Companion Animal Advanced Clinical Management WEEK 5
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Questions and Answers

Which insulin is NOT typically administered at home every 12 hours?

  • lente insulin
  • NPH insulin
  • PZI
  • regular crystalline insulin (correct)

    • When administered every 12 hours, which insulin has the greatest likelihood of causing hypoglycemia due to the next dose occurring before the prior dose's effects have ended?

  • glargine insulin (correct)
  • lente insulin
  • NPH insulin
  • regular crystalline insulin

    • Which statement about at-home treatment during a hypoglycemia-induced seizure is correct?

  • Hypoglycemic seizures are life-threatening and require immediate IV therapy.
  • Treat initially at-home with 1-to 2-sugar cubes, PO.
  • Treat initially at-home with sugar solution rubbed on gums. (correct)
  • Treat initially at-home with 10 mls of a sugar solution squirted into the mouth.

    • You are caring for a cat that has been taking another drug for a prior condition unrelated to its new diagnosis today of diabetes mellitus. Which concurrent drug would you be most concerned about in terms of complicating treatment of his new diagnosis?

    <p>prednisolone</p> Signup and view all the answers

    Which insulin preparation can be administered IV to affect a rapid response under emergency conditions (e.g., a DKA patient)?

    <p>regular crystalline insulin</p> Signup and view all the answers

    Which drug is a teratogen and has been associated with hypersensitivity reactions that can lead to dermatitis, vasculitis, and blood-cell dyscrasias?

    <p>methimazole</p> Signup and view all the answers

    Which drug inhibits the formation of functional T3 and T4?

    <p>methimazole</p> Signup and view all the answers

    Which drug COMMONLY causes adrenocortical cell death?

    <p>mitotane</p> Signup and view all the answers

    The primary goal of diabetes mellitus therapy is:

    <p>Eliminating client-observed clinical signs.</p> Signup and view all the answers

    In the pre-work reading from Nelson-Couto, which drug is recommended as a first-choice diabetes mellitus drug in dogs?

    <p>lente insulin</p> Signup and view all the answers

    What is the treatment of choice for large pituitary tumors?

    <p>RT</p> Signup and view all the answers

    What medication should be dispensed to patients taking mitotane in case they develop severe adverse effects?

    <p>prednisone</p> Signup and view all the answers

    What frequency of dosing has been shown to BEST control clinical signs in dogs with hyperadrenocorticism? (trilostane)

    <p>q12hrs</p> Signup and view all the answers

    True or false: Mitotane can cause necrosis of the adrenal cortex but trilostane cannot.

    <p>False</p> Signup and view all the answers

    Which antifungal drug inhibits glucocorticoid and androgen synthesis and can be used to treat hyperadrenocorticism?

    <p>ketoconazole</p> Signup and view all the answers

    When do you tell the owner to stop administering mitotane during the induction phase?

    <p>When the patient starts showing signs of decreased appetite.</p> Signup and view all the answers

    True or false: Compounded trilostane is equivalent to the brand name trilostane product, Vetoryl, and can be used interchangeably to save the client money.

    <p>False</p> Signup and view all the answers

    What medication is most commonly used to treat hyperadrenocorticism in cats

    <p>trilostane</p> Signup and view all the answers

    If a dog with a functional adrenal tumor is not a surgical candidate, what is the treatment of choice?

    <p>trilostane</p> Signup and view all the answers

    A ferret is hospitalized for hypoglycemia, intermittent ataxia, lethargy and tremors. You suspect insulinoma as the top differential for this ferret. Which treatment is the preferred choice for ferrets with insulinomas?

    <p>Partial pancreatectomy</p> Signup and view all the answers

    In general, which describes the best nutritional recommendation for diabetic dogs?

    <p>The diet should optimize body condition and minimize postprandial hyperglycemia and this may vary based on the individual dog.</p> Signup and view all the answers

    What does a spot blood glucose of 356 in a diabetic dog indicate, regarding how well the diabetes is regulated?

    <p>This spot blood glucose does not tell you how well the diabetes is regulated.</p> Signup and view all the answers

    What is the most important manageable risk factor for diabetes mellitus in cats?

