Identify any concurrent problems often associated with the disease (e.g., urinary tract infections, pancreatitis). Identify any complications that may be associated with the disease (e.g., cataracts in dogs, peripheral neuropathy in cats). Assess the overall health of the pet (history including diet and concurrent medications, and a complete physical exam). The initial evaluation of the diabetic dog and cat should: Some patients will present with systemic signs of illness due to diabetic ketosis/ketoacidosis, such as anorexia, vomiting, dehydration, and depression. Dogs may have cataracts, and cats may present with a complaint of impaired jumping and abnormal gait. Some may present with lethargy, weakness, and poor body condition. 9Īnimals with clinical DM will present with PU, PD, PP, and weight loss. 9 Fructosamine levels may be only mildly elevated with lower levels of persistent hyperglycemia, and should be interpreted as part of a complete evaluation. Reassessing BG or monitoring urine glucose (UG) levels once the patient is no longer stressed at home or measuring serum fructosamine concentrations may help differentiate between stress hyperglycemia and DM, and determine if further action should be taken.Ĭlinical DM is diagnosed on the basis of persistent glucosuria, persistent hyperglycemia, and presence of characteristic clinical signs.ĭocumentation of an elevated serum fructosamine concentration may be necessary to confirm the diagnosis in cats. Stress hyperglycemia needs to be ruled out, as well as correction of any insulin-resistant disorders and discontinuation of drugs associated with impaired insulin release or sensitivity. Blood glucose concentrations in these ranges may occur for a variety of reasons, including stress hyperglycemia in cats, corticosteroid administration, the presence of concurrent insulin-resistant disease (hyperadrenocorticism, obesity), or as part of the early stage of developing DM.ĭogs and cats in the early stages of nonclinical DM appear healthy, have a stable weight, and are usually identified as a result of routine laboratory evaluation. Clinical signs are usually absent with glucose levels ranging between the upper reference levels and the renal threshold values noted above. Glucosuria will typically develop when the BG concentration exceeds approximately 200 mg/dL in dogs and 250–300 mg/dL in cats.Ĭlinical signs of DM will typically be present when there is persistent hyperglycemia and glucosuria. Clinical signs of PU/PD do not develop until the BG concentration exceeds the renal tubular threshold for spillage of glucose into the urine. 
In such cases, if stress hyperglycemia can be ruled out, the patient may be classified as at-risk for developing DM. Elevated BG can sometimes be identified on blood work in the absence of consistent clinical signs.
#NET RADAR ALP REVIEW FULL#
These guidelines describe different approaches to DM diagnosis and assessment depending on the level of hyperglycemia and the presence of clinical signs.įor cats and dogs who present with clinical signs suggestive of DM, perform a physical exam and full laboratory evaluation (complete blood count ), chemistry with electrolytes, urine analysis with culture, urine protein:creatinine ratio (UPC), triglycerides, blood pressure (BP), and thyroxine (T4) in cats to confirm the diagnosis as well as to rule out other diseases.
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