Rudloff Elke
Lakeshore Veterinary Specialists, 2100 W Silver Spring Dr, Glendale, WI 53024, USA.
J Feline Med Surg. 2017 Nov;19(11):1167-1174. doi: 10.1177/1098612X17735762.
Practical relevance: Diabetic ketoacidosis (DKA) is a not uncommon emergency in both newly diagnosed and poorly regulated diabetic cats. When there is a heightened metabolic rate and energy requirement due to concurrent illness, an increase in the release of glucose counter-regulatory hormones causes insulin receptor resistance, lipolysis, free fatty acid release and ketogenesis. This necessitates not only treatment to eliminate the ketosis and control blood glucose, but also investigation of concurrent illnesses. Clinical challenges: A number of metabolic derangements can occur with DKA, requiring a comprehensive diagnostic evaluation, elimination of ketones, careful correction of glucose, electrolyte and acid base abnormalities, and close monitoring.
Any veterinarian that cares for cats in urgent and emergency situations should understand the pathophysiology of DKA in order to address an individual's clinical signs and metabolic derangements. Evidence base: This review draws evidence from the peer-reviewed literature as well as the author's personal clinical experience.
实际相关性:糖尿病酮症酸中毒(DKA)在新诊断的和血糖控制不佳的糖尿病猫中是一种并不罕见的急症。当由于并发疾病导致代谢率和能量需求增加时,葡萄糖反调节激素释放增加会导致胰岛素受体抵抗、脂肪分解、游离脂肪酸释放和酮生成。这不仅需要进行治疗以消除酮症并控制血糖,还需要对并发疾病进行调查。临床挑战:DKA可能会出现多种代谢紊乱,需要进行全面的诊断评估、消除酮体、谨慎纠正血糖、电解质和酸碱异常,并密切监测。
任何在紧急和急诊情况下照顾猫的兽医都应该了解DKA的病理生理学,以便处理个体的临床症状和代谢紊乱。证据基础:本综述借鉴了同行评审文献以及作者的个人临床经验中的证据。