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The difference between cataracts and nuclear sclerosis (part of the aging process) can be seen by comparing the changes in the lens. Hypoglycemia-graphic illustration of how too much insulin in the bloodstream means not enough glucose. Hypoglycemia, also referred to as an insulin reaction, [1] is what every diabetic fears -- very low blood glucose. The blood glucose level at which an animal (or person) is dangerously hypoglycemic is fuzzy, and depends on several factors. The most likely time for an acute hypoglycemia episode is when the insulin is working hardest, or at its peak; this is when blood glucose levels are at their lowest, or nadir, due to the action of the insulin.
An acute hypoglycemic episode can happen even if you are careful, since pets' insulin requirements sometimes change without warning. Vomiting [9] and diarrhea [13] episodes can bring on a hypoglycemia reaction, due to dehydration or simply because there's more insulin than properly digested food.
According to a 2000 JAVMA study, dogs receiving insulin injections only once daily at high doses [14] are more likely to have hypoglycemic episodes than those who receive insulin twice daily.
As soon as possible, administer honey or corn syrup by rubbing it on the gums (even if unconscious, but not if in seizures), and rush it to the vet. Intervet suggests an especially good place to also rub sugar, syrup or honey is under the pet's tongue. If that doesn't work, administer some honey or syrup followed by food or treats, and continue to do so until the blood glucose is rising, and the latest insulin shot's peak action is past.
The honey, syrup or "fast-acting" sugar (simple carbohydrates) will make the blood glucose rise, but the rise will not last very long.
Feeding something with complex carbohydrates in it when the pet is able to take it will make sure hypoglycemia doesn't overtake the "quick" sugar fix. Intervet suggests 1 gram of glucose for every kilogram (2.2 lb) [30] of the animal's body weight and extra food every 1-2 hours to counter the insulin's effects. An interesting quick treatment tip is to keep frozen ice cubes of syrup for emergencies and simply slipping it into the pet's mouth.
Its also important to remember that it takes a little time to fully come back from a hypo incident.
Sometimes a mild hypoglycemic episode will go unnoticed, or leave evidence such as an "accident". A single hypoglycemia or near hypoglycemia episode [35] can result in hyperglycemia for up to 3 days following it. People and pets can also exhibit signs of hypoglycemia if their glucose levels drop rapidly. The system can only determine that blood glucose levels are falling at a rapid rate, not whether they are "supposed to" in this hypothetical case, and sends out "hypo" warning signals to protect itself. In both hypoglycemia and hyperglycemia, the inflamation lessens as the proper bg corrections are made, reverting to no visible irritation when euglycemia is achieved. The question of why some diabetics exhibit more overt signs of low blood glucose than others came up in a talk with a Certified Diabetes Educator who is also a registered nurse. What has definitely been learned from all the human research into the problem is that having serious hypoglycemia episodes puts one at risk for becoming hypoglycemia unaware. Those who have suffered bouts of serious hypoglycemia are also more at risk, unfortunately, to have more of them, as opposed to persons with diabetes who have never experienced any serious hypoglycemia incidents. Chemical structures of various ketone bodies - acetone (top), acetoacetic acid (middle), and beta-hydroxybutyric acid (bottom). Ketones in the urine or blood, as detected by urine testing stix or a blood ketone testing meter, [1] may indicate the beginning of diabetic ketoacidosis (DKA), a dangerous and often quickly fatal condition caused by low insulin levels [2] combined with certain other systemic stresses. Because of the hyperglycemia Cushing's disease creates, it's possible (but not frequent) to find ketones in the urine. The three ketone bodies are acetone, acetoacetic acid, and beta-hydroxybutyric acid, with the predominating ketone body formed being beta-hydroxybutyrate acid. Ketones are produced by the liver as part of fat metabolism and are normally not found in sufficient quantity to be able to be measured in urine or blood (non-diabetics or well-controlled diabetics). Fruity ornail-polish remover odorTesting breath samples for acetone with gas chromatography.
Note that the triggers and signs are somewhat interchangeable because ketoacidosis is, once begun, a set of vicious circles which will make itself worse. In a diabetic, any urinary ketones above trace, or any increase in urinary ketone level, or trace urinary ketones plus some of the symptoms above, are cause to call an emergency vet immediately, at any hour of the day. It's important to time the test accurately and not take into account any color changes on the Ketostix strip which occur after 15 seconds. Most urine tests for ketones measure acetoacetic acid, not the most common beta-hydroxybutyrate acid. Because most urine tests measure acetoacetic acid, and not the most commonly found beta-hydroxybutyrate acid, it is possible to have ketones present and get a negative urine test result.


