Diabetes mellitus

 

   SYNONYM

       “Madhu meh

       “The honey urine disease

  DEFINITION

⇨ This is a chronic disorder related to glucose metabolism due to insulin deficiency.

⇨ Mostly seen in female dog and male cat.

⇨ Rare in horse

⇨ And extremely rare in cattle & Buffalo.

  ETIOLOGY

⇨ There are two type

1)    ⇨ Primary diabetes

2)    ⇨ Secondary diabetes

 In primary diabetes type...

A)   ⇨ Insulin dependent diabetes mellitus IDDM :- Juvenile diabetes

B)   ⇨ Insulin independent diabetes mellitus IIDM:- Senile diabetes

⇨ In secondary diabetes. It’s occurred due to affected glands, overweight and other reasons they are…

A)   Loss of pancreatic Islet Cell :-

Because….

                                      I.        Pancreatic atrophy

                                    II.        Pancreatic fibrosis

                                   III.        Removal of pancreas

                                  IV.        Auto immune complications

B)   Change in kidney

Because….

                                      I.        High dose or long time use of corticosteroid

                                    II.        Cushing's syndrome

C)   Change in liver

Because…

                                      I.        Liver damage

                                    II.        Liver disease

                                   III.        Cirrhosis

                                  IV.        Hepatitis

   Pathogenesis

Insufficient Insulin

Reduce tissue uptake of glucose

人


                                ⇓                                                           

For intracellular hypoglycaemia.              For extracellular hyperglycemia

                                                                                

glucogenesis and gluconeogenesis         blood glucose level increase

 ⇓                                                                               

Break down of fats and high level of ketones.     glucosuria  hyperglycaemic coma

丫

Diabetic ketoacidosis


  Clinical signs

⇨ Mainly any clinical sign not seen at starting

⇨ Some clinical finding seen are….

·        ⇨ Animal having good appetite but further they loss body weight

·        ⇨ In blood test increase blood glucose level

·        ⇨ Polyuria :- Excessive urination

·        ⇨ Polydipsia:- Excess thirst

·        ⇨ Emaciation :- excessive thinning

·        ⇨ Smell of acetone in urine

·        ⇨ Large amount of sugar in urine

·        ⇨ Some sign of chronic pancreatic

·        ⇨ And In more complications the cataract and corneal opacity also seen

  Diagnosis

1)    Diagnosis of blood sugar level of fasting animal

2)    Diagnosis of urine sugar level


Urine Glucose:

⇨ Glucose is relatively small molecule and freely passes through the glomerulus into the  unfiltrate. In Renal proximal tubular cells glucose is reabsorbed by both active and facilitated glucose transport system.

Glycosuria can be expected when serum glucose concentration excess this levels.

⇨ Above 100 mg/dL in cow

⇨ Above 180 mg/dL in dog

⇨ Above 280 mg/DL in cat

Method of estimation

  1. Reagent test strip
  2. Benedict qualitative test

Procedure

⇨ Take 5 ml Benedict qualitative reagent and test tube

⇨ Add 8 drop (0.5 ml) of urine

⇨ Heat to boil for 2 minutes

⇨ Colon water bath or in running tap water

Result


⇨ Change Benedict test for reducing substance excreted in the urine the test is positive for reducing sugar like glucose, Fructose, maltose, lactose but not for sucrose and also positive for other substance like ascorbic acid, salicylate, antibiotics and L-dopa.  

Treatment

·         Go for insulin therapy :- it’s control the hyperglycemia

⇨ There is mainly 3 type of insulin

1.    Short acting insulin :-  Crystalline use in sick diabetic animal until they start feeding again

2.    Intermediate acting insulin :-  Isophane (NPH)  and Lente

3.    Long acting insulin :- Protaminezine(PZI) &  ultralente

       ⇨ Duration of action of insulin

a)    Crystalline :- 5-8 hrs

b)    NPH :- 28-30 hrs

c)    Lente :-28-32 hrs

d)    PZI :- 24 -36 hrs

e)    Ultralente :- more than 36 hrs

     ⇨ Doses of insulin therapy

·         It’s depending on body weight but it’s range is 5 to 50 units/day

·         Dose are depending on body glucose level and urine glucose level

·         Proper diet has to be regulate the dose

Complications of high dose of insulin therapy

·       ⇨  Mainly hypoglycemia occurred

·      ⇨ Symptoms of hypoglycemia are vomiting, increase temperature of extremities, sleepiness, headache.


Also give the ORAL HYPOGLYCEMIC drugs

⇨ They have two groups….

1.    ⇨ Sulfonylureas :- “tolbutamide” & “chlorpropamide”

2.    ⇨ Bigunaides :- “ phenformin”

⇨ This drugs use in maturity onset, non-ketosis prone diabetic patient. But not use in juvenile onset and ketoacidosis prone diabetic patient.


Management or care of diabetic patient

·        ⇨ Proper diet is very important

·        ⇨ Proper insulin therapy

·        ⇨ Proper dose of insulin

·        ⇨ Low carbohydrates diet

·        ⇨ Meat and milk should given to dog

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