🚨 Diabetic Ketoacidosis in Dogs and Cats – A 2025 Vet’s Guide to Recognizing and Treating DKA

By Dr Duncan Houston, BVSc

🔍 What Is Diabetic Ketoacidosis (DKA)?

Diabetic ketoacidosis (DKA) is one of the most serious and life-threatening complications of uncontrolled diabetes mellitus in pets. It typically develops when a diabetic dog or cat goes untreated or experiences another health crisis that triggers metabolic instability. 🧪⚠️

🧬 How DKA Develops

In diabetic pets, the body lacks insulin. Without insulin, glucose (sugar) can’t enter cells. Instead of being used as energy, glucose accumulates in the bloodstream—while the body’s cells starve for fuel. 🧊

When a secondary stressor like infection, pancreatitis, or another illness arises, the energy demand rises even higher. The body starts to burn fat for fuel, producing substances called ketone bodies.

Ketones help supply energy short-term—but they also acidify the blood and disrupt electrolytes. The result is a vicious cycle of:

• 💧 Dehydration
• 🧂 Electrolyte imbalance (potassium, phosphorus, sodium)
• ⚡ Acidosis (low blood pH)
• 🧠 Brain and organ damage

⚠️ Common Signs of DKA in Pets

• 😴 Lethargy or weakness
• 🚫 Loss of appetite
• 🤢 Nausea or vomiting
• 💧 Dehydration
• 🍬 Very high blood glucose
• 🧪 Ketones in urine (detected with Ketostix)

Many pets with DKA are newly diagnosed diabetics. This means pet owners often receive two major diagnoses at once—diabetes + a life-threatening emergency. 😢

🏥 What to Expect in the Hospital

DKA requires intensive 24-hour care at a veterinary hospital. Key treatments include:

💧 Intravenous Fluids

Fluids are essential to reverse dehydration, correct electrolyte imbalances, and flush out ketones. The IV line also delivers potassium, phosphorus, and other needed supplements. 💉

💉 Insulin Therapy

To reduce blood glucose, short-acting insulin (e.g., Humulin R®) is used either via IM injection or IV drip. The goal is to lower glucose gradually—too fast can cause brain swelling. 🚨

⚖️ Potassium Supplementation

Insulin drives potassium into cells, which worsens the already low potassium levels caused by DKA. Potassium is added to fluids and carefully monitored. 🧪

🔬 Phosphorus Replacement

Low phosphorus can cause red blood cells to rupture. Supplementation prevents hemolysis and supports energy production. 💊

🌡️ pH Correction

If the blood is dangerously acidic, sodium bicarbonate may be added to restore normal pH. ⚖️

📊 Lab Monitoring

Bloodwork is repeated every few hours to monitor electrolytes, blood glucose, pH, and response to therapy. 🧫

🧩 Diagnosing the Underlying Trigger

Besides treating DKA, vets must identify the secondary issue that triggered it:

🐕 Common DKA Triggers in Dogs:

• Pancreatitis
• Urinary tract infection (UTI)
• Cushing’s disease

🐈 Common DKA Triggers in Cats:

• Hepatic lipidosis
• Kidney infection
• Pancreatitis
• Cholangiohepatitis

📆 Recovery Timeline

Stabilizing a pet with DKA may take up to a week of hospitalization. Once ketones are gone from the urine and your pet is eating and feeling better, insulin can be transitioned to a long-term regimen. 💉🐾

🏡 Home Monitoring After DKA

Once home, your pet will need the same care as any diabetic pet:

• 🍽️ Consistent meals and insulin
• 📈 Blood glucose monitoring
• 🧪 Urine ketone testing (use Ketostix strips from the pharmacy)

📉 Preventing Future Crises

Here’s how to avoid another episode of DKA:

• ⏰ Give insulin on time
• 📋 Stick to a routine feeding schedule
• 🧪 Monitor glucose and ketones regularly
• 🩺 Check in with your vet for rechecks and lab work
• 🚑 Get help immediately if your pet seems tired, wobbly, or nauseated

📲 Ask A Vet for Emergency Support

If your diabetic pet suddenly stops eating, appears confused, or seems “off,” it’s time to act. DKA progresses rapidly and can be fatal without treatment. 😢

The Ask A Vet App can help you determine if your pet’s symptoms are urgent, and guide you in the next steps. You can also use the app to track blood sugar, set medication reminders, and ask real-time questions. Visit AskAVet.com for expert support. 🐾📱

✅ Summary: Key DKA Takeaways

• ⚠️ DKA is a diabetic emergency that requires hospitalization
• 🧬 It involves fat breakdown, ketone buildup, and acid-base imbalances
• 💧 IV fluids, insulin, potassium, and monitoring are essential
• 🔍 Underlying triggers must be found and treated
• 📈 After recovery, pets still need lifelong diabetic care

💬 Final Words from Dr Duncan Houston

Diabetic ketoacidosis is frightening—but with prompt, skilled care, most pets recover and live full lives with managed diabetes. Be vigilant, know the signs, and never hesitate to seek help if your diabetic dog or cat seems unwell. 🐕❤️🐈

Need fast answers or support in a crisis? Open the Ask A Vet App or visit AskAVet.com to chat with a licensed veterinary professional, anytime. 🩺📱