What is the protocol for DKA?

A mix of 24 units of regular insulin in 60 mL of isotonic sodium chloride solution usually is infused at a rate of 15 mL/h (6 U/h) until the blood glucose level drops to less than 180 mg/dL; the rate of infusion then decreases to 5-7.5 mL/h (2-3 U/h) until the ketoacidotic state abates.

How is DKA treated in cats?

Treatment includes aggressive fluid therapy (most important), potassium and phosphorus supplementation, insulin therapy and possible bicarbonate administration (rarely needed).

What is the most appropriate treatment for DKA?

Treatment usually involves: Fluid replacement. You’ll receive fluids — either by mouth or through a vein — until you’re rehydrated. The fluids will replace those you’ve lost through excessive urination, as well as help dilute the excess sugar in your blood.

How do pediatrics manage DKA?

Administer isotonic sodium chloride solution until blood glucose levels have fallen to 250-300 mg/dL (ie, 12-15 mmol/L), at which time glucose-containing fluids should be introduced (either 5% glucose with 0.9% saline or 5% glucose with 0.45% saline); continue maintenance with dextrose saline until the child is eating …

When is DKA resolved?

DKA is resolved when 1) plasma glucose is <200–250 mg/dL; 2) serum bicarbonate concentration is ≥15 mEq/L; 3) venous blood pH is >7.3; and 4) anion gap is ≤12. In general, resolution of hyperglycemia, normalization of bicarbonate level, and closure of anion gap is sufficient to stop insulin infusion.

Can cats recover from diabetic ketoacidosis?

The condition can result in an accumulation of fluid in the brain and lungs, renal failure or heart failure. Affected animals that are not treated are likely to die. With timely intervention and proper treatment, it is likely that an affected cat can recover with little to no side effects.

How long can a diabetic cat survive without insulin?

It is safer to go without insulin, even for 36-48 hours, than to risk giving too much insulin and possibly causing hypoglycemia (low blood sugar/glucose).

What are the key nursing responsibilities when treating DKA?

Nursing Management

• Monitor vitals.
• Check blood sugars and treat with insulin as ordered.
• Start two large-bore IVs.
• Administer fluids as recommended.
• Check electrolytes as potassium levels will drop with insulin treatment.
• Check renal function.
• Assess mental status.
• Look for signs of infection (a common cause of DKA)

Why is there no insulin bolus in pediatric DKA?

While bolus insulin is common in the treatment of DKA in adults, it is relatively contraindicated in the pediatric patient. Dehydration and secondary sympathetic activation can interfere with local tissue perfusion and may cause irregular and unpredictable absorption.

How to manage adult diabetic ketoacidosis (DKA)?

Management of adult diabetic ketoacidosis 1 Fluid therapy. 2 Insulin therapy. 3 Potassium, bicarbonate, and phosphate therapy. 4 Treatment of DKA in dialysis patients. 5 Metabolic treatment targets. 6 (more items)

Which long-acting insulin is used in diabetic ketoacidosis (DKA)?

Upon DKA resolution, given the possibility of fluctuating oral intake, use of once-daily long-acting insulin glargine or detemir to provide basal insulin coverage is encouraged.

Which medications may precipitate diabetic ketoacidosis (DKA)?

Medications such as diuretics, beta-blockers, corticosteroids, antipsychotics, and/or anticonvulsants may affect carbohydrate metabolism and volume status and, therefore, could precipitate DKA.

What is the annual cost of diabetic ketoacidosis (DKA)?

Introduction In 2009, there were 140,000 hospitalizations for diabetic ketoacidosis (DKA) with an average length of stay of 3.4 days.1The direct and indirect annual cost of DKA hospitalizations is 2.4 billion US dollars.