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

Lawren L. Durocher DVM, MS, DACVIM1, Kenneth W. Hinchcliff BVSc, PhD, DACVIM2, Stephen P. DiBartola DVM, DACVIM3, and Susan E. Johnson DVM, MS, DACVIM4
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  • 1 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 2 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 3 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.
  • | 4 Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210.

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 μmol/L had a serum insulin concentration < 5 μU/mL. There were strong relationships between serum ketone concentration and serum glucagon-insulin ratio, serum cortisol concentration, and plasma norepinephrine concentration. Serum β-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.

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 μmol/L had a serum insulin concentration < 5 μU/mL. There were strong relationships between serum ketone concentration and serum glucagon-insulin ratio, serum cortisol concentration, and plasma norepinephrine concentration. Serum β-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.

Contributor Notes

Dr. Durocher's present address is Carolina Veterinary Specialists, 1600 Hanes Mall Blvd, Winston Salem, NC 27103.

Dr. Hinchcliff's present address is Veterinary Clinical Centre, Faculty of Veterinary Science, University of Melbourne, Princes Highway, Werribee, Victoria, Australia, 3030.

Supported by a grant from the Iams Company.

Presented in part at American College of Veterinary Internal Medicine Annual Forum, Seattle, June 2007.

Address correspondence to Dr. Hinchcliff.