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Ketone Measurements (ketone + measurement)
Selected AbstractsKetone measurements using dipstick methodology in cats with diabetes mellitusJOURNAL OF SMALL ANIMAL PRACTICE, Issue 1 2009F. Zeugswetter Objectives: To compare the results of urine and plasma ketone dip test in a group of diabetic cats with possible ketosis or ketoacidosis, using laboratory plasma ,-hydroxybutyrate measurements as the gold standard. Methods: According to clinical examinations, plasma ,-hydroxybutyrate measurements and venous blood gas analysis, 54 cats with diabetes mellitus were classified as non-ketotic (n=3), ketotic (n=40) or ketoacidotic (n=11). Plasma and urine acetoacetate concentrations were determined using urine reagent strips. Results: Although there was a significant positive correlation between blood and urine ketone measurements (r=0·695, P<0·001), the results differed significantly (Z=,3·494, P<0·001). Using the differential positive rates, the best cut-off value to detect cats with ketoacidosis was 1·5 mmol/l for urine and 4 mmol/l for plasma. The sensitivity/specificity was 82/95 per cent for urine and 100/88 per cent for plasma, respectively. Clinical Significance: The urine and plasma ketone dip tests have a different diagnostic accuracy, and results have to be interpreted differently. Because of its high sensitivity, the plasma ketone dip test performs better than the urine ketone dip test to identify cats with impending or established ketoacidosis. [source] Near patient blood ketone measurements and their utility in predicting diabetic ketoacidosisDIABETIC MEDICINE, Issue 2 2005S. Harris Abstract Aim To assess the utility of near patient blood ketone measurements in predicting diabetic ketoacidosis (DKA) among a group of hyperglycaemic unwell patients presenting to a hospital emergency department. Methods Near patient blood ,-hydroxybutyrate (,-OHB) testing has recently been introduced as a new tool in our hospital Accident and Emergency department (A&E) for patients with a finger-prick glucose of > 11 mmol/l. We reviewed the records of the first 50 patients to have a ,-OHB measurement to establish if they developed DKA or received treatment with intravenous insulin within 48 h of presentation. We then compared the diagnostic power of ,-OHB measurements with other clinical, physiological and biochemical markers of DKA. Results Nine patients had DKA, eight had a compensated metabolic acidosis secondary to raised serum ketones, and 33 had no evidence of DKA during the following 48 h. The median (range) ,-OHB levels in each group were 6.0 (3.1,6.0) mmol/l, 3.4 (1.2,5.7) mmol/l, and 0.1 (0.0,1.2) mmol/l, respectively. A ,-OHB level of , 3.0 mmol/l had a sensitivity of 100% and specificity of 88% for DKA. All those with ,-OHB level > 3.0 mmol/l required treatment with intravenous insulin. Conclusion Measuring ,-OHB when a hyperglycaemic patient is identified could offer a simple method of identifying at an early stage those patients at highest risk of DKA (,-OHB > 3.0 mmol/l), and redirecting the search for a diagnosis in others (,-OHB < 1.0 mmol/l). [source] Ketone measurements using dipstick methodology in cats with diabetes mellitusJOURNAL OF SMALL ANIMAL PRACTICE, Issue 1 2009F. Zeugswetter Objectives: To compare the results of urine and plasma ketone dip test in a group of diabetic cats with possible ketosis or ketoacidosis, using laboratory plasma ,-hydroxybutyrate measurements as the gold standard. Methods: According to clinical examinations, plasma ,-hydroxybutyrate measurements and venous blood gas analysis, 54 cats with diabetes mellitus were classified as non-ketotic (n=3), ketotic (n=40) or ketoacidotic (n=11). Plasma and urine acetoacetate concentrations were determined using urine reagent strips. Results: Although there was a significant positive correlation between blood and urine ketone measurements (r=0·695, P<0·001), the results differed significantly (Z=,3·494, P<0·001). Using the differential positive rates, the best cut-off value to detect cats with ketoacidosis was 1·5 mmol/l for urine and 4 mmol/l for plasma. The sensitivity/specificity was 82/95 per cent for urine and 100/88 per cent for plasma, respectively. Clinical Significance: The urine and plasma ketone dip tests have a different diagnostic accuracy, and results have to be interpreted differently. Because of its high sensitivity, the plasma ketone dip test performs better than the urine ketone dip test to identify cats with impending or established ketoacidosis. [source] |