Retrospective Evaluation of Prognostic Variables and Overall Survival Associated With Nonketotic Hyperosmolar Hyperglycemia in Diabetic Cats: 29 Cases (2000–2020)

IF 1.2 3区农林科学 Q3 VETERINARY SCIENCES

Journal of veterinary emergency and critical care Pub Date : 2025-08-29 DOI:10.1111/vec.70025

Annalisa Judy, Aaron Rendahl, Kelly Tart

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引用次数: 0

Abstract

Objective

To compare survival between cats diagnosed with a nonketotic hyperosmolar hyperglycemic state (HHS) and cats diagnosed with diabetic ketoacidosis (DKA), and to determine whether clinical parameters, clinicopathologic data, and insulin type are associated with survival. Secondary objectives were to evaluate whether these parameters were associated with survival in cats undergoing a generalized hyperglycemic diabetic crisis.

Design

Retrospective evaluation of medical records of cats diagnosed with DKA and HHS between 2000 and 2020.

Setting

University teaching hospital.

Animals

The HHS group consisted of 29 cats (blood glucose concentration [BG] ≥31.08 mmol/L [≥560 mg/dL]; calculated serum osmolality ≥350 mOsm/kg; ketone negative). The DKA group consisted of 71 cats (BG ≥7.77 mmol/L [≥140 mg/dL]; pH <7.35; ketone positive).

Interventions

None.

Measurements and Main Results

No clinicopathologic parameters or previous use of glargine U-100 were significantly associated with survival in the HHS group. There was no difference in survival of the HHS group versus the DKA group (65.5% vs. 68.6%; p = 0.85). In all cats, higher serum BUN (p = 0.014), creatinine (p = 0.0098), or BG (p = 0.015) and lower serum sodium concentration (p = 0.03) or body temperature (p = 0.0098) were associated with decreased odds of survival. Calculated total and effective osmolalities were not associated with survival in either group.

Conclusions

Cats with HHS had a survival of 65.5% in this study. No serum biochemical parameters predicted prognosis for the HHS group, and insulin type was not found to be associated with survival. Azotemia, hyponatremia, hyperglycemia, and hypothermia were associated with decreased survival when combining all cats. Hyperosmolality was not associated with survival; therefore, distinguishing HHS and DKA into separate syndromes may be arbitrary.

Abstract Image

查看原文本刊更多论文

29只糖尿病猫（2000-2020）与非酮症高渗性高血糖相关的预后变量和总生存率的回顾性评估。

目的：比较诊断为非酮症高渗性高血糖状态（HHS）的猫和诊断为糖尿病酮症酸中毒（DKA）的猫的生存率，并确定临床参数、临床病理数据和胰岛素类型是否与生存率相关。次要目的是评估这些参数是否与发生全身性高血糖糖尿病危象的猫的生存有关。设计：回顾性评估2000年至2020年间诊断为DKA和HHS的猫的医疗记录。单位：大学教学医院。动物：HHS组29只猫（血糖浓度[BG]≥31.08 mmol/L[≥560 mg/dL]，计算血清渗透压≥350 mOsm/kg，酮阴性）。DKA组共71只猫（血糖≥7.77 mmol/L[≥140 mg/dL]）； pH干预：无。测量和主要结果：在HHS组中，没有临床病理参数或既往使用甘精U-100与生存显著相关。HHS组与DKA组的生存率无差异（65.5% vs 68.6%; p = 0.85）。在所有猫中，较高的血清BUN （p = 0.014）、肌酐（p = 0.0098）或BG （p = 0.015）和较低的血清钠浓度（p = 0.03）或体温（p = 0.0098）与生存几率降低有关。计算的总渗透压和有效渗透压与两组患者的生存无关。结论：本研究中HHS猫的生存率为65.5%。血清生化指标不能预测HHS组的预后，胰岛素类型与生存率无相关性。氮血症、低钠血症、高血糖和体温过低与所有猫的生存率降低有关。高渗透压与生存无关；因此，将HHS和DKA区分为不同的证候可能是武断的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of veterinary emergency and critical care 农林科学-兽医学

CiteScore

2.50

自引率

15.40%

发文量

121

审稿时长

18-36 weeks

期刊介绍： The Journal of Veterinary Emergency and Critical Care’s primary aim is to advance the international clinical standard of care for emergency/critical care patients of all species. The journal’s content is relevant to specialist and non-specialist veterinarians practicing emergency/critical care medicine. The journal achieves it aims by publishing descriptions of unique presentation or management; retrospective and prospective evaluations of prognosis, novel diagnosis, or therapy; translational basic science studies with clinical relevance; in depth reviews of pertinent topics; topical news and letters; and regular themed issues. The journal is the official publication of the Veterinary Emergency and Critical Care Society, the American College of Veterinary Emergency and Critical Care, the European Veterinary Emergency and Critical Care Society, and the European College of Veterinary Emergency and Critical Care. It is a bimonthly publication with international impact and adheres to currently accepted ethical standards.