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.
You diagnose the cat with Diabetes Mellitus with ketoacidosis (DKA), what do you think could have triggered the ketoacidosis?
