Diabetic ketoacidosis in dogs, or DKA, is a potentially life-threatening complication of diabetes. DKA occurs when there are high levels of blood sugar (hyperglycemia) and also high levels of ketones in the bloodstream and urine. Dogs with DKA may have a fruity odour to their breath, as acetone is one of the ketones that is produced by the body. Luckily, if caught early enough, it can be treated successfully. Keep reading to learn more about diabetic ketoacidosis in dogs and how you can prevent it from happening!

What is diabetic ketoacidosis in dogs or DKA?

Diabetic ketoacidosis (DKA) is a serious, life-threatening complication of diabetes mellitus. It occurs when the body doesn't have enough insulin (i.e. diabetes mellitus), which is a hormone that helps the body use sugar (glucose) for energy. When there isn't enough insulin, the body starts to break down fat instead of glucose for energy. This process produces ketones, which are acids that can build up in the blood and urine.

Diabetic ketoacidosis in dogs is not only caused by an insulin deficiency. The release of diabetogenic hormones, such as glucagon, growth hormone, and epinephrine, also contributes to the condition. These hormones stimulate the breakdown of fat, which increases the formation of ketones.

Why does diabetic ketoacidosis occur in dogs?

Ketones are produced as a response to perceived starvation by the body, but their use for energy decreases over time due to limited cellular uptake. If ketone bodies continue to form and aren't used for energy, they start to accumulate within the body. Ketones are strong acids and their accumulation can cause metabolic acidosis, which results in clinical symptoms.

Diabetic ketoacidosis in dogs is more common in dogs with newly diagnosed diabetes. Study results found that most dogs with diabetic ketoacidosis were diagnosed at the time of discovery of diabetes mellitus. A majority of dogs and cats with diabetic ketoacidosis present with concurrent diseases. Cushing's disease, pancreatitis and bacterial urinary tract infections are among the more common concurrent diseases found in dogs.

What are the symptoms of diabetic ketoacidosis in dogs?

The symptoms of diabetic ketoacidosis can vary from dog to dog, but may include:

  • Fruity odour on breath
  • Increased thirst and urination
  • Vomiting
  • Lethargy
  • Decreased appetite

The key takeaway for the symptoms of diabetic ketoacidosis in dogs is that the symptoms can vary from dog to dog and may include a fruity odour in the breath, increased thirst and urination, vomiting, lethargy, and decreased appetite.

How is diabetic ketoacidosis diagnosed in dogs?

When diabetic ketoacidosis is suspected, your veterinarian will check your dog's blood sugar (glucose) level. In addition, a urine test will be done to measure the level of ketones in the urine. The presence of high levels of ketones in the urine with clinical symptoms confirms the diagnosis of diabetic ketoacidosis.

Additional tests may be needed to look for concurrent diseases. These could include tests of the adrenal gland, thyroid function, radiographs of the chest and abdomen, ultrasound of the abdomen, and specific evaluation of the pancreas.

What is the treatment for diabetic ketoacidosis in dogs?

In almost all cases, successful treatment for diabetic ketoacidosis requires hospitalization with intensive care. Treatment includes:

  • Intravenous fluids (IV) to help replenish fluids
  • Correction of electrolyte abnormalities; especially potassium as many dogs with DKA can become hypokalemic (low blood potassium)
  • Insulin therapy - your veterinarian may temporarily switch your dog's insulin to a short acting insulin to obtain better management of the blood glucose levels
  • Monitoring of blood sugar levels and electrolytes
  • Other supportive care measures, such as monitoring for and treating concurrent conditions such as hypophosphatemia (low blood phosphorus) and pancreatitis for example.

The hospital will discharge the dog after he or she is eating, drinking, and thoroughly hydrated (on average within 5 days with treatment).

What is the prognosis for diabetic ketoacidosis in dogs?

The prognosis for dogs with diabetic ketoacidosis can be good provided they receive the proper treatment. Studies suggest a favourable prognosis in approximately 70% of all treated dogs. Dogs with severe symptoms and especially with concurrent illnesses, however, have a poorer prognosis and may be life-threatening.

How can you prevent diabetic ketoacidosis from occurring?

To keep your dog healthy and prevent diabetic ketoacidosis from occurring, it is important to check its blood glucose regularly. Keeping your dog's blood sugar at an acceptable level and preventing long-standing hyperglycemia can help prevent diabetic ketoacidosis.

In this article, we discussed diabetic ketoacidosis in dogs (DKA). DKA is a potentially life-threatening complication of diabetes mellitus and typically occurs when there are high levels of blood sugar, ketones and metabolic acidosis. The symptoms can vary from dog to dog but may include a fruity odour in the breath, increased thirst and urination, vomiting, lethargy and decreased appetite. Treatment typically requires hospitalization with intensive care and includes intravenous fluids, insulin therapy, and monitoring of blood sugar levels and electrolytes. The prognosis for dogs with diabetic ketoacidosis is good provided they receive the proper treatment. If you have any further questions about diabetic ketoacidosis in dogs, please contact your veterinarian.