Changes in serum glucose,sodium, and tonicity in cats treated for diabetic ketosis |
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| Authors: | Stephanie Kotas BS Lisa Gerber BS Lisa E Moore DVM DACVIM Thomas Schermerhorn VMD DACVIM |
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| Institution: | Department of Clinical Sciences, Kansas State University, Manhattan, KS 66506‐5606, USA |
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| Abstract: | Objective – To examine serum sodium, glucose, and tonicity in cats with diabetic ketosis. Design – Retrospective study. Setting – A university‐based referral hospital. Animals – Cats admitted to the ICU during the period 1998 to 2002 with a diagnosis of diabetic ketosis. Interventions – None. Routine clinical management of diabetes and associated conditions. Measurements – Serum biochemistry assessments. Main Results – Abnormalities of glucose, sodium and serum tonicity (ST) were common in the study group. Serum sodium but not glucose correlated closely with ST. A subset of cats treated with intravenous insulin and an isotonic sodium‐containing solution for 72 hours showed a significant decrease in glucose from admission values at 48 and 72 hours (but not at 24 hours). Serum sodium, potassium, and ST were not significantly different from admission values at any time over the 72‐hour period. However, the relative contribution of individual osmolytes varied over the course of treatment. Although glucose decreased >120% from admission values over the 72‐hour treatment period, the approximately 5% rise in serum sodium that occurred offset the osmotic effect of falling glucose and the overall ST change was <3%. Conclusions – The incidence of osmotic‐mediated neurologic complications during treatment of cats with diabetic ketosis is low in part because the minimal fluctuation in ST during treatment likely prevents the development of osmotic gradients between serum and central nervous system tissues. The use of isotonic sodium‐containing fluids in the treatment of feline diabetes acts to minimize large osmotic shifts by adding sodium to the serum compartment as the glucose concentration falls. |
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| Keywords: | feline hyperglycemia hyperosmolality hypertonicity ketoacidosis |
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