Hyperosmolar hyperglycaemic syndrome in a dog resulting from parenteral nutrition overload

A dog treated for a pancreatic abscess inadvertently received 1800 ml of hyperosmolar solution within a two hour period. Blood glucose reached 44 mmol/litre and the plasma osmolality was estimated to be more than 334 mOsm/litre. Lipaemia was severe and persisted for several days. The dog developed nausea, vomiting, depression, severe hyperglycaemia, polyuria, glucosuria and hypokalaemia. These symptoms were consistent with a hyperosmolar hyperglycaemic syndrome. Treatment with insulin and intravenous fluid rapidly corrected the hyperglycaemia, electrolyte imbalances and water deficits. The dog recovered and no long-term sequelae were observed.