    <p>obesity</p> Signup and view all the answers

    What is the foundation of treatment for diabetic dogs?

    <p>Insulin therapy and dietary modification.</p> Signup and view all the answers

    How does exercise affect blood glucose?

    <p>Exercise helps with weight loss and obesity, leading to better glycemic control and lowers glucose.</p> Signup and view all the answers

    Which clinical sign is an indication of poorly controlled diabetes mellitus?

    <p>unplanned weight loss</p> Signup and view all the answers

    What does diabetic remission mean?

    <p>Blood glucose levels can be managed by diet alone without insulin that previously required treatment to control diabetic signs.</p> Signup and view all the answers

    What is the most important complication associated with insulin therapy?

    <p>hypoglycemia</p> Signup and view all the answers

    True or false: Regarding insulin dosing, it is always better to error on the side of giving too low of a dose rather than too high of a dose.

    <p>True</p> Signup and view all the answers

    Which nutritional recommendation describes the best option for diabetic cats?

    <p>Feed a diet that is high in protein and restricted in carbohydrates, ad lib or multiple small meals each day.</p> Signup and view all the answers

    Study Notes

    Insulin Administration

    • NPH insulin is NOT typically administered at home every 12 hours.
    • NPH insulin has the greatest likelihood of causing hypoglycemia due to the next dose occurring before the prior dose's effects have ended.

    Hypoglycemia-Induced Seizure

    • During a hypoglycemia-induced seizure, at-home treatment involves providing glucose orally or intravenously, without attempting to restrain the patient.

    Concurrent Medications

    • Concurrent administration of beta blockers with insulin can complicate treatment of diabetes mellitus.

    Insulin Preparations

    • Regular insulin can be administered IV to affect a rapid response under emergency conditions (e.g., a DKA patient).

    Teratogenic Drugs

    • Streptozotocin is a teratogen and has been associated with hypersensitivity reactions that can lead to dermatitis, vasculitis, and blood-cell dyscrasias.

    Thyroid Inhibitors

    • Methimazole inhibits the formation of functional T3 and T4.

    Adrenocortical Death

    • Mitotane commonly causes adrenocortical cell death.

    Diabetes Mellitus Therapy

    • The primary goal of diabetes mellitus therapy is to control blood glucose, alleviate clinical signs, and prevent complications.

    Canine Diabetes Mellitus

    • Insulin is the first-choice diabetes mellitus drug in dogs.

    Pituitary Tumors

    • The treatment of choice for large pituitary tumors is surgical removal.

    Mitotane Therapy

    • Hydrocortisone should be dispensed to patients taking mitotane in case they develop severe adverse effects.
    • The owner should be instructed to stop administering mitotane during the induction phase when the patient's clinical signs resolve or improve.

    Hyperadrenocorticism

    • Trilostane is used to treat hyperadrenocorticism.
    • Twice daily dosing of trilostane has been shown to best control clinical signs in dogs with hyperadrenocorticism.

    Antifungal Drugs

    • Ketoconazole inhibits glucocorticoid and androgen synthesis and can be used to treat hyperadrenocorticism.

    Feline Diabetes Mellitus

    • Glipizide is the most commonly used medication to treat hyperadrenocorticism in cats.

    Insulinoma

    • Streptozotocin is the preferred treatment choice for ferrets with insulinomas.

    Nutritional Recommendations

    • The best nutritional recommendation for diabetic dogs is to feed a high-fiber, low-fat diet.
    • The foundation of treatment for diabetic dogs is diet.
    • Exercise decreases blood glucose.

    Blood Glucose Monitoring

    • A spot blood glucose of 356 in a diabetic dog indicates poorly regulated diabetes.

    Diabetic Remission

    • Diabetic remission means the absence of clinical signs of diabetes mellitus, with normal blood glucose levels, without insulin therapy.

    Complications of Insulin Therapy

    • Hypoglycemia is the most important complication associated with insulin therapy.
    • It is better to err on the side of giving too low of an insulin dose rather than too high of a dose.

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