Open AccessAccuracy of Serum β‐Hydroxybutyrate Measurements for the Diagnosis of Diabetic Ketoacidosis in 116 Dogs
Author(s) -
Duarte Ricardo,
Simoes Denise M.N.,
Franchini Maria Luisa,
Marquezi Maurício L.,
Ikesaki Julia H.,
Kogika Marcia M.
Publication year - 2002
Publication title -
journal of veterinary internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.356
H-Index - 103
eISSN - 1939-1676
pISSN - 0891-6640
DOI - 10.1111/j.1939-1676.2002.tb01258.x
Subject(s) - medicine , diabetic ketoacidosis , ketonuria , ketosis , ketoacidosis , diabetes mellitus , ketone bodies , anion gap , endocrinology , receiver operating characteristic , gastroenterology , urine , reference range , venous blood , acidosis , type 1 diabetes , metabolism
The aim of this study was to evaluate the accuracy of serum β‐hydroxybutyrate (β‐OHB) measurements for the diagnosis of diabetic ketoacidosis (DKA) in dogs. One hundred sixteen diabetic dogs were prospectively enrolled in the study: 18 insulin‐treated (IT) diabetic dogs that had a positive urine ketone test and 88 untreated, newly diagnosed diabetic dogs. Venous blood gas tensions and pH, serum glucose and urea nitrogen (SUN), and electrolyte (Na+, Cl ‐ , and K+) and urine acetoacetate (AA) concentrations were measured concurrently with serum β‐OHB concentrations. On the basis of laboratory findings, the patients were assigned to 1 of 3 groups: diabetic ketoacidosis (n = 43); diabetic ketosis (DK, n = 41); and nonketotic diabetes (NDK, n = 31). Serum β‐OHB concentrations differed significantly ( P < .001) among the study groups. Although marked differences in β‐OHB concentrations were found, a considerable overlap exists between the distributions of dogs with DK and those with DKA. The overall accuracy of β‐OHB determination as a diagnostic test for DKA, determined by the area under the receiver operating characteristic (ROC) curve, was 0.92. In the 1.9‐ to 4.8‐mmol/L range, serum β‐OHB determination sensitivity varied from 100 to 35.7%, whereas specificity varied from 39 to 100%. The cutoff value of 3.8 mmol/L showed the best equilibrium between specificity (95%), sensitivity (72%), and likelihood ratio (14.8). We concluded that the quantitative measurement of serum β‐OHB may be a potential tool for diagnosing and monitoring ketosis and ketoacidosis in diabetic dogs.