Vet Guide to Diabetes Mellitus with Ketoacidosis in Dogs 2025 🐶🩺  

By Dr. Duncan Houston BVSc

Diabetic ketoacidosis (DKA) is a life-threatening emergency in dogs with diabetes mellitus, characterized by uncontrolled blood sugar, ketone buildup, dehydration, electrolyte imbalance, and acidosis.

📍 Causes & Risk Factors

• Triggered by stressors—such as infections, pancreatitis, UTI, or missed insulin—that raise blood sugar and promote ketone production.
• Dogs with poorly controlled or newly diagnosed diabetes are at highest risk.

⚠️ Clinical Signs

• Lethargy, weakness, rapid breathing, unkempt coat
• Vomiting, diarrhea, loss of appetite
• Acetone ("pear-drop") breath
• Neurological symptoms: confusion, seizures, collapse

🔬 Diagnostic Steps

• Bloodwork reveals hyperglycemia, ketonemia, acidosis, and electrolyte disturbances.
• Urinalysis shows glucosuria and ketonuria (minimal or no ketones indicate HHS instead).
• Additional tests: CBC, biochemistry, imaging to identify triggers.

💊 Hospital Treatment & Care

• IV fluids: Start with isotonic saline to correct dehydration slowly (first 4–6 hours).
• Insulin therapy: Use low-dose regular insulin after initial fluids to avoid rapid osmotic shifts.
• Electrolyte monitoring: Replace potassium, phosphorus, and sodium as needed.
• Supportive care: Treat nausea, manage acidosis, and address underlying illness.

📈 Prognosis & Follow-Up

• About 70% survival with prompt treatment, average 6-day hospitalization.
• Main mortalities due to cerebral edema, electrolyte imbalances, lung/kidney issues.
• After recovery, tight diabetic control and regular checks are essential to prevent recurrence.

✅ Dr Houston’s Clinical Tips

• 📉 Don’t ignore PU/PD in diabetic dogs—early signs matter.
• 📋 Use home glucose and ketone monitoring to catch deterioration.
• 🚰 Start fluids before insulin—prevents cerebral edema.
• ⚡ Regularly monitor electrolytes and provide supplements.
• 🔍 Identify and treat any concurrent diseases to reduce relapse.
  

If your diabetic dog becomes lethargic, vomits, breathes heavily, shows seizures, or smells fruity—seek emergency veterinary care ASAP. With timely treatment, we can guide recovery and help maintain long-term stability. 🐾❤️