Approach to Small Animal Patient with Suspected Diabetes Mellitus Flashcards
(30 cards)
Define Diabetes Mellitus
Chronic medical condition characterized by elevated levels of blood glucose (blood sugar) due to either insufficient insulin production or the body’s ineffective use of insulin
Outline pathogenesis of diabetes in dogs
- Resistance to insulin
- Insulin production increased
- Islet cell exhaustion / destruction
- Insulin production reduced relative to requirement
- Diabetes Mellitus
What organ releases insulin
Pancreas
Outline pathogenesis of diabetes in cats
- Islet cell pathology (e.g. Amyloidosis)/ Peripheral resistance to insulin
- Islet cell destruction/ Islet cell insufficiency
- Insulin production reduced relative to requirement
- Diabetes Mellitus
Type 1 vs type 2
Type 1 diabetes is autoimmune-driven, leading to insulin deficiency. Type 2 diabetes involves insulin resistance and relative insulin deficiency, managed through lifestyle changes, medications, and sometimes insulin.
Signalment of diabetes
Commoner in older animals
females more likely
terriers more likely
What dog breed is predisposed to diabetes
Samoyed and Terries
Clinical History of diabetes
Polyuria, polydipsia
Weight loss
Polyphagia
Exercise intolerance/lethargy
Blindness (dogs)
Severe HL weakness (cats)
Recent oestrus
Clinical signs of diabetes
BAR
Thin
Cataracts
Neuropathies
What results should you see in urinalysis of a diabetic patient
Glucosuria and Ketone bodies (Ketosis)
What results should you see in Serum biochemistry
of a diabetic patient
Increased Glucose, Cholesterol and Liver enzymes
Treatment of diabetes in dogs
Caninsulin injection
Treatment of diabetes in cats
Insulin injections
Oral Hypoglycaemics
State some oral hypoglycaemics
SGLT2 inhibitors (velagliflozin, bexagliflozin)
What do SGLT2 inhibitors, or sodium-glucose cotransporter 2 inhibitors do?
Work by inhibiting a specific protein in the kidneys, SGLT2, which plays a key role in glucose reabsorption in the renal tubules. By inhibiting SGLT2, these medications promote the excretion of glucose in the urine, leading to lower blood glucose levels.
Two requirements for effective diabetes management
Owner compliance and Veterinary support
Which cats should NOT be selected for SGLT2i?
DKA (Diabetic Ketoacidosis) , pancreatitis, liver disease, significant kidney disease, Blood ketones >2.5 mmol/L, Urine ketones positive
Why cant i use sglt2 in patients with DKA
In DKA, there is a relative or absolute deficiency of insulin, leading to uncontrolled breakdown of fats and the production of ketones. SGLT2 inhibitors may exacerbate this process by promoting further ketone production through their mechanism of action. Their mechanism of action and potential for fluid and electrolyte imbalances make their use inappropriate in the context of DKA.
What percentage of energy requirement in diabetes mellitus in Obese, Thin and normal animal
Obese animals: 70% of calculated requirement for target weight
Thin animals: 100% requirement for optimal weight
Normal animals: 100% of calculated requirement
How many percent of metabolisable energy from complex carbohydrates of a diabetic canine patient
50-55
How many percent of metabolisable energy from fat should a diabetic canine patient consume
Restricted (<20% ME)
How many percent of metabolisable energy from protein should a diabetic canine patient consume
Moderate (14-30% ME)
Should there be simple sugars in a diet for a diabetic canine patient
No simple sugars
Should there be simple sugars and complex CHO in a diet for a diabetic feline patient
no simple and reduced complex CHOs
