Insulin in dogs with diabetic ketoacidosis
Diabetes is due to a reduction or the total loss of insulin function in the body. This means glucose cannot be used correctly and so it starts to accumulate in the blood, causing hyperglycaemia and ketosis. When accompanied by metabolic acidosis, the situation is known as ketoacidosis, which is a medical emergency that can be life-threatening for veterinary patients.
Diabetes in dogs
Estimates indicate that about 1 in 500 dogs eventually develop diabetes. Just as with humans, the development of diabetes in dogs is closely related to lifestyle habits: being overweight or obese, a sedentary lifestyle and diet are key factors in the onset of this chronic disease, as are age and genetic predisposition (some breeds, such as Poodle, Yorkshire Terrier or Golden Retriever, have an increased risk of diabetes).
The treatment of diabetes consists of:
- Injecting exogenous insulin (to rebalance the patient’s blood glucose level).
- Increasing the patient’s amount of physical activity.
- Prescribing a diet that helps control glycaemia.
With this therapeutic purpose in mind, Advance Veterinary Diets has developed a special glucose control diet that has been clinically tested with proven results.
For dogs with an increased risk of diabetes due to overweight or obesity, the Advance Veterinary Diets Weight Balance range helps them recover their correct weight.
Complications of diabetes in dogs: diabetic ketoacidosis
There are two types of complication: chronic and acute.
- Chronic complications: these stem from high blood glucose levels for long periods of time, which leads to tissue damage. Typical complications in dogs include cataracts or neuropathy.
- Acute complications: these occur when there is a very limited amount of glucose available for tissues. To compensate for this limited availability, the body starts to metabolise large quantities of fat for energy, with the consequent production of ketone bodies and acidification of the internal environment that could even prove fatal. This process is called ketosis and, depending on the degree and duration of the ketogenic crisis, it may be accompanied by metabolic acidosis (diabetic ketoacidosis).
The serum concentration of endogenous insulin during metabolic acidosis has traditionally been considered to be almost zero, which would explain the clinical signs. However, recent studies have shown that this is not true, so other factors that trigger diabetic ketoacidosis ought to be studied.
Study: absence of endogenous serum insulin in dogs with diabetic ketoacidosis?
A study conducted at the University of Pennsylvania looked at insulin concentrations in dogs with diabetic ketoacidosis. The authors aimed to demonstrate that the subjects’ serum insulin would be close to 0 when in a state of ketoacidosis.
To this end, blood tests were performed on 42 dogs, a sample which included subjects with diabetic ketoacidosis, some with uncomplicated diabetes, a group with ketonuria but no acidosis, and control subjects with other diseases unrelated to diabetes.
Statistical analysis of the results showed there was no significant differences between the three groups of dogs with complicated/uncomplicated diabetes. There was, however, a statistically significant difference between the groups with diabetes and the control group.
Thus, according to this study, dogs with ketoacidosis maintain an endogenous serum insulin concentration that is akin to the levels normally observed in dogs with diabetes.
