• Jillian DiFazio and Daniel J Fletcher.
• Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853.
• J Vet Emerg Crit Care (San Antonio). 2016 Jan 1; 26 (1): 108-15.

ObjectiveTo determine whether early insulin administration (≤6 h after admission) results in more rapid resolution of diabetic ketosis (DK) and ketoacidosis (DKA), shorter duration of hospitalization, and higher incidence of complications, and whether more severe ketonuria is associated with longer time to resolution of DK/DKA.DesignRetrospective study (January 1, 2003-March 1, 2013).SettingUniversity teaching hospital.AnimalsSixty dogs and cats with DK or DKA receiving short-acting insulin therapy.InterventionsNone.Measurements And Main ResultsMedical records were reviewed and data recorded including signalment; previous history of diabetes; intake temperature, blood pressure, blood glucose, pH, base excess, and degree of ketonuria; time to short-acting insulin therapy and resolution of DK/DKA; length of hospitalization; and complications. Insulin was initiated ≤6 hours in the early group and >6 hours in the late group after hospital admission. Early group patients had more rapid resolution of DK/DKA after starting short-acting insulin therapy (36.4 ± 22.6 vs. 55.4 ± 26.6 h, P = 0.014). There was no difference in duration of hospitalization or complications. More severe ketonuria resulted in longer time to resolution of DK/DKA after initiation of short-acting insulin (severe: 50.9 ± 24.2; moderate: 29.6 ± 19; mild: 23.4 ± 21.9 h, P = 0.005, all individual pairwise comparisons P < 0.05).ConclusionsEarly insulin administration is associated with more rapid resolution of DK/DKA without an associated increase in complication rates. DK/DKA took longer to resolve with more severe ketonuria. Prospective studies are warranted to identify specific time targets for insulin administration in DK/DKA patients.© Veterinary Emergency and Critical Care Society 2015.

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