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Clin Path Quiz 13/14
Lecture 14: Pancreas Endocrine
| Question | Answer |
|---|---|
| pancreas endocrine function | produce hormones and deposit them directly into the bloodstream; consists of pancreatic islets |
| specific cells that produce specific hormones | ALPHA -> glucagon, BETA -> insulin, delta, C-cells |
| beta cells produce | insulin; used to transport glucose into most cells, lowers BG levels, glucose stored as glycogen in the liver, fat is adipose tissue and protein in other tissues |
| alpha cells produce | glucagon; stimulated glucogenesis, increases BG levels, inhibited by high glucose levels |
| both alpha and beta cells are controlled by | blood glucose levels |
| control of blood glucose in the body | pancreas (hormonal), kidneys (filtration), liver (location of storage of excess glucose as glycogen) |
| blood glucose and the kidneys | glucose is filtered by the kidneys but it is normally reabsorbed, if BG is too high, the kidneys cannot keep up and reabsorb all of it; excess glucose leaves in the urine, causes GLUCOSURIA |
| diabetes mellitus (DM) | insulin deficiency; there are two types |
| type 1 diabetes mellitus | juvenile onset (insulin dependent); due to the destruction of beta cells, most common form in DOGS, rare in CATS |
| type 2 diabetes mellitus | adult onset (non-insulin dependent, insulin resistant); induced by drugs or obesity; insulin is produced but not sufficient for body use, most common in CATS, uncommon in DOGS |
| clinical signs of DM | PU/PD (polyuria/polydipsia), polyphagia, weight loss, cataracts (dogs), re-occurring infections, weakness or diabetic neuropathy |
| diabetic neuropathy | plantigrade stance -> more common in CATS |
| endocrine pancreatic tests | BLOOD GLUCOSE, FRUCTOSAMINE, serum cholesterol, urinalysis |
| blood glucose (BG) | indication of carbohydrate metabolism in the body and pancreatic endocrine function; net balance of glucose production and glucose utilization; indicates the balance between INSULIN and GLUCAGON levels in the body |
| hyperglycemia/hypoglycemia | elevated blood glucose/decreased blood glucose |
| testing blood glucose | routine test on in house chemistry (serum or plasma); GLUCOMETER used to test |
| glucometer | table side test that can be used in practice or at home by owner to monitor BG; AlphaTRAK, requires 1 drop of blood |
| normal canine BG range | 68-104 mg/dL |
| normal feline BG range | 71-182 mg/dL |
| hyperglycemia | increase in BG above the normal range, fasting BG diagnostic for DM; DOG -> >200 mg/dL, CAT -> 350 mg/dL |
| interpret hyperglycemia | DIABETES MELLITUS, stress (physiologic stress from travel to the vet or restrain for blood draw, more common in CATS), glucorticoid (steroid production or administration) |
| glucosuria | glucose in urine due to blood glucose exceeding the renal threshold (DOG: 180-220 mg/dL, CAT 200-280 mg/dL), tested on routine urinalysis tests; tests also check for presence of ketones |
| ketoacidosis | when glucose is not available to the tissues in the body, the cells will metabolize fat for energy and produce ketone bodies, this causes a METABOLIC ACIDOSIS |
| diabetic ketoacidosis | in small animal medicine, unregulated DM is the most common cause (insulin deficiency) and can be life threatening due to effects on the body, including DEHYDRATION, electrolyte abnormalities, and acid-base abnormalities |
| keotsis | common disease of lactating dairy cows where the cow's body have trouble keeping up with the high energy demand of milk production; leads to a 'negative energy balance'; similar condition in sheep and goats -> pregnancy toxemia |
| ketosis signs | lethargy, anorexia, occasional neurologic signs |
| ketosis diagnosis | ketonuria or BHB |
| ketosis treatment | dextrose |
| interpreting hypoglycemia (LIFE THREATENING) | decrease in BG below the normal range |
| causes of hypoglycemia | starvation (extremely rare cause in adult DOGS and CATS), iatrogenic , idiopathic, liver failure, decreased absorption (GI), hyperadrenocorticism, insulinoma |
| iatrogenic | administering too much insulin or administering insulin without a meal |
| idiopathic | delayed serum or plasma separation due to consumption of glucose by RBCs |
| insulinoma | rare tumor of beta cells in the pancreas; cells are not longer responsive to negative feedback loop and produce insulin, despite low BG |
| insulinoma in ferrets | more common in ferrets than other companion animals AND most common neoplasm in ferrets |
| clinical signs of insulinoma in ferrets | lethargy, weight loss, weakness, seizures, death |
| diagnosis of insulinoma in ferrets | fasting BG <60 mg/dL along with clinical sings (monitored 3-4 hr fast) |
| fructosamine | when glucose is persistently elevated in the blood, it will bind with serum proteins (albumin) to produce fructosamine; increased fructosamine levels indicate a PERSISTENT HYPERGLYCEMIA |
| practical applications of fructosamine | to rule in DM if BG is borderline, evaluate diabetic animal to determine effectiveness of therapy, rule out 'stress' hyperglycemia |
| glycosated hemoglobin | irreversible reaction of hemoglobin bound to glucose, indicates a persistent hyperglycemia; NOT performed routinely in vet patients |
| glucose tolerance test | direct challenges to the pancreas with a glucose load; fast animal for 24 hrs, baseline blood sample, load glucose IV or PO, serial blood samples to measure blood 15 min, 30 min, 45 min, 60 min, 90 min; normal BG within 2 hrs rules OUT DM |
Created by:
mkroon26
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