Understanding the Relationship between Hyperglycaemia and Polyuria in Diabetes Mellitus

Increased urination and drinking

Polyuria

Long-term glycemic control

High blood sugar

Diabetes Mellitus

Increased glucocorticoids

Long-term glycemic control

Concentration of solutes in the urine

Progesterone

Growth hormone

Growth hormone

Stress

Glomerular filtration of more glucose than the kidneys can absorb

Adrenaline

Lack of insulin leading to breakdown of fat stores into glucose

GHRH

Excretion of excess glucose in the urine

Glucose

Assessing average blood glucose concentration over 2-3 weeks

Pain

$25-50$ ml per kilogram of body weight over a 24-hour period

Immediate refrigeration after collection

Monitor the number of times the dog urinates in a day

Evaluating fructosamine's ability to reduce tetrazolium salts

15-20 degrees

Collect the sample in a yellow vacutainer tube containing fluoride-oxalate

Increased appetite

Diabetes mellitus affects blood sugar levels

Cats and dogs

Cushing's Disease (PPID)

Arrange a clinical waste collection from the local council

Take measures to avoid water contamination and release of toxic pollutants

Insulin injections

Low glycemic index complex carbs and increased fiber

Analogies and visual aids

Limited insulin options for dogs

Affordability of treatment

It ensures proper management of the condition

Reducing the volume of wastes generated

"Universal, long-term improvement"

Improving waste segregation strategies and systems

Stress

Poorly-controlled blood glucose levels

Excessive thirst and urination with normal blood glucose levels

Cortisol

High blood glucose levels

Use of basic terminology to avoid overcomplication

'Commitment and support' for universal, long-term improvement

Diabetes mellitus

Insulin-like growth factor 1 (IGF-1)

Hyperglycemia

The main difference is in the underlying cause; diabetes mellitus is caused by insufficient or ineffective insulin, while diabetes insipidus is caused by impaired secretion of or response to the pituitary hormone vasopressin.

Hypoadrenocorticism is characterized by insufficient production of glucocorticoids from the adrenal cortex.

Growth hormone

A high fructosamine level indicates poor long-term glycemic control in diabetic dogs and cats.

The primary stimulus for the secretion of glucocorticoids is stress or the activation of the hypothalamic-pituitary-adrenal axis.

Consistent treatment is essential for maintaining stable blood glucose levels and avoiding complications associated with diabetes mellitus.

Medical waste should be disposed of properly according to local regulations and guidelines, to prevent environmental and health hazards.

Osmotic diuresis occurs when the amount of glucose in the urine exceeds the capacity of the kidney tubules to reabsorb it, drawing water into the urine by osmosis and increasing the volume of urine produced.

Serum fructosamine is a complex of glucose and protein formed when glucose binds to serum proteins. It is used to assess the average blood glucose concentration in dogs and cats over the previous 2-3 weeks, providing information on glycaemic control in diabetic animals.

Common causes include diabetes mellitus, chronic renal failure, hyperadrenocorticism (Cushing's disease), hypoadrenocorticism (Addison's disease), and neoplasia.

The typical water intake for a dog is 1-2ml per kilogram of body weight every hour, equating to roughly 25-50ml/kg over a 24-hour period. Owners can assess increased drinking by monitoring the number of water bowls used and observing signs of restlessness and increased urination.

Owners should collect a morning urine sample, preferably the first urination, using a free catch technique into a sterile container. The sample should be immediately refrigerated before analysis and brought to room temperature.

The correct technique involves cleansing the area, applying a tourniquet, inserting the needle at a 30-45 degree angle, and securely holding the vessel to prevent movement during blood collection.

Hyperglycemia in diabetes mellitus leads to polyuria as the excess glucose in the urine draws water into the urine by osmosis, increasing the volume of urine produced.

Increased serum fructosamine is linked to diabetes mellitus and indicates elevated blood glucose levels. It helps distinguish glycaemic control by reflecting average blood glucose concentration over the previous 2-3 weeks, unaffected by short-term increases in serum glucose such as those due to stress and excitement.

Promoting practices to reduce waste volume, developing waste segregation strategies, using safer alternatives, raising awareness of risks, and selecting safe management options.

Regulating blood glucose with insulin injections, dietary change, and home monitoring of blood sugar levels.

Restricted fat, increased complex carbs, low GI complex carbs, and minimal added sugars and salts.

Use analogies and visual aids, employ the chunk and check method, use basic terminology, and provide educational material.

Expectations, time commitment, excessive planning, constant monitoring, stressful responsibility, emotional stress, financial factors, and goals.

Time commitment, lifelong commitment, financial costs, decision on euthanasia, constant monitoring, and difficult conversations with owners.

To reduce waste volume and select safe and environmentally-friendly management options.

The inability to regulate and utilize glucose properly due to ineffective insulin production or insulin resistance.

Collect in a yellow vacutainer tube with fluoride-oxalate as a preservative to inhibit glycolysis. Invert the tube in a figure of 8 to ensure good mixing without causing hemolysis.

Polyuria, polydipsia, polyphagia, weight loss, cataracts, weakness, decreased appetite, hepatomegaly, lethargy, diabetic neuropathy, diabetic ketoacidosis, hyperosmolar hyperglycemic state.