Further, it's also possible to have high levels of beta-hydroxybutyrate acid, get a negative urine ketone test result, but to have the test turn positive as the ketosis improves, due to the tests' measuring acetoacetic acid and not beta-hydroxybutyrate acid. Positive-Any other color except yellow or clear[33] May be the result of other disease processes.
If your pet is taking any type of vitamin supplements, it should be noted on his or her medical records. Many times, the polyuria of hyperglycemia and ketosis means too much potassium leaves the system via the too-frequent urination, so it's possible for the body to be low on potassium because of it. What happens then is we have someone whose potassium levels are low from too much urination and who must have insulin to manage blood glucose levels, with the knowledge that the use of the needed insulin will further deplete the potassium in the system. Dehydration becomes involved with ketoacidosis, which can mean that subcutaneous insulin injections are not properly absorbed; [51] when this occurs, intravenous treatment with soluble, short-acting insulin is needed.
Veterinarians have sometimes been known to send pets home from a DKA episode while still displaying ketones in the urine due to owner financial constraints -- this can turn into a fatal mistake. When there's not enough insulin to allow conversion of glucose to energy, the body begins to break down fat cells, which produce fatty acids. Our bodies normally are "fueled" by burning glucose; they are able to do this provided they have enough insulin (normally or by injection).
Normally, ketone bodies are produced in minuscule quantities, feeding only part of the energy needs of the heart and brain.
At the same time, massive amounts of ketone bodies are produced, which in addition to increasing the osmolal load of the blood, are acidic.
Glucose begins to spill into the urine as the proteins responsible for reclaiming it from urine reach maximum capacity.
Since diabetic dogs are considered insulin-dependent--unable to naturally provide any of their own insulin needs once diagnosed with diabetes--they are prone to ketoacidosis. The usual method of testing for ketones is with urine testing stix, available at any pharmacy. At present there is only one device for consumers who wish to test blood instead of urine for ketones--Abbott's Precision Xtra glucometer. The premise behind blood testing for ketones is the same as that for favoring glucose testing of blood over urine. Testing blood for ketones also means there are less medications and other things like lipids which can interfere with the accuracy of the test. Children with Diabetes [74] advises every family with a child with diabetes should have this type of meter because of its blood ketone testing ability.
Most urine tests for ketones measure acetoacetic acid, which is 20% of the ketones produced. When the bg readings are high enough to produce some ketones, you've taken action to bring them down and they are normal once more, it is possible to still see some positive urine ketone test results.
While the cause of the hyperglycemia which began the ketoacidosis may be suspected Cushing's disease, any testing done for the disease until the ketoacidosis episode has passed will result in false positive reports. In balance-the relationship between the glucagon-producing alpha cells and the insulin-producing beta cells of the normal endocrine pancreas. Although we focus mainly on its insulin-secreting capabilities, the pancreas is actually comprised of two sections. The pancreas has 2 separate sections, the exocrine, which deals with the digestive process, and the endocrine, which deals with the production of insulin (Beta cells) and glucagon (Alpha cells).
Healthy beta cells are constantly making insulin and storing it, as seen in this photo link below. When the insulin level drops, this signals the liver to release glucose by converting stored carbohydrates (glycogen) into glucose for fuel. When this occurs, if there are not enough stored carbohydrates in the form of glycogen, the liver will convert protein into glucose in an attempt to keep the body going.
Glucose [7] is important enough to the bodies of all mammals that there are 5 different glucose transporters [8] which carry it to the various body cells. Illustration of how glucose rises after meals and how the normal working pancreas responds by secreting insulin above the basal (body's needs without food) level to manage the rise in glucose. Dogs who don't have diabetes have a similar insulin secreting pattern to people who don't have diabetes, with the same two phases intended for the same purposes as in humans.
It is this pattern that diabetics try to mimic as closely as possible; with basal insulin injections for the body's needs without considering food and bolus insulin injections to cover meals replacing the Basal and Postprandial insulin their bodies no longer produce or do not produce in sufficient quantity. When there's not enough beta cell insulin production to meet the body's basal needs, it can happen very quickly.
