Comparison of a novel continuous insulin infusion protocol to standard of care treatment for diabetic ketoacidotic dogs

Species: 
Dog
Area of Study: 
Internal Medicine

Purpose of Study: 

The usual treatment of diabetic ketoacidosis (DKA) is the administration of regular insulin intravenously based on a sliding scale relative to the animal’s blood glucose level, in addition to standard supportive care measures.

The purpose of this study is to administer regular insulin intravenously using a different (novel) scale, in addition to the standard supportive care measures. The goal is that this novel administration protocol, which more closely mimics the insulin regime used in human medicine, will result in faster resolution of the DKA state, thus resulting in shorter hospitalization times.

Client Responsibilities: 

If you agree to have your animal participate in this study, the participation will last for the entire duration of your animal’s hospitalization during this initial visit while we are resolving their DKA condition. There will be no further follow up or visits necessary for the study, although further monitoring of your animal’s diabetic condition will be necessary as normal standard of care for any diabetic patient.

During the study, you may expect the following procedures to be used:  All procedures outlined are part of standard treatment for DKA with the exception of the insulin administration protocol.

  • A sampling IV catheter will be placed in a vein in the back leg or the neck; this will allow us to collect all samples for your patient’s treatment and our study without any further venipuncture. At the start of the study 5 ml (1 tsp) of blood will be collected to assess the animal’s overall health and check for other diseases that may have predisposed your patient to developing DKA.
  • A sterile urine sample will also be collected from the bladder with a needle to check for infection in the urine.
  • A small amount of blood (less than a drop) will be collected every 2 hours to measure blood glucose level.
  • Every 6 hours 0.5 ml (1/10th of a teaspoon) of blood will be collected to monitor blood pH, electrolyte levels, and ketone levels until these values are normal.
  • Patients will all be treated supportively with standard care such as IV fluids, IV antibiotics, anti-nausea medication, electrolyte supplementation as needed, nutritional support as needed, etc.
  • After being on IV fluids for 6 hours, they will be started on the standard or novel insulin infusion protocol until their ketone level and blood pH normalize and they are able to be switched to a long-acting insulin formulation.
  • Further blood sampling may be necessary at the direction of the clinician on the case to monitor any other conditions present.
Client Benefits: 

You will not have costs from your animal’s participation in this study. All of the monitoring and data collection that occurs in this study is part of the normal care for a patient with DKA. The only difference is in the protocol used to give the insulin.  You will be responsible for any costs associated with the normal course of treatment, the treatment of any complications that may arise, and unrelated medical conditions.

You will not be compensated for your animal’s participation in this study

Contact: 

Dr Heinrich Ellen: 515-294-4900

Dr Bourgois-Mochel Agnes: 515-291-9866