Hyperglycemic Hyperosmolar Syndrome in a Lhasa Apso Dog

Hyperglycemic hyperosmolar syndrome is an infrequently described complication of canine diabetes mellitus, differing from diabetic ketoacidosis in certain aspects, including treatment. A nine-year-old Lhasa Apso was presented to the Madras Veterinary College Teaching Hospital with a history of polyuria and polydipsia for a period of one week, and sudden dullness and inappetence. Clinical examination revealed the presence of hyperglycemia (799 mg/dL). An arterial blood gas analysis revealed a primary respiratory alkalosis, hyponatremia and hypokalemia. The serum creatinine level was elevated. Based on the absence of acidosis and ketonuria, and the eventual development of obtundation, a diagnosis of hyperglycemic hyperosmolar syndrome was made. Chronic kidney disease was diagnosed by ultrasonography. Treatment was done with intravenous infusion of normal saline, soluble insulin as a constant rate infusion and potassium chloride. The animal died after four days of treatment. The prognosis is guarded to poor.