Schramm Fabian, Weiß Mirjam, Dahlem Dorothee
Klinik für Kleintiere, Abteilung Innere Medizin, Justus-Liebig-Universität Gießen.
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2020 Oct;48(5):322-328. doi: 10.1055/a-1245-8219. Epub 2020 Oct 21.
The measurement of beta-hydroxybutyrate (BOHB) carries high significance for the diagnosis, prognosis as well as treatment decisions in canine and feline diabetic ketoacidosis. The aim of this study was to establish clinically usable cut-off values for BHOB measurements in dogs and cats using the glucometer GlucoMenLX Plus.
We measured BOHB with the GlucoMenLX Plus in 4 patient groups (diabetic ketoacidosis, diabetic non-ketoacidic, catabolic non-diabetic status, control). These were classified based upon medical history and laboratory findings (pH, glucose-, HCO concentrations, anion gap). The data was analyzed in a ROC-curve-analysis in order to create cut-off values.
A total of 47 dogs and 55 cats were included into the study. In the differentiation between the two diabetic groups, cut-off values for dogs and cats amounted to 2.55 mmol/l and 4.05 mmol/l, respectively. Here, good sensitivity (100 %) and specificity (82 % and 100 %, respectively) were attained. In the comparison of the catabolic non-diabetic status group and the individuals with diabetic ketosis, the analysis resulted in a cut-off value of 0.25 mmol/l in dogs and 0.25 mmol/l in cats, carrying poor sensitivity (58 % and 59 %, respectively) and specificity (90 %).
Measurements with the GlucoMenLX Plus are suitable for a reliable differentiation between ketoacidosis and ketosis in dogs and cats. Here, the determined cut-off values carried high sensitivity and specificity. A distinction between non-diabetic catabolic individuals and patients with diabetic catabolic states, however, cannot be achieved with adequate consistency.
The established cut-off values aid in the treatment decision-making process as well as the assessment of prognosis and treatment success in diabetic ketoacidosis. In representing a point of care technique, the method allows for direct owner communication of the results and immediate adjustment of the treatment regime. Concerning the initial diagnosis or a differentiation between non-diabetic and diabetic catabolic states, however, the presented method alone is not sufficient, therefore additional diagnostic procedures are warranted in order to ascertain a correct diagnosis.
β-羟基丁酸（BOHB）的测定对于犬猫糖尿病酮症酸中毒的诊断、预后以及治疗决策具有重要意义。本研究的目的是使用GlucoMen LX Plus血糖仪建立犬猫BOHB测量的临床可用临界值。
我们使用GlucoMen LX Plus对4组患者（糖尿病酮症酸中毒、非酮症糖尿病、分解代谢非糖尿病状态、对照组）进行了BOHB测量。这些组是根据病史和实验室检查结果（pH值、血糖、HCO浓度、阴离子间隙）进行分类的。通过ROC曲线分析对数据进行分析，以确定临界值。
共有47只犬和55只猫纳入本研究。在区分两个糖尿病组时，犬和猫的临界值分别为2.55 mmol/l和4.05 mmol/l。在此，获得了良好的敏感性（100%）和特异性（分别为82%和100%）。在比较分解代谢非糖尿病状态组和糖尿病酮症患者时，分析得出犬的临界值为0.25 mmol/l，猫为0.25 mmol/l，敏感性较差（分别为58%和59%），特异性为90%。
使用GlucoMen LX Plus进行测量适用于可靠地区分犬猫的酮症酸中毒和酮血症。在此，确定的临界值具有较高的敏感性和特异性。然而，无法以足够的一致性区分非糖尿病分解代谢个体和糖尿病分解代谢状态患者。
所建立的临界值有助于糖尿病酮症酸中毒的治疗决策过程以及预后和治疗效果评估。作为一种即时检测技术，该方法允许直接向主人传达结果并立即调整治疗方案。然而，对于初始诊断或区分非糖尿病和糖尿病分解代谢状态，仅采用本方法是不够的，因此需要进行额外的诊断程序以确定正确的诊断。
