Diabetic ketoacidosis in dogs and cats

Ketoacidosis is a complication of diabetes in pets, and is one of the most severe side effects that can accompany the condition. Finding your pet seriously ill and receiving a diagnosis of diabetic ketoacidosis can be a big shock to the pet owner, as most presentations of the condition occur in animals that were not actually known to be diabetic in the first place. This is of course extremely worrying for the pet owner, as they will have to face not only the very serious and possibly life-threatening immediate issue of diabetic ketoacidosis itself, but have to face the reality that assuming their pet survives, they will have to deal with the serious and potentially expensive diagnosis of diabetes as well.

What is ketoacidosis?

Ketoacidosis occurs when the animal’s metabolism is thrown severely out of whack, as part of the development of diabetes in the pet. Usually, an additional trigger such as an inflammation, infection or condition such as pancreatitis is also required to trigger ketoacidosis, as any of these things can interfere with the way that the body regulates and processes glucose.

Ketoacidosis starves the body’s cells of glucose, despite the fact that sufficient glucose is present within the blood. The diabetic element of this is that sufficient natural insulin is not being made available to the body to allow the glucose in the blood to enter the cells, as glucose requires insulin in order to metabolise.

The body responds to this issue by metabolising all of the fat stores and other sources of fuel available to it, breaking down the very structure of the body itself. This process causes the production of ketones, which the body then attempts to burn as fuel, which is not a normal healthy process. In turn, the burning of ketones by the body leads to a dangerous imbalance of the body’s electrolytes and pH balance, which can be life threatening.

The symptoms of ketoacidosis in dogs and cats

When a pet enters a state of ketoacidosis, the body becomes dehydrated and goes into shock. A marked loss of appetite may be observed, as can nausea and sometimes excessive thirst. The breath of the pet many take on a signature ketosis smell, which is a kind of rotten sweetness or acidity that is sometimes said to smell like acetone or pear drops.

Treatment of diabetic ketoacidosis

Diabetic ketoacidosis is a veterinary emergency, and requires prompt treatment.

The electrolyte levels within the body will be peaking and dropping on an ongoing basis, and so continual inpatient monitoring will be required to track this, and correct the imbalance. Blood and urine tests will usually be taken to confirm the diagnosis, and determine the original trigger of the attack.

The actual treatment itself will take a multi-layered approach, and may require an inpatient stay of several days to get the condition under control and in balance, as well as to work out an appropriate diabetes treatment protocol if this is the first indication that the pet is diabetic.

Intravenous fluids

IV fluid therapy is the most important part of treatment, as pets with diabetic ketoacidosis are generally very dehydrated by this point, which will interfere with recovery and serve to concentrate the levels of ketones within the body.

Insulin

The blood sugar levels of the pet must also be regulated and corrected, in order to prevent further cell damage and potentially fatal brain damage. Short-acting insulin shots are administered regularly in order to allow for adjustments to be made to the dosage on an ongoing basis as needed, something that is not usually given to diabetic animals on a regular basis. Unlike the diabetic treatment of people, pets are usually only given daily maintenance doses of insulin rather than tailored short-acting insulin just before a meal. This routine cannot be started, however, until the pet’s condition has stabilised and they have started to eat and drink normally.

Potassium and phosphorus

Ketoacidosis greatly depletes the body’s stores of both potassium and phosphorus, both of which are essential to regulate the integrity of the blood cells. Normally, phosphorus and potassium will be administered via the IV drip.

Blood testing

In order to work out what is going on within the body and tailor each aspect of the treatment protocol to the pet’s needs, blood tests will need to be performed regularly to monitor the pH of the blood and the levels of glucose and insulin present within it.

Conclusion

As you can see, the veterinary and nursing care of a cat or dog suffering from diabetic ketoacidosis is very intensive, and requires constant monitoring and adjustment until the pet begins to recover and eat and drink unaided. Even after treatment is completed and the pet can go home, monitoring and treatment of the underlying diabetes is required in order to prevent a recurrence and bring the pet’s health back within normal parameters.

Diabetic ketoacidosis is a life-threatening condition that will not correct itself. Left untreated, it will lead to the death of the affected pet, and if treatment is delayed, irreparable cell damage and brain damage may occur. The ultimate prognosis for any cat or dog with the condition will depend upon many factors, but one of the largest of them is seeking treatment promptly.

If you are worried about your pet’s eating habits, water intake or urination schedule, it is worth getting them checked out by your vet to find out if they are diabetic, and whether or not your pet is diagnosed as diabetic, be alert to the signs of ketoacidosis and seek treatment promptly if you have any concerns.