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患有自然发生的糖尿病的犬只的酸碱及激素异常情况。

Acid-base and hormonal abnormalities in dogs with naturally occurring diabetes mellitus.

作者信息

Durocher Lawren L, Hinchcliff Kenneth W, DiBartola Stephen P, Johnson Susan E

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA.

出版信息

J Am Vet Med Assoc. 2008 May 1;232(9):1310-20. doi: 10.2460/javma.232.9.1310.

Abstract

OBJECTIVE

To examine acid-base and hormonal abnormalities in dogs with diabetes mellitus.

DESIGN

Cross-sectional study.

ANIMALS

48 dogs with diabetes mellitus and 17 healthy dogs.

PROCEDURES

Blood was collected and serum ketone, glucose, lactate, electrolytes, insulin, glucagon, cortisol, epinephrine, norepinephrine, nonesterified fatty acid, and triglyceride concentrations were measured. Indicators of acid-base status were calculated and compared between groups.

RESULTS

Serum ketone and glucose concentrations were significantly higher in diabetic than in healthy dogs, but there was no difference in venous blood pH or base excess between groups. Anion gap and strong ion difference were significantly higher and strong ion gap and serum bicarbonate concentration were significantly lower in the diabetic dogs. There were significant linear relationships between measures of acid-base status and serum ketone concentration, but not between measures of acid-base status and serum lactate concentration. Serum insulin concentration did not differ significantly between groups, but diabetic dogs had a wider range of values. All diabetic dogs with a serum ketone concentration > 1,000 micromol/L had a serum insulin concentration < 5 microU/mL. There were strong relationships between serum ketone concentration and serum glucagon-insulin ratio, serum cortisol concentration, and plasma norepinephrine concentration. Serum beta-hydroxybutyrate concentration, expressed as a percentage of serum ketone concentration, decreased as serum ketone concentration increased.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that ketosis in diabetic dogs was related to the glucagon-insulin ratio with only low concentrations of insulin required to prevent ketosis. Acidosis in ketotic dogs was attributable largely to high serum ketone concentrations.

摘要

目的

研究患有糖尿病的犬的酸碱及激素异常情况。

设计

横断面研究。

动物

48只患有糖尿病的犬和17只健康犬。

方法

采集血液,测量血清酮、葡萄糖、乳酸、电解质、胰岛素、胰高血糖素、皮质醇、肾上腺素、去甲肾上腺素、非酯化脂肪酸和甘油三酯的浓度。计算酸碱状态指标并在组间进行比较。

结果

糖尿病犬的血清酮和葡萄糖浓度显著高于健康犬,但两组间静脉血pH值或碱剩余无差异。糖尿病犬的阴离子间隙和强离子差显著升高,强离子间隙和血清碳酸氢盐浓度显著降低。酸碱状态指标与血清酮浓度之间存在显著的线性关系,但与血清乳酸浓度之间不存在显著线性关系。两组间血清胰岛素浓度无显著差异,但糖尿病犬的值范围更广。所有血清酮浓度>1000微摩尔/升的糖尿病犬血清胰岛素浓度<5微国际单位/毫升。血清酮浓度与血清胰高血糖素-胰岛素比值、血清皮质醇浓度和血浆去甲肾上腺素浓度之间存在密切关系。血清β-羟基丁酸浓度占血清酮浓度的百分比随血清酮浓度升高而降低。

结论及临床意义

结果表明,糖尿病犬的酮症与胰高血糖素-胰岛素比值有关,仅需低浓度胰岛素即可预防酮症。酮症犬的酸中毒主要归因于高血清酮浓度。

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