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Diabetes Complications in Dogs and Cats: Diabetes Ketoacidosis (DKA)

Reviewed by Dr. Peter Kintzer, DVM, DACVIM on Friday, August 28, 2015
Posted January 10, 2014 in Dog Diseases & Conditions A-Z

Sad black Pug

Unfortunately, we veterinarians are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). So, if you just had a dog or cat diagnosed with diabetes mellitus, what do you do? First, we encourage you to take a look at these articles for an explanation of the disease:

Diabetes Mellitus (Sugar Diabetes) in Dogs

Diabetes Mellitus (Sugar Diabetes) In Cats

Once you have a basic understanding of diabetes mellitus (or if you already had one), this article will teach you about life-threatening complications that can occur as a result of the disease; specifically, I discuss a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it!

What is DKA?
When diabetes goes undiagnosed, or when it is difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells -- resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body.

Symptoms of DKA
Clinical signs of DKA include the following:

  • Weakness
  • Not moving (in cats, hanging out by the water bowl)
  • Not eating to complete anorexia
  • Vomiting
  • Excessive thirst and urination (clear, dilute urine)
  • Large urinary clumps in the litter box (my guideline? If it’s bigger than a tennis ball, it’s abnormal)
  • Weight loss (most commonly over the back), despite an overweight body condition
  • Obesity
  • Flaky skin coat
  • Excessively dry or oily skin coat
  • Abnormal breath (typically a sweet “ketotic” odor)
  • Diarrhea

In severe cases DKA can also result in more significant signs:

  • Abnormal breathing pattern
  • Jaundice
  • Abdominal pain (sometimes due to the secondary problem of pancreatitis)
  • Tremors or seizures
  • Coma
  • Death

What can cause DKA?
When DKA occurs, it’s often triggered by an underlying medical problem such as an infection or metabolic (organ) problem. Some common problems that we see with DKA include the following:

  • Pancreatitis
  • Urinary tract infection
  • Chronic kidney failure
  • Endocrine diseases (e.g., hyperadrenocorticism [when the body makes too much steroid], or hyperthyroidism [an overactive thyroid gland])
  • Lung disease (such as pneumonia)
  • Heart disease (such as congestive heart failure)
  • Liver disease (such as fatty changes to the liver or “hepatic lipidosis”)
  • Cancer

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Justine has more than 18 years of experience in the veterinary industry and is a board-certified emergency critical care veterinary specialist and toxicologist as well as the CEO and founder of Vetgirl. She is also a founding member of IDEXX’s Pet Health Network team.