DiagnosisVeterinary care should include diagnostic tests to determine level of blood sugar, the presence of ketones, and electrolyte concentrations to help guide subsequent treatment recommendations.
Some of these tests include:
Complete medical history and thorough physical examination.
Serum biochemical profile to determine the blood glucose concentration and to exclude other potential causes of the same symptoms such as pancreatitis. Elevated blood glucose is the hallmark of DM. In addition, these tests will allow some assessment of kidney and liver function and of the acidity (pH) of the blood.
Analysis of the urine to check for glucose and ketones and for signs of urinary tract infection. Elevated glucose and ketones are hallmark signs of DKA.
Urine culture may confirm the presence of a urinary bladder infection, prove what type of bacteria is causing the infection and tell the veterinarian which antibiotics should be effective in treating it (and which ones will not).
Complete blood count (CBC) can discover anemia (too few oxygen-carrying red blood cells), abnormal platelet numbers (too few or too many blood clotting cells) and abnormal white blood cell counts (too few or too many infection-fighting cells). Infections are a common complication of DM and can be a contributing factor in development of DKA.
Additional tests may be recommended on an individual basis. These tests include:
Abdominal radiographs (X-rays) may be requested to rule out changes in size of organs like the liver or kidneys or to look for evidence of abdominal tumors. Kidney disease, intestinal disease, disease of the adrenal gland or certain abdominal tumors may be present and have signs very similar to DM.
Abdominal ultrasonography uses sound waves to evaluate the contents of the abdominal cavity. A specialist often performs the test in which the fur is shaved and a probe is held against the abdomen (this is the same test given to many pregnant women to visualize the fetus). This test can reveal many of the same things as abdominal radiographs, but provides a more detailed examination along with views of the inside of organs rather than just the shadow of the organ.
Specific endocrine tests including an ACTH stimulation test, low and/or high dose dexamethasone suppression test, or urine cortisol/creatinine ratios may be requested if hyperadrenocorticism is suspected (generally in older dogs). Hyperadrenocorticism complicates both the diagnosis and treatment of DM.
