Diabetic ketoacidosis (DKA) is a life-threatening complication of
diabetes mellitus (DM). The standard method of detection of
ketone bodies is the dipstick method, which detects semiquantitatively
acetoacetate, but not β-hydroxybutyrate (β-HB). The objectives of the current study were to assess the diagnostic utility of β-HB to diagnose
diabetic ketosis (DK) and DKA in cats and to establish a cut-off value for the diagnosis of DKA. Sixty-two cats were included in the study. Eleven cats were healthy (group 1); in the remainder of cats (51), a diagnosis of DM was based on
hyperglycemia, glucosuria, and increased
fructosamine concentrations. Nineteen of 51 cats suffered from nonketotic
diabetes mellitus (group 2). In 11 cats, plasma
ketone bodies were detected with the dipstick method (
diabetic ketosis, group 3). In 21 cats, plasma
ketone bodies and
metabolic acidosis were present (DKA, group 4). Plasma β-HB was measured in all cats by an enzymatic method (spectrophotometry). A cut-off value for the diagnosis of DKA was calculated based on the receiver operating characteristic curve. In healthy cats, the β-HB concentration ranged from 0 to 0.1 mmol/l; in cats of group 2, from 0 to 0.9 mmol/l (median: 0.1 mmol/l); in cats of group 3, from 0.6 to 6.8 mmol/l (median: 1.7 mmol/l); and in cats of group 4, from 3.8 to 12.2 mmol/l (median: 7.9 mmol/l). A cut-off value of 2.4 mmol/l revealed 100% sensitivity and 87% specificity to diagnose DKA.
Beta-hydroxybutyrate is a useful parameter for the diagnosis of
diabetic ketosis and DKA in cats.