• Card 25 / 34: 8 yr old MC DSH cat presented for weight loss with anorexia and vomitting PE : Temp 103 (increased) , Resp: 60 (increased) HR normal Tacky mucous membranes Weight: obese 6.1 kg Integ: 10% dehydrated; Harsh lung sounds throughout all lung field but no murmurs. The cat is laterally recumbent and somewhat responsive. CBC shows inflammatory leukogram. Biochem panel reveals Azotemia (increased BUN and Creat) , hyperglycemia Glu: 470 (normal140) Low HCO3 :10 (normal 24) , low Cl :110 (normal 125), and low Na : 144 (normal 147) with High K. Urinalysis shows Ketones 4+ and glucose 4+ Thoracic Radiographs: Diffuse, mixed interstitial and alveolar pattern suggestive of bronchopneumonia. After diagnosis of Diabtes Mellitus with ketoacidosis, what is the next immediate therapy?
    A) Fructosamine test to confirm the Diabetes Mellitus
    B) Do an Ultrasound to make sure there are no masses
    C) Do a urine culture to check for specific bacteria
    D) Intravenous fluids
    E) send animal home with vetsulin twice daily

    Answer:
    D) Intravenous fluids

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Explanation:

While it is instinctive to want to give a hyperglycemic animal insulin, rehydration with intravenous fluids is the most important first step you can take with these critical patients. You will certainly start insulin therapy at some point

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Dr Dowers Endocrinology

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