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Hyperglycemic-hyperosmular syndrome in cats with diabetes
2032.jpg Picture: © Bayer Animal Health
The hyperglycemic-hyperosmolar syndrome (HHS), also known as nonketotic hyperosmolar diabetes, is one of the less known emergencies in cats with diabetes. Its prognosis is very poor. This retrospective study tries to determine the prevalence and find some predisposing factors/predictors for survival.

The case records of 17 cats with hyperglycemic- hyperosmolar syndrome presenting from 1995 to 2001 were evaluated. An additional 37 cats with diabetic ketoacidosis and 80 cats with diabetes mellitus served as comparison groups.

Signalment, history, physical examination findings, clinico-pathologic data, concurrent disease, and outcome were recorded.
Hyperglycemic, hyperosmolar syndrome was seen in older cats that were often long-standing diabetics receiving insulin for many months.

Client concerns included polydipsia, polyuria, and lethargy. Neurologic and respiratory signs occurred frequently. Evaluation at presentation revealed profound dehydration, lactic acidosis, and azotemia.

Serious concurrent diseases that likely contributed to the development of the HHS crisis were diagnosed in 88% (15/17) of the HHS cats. The most common concurrent diseases were renal failure, respiratory compromise, infection, congestive heart failure, neoplasia, and gastrointestinal tract disease.
Pancreatitis and hepatic disease did not occur frequently in this diabetic cat population.

Sixty-five percent of HHS cats did not survive the initial hospitalization, with most dying or being euthanized within 10 hours of presentation. The long-term survival rate was low (12%).

Conclusions: HHS is a serious life-threatening form of diabetic crisis and cats with HHS often have other severe systemic diseases. Cats with diabetes and concurrent disease, especially renal failure and congestive heart failure, are at increased risk of HHS and should be closely monitored for signs of crisis. The mortality rate for HHS cats is high.

Source: Koenig, Amie, Drobatz, Kenneth J., Beale, A. Brady & King, Lesley G. (2004): Hyperglycemic, hyperosmolar syndrome in feline diabetics: 17 cases (1995-2001). In: Journal of Veterinary Emergency and Critical Care 14 (1), 30-40.




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