Diabetes mellitus involves issues with insulin production or resistance, leading to high blood sugar. Diabetes insipidus is unrelated to insulin and causes extreme thirst and urination.

Type 1: inability to produce insulin; Type 2: cells become resistant to insulin's effects.

Cats, dogs, apes, pigs, sheep, ferrets.

Pituitary pars intermedia dysfunction (PPID) or Cushing's Disease.

Arrange clinical waste collection from the local council or vet clinic. Use yellow sharps box for sharps and arrange a sharps collection when full.

Avoid inadequate incineration, release of chemical substances, and water contamination. Increase attention and diligence in waste management.

Insulin - increased glucose concentrations, increased parasympathetic nerve activity; Glucagon - decreased glucose concentrations, increased sympathetic nerve activity; Adrenaline (epinephrine) - acetylcholine release from preganglionic nerve fibres; Growth hormone (GH) - hypoglycemia can trigger secretion, and the main regulator is GHRH; Progesterone - GnRH stimulates LH and FSH; Glucocorticoids (mainly cortisol) - secretion is stimulated by stress

Insulin - islets of Langerhans, Beta cells; Glucagon - islets of Langerhans, Alpha cells; Adrenaline (epinephrine) - adrenal medulla, chromaffin cells; Growth hormone (GH) - somatotrophs in anterior pituitary; Progesterone - gonadotroph in anterior pituitary gland; Glucocorticoids (mainly cortisol) - adrenal cortex, zona fasciculata

Insulin - binds to cell surface receptors, activates downstream signaling, causes glycogen synthesis, decrease in glycogenolysis, and decrease in gluconeogenesis; Glucagon - binds to cell surface receptors, activates downstream signaling, causes mobilization of glucose from the liver, increases glycogenolysis, and gluconeogenesis

Adrenaline binds to cell surface receptors or nuclear receptors, either activates downstream signaling or protein synthesis; Effects: increases blood glucose concentrations, mainly in the liver, promotes hepatic glycogenolysis, and gluconeogenesis

Stimulus: hypoglycemia can trigger secretion, and the main regulator is GHRH; GH stimulates liver by receptors on the cell membrane, releasing IGF-1, which binds to receptors on the cell membrane, triggering downstream signaling. This results in increased glucose production through gluconeogenesis and glycogenolysis from the liver and kidney.

Progesterone binds to cytosolic or nuclear receptors, activates protein synthesis of specific proteins; The primary effect of progesterone is to divert glucose utilization away from muscle and fat to other tissues and promote more storage of glycogen in the liver.

Stimulus: stress, higher brain centers, hypothalamus; Glucocorticoids are lipid soluble, diffuse through the plasma membrane, bind to cytosol receptors, and influence the transcription of specific genes.

The pancreas is located in the dorsal section of the epigastric and mesogastric abdominal segments, caudal to the liver. It is divided into the right lobe, left lobe, and body. The right lobe is thin and slender, and the left lobe is shorter, thicker, and wide. The right lobe extends caudally from the body of the pancreas along the body of the duodenum, while the left lobe extends left and caudally (caudosinistrally) from the body to the hilum of the spleen.

Reducing the volume of wastes generated = Promoting practices that aim to minimize the amount of waste produced in healthcare facilities Improving waste segregation = Developing systems and strategies to effectively separate different types of healthcare waste for proper disposal and recycling Using safer alternatives where feasible = Employing alternative methods such as autoclaving over incineration to ensure safer and environmentally-friendly waste management Raising awareness of health-care waste risks = Educating individuals about the potential dangers associated with healthcare waste and the importance of safe management options

Restricted fat = Including limited fat content in the dog's diet to manage diabetes mellitus More complex carbs and increased fiber = Incorporating carbohydrates with slow burn and higher fiber content in the dog's diet to regulate blood sugar levels Low GI complex carbs and minimal sugars/salts = Selecting carbohydrates with low glycemic index and minimizing added sugars and salts in the dog's diet Special food for dogs with diabetes = Providing specific dietary options tailored for dogs with diabetes mellitus

Huge commitment – lifelong condition = lifelong treatment = Recognizing the long-term commitment required for managing a dog's diabetes mellitus Excessive planning and constant monitoring = Understanding the need for rigorous planning and continuous supervision in treating a dog with diabetes mellitus Limited insulin licensed for dogs = Considering the limited availability of approved insulin preparations for dogs, posing a challenge in treatment Euthanasia as a consideration = Acknowledging that some owners may contemplate euthanasia due to the challenges associated with caring for a diabetic dog

Time commitment and costs of treatment = Balancing the time and financial commitments required for managing a dog's diabetes mellitus Constant monitoring and excessive planning = Dealing with the demanding task of continuous supervision and meticulous preparation in caring for a diabetic dog Euthanasia as a humane option = Confronting the ethical question of whether euthanasia is a compassionate choice for a diabetic dog Difficult conversations with owners = Navigating sensitive discussions with pet owners about various options for managing their dog's diabetes mellitus

Use analogies and visual aids = Employing visual representations and relatable comparisons to convey complex information effectively Chunk and check method = Breaking down information into manageable chunks and verifying understanding at each stage Basic terminology use = Utilizing simple language to avoid overwhelming clients with technical terms Supply educational material = Providing clients with additional resources or materials to aid their understanding of their animal's care

injection

two

fat

carbs

safer

twice

treats

lifelong

hour

dogs