Efficacy of plasma ß-hydroxybutyrate concentration as a marker for diabetes mellitus in acutely sick cats

Abstract

Urine ketone measurement is routinely performed in cats with diabetes mellitus to identify impending or established ketoacidosis. Studies using the urinary ketone dipstick test have shown that ketonuria is common in cats with newly diagnosed untreated diabetes mellitus. This test has a low sensitivity as it quantifies the less abundant ketone acetoacetate. The objective of the present study was to determine if ketonaemia is an inherent biochemical finding in untreated feline diabetes mellitus by measuring plasma ss-hydroxybutyrate (ss-OHB) in acutely sick cats. In 122 sick cats (37 diabetic and 85 non-diabetic cats) plasma ss-OHB, glucose, fructosamine, total protein and thyroxine were measured as part of the routine work up. Diabetic cats had significantly elevated ss-OHB values and ss-OHB measurement was a sensitive and specific test to identify diabetes mellitus. The area under the receiver operating characteristic (ROC) curve was 0.93. The cut off value with the highest positive likelihood ratio was 0.58 mmol/l. These results suggest that determination of plasma ss-OHB concentration is a useful method to distinguish between diabetic and non-diabetic sick cats.

Accuracy of capillary blood 3-β-hydroxybutyrate determination for the detection and treatment of canine diabetic ketoacidosis

“…Proposed methods to detect the increase of ketone bodies include 3-HB measurement with laboratory methods [7], which is not practical in emergency settings, the determination of urinary or plasma AcAc with dip stick methods [3,31,32], and the detection of 3-HB using a hand-held ketone sensor [6,14,29]. The detection of urinary AcAc is the most commonly used method, but many studies have demonstrated that this test is associated with a considerable risk of false-positive and false-negative results [3,31,32]. Based on the severity of the disease, a false positive result is less dangerous because the disease can then be excluded by the blood gas analysis.…”

“…Hand-held ketone sensors [6,13,14,29] or reference laboratory methods [7,8,31,32] for analysis of venous blood samples were used in these studies, and the results suggested that 3-HB measurement was superior to urinary AcAc for diagnosis of canine and feline DKA [6,13,14,29,31,32]. Therefore, the present study was conducted to evaluate the accuracy of an electrochemical sensor (Optium Xceed; Abbott Laboratories, UK) for measurement of 3-HB from capillary and venous blood samples, and to assess the potential utility of the capillary 3-HB measurement to diagnose and monitor the treatment of canine DKA.…”

Effects of supplementation of chromium histidinate on glucose, lipid metabolism and oxidative stress in cats

“…In our study, β‐hydroxy‐butyrate plasma levels decreased significantly, but without group effect. Beta‐hydroxy‐butyrate plasma levels correlate well with the glucose plasma concentrations and fructosamine plasma concentrations in diabetic cats and are markers for glucose intolerance as well (Zeugswetter, Handl, Iben, & Schwendenwein, ). Mean β‐hydroxy‐butyrate plasma concentrations in our study did not exceed reference values.…”

Point‐of‐care β‐hydroxybutyrate measurement for the diagnosis of feline diabetic ketoacidaemia

“…Ten microlitres of a whole blood sample are applied on the sensor and the concentrations are displayed after 30 seconds. For validation of the ketone sensor β‐OHB values of 43 cats were measured three times in series and the mean was compared with a laboratory reference method (Ranbut; Randox Laboratories Limited; Zeugswetter and others 2010). Two representative samples with low, medium and high β‐OHB concentrations were measured 10 times in sequence within 15 minutes to assess within‐ day precision.…”