Overview:

Diabetic ketoacidosis (DKA) is a life threatening complication of uncontrolled diabetes caused by a lack, or insufficient amount of insulin. This means glucose is unable to be used by the body for energy.  The body begins to search for alternate supplies of energy & begins to break down fat. When fat is broken down (metabolised) into fatty acids, waste products known as ketones (also known as ketone bodies) are produced & accumulate in the bloodstream. This causes the blood to become too acidic (acidosis).

The body will try to get rid of the ketones by excreting them into the urine, which causes increased urine output & increased thirst.

What causes ketoacidosis in cats?

There are several possible causes including;

• Undiagnosed diabetes
• Insufficient insulin
• Missed insulin
• Not enough food
• Illness & or infections (especially of the urinary tract)
• Obesity
• Stress
• Surgery
• Idiopathic (no known cause)

What are the symptoms of ketoacidosis?

• Polyuria (frequent urination)
• Polydipsia (excessive/abnormal thirst) or decreased/absent thirst (hypodipsia)
• Anorexia or increased hunger (polyphagia)
• Weight loss
• Dehydration
• Lethargy
• Ketones in urine
• Vomiting
• Weakness
• Breath may have an unusual 'fruity' smell, similar to acetone (used in nail polish remover)
• Diarrhea
• Coma

How is ketoacidosis diagnosed?

Your veterinarian will perform a complete physical examination from you & obtain a medical history. Some tests he may wish to perform include;

• Blood tests (including biochemical profile & complete blood count) to check the blood sugar levels, ketones, blood acid levels & liver function.
• Urinalysis to check for ketones, glucose & urinary tract infection.
• Abdominal x-ray

How is ketoacidosis treated?

Treatment depends on the severity of the condition. In mild cases, where your cat is still bright & alert home therapy may be all that is necessary. Regular monitoring of blood glucose levels should be performed.

In more serious cases, treatment includes;

Intravenous fluids & electrolytes  to treat  & correct dehydration & electrolyte imbalance (possibly supplementing with electrolytes such as sodium, potassium and chloride). This also dilutes glucose & acid levels.

Frequent administration of short-acting insulin to lower blood sugar levels.

Where possible, find out the cause (such as infection) of ketoacidosis & treat.

Regular monitoring of blood glucose, blood chemistry, electrolytes & urine for ketones.

Once the cat is stable (eating, hydrated, no vomiting etc), your veterinarian will change to a long-acting or intermediate-acting insulin. [2]

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