Emergency treatment of diabetic ketoacidosis

摘要

Ketoacidosis is a potentially life-threatening complication of diabetes mellitus that is commonly encountered in small animal practice. It is characterized by a complex set of metabolic derangements that stem from relative or absolute insulin deficiency combined with diabetogenic hormone excess. Affected animals are typically presented with signs of multiple organ dysfunction, including anorexia, vomiting, depression, weakness, tachypnea, and dehydration. Concurrent disorders, such as pancreatitis, pneumonia, urinary tract infection, and congestive heart failure, are often present. The diagnosis of diabetic ketoacidosis (DKA) is usually based on the presence of ketones in the urine of a diabetic animal that is showing signs of systemic illness. Further supportive findings include severe hyperglycemia, dehydration, azotemia, and a high anion gap metabolic acidosis. Once the diagnosis of DKA has been made, goals of therapy should include correction of hypovolemia, administration of insulin, adjustment of electrolyte and acid/base imbalances, and treatment of complicating concurrent disorders.