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Pancreatic Endocrine DZ Plus Parathyroid (DKA (cerebral edema, metabolic…
Pancreatic Endocrine DZ Plus Parathyroid
Diabetes Mellitus
Clinical Picture
Physical
neuropathy
hepatomegaly
history
Weight loss
sudden blindness (cataracts)
Polyphagia
ketoacidotic crisis
PU/PD
Biochem
elevated pancreatic enzymes
hyperlipidemia
elevated liver enzymes
azotemia (uncommon)
Hyperglycemia
signalment
male cats
female dogs
urinalysis
proteinuria
Glucosuria
pyuria
Types
2
insulin resistance of tissues, not insulin dependent
fat cats
carbohydrate intolerance
1
loss of beta cells, insulin dependent
dogs
Diagnosis
initially based on lab data
IV glucose tolerance test rarely needed
differentiate IDDM from NIDDM
ketoacidosis
response to insulin
severity of hyperglycemia
glycated proteins
glycosylated hemoglobin
fructosamine
used more often
assess glucose control over a period of time
DKA
cerebral edema
metabolic acidosis
osmotic diuresis
electrolyte loss
hypokalemia
neoplasms
insulinoma
release of insulin despite hypoglycemia
tumor of beta cells
fasting hypoglycemia with high insulin concentration
the most common tumor in ferrets
mets common
gastrinoma
glucagonoma
tumor of alpha cells
dogs only
increased glucagon leads to gluconeogenesis, glycogenolysis, and ketogenesis
Parathyroid gland
Hypoparathyroidism
uncommon
severe hypocalcemia
Hyperparathyroidism
usually due to adenoma of chief cells
PU/PD
weakness
marked and persistent hypercalcemia
low or normal serum phosphorus
increased serum PTH
hyper calcemia DDx
chronic renal failure
hypervitaminosis D
of malignancy
hypoadrenocorticism
hyperparathyroidism