{"title":"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。","authors":"Annalisa Judy, Aaron Rendahl, Kelly Tart","doi":"10.1111/vec.70025","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Retrospective evaluation of medical records of cats diagnosed with DKA and HHS between 2000 and 2020.</p>\n </section>\n \n <section>\n \n <h3> Setting</h3>\n \n <p>University teaching hospital.</p>\n </section>\n \n <section>\n \n <h3> Animals</h3>\n \n <p>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).</p>\n </section>\n \n <section>\n \n <h3> Interventions</h3>\n \n <p>None.</p>\n </section>\n \n <section>\n \n <h3> Measurements and Main Results</h3>\n \n <p>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%; <i>p</i> = 0.85). In all cats, higher serum BUN (<i>p</i> = 0.014), creatinine (<i>p</i> = 0.0098), or BG (<i>p</i> = 0.015) and lower serum sodium concentration (<i>p</i> = 0.03) or body temperature (<i>p</i> = 0.0098) were associated with decreased odds of survival. Calculated total and effective osmolalities were not associated with survival in either group.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":17603,"journal":{"name":"Journal of veterinary emergency and critical care","volume":"35 4","pages":"415-424"},"PeriodicalIF":1.2000,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.70025","citationCount":"0","resultStr":"{\"title\":\"Retrospective Evaluation of Prognostic Variables and Overall Survival Associated With Nonketotic Hyperosmolar Hyperglycemia in Diabetic Cats: 29 Cases (2000–2020)\",\"authors\":\"Annalisa Judy, Aaron Rendahl, Kelly Tart\",\"doi\":\"10.1111/vec.70025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>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.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Retrospective evaluation of medical records of cats diagnosed with DKA and HHS between 2000 and 2020.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Setting</h3>\\n \\n <p>University teaching hospital.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Animals</h3>\\n \\n <p>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).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Interventions</h3>\\n \\n <p>None.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Measurements and Main Results</h3>\\n \\n <p>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%; <i>p</i> = 0.85). In all cats, higher serum BUN (<i>p</i> = 0.014), creatinine (<i>p</i> = 0.0098), or BG (<i>p</i> = 0.015) and lower serum sodium concentration (<i>p</i> = 0.03) or body temperature (<i>p</i> = 0.0098) were associated with decreased odds of survival. Calculated total and effective osmolalities were not associated with survival in either group.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>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.</p>\\n </section>\\n </div>\",\"PeriodicalId\":17603,\"journal\":{\"name\":\"Journal of veterinary emergency and critical care\",\"volume\":\"35 4\",\"pages\":\"415-424\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2025-08-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/vec.70025\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of veterinary emergency and critical care\",\"FirstCategoryId\":\"97\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/vec.70025\",\"RegionNum\":3,\"RegionCategory\":\"农林科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"VETERINARY SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of veterinary emergency and critical care","FirstCategoryId":"97","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/vec.70025","RegionNum":3,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
Retrospective Evaluation of Prognostic Variables and Overall Survival Associated With Nonketotic Hyperosmolar Hyperglycemia in Diabetic Cats: 29 Cases (2000–2020)
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.
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.
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