Diabetic Ketoacidosis


Why Should I Bring my Pet to Willows for Diabetic Ketoacidosis?

Willows is one of Europe’s leading small animal referral centres. Our state-of-the-art hospital is led by internationally renowned Specialists, committed to providing the highest standards of veterinary care. At Willows our Specialist-led Emergency and Critical Care service is based within our advanced Intensive Care Unit and fully supported by our experienced multi-disciplinary team, providing advanced diagnostics and treatment of the most critical patients.

Our Emergency and Critical Care team have extensive experience in managing patients with Diabetic Ketoacidosis. Our Intensive Care Unit and very close monitoring enables the diagnosis, stabilization and most appropriate treatment to be given to your pet.


What is Diabetic Ketoacidosis?

When food is ingested and digested, most of this goes towards making sugars that the body uses and stores for later. Hormones help the body to carefully regulate this sugar level throughout the day during periods of fasting and feasting. One of the main hormones involved in the regulation of sugar is insulin which is produced by the pancreas. Animals that do not produce enough insulin cannot regular their blood sugar levels and are termed diabetic.

Diabetic ketoacidosis occurs as a result of uncontrolled diabetes (uncontrolled high blood sugar levels). This results in an increase of fatty acid within the body which when broken down, will produce compounds known as ketones. Ketones in high levels are very dangerous for the body as they alter the natural pH balance. Patients with DKA become more acidic, in turn this makes proteins within the body more liable to damage and change, affecting a whole host of processes and making for a very unwell pet.

If you have a diabetic pet who starts to appear unwell, lethargic, changes in appetite and vomiting, they may be showing signs of Diabetic Ketoacidosis (DKA) and should be seen as emergency for investigation.

What are the Most Common Causes of DKA?

The most common causes of DKA in dogs includes:

  • Uncontrolled Diabetes Mellitus (sugar diabetes)
  • Pancreatitis (inflammation of the pancreatic gland that produces hormones to regulate blood sugar levels)
  • Liver disease
  • Hyperadrenocorticism (Cushings disease)
  • Neoplasia (Cancer)
  • Urinary tract infections

The most common causes of DKA in cats includes:

  • Hepatic lipidosis (liver disease)
  • Chronic renal failure
  • Acute pancreatitis
  • Bacterial or viral infections
  • Neoplasia (Cancer)

What are the Signs of Diabetic Ketoacidosis?

The signs of Diabetic Ketoacidosis include:

  • Increased thirst
  • Increased urination
  • Vomiting
  • Diarrhea
  • Collapse
  • Lethargy
  • Sweet smelling breath
  • Anorexia
  • Weight loss

How is Diabetic Ketoacidosis Diagnosed?

Fortunately, the diagnosis of diabetic ketoacidosis is a fairly simple one. The disease is usually diagnosed using a blood sample to evaluate the blood sugar of the patient and the levels of ketones within the blood. Dogs and cats with DKA have high blood sugar and blood/urine ketone values on examination. Clinical signs and presenting history also help in the diagnosis of this disease. Abnormalities can also be seen in blood gas due to a low pH as well as profound electrolytes imbalance (variation of sodium, chloride, potassium, phosphorous).


What Treatments Are Available for Diabetic Ketoacidosis?

Treatment for DKA has two stages; initial and ongoing. DKA requires intense and rapid management during the first few days. This initial treatment involves addressing the patient’s clinical problems at the time of presentation. Patients that present with DKA will often require hospitalisation for several days. Treatments initially required for DKA include:

  • Rehydration fluid therapy
  • Correction of electrolytes (these are salts within the blood that play many a different role throughout the body and are important for many processes)
  • Reduction of high blood sugar levels.

Further diagnostic tests may be recommended at this time also (including imaging) to assess for any underlying reason for the development of disease i.e. liver disease or pancreatitis. Ongoing treatments will most often mean regular administration of insulin via injection to control the body’s blood sugar levels. With this, regular monitoring of the patient’s blood sugar over periods and blood samples will become a regular part of the disease management. Dietary management is indicated in many cases.


What can I Expect if my Pet is Treated for DKA?

Most dogs and cats (70%) treated for DKA are discharged successfully from hospital. Initial management of the disease will require intensive hospitalisation and treatment with round the clock nursing to closely monitor the patient.

Long Term Management

Most often, patients will require regular injections of insulin to regulate their blood sugar levels throughout the day. Regular blood samples to check the blood sugar levels and function of other organs within the body are also required to ensure control is achieved.

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Emergency and Critical Care

Find out more

To assist owners in understanding more about Emergency and Critical Care, we have put together a range of information sheets to talk you through some of the more common critical disorders cared for by our Specialists.