Diabetic Ketoacidosis In Cats A Complete Guide
A complication of diabetes mellitus, diabetic ketoacidosis is a life-threatening medical emergency seen in cats. When a cat develops diabetes mellitus, it does not produce sufficient insulin to process the glucose it takes in. This situation gets worse and ultimately to the point where there is no insulin to transport sugar to body cells. This condition is called diabetic ketoacidosis. The cells signal that they are in need of a source of energy.
As the body is unable to use glucose, it begins breaking down fat. The liver converts fat into energy for the cats body and produces ketone bodies as well. Ketones can be toxic to the body, resulting in an electrolyte imbalance and increased acid in the blood. Such imbalances with a loss of glucose cause dehydration which creates more acid and imbalance. This cycle can turn fatal if it continues.
A cat can suffer from diabetic ketoacidosis if it has untreated or undiagnosed diabetes. It also occurs when the cat has poorly-regulated diabetes. Most cats affected by this condition are lethargic, depressed and refuse to eat. Their blood glucose levels are high and ketones are present in the urine. Treatment of feline diabetic ketoacidosis involves close monitoring of blood glucose and the reversal of the condition.
Is Your Dog A Puppy
A young, healthy puppy shouldnt go more than a few hours without eating.
Small breed puppies, especially, are at a high risk of hypoglycemia and should be watched closely for signs of lethargy or collapse if they are not eating. If this happens, they should be treated on an emergency basis.
Some puppies may not like larger kibble, as it can be hard for their puppy teeth to chew, especially if they are just transitioning to solid food. This can be remedied by mixing in water and letting it soak to create more of a porridge consistency, or the kibble can be mixed with canned food as well.
If your puppy still will not eat, they should be seen right away by a veterinarian. If they are also lethargic, vomiting, or having diarrhea, they should be seen on an emergency basis.
Low Or High Blood Sugar
Low blood sugar occurs when your blood glucose drops below your target range. This usually happens at less than 70 mg/dl, but everyones range is different. It is best to talk to your doctor about what is healthy for you. Often, when you experience low blood sugar, you will need to take action to fix it quickly.
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Is Diabetes Causing My Nausea
Nausea comes in many forms. Sometimes it can be mild and short-lived. Other times, it can be severe and last for a long time. For people with diabetes, nausea is a common complaint. It can even be a sign of a life-threatening condition that requires swift medical attention.
Factors related to your diabetes may cause you to feel nausea.
High Or Low Blood Sugar Levels
Both type 1 and type 2 diabetes involve problems with insulin and the levels of glucose in the blood, which can lead to two events:
- hyperglycemia, or high blood sugar levels
- hypoglycemia, or low blood sugar levels
Hyperglycemia occurs when the body has too little insulin, for example, when a person eats more or exercises less than they had planned. It can also happen in the morning, which is known as the dawn phenomenon. Learn more about high blood sugar in the morning.
Hypoglycemia can occur when a person takes too much insulin or does not eat enough food. It can lead to serious complications, including insulin shock.
Both hyperglycemia and hypoglycemia can make a person feel nauseated.
Other symptoms to look out for include:
- disorientation
- fainting
- seizures
Without treatment, people with diabetes will go through repeat events of hypoglycemia and hyperglycemia. Over time, this can result in health complications, such as insulin shock, diabetic ketoacidosis, and diabetic neuropathy.
People can usually prevent these complications by managing their diabetes.
A person can avoid hyperglycemia and hypoglycemia by:
- eating regular meals and snacks
- taking medications according to the prescription
- adjusting food and medication intake when increasing activity levels
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Type 1 Diabetes And Exercise
People with type 1 diabetes benefit from exercise, but they need to take precautions to prevent sudden drops in blood glucose levels. Diabetics should check their blood sugars before exercising and may require eating a snack before or during exercise. They may need to adjust their insulin dosage before exercising to ensure they stay within normal ranges of blood glucose. People with type 1 diabetes may also need to check their urine for ketones â ketones suggest that your blood sugar is too high. Strenuous activity needs to be avoided if ketones are detected or if your blood sugar level is either high or low before exercise.
