[Diabetic ketoacidosis in cats: pathogenesis and diagnosis]

Diabetic ketoacidosis represents a serious complication of diabetes mellitus. In 1/3 to 2/3 of reported cases, diabetes mellitus is known beforehand. At presentation, affected cats are severely ill. Anorexia, vomiting and dehydration are the most common signs and affected cats usually present with volume depletion. Hepatic lipidosis and pancreatitis are frequent concurrent conditions. It is necessary for the disease to be promptly recognized and diagnosed in order to initiate necessary therapeutic measures as rapidly as possible in order to improve the prognosis of affected animals. Diagnostic criteria include the documentation of severe hyperglycemia and the detection of elevated blood ketone bodies or ketonuria. In case of euglycemic diabetic ketoacidosis under treatment with SGLT2 inhibitors, blood glucose levels are within normal range. Blood gas analysis is required to assess metabolic acidosis resulting from ketosis and to determine its severity. The aim of this article is to provide a detailed overview of the pathogenesis of diabetic ketoacidosis, to offer guidance for the identification of affected cats and to present diagnostic guidance as well as to address advantages and disadvantages of the different diagnostic tests.