Nonketotic hyperosmolar syndrome

Nonketotic hyperosmolar syndrome, also known as hyperglycaemic, hyperosmolar non-ketotic (HHNK) syndrome,, or hyperglycemic hyperosmolar syndrome (HHS) is an uncommon complication of untreated diabetes mellitus.

It is an emergency.
It is characterized by extremely high blood glucose levels.
It results in hyperosmolality--dehydration on a cellular level.
There is minimal ketosis; that is little or no ketones show in the urine.
The brain is affected and coma may result.

Animals with this syndrome need:

IV rehydration, more so than with diabetic ketoacidosis.
Replacement therapy for potassium and phosphate losses.^[1]
A slow reduction in their blood glucose levels.

Unfortunately, the prognosis for recovery from the syndrome is poor.

References[]

↑ Wortinger, Ann (February 2001). Electrolytes, Fluids and the Acid-Base Balance. Veterinary Technician.

More Information[]

Information on HHNK in dogs Intervet
Wikipedia article on hyperosmotic diabetic coma
Fluid and electrolyte therapy in endocrine disorders: diabetes mellitus and hypoadrenocorticism Boysen SR., 2008, Veterinary Clinics of North America
Diabetic crises: Recognition and management (Proceedings) Macintyre, Douglass, April 2008, DVM 360
Endocrine emergencies (Proceedings) Durkan, Samuel, October 2008, DVM 360
Vetsulin-Treating Hyperosmolar Syndrome Intervet

[1] Wortinger, Ann (February 2001). Electrolytes, Fluids and the Acid-Base Balance. Veterinary Technician.

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