anesthetic complications between diabetic and nondiabetic dogs undergoing phacoemulsification cataract surgery: a retrospective study

“…Anesthetic complications occurred in 59% of diabetic and 33% of nondiabetic dogs. In agreement with previous studies, hypotension was the most common complication occurring in 71% of diabetic and 63% of nondiabetic dogs, however, hypotension occurred more frequently than previously reported 16,20,22 . The discrepancies between studies may be in part due to differences in definitions of hypotension and methods of measuring blood pressure.…”

“…Although hypotension was defined as MAP <60 mmHg in concordance with other studies, a complication was recorded if it occurred at any time point during the anesthetic record. A smaller study, which reported hypotension to occur in 21% of diabetic dogs undergoing phacoemulsification, documented a complication only if it was present for at least 10 min, which could account for the apparent lower incidence 16 . Direct arterial blood pressure measurement is more accurate than indirect, noninvasive techniques 23,24 .…”

“…Diabetic dogs referred for cataract surgery at DVS frequently have poorly controlled diabetes mellitus as assessed by clinical signs, serum fructosamine, and serial blood glucose analysis. The stress of hospitalization in the immediate preoperative period may further exacerbate diabetic instability resulting in marked preoperative and intraoperative hyperglycemia 16 . At plasma glucose levels above approximately 9.9 mmol/L (180 mg/dL) the glucose load filtered by the kidneys exceeds the renal tubular capacity for reabsorption 26,27 .…”

“…Diabetic dogs requiring cataract surgery are typically middle‐aged to elderly and often have coexisting morbidity, which may act as risk factors for the development of perioperative complications 7,9–15 . One study, which compared two insulin protocols for diabetic dogs undergoing cataract surgery, briefly described some of the intraoperative complications encountered 16 . Hypotension was reported in 21% of dogs, bradycardia in 8%, and mortality in 4%.…”

The Endocrine and Metabolic Systems

“…Hypoglycemia is more likely if full maintenance doses of insulin are given on the day of surgery. 31 A safer approach is to administer twice the normal morning maintenance dose, administer 5% dextrose as a slow IV drip during induction and surgery, and monitor the blood glucose to…”