Peer-reviewed veterinary case report
Portable blood ketone meter better than urine test for diabetic
By Di Tommaso, M et al.·Published in Journal of veterinary internal medicine·2009·Department of Veterinary Clinical Sciences, Italy·View original on PubMed →
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Original publication title: Evaluation of a portable meter to measure ketonemia and comparison with ketonuria for the diagnosis of canine diabetic ketoacidosis.
- Species:
- dog
Plain-English summary
A group of 72 diabetic dogs was tested to see if measuring ketones in the blood (ketonemia) is better than testing for ketones in urine (ketonuria) for diagnosing diabetic ketoacidosis (DKA), a serious condition. The results showed that blood tests were much more accurate, with 100% sensitivity and specificity at certain levels, compared to urine tests, which had lower accuracy. This means that if your dog is diabetic and showing signs of DKA, a blood test for ketones is a more reliable way to confirm the diagnosis.
People also search for: dog diabetic ketoacidosis symptoms · blood test for dog ketones · urine test for dog diabetes
Abstract
BACKGROUND: The diagnosis of canine diabetic ketoacidosis (DKA) usually is based on measurement of urinary acetoacetate (ketonuria). In humans, this test is less sensitive and specific than blood 3-beta-hydroxybutyrate (ketonemia) evaluation. HYPOTHESIS: Ketonemia measurement using a portable meter is more accurate than ketonuria determination with a dipstick to diagnose canine DKA. ANIMALS: Seventy-two client-owned diabetic dogs with ketonemia, ketonuria, or both. METHODS: Prospective observational study. Based on blood bicarbonate concentration and anion gap, dogs were divided into 2 groups: patients with DKA (n= 25); patients with diabetic ketosis (n= 47). Sensitivity, specificity, and positive and negative likelihood ratio (LR) at different cut-off points were determined for both ketonemia and ketonuria. Receiver operating characteristic (ROC) analysis was used to assess the accuracy of each diagnostic test to diagnose DKA. RESULTS: With regard to ketonemia, cut-off values of 2.3 and 4.3 mmol/L revealed 100% sensitivity and 100% specificity, respectively, whereas cut-off values of 2.8 and 3.5 mmol/L showed a -LR of 0.05 and a + LR of 13.16, respectively. With regard to ketonuria, a cut-off value of 1+ revealed 92% sensitivity, 40% specificity, and -LR of 0.20, whereas a cut-off value of 3+ revealed 44% sensitivity, 94% specificity, and +LR of 6.89. The areas under the ROC curves for the ketonemia and ketonuria tests were significantly different (0.97 and 0.81, respectively, P= .003). CONCLUSIONS AND CLINICAL IMPORTANCE: Measurement of ketonemia is accurate and more effective than measurement of ketonuria to diagnose canine DKA.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/19645834/