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17 Cards in this Set
- Front
- Back
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Main points for managing uncomplicated DM in the cat? |
1) Remission 2) Twice- three times daily caninsulin and if this doesn't lead to remission within 4 weeks switch to glarginine. 3) Cats retain normal feeding schedule. 4) Weight reduction. 5) Start on a dose of 0.25 UI/kg ) Revisit 1 week later. |
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What should we warn owners with as a serious complication of insulin therapy? |
Signs of hypoglycaemia. |
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What is glipizide? |
A drug that stimulates insulin secretion from beta cells. |
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Once diabetes has been brought under control how often should animal be brought for check ups? |
every 2 months |
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Name a serious complication of DM and signs of it? What is diangosis based on? |
Ketoacidosis. Inappetance, vomiting, lethargy and collapse. Presence of ketones in the blood and urine. Hyperglycaemia, ketoanemia, metabolic acidosis and imbalances in electrolytes such as potassium, phosphate and sodium. |
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A patient comes into your practice with diabetic ketoacidosis what must we do first? |
Place a central intravenous line and run an electrolyte panel. |
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How do we address the hypovolaemia with diabetic ketoacidosis? |
1) Assess degree of dehydration, calculate fluid deficit, add in maintenance. 2) Administer shock doses of isotonic crystalloid like 0.9% hartmanns saline. 90 ml/kg in first few hours and then rest over 12-24 hours. 3) For cats give 5-10 ml/kg as less well tolerated. |
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Other than hydration status, and addressing the hypovolaemia what else must we monitor in a cat with diabetic ketoacidosis? |
Urinary output >2ml/kg/hr |
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Once hypovolaemia has been addressed what must we do in a patient with diabetic ketoacidosis if a fluid pump is available? |
Start insulin therapy. Make up soluble insulin in 0.9 % NaCl and give until blood glucose falls below 15 mmol/l. If it falls below 10 give 2.5- 5% dextrose saline |
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If a fluid pump is not available how can we administer insulin therapy in a ketoacidotic patient? |
Inject soluble insulin intramuscularly hourly. |
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What electrolyte is moved into the cell during ketoacidosis? Why is it important we address this? |
Potassium. It will delay eating. |
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How do we correct hypophosphataemia in DKA? |
If it drops below 0.35 mmol/l supplement as can lead to severe haemolytic anaemia. |
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How should we address patients with hypo-hyper natraemia with DKA and what should be cautious of? |
Don't adjust to rapidly as can cause cerebral oedema or dehydration. |
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How can we address the acidosis of DKA? |
Sodium bicarbonate I/V only if ph below 7.1 |
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In summary how do we address a patient with DKA? |
1) FLUIDS - Correction of hypovolaemia 2) Monitor urine output. 3) Start insulin therapy 4) Address the hypokalaemia 5) Address phosphate issues 6) Address sodium imbalances 7) Treat the acidosis. |
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What are common reasons for a failure to stabilise DM? |
Poor owner injection technique. Poor storage. Out of date insulin. Shaking insulin. Incorrect feeding. |
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What are signs of hypoglycemia in a DM patient we are trying to stabilize? How should we treat these patients? |
Anxiety, muscle tremors, ataxia, collapse, convulsions, coma and death. Treat with a high glucose meal. If unconscious give IV glucose. |
