Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis

Area of Science:

• Veterinary Cardiology
• Canine Internal Medicine
• Critical Care Veterinary Medicine

Background:

• Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus in dogs.
• Metabolic disturbances in DKA can affect multiple organ systems, including the cardiovascular system.
• Extreme axis deviation (EAD) is a rare electrocardiographic finding with various potential causes.

Observation:

• A 7-year-old dog with DKA presented with severe dehydration and metabolic acidosis.
• Electrocardiogram (ECG) revealed extreme axis deviation (EAD) with a mean electrical axis of -101°.
• Elevated serum cardiac troponin I levels indicated myocardial injury, despite normal echocardiogram findings.

Findings:

• The study documents the first case of EAD associated with DKA in a dog.
• Treatment of DKA with intravenous fluids and insulin infusion led to the resolution of EAD.
• Normalization of ECG parameters and cardiac troponin I levels confirmed the reversibility of myocardial abnormalities.

Implications:

• DKA should be considered a potential cause of EAD in dogs.
• Routine ECG evaluation is crucial for dogs with severe DKA to detect EAD.
• The reversibility of EAD with DKA treatment suggests a direct link between metabolic derangement and cardiac electrical activity.