Retrospective evaluation of risk factors and outcome predictors in cats with diabetic ketoacidosis (1997–2007): 93 cases

Abstract

Cats with DKA are more likely to be Siamese than cats with uncomplicated DM. Poor outcome of cats with DKA is associated with increased initial creatinine, BUN, total magnesium, and total bilirubin concentrations. Good outcome was associated with a higher concentration of IV insulin CRI.

Diabetic ketoacidosis in the cat: Recognition and essential treatment

“…A higher dose of insulin infusion (up to 2.2 U/kg q24h) may be more effective at reducing hyperglycemia in the cat and is associated with a better outcome than a lower dose. 13 There does not appear to be a relationship between osmolality at presentation, administered insulin dose and mentation changes. 14…”

“…A higher dose of insulin infusion (up to 2.2 U/kg q24h) may be more effective at reducing hyperglycemia in the cat and is associated with a better outcome than a lower dose. 13 There does not appear to be a relationship between osmolality at presentation, administered insulin dose and mentation changes. 14 A pilot study involving 29 cats with dKA compared the concurrent use of regular insulin iM (1 U up to q6h) and SC glargine (0.25 U/kg q12h) with a continuous infusion of regular insulin (1 U/kg q24h) in cats with dKA.…”

Lispro insulin and electrolyte supplementation for treatment of diabetic ketoacidosis in cats

“…5 However, a different retrospective study of 93 cats with DKA treated with regular insulin found that cats treated with an initial IVCRI dose of 0.09 U/kg/h had a better outcome compared to cats treated with an initial IVCRI dose of 0.045 U/kg/h. 1 Therefore, the protocol of the study reported here was designed to begin the lispro and regular insulin IVCRI at a dose of 0.09 U/kg/h. The T A B L E 3 Median blood glucose (BG) concentration, beta-hydroxybutyrate (BOHB) concentration, and venous pH at the time of admission to the hospital and during the first 96 hours of hospitalization, and median times to resolution of hyperglycemia, ketosis, and acidosis findings of this study augment the findings of the case series involving lispro treatment in cats with DKA in that it can now be concluded that lispro insulin is a safe and effective treatment for cats with DKA at a starting dose of 0.09 U/kg/h.…”

“…Another limitation is that cats with DKA have concurrent illness. 1 Therefore, response to treatment and electrolyte concentrations were likely influenced not only by treatment protocols but also by the presence of concurrent diseases. Additionally, the protocol required that IVCRI of insulin begin after 6 hours of fluid resuscitation.…”

“…3 For the purpose of the current study, an initial IVCRI insulin dose of 0.09 U/kg/h (prepared by adding 2.2 U/kg/240 mL bag of 0.9% NaCl) was chosen rather than an initial IVCRI insulin dose of 0.045 U/kg/h because treatment with the higher dose has been associated with a better prognosis in cats with DKA. 1 The type of fluid used for resuscitation has not been standardized in cats with DKA. Although 0.9% NaCl is recommended for the initial phase of fluid resuscitation and as long as hyponatremia is present in humans with DKA, the use of 0.9% NaCl has not been investigated in an original study of cats with DKA.…”