What Are The Signs Of Diabetic Ketoacidosis
The signs of diabetic ketoacidosis include:
- excessive thirst/drinking
- weight loss with muscle wasting
- dehydration
- unkempt haircoat
These same signs can occur with other medical conditions, so it is important for your veterinarian to perform appropriate diagnostic tests to determine if diabetic ketoacidosis is truly the issue at hand.
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Questions To Ask Your Doctor
- Ive never been diagnosed with diabetes, but I have many of the symptoms of diabetic ketoacidosis. Do I have diabetes?
- Im having a hard time controlling my blood sugar levels. Am I at risk of diabetic ketoacidosis?
- Will diet and exercise help me to avoid diabetic ketoacidosis?
- If I notice Im having symptoms of diabetic ketoacidosis, what should I do first?
- Is it safe for me to exercise?
- How often should I check my blood sugar level if Im sick?
- What is the best way for me to check the ketone level in my body?
- I missed a dose of insulin. Should I start testing my blood sugar level and ketone level right away?
Dietary Management Is Key To Improving Gi Symptoms
For some individuals the easiest method for feeling bettera semi-liquid dietcan be hard to implement, says Dr. Grover. The way to reduce most of the unpleasant symptoms is to blend up solid food into a soft paste, which solves the problem of poor gastric emptying, but this is often unappealing and so not readily embraced.
Dr. Camilleri agrees liquids and blended solid foods are often much better tolerated but his patients find it distasteful. So hell often say, Consider this: blending up a peanut butter sandwich is a better option than tube feeding, which may happen if the symptoms get bad and last long enough. Often, individuals who are very rigorous with their diet are able to avoid the need for medications altogether,6 the doctors point out.
Many patientsabout 80%can avoid tube feeding by adjusting your diet to facilitate speedy gastric emptying.6 Dr. Camilleri says: Gastroparesis is a chronic condition that will probably not go away but also isn’t likely to get worse.
Be aware of the potential for nutrient deficiencies of some minerals, like copper and zinc,6 says Dr. Grover. This is more likely to occur when the condition has been present a long time. He also warns against any suggestion that you are a candidate for gastric bypass surgery or removing the stomach as a way to manage the symptoms. This often replaces one problem with another, he says.
Neither doctor has any financial conflicts regarding this discussion.
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Does Am Have Gastroparesis
Gastroparesis is defined by the presence of delayed gastric emptying without mechanical obstruction. The abnormality can be demonstrated by retained food on imaging studies or endoscopy following an overnight fast or, more precisely, by delayed clearance of radionuclide on a quantitative gastric emptying study, as occurred in this case. Obstruction in the antropyloric region, duodenum, or proximal small intestine must be excluded as the cause of delayed emptying. This usually is accomplished with endoscopy, as was done for A.M., who indeed has gastroparesis.
Unfortunately, upper gastrointestinal symptoms, especially nausea and vomiting, are too frequently attributed to gastroparesis, which then becomes the focus of therapy. Gastroparesis is found in diabetic as well as nondiabetic subjects and has many causes. Delayed gastric emptying, like slow transit in other gut organs, appears to be one of the gastrointestinal sequelae of diabetes, but because of its many other causes, the relationship of gastroparesis to markers of advancing diabetes is only modest in symptomatic patients. As many as 40% of nondiabetic patients with functional nausea and vomiting and no definable pathological explanation for symptoms also have delayed gastric emptying. Thus, gastroparesis should be considered a nonspecific finding in diabetes and may be unrelated to the metabolic disorder.
Why Does My Cat Vomit All The Time
Vomiting isnt one of the most common feline symptoms of this disease. Having said that, if a cat is being treated for feline diabetes, vomiting is definitely something to watch out for. It can indicate that their blood glucose is not being well controlled, and they may be developing diabetic ketoacidosis.
