Question 23 / 30:  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
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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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