Diabetic ketoacidosis in the cat: Recognition and essential treatment

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.