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Other Tips For Treating Anorexia Or Appetite Loss
Contrary to conventional belief, loss of appetite is not an eating disorder and is usually a symptom of a greater health problem, especially among the elderly.
Other ways to stimulate appetite in the elderly and others with a particular disease include:
- Keeping busy on a regular basis, and participate in group activities like artwork or other hobbies. As a result, the person will experience reduced depression and desire food when it is time to eat.
- Try mind-body exercises, such as meditation, yoga, qigong, or tai chi. These will create inner peace and help stimulate the desire to nourish the body.
- Spend valuable time outdoors in nature, including walking, hiking, or gardening. Going barefoot is called earthing, and it can also help create a connection with nature. Doing this can increase self-worth and the desire to eat.
When To Call The Doctor
Being sick increases the risk of more serious emergencies seen with diabetes.
- Blood sugar higher than 240 mg/dL for more than 1 day
- Moderate-to-large ketones with your urine tests
- Vomiting or diarrhea for more than 4 hours
- Any severe pain or chest pain
- A fever of 100°F or higher
- Trouble moving your arms or legs
- Vision, speech, or balance problems
- Confusion or new memory problems
If your provider does not call back right away, you may need to go to the emergency room. This is particularly important if you are vomiting or have diarrhea for more than 4 hours.
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Other Causes Of Polyphagia Unrelated To Diabetes
If none of the diabetes-related causes of excessive hunger apply to you, there are certainly other causes to consider.
- Eating disorders: bulimia, anorexia
- Prader-Willi Syndrome
If you suspect any of these factors may be contributing to your polyphagia, talk to your healthcare team about getting the support you need to manage or treat these issues.
Are There Any Problems That Can Occur Secondary To Diabetic Ketoacidosis
Unfortunately, there are several potentially serious conditions that can occur in conjunction with, or secondary to, diabetic ketoacidosis including:
- persistently low potassium levels
These potentially life-threatening complications help to explain why hospitalization and aggressive treatment are so important.
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How Does Illness Affect Blood Sugar Levels
When you get sick whether it’s a minor illness like a cold or a bigger problem the body sees the illness as stress. To deal with the stress, it releases hormones that increase sugar in the blood.
In one way, this is good because it helps supply the extra fuel the body needs. But in a person with diabetes, it can lead to blood sugar levels that are too high. Some illnesses cause the opposite problem. If you don’t feel like eating or have nausea or vomiting, and you’re taking the same amount of insulin you normally do, your blood sugar levels can get too low.
Blood sugar levels can be very unpredictable when you’re sick. Because you can’t be sure how the illness will affect them, it’s important to check blood sugar levels often on sick days and change your insulin doses as needed.
A Side Effect Of Medication
Like other medications, some diabetes drugs can cause nausea as a side effect.
These include the common medication metformin, which people should take with food to avoid or reduce nausea.
A person may experience nausea when they start taking injectable medications, but this symptom often goes away once they become used to the injections. If it does not, it is worth talking to the doctor about possibly adjusting the dosage.
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Dos And Donts Of Managing Diabetes When Youre Sick
When youre sick, your body releases hormones that can raise blood sugar which is already a concern when you have type 2 diabetes. Find out what you need to know before the next cold or flu strikes.
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Type 2 diabetes doesnt take a day off even if youre feeling lousy because you have a cold or the flu. In fact, when youre sick, you need to be extra mindful to stay on top of your diabetes self-care. Thats because a cold, sinus infection, or the flu can put your body under stress, causing it to release hormones that help fight the illness but these hormones can also affect your blood sugar levels.