The failure of the first phase of insulin discussed above above is what brings about the vicious circle of glucose toxicity, which, in turn, damages even more of the insulin-producing beta cells.
Journal of the Pancreas is free to read and contains many relevant articles on diabetes including feline and canine. Illustration of how the kidneys are shrunken and scarred with chronic renal failure, making them less able to do their job of removing wastes from the body.


Renal failure, especially CRF (Chronic renal failure), is a fairly common condition in older cats and dogs.
CRF can sometimes be mistaken for diabetes, since polyuria and polydipsia can occur in both; this may lead to incorrect treatment and progression of the renal failure.
CRF and high blood pressure are both possible complications of diabetes, and of each other. Difficult Vomiting Disorders-pages 108-110 Washabau, Robert J., March 2010, 110th Penn Annual ConferenceNote this is a very large file-over 300 pages--and may take some time to download. Staged Management of Chronic Kidney Disease-pages 89-90 Brown, Scott A., March 2010, 110th Penn Annual ConferenceNote this is a very large file-over 300 pages--and may take some time to download.
Canine and Feline Diabetes Mellitus: Nature or Nurture?-Diestrus-and gestation-associated diabetes Rand, Jacqueline, Fleeman, Linda et. Hypurin Bovine Neutral [1] is a beef-based short-acting insulin made by CP Pharma, [2][3] which has had nothing added to change its speed or length of activity. A comparable insulin for veterinary use was Insuvet Neutral, made for Pfizer Animal Health, UK; and Hypurin Vet Neutral. Any event that means more than the usual (and planned for) activity, can cause a low, since the food that supplies energy is used faster than expected. In these cases the blood sugar will often be paradoxically high upon the next test hours later, since the pet's body will react to the low blood sugar by stimulating the liver to release stored glycogen. The symptoms were first discovered with an individual dog, and extended to all diabetic dogs in the veterinary practice. Orzick, a professor at Baylor College of Medicine in Houston, also says that the rate at which blood glucose levels fall is the primary reason for lack of body warning responses. So dehydration, hyperglycemia, fasting, and presence of ketones are not only signs, they're also sometimes triggers. This color key works with the ReliOn brand ketone urine test strips also as both are made by Bayer. If a vet is unavailable, look for some of the other signs or triggers, and try to remedy any you can. When there's not enough insulin to allow the body to burn glucose for energy, it begins metabolizing fat to fuel its cells. When insulin is inadequate, fat must be turned into ketones for energy instead, and they rapidly become a major component of the brain's fuel. Spaying a female can solve transient diabetes because it ends the flow of hormones responsible for the diabetes. The result of the body turning to burning fat instead of glucose means more ketone production which is able to be measured when testing either urine or blood for them. If your cat or dog comes back from the hospital and still has ketones showing on urine testing stix, it's usually best to find the financial means to go right back to the vet's as your pet may need to stay in hospital longer. In particular, the brain cannot go without energy even for a second, so it demands fat conversion to ketones when glucose energy is unavailable.
As a result, the bloodstream is filled with an increasing amount of glucose that it cannot use (as the body continues adding glucose to the blood with gluconeogenesis and perhaps also glycogenolysis). The trace element balance of the system is altered by falling bicarbonate blood levels and rising serum potassium levels. The Precision Xtra also does blood glucose testing with standard blood glucose test strips made for use with the meter.
Excitement generally means more activity than normal, so it needs to fall into the category of "exercise" and possibly "fed" to avoid low blood glucose problems. In hypoglycemia, this would provide the brain with the glucose fuel it needs to make proper use of oxygen. When the system processes insulin (and other medications) at a slower than normal rate, they remain in the system longer.
It really kicks into action for me in certain social situations, thereby turning on the Fight or Fight hormones like cortisol, which in turn counteract the insulin in my system and completely throw me out of balance. What made you choose biochem' over molecular biology (I say this realising that they overlap a lot)? The basal, or body's needs minus the processing of food, insulin levels are the lower, often wavy lines shown. The sharp peaks represent how the body responds automatically with secretion of additional insulin to handle the extra glucose creating by eating meals, which are referred to as post-prandial (after-meals) on this graph.
People using insulin try to re-create this pattern as much as possible by using fast or short-acting insulin at meal times.



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