Infections, particularly serious ones, can lead to diabetes complications. The most dangerous although its rare in people with type 2 diabetes is diabetic ketoacidosis, which can lead to a diabetic coma, according to endocrinologist Alan Garber, MD, PhD, a professor of medicine in diabetes, endocrinology, and metabolism at the Baylor College of Medicine in Houston and president of the American College of Endocrinology. “Infection is a metabolic stress, and it raises your blood sugar,” Dr. Garber says. It can be hard to know how you will respond to each infection, he adds.
Being sick can also lead to dehydration, eating differently, oversleeping, and losing track of your schedule all of which can make diabetes management harder.
There are also many things you can do to help keep your diabetes under control if you do get sick.
What Is The Difference Between Type 1 And Type 2 Diabetes
Type 1 diabetes usually starts in childhood or young adulthood, whereas type 2 diabetes usually starts in adulthood. In people with type 1 diabetes, the bodys immune system attacks and destroys pancreatic cells that produce insulin. In people with type 2 diabetes, the pancreas is not attacked and usually produces insulin. However, people with type 2 diabetes, for numerous reasons, cannot use the available insulin effectively.
People with type 2 diabetes can have the same symptoms as those with type 1 diabetes, however, people with type 1 diabetes usually have symptoms that occur more rapidly. Type 1 diabetes cannot be prevented, but type 2 diabetes can be prevented or delayed with a healthy lifestyle.
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What Are The Late Signs Of Kidney Disease In Patients With Diabetes
As your kidneys fail, your blood urea nitrogen levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps and anemia . You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.
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Watch How To Help Someone Who Is Having A Diabetic Emergency
What is diabetes?
Diabetes is a medical condition that affects blood sugar levels. Normally, peoples bodies maintain the ideal blood sugar levels automatically. When a person has diabetes, their body fails to maintain the blood sugar balance, so they need to manage it through diet, tablets or insulin injections.
Sometimes, a person who has diabetes can suffer diabetic emergencies, which require first aid.
What are the signs and symptoms of a diabetic emergency?
Signs and symptoms vary, but common ones include:
- hunger
What happens in a diabetic emergency?
In most cases, the persons blood sugar levels become too low. This is called hypoglycaemia. It can happen when the person has missed a meal or exercised too much. If left untreated, a diabetic emergency can become very serious.
What should I give them to eat or drink?
You can give them sugary drinks such as cola, lemonade, fruit juice and isotonic sports drinks, and sweet foods such as jelly beans, chocolate and sugar cubes. The person may also be carrying glucose gel or tablets. Avoid giving them a diet drink, as it wont have any sugar in it and will not help them.
But some people have high blood sugar levels, so wont giving them sugary drinks or food make their diabetic emergency worse?
Some people do have high blood sugar levels, but giving them sugary drinks or food is unlikely to do any harm.
How will I know if this is a long-term condition for the person?
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How Do I Prevent Diabetic Ketoacidosis From Happening Again
Diabetic ketoacidosis is life-threatening, so preventing it is important. The most important step in prevention is ensuring proper insulin dosing. The importance of home-monitoring of blood glucose levels cannot be overemphasized. If you are not yet performing home blood glucose monitoring, your veterinary healthcare team can help get you started. The necessary blood sample is tiny – just a tiny drop of blood – and the tiny needle that is used will not hurt your dog. Most dogs barely notice the pin-prick.
Your veterinarian will guide you on how often to take readings, when to report the results to the practice, and will explain how the values are interpreted in order to make decisions about modifying your dog’s insulin dose.
“The importance of home-monitoring of blood glucose levels cannot be overemphasized.”
If you are already doing home monitoring of your dog’s blood glucose levels, your veterinarian will guide you as to how often to check glucose levels once your dog returns home. The key to preventing a recurrence of diabetic ketoacidosis is to be very aware of your dog’s glucose levels both throughout the day, as well as the pattern of his blood glucose levels over the span of several days to several weeks. As you report the glucose levels, your veterinarian will be able to help you fine- tune your dog’s insulin doses and set the stage to prevent this crisis from recurring.