Amybee and Pandora (GA)
Member Since 2021
Hello all
I just wanted to make everyone aware of the dangers of Hyperglycaemic Hyperosmolar Syndrome (HHS) as I have lost my beloved Pandora to this horrible complication.
I will summarise the key points below:
Severe dehydration is also usually present but not always. So if your cat doesn't seem overly dehydrated (skin pinch test, tacky gums), and they are still drinking a lot, this doesn't mean it is not HHS.
HHS cats need urgent hospitalisation with IV fluids (slower replacement rate than for DKA), administering fast acting insulin to get the blood glucose down and continuous veterinary nursing monitoring until they are stable.
Often HHS comes on after an infection. This was the case with Pandora following successful treatment with antibiotics.
I lost Pandora because even though she was severely hyperglycaemic and lethargic, I was reassured by her testing negative for ketones. Even the vet missed this (my usual vet AND the emergency vet I spoke to on the phone). I just thought her symptoms would resolve as the insulin eventually started to work and we just needed to find the right dose. She deteriorated in a matter of a few days and by the time I got her to the vet, it was too late to save her.
Here are some useful articles on the topic:
https://todaysveterinarynurse.com/endocrinology/diabetes-hyperglycemic-hyperosmolar-syndrome/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484192/
Moderators - please would you consider making this post a sticky, and including in information for new members? Maybe what happened to Pandora can save even just one other cat, and one other human the suffering of finding out about this too late.
I just wanted to make everyone aware of the dangers of Hyperglycaemic Hyperosmolar Syndrome (HHS) as I have lost my beloved Pandora to this horrible complication.
I will summarise the key points below:
- HHS is a serious complication of diabetes mellitus (DM).
- It resembles diabetic ketoacidosis (see elsewhere on this site for lots of information on this) - DKA.
- However cats with HHS are typically type 2 diabetics who may have some circulating insulin and therefore they DO NOT PRESENT with ketones in blood or urine.
- These cats tend to have severe hyperglycaemia (very high blood glucose) but negative to trace ketones.
- Other signs include severe lethargy / depression, hypothermia and anaemia and even coma.
- HHS cats often have a strong anti-regulatory reaction to insulin which means that on receiving insulin, they release hormones which increase their blood sugar, you would tend to see an initial response followed by very high blood glucose level which appear unresponsive to insulin so a flat or fairly flat curve.
Severe dehydration is also usually present but not always. So if your cat doesn't seem overly dehydrated (skin pinch test, tacky gums), and they are still drinking a lot, this doesn't mean it is not HHS.
HHS cats need urgent hospitalisation with IV fluids (slower replacement rate than for DKA), administering fast acting insulin to get the blood glucose down and continuous veterinary nursing monitoring until they are stable.
Often HHS comes on after an infection. This was the case with Pandora following successful treatment with antibiotics.
I lost Pandora because even though she was severely hyperglycaemic and lethargic, I was reassured by her testing negative for ketones. Even the vet missed this (my usual vet AND the emergency vet I spoke to on the phone). I just thought her symptoms would resolve as the insulin eventually started to work and we just needed to find the right dose. She deteriorated in a matter of a few days and by the time I got her to the vet, it was too late to save her.
Here are some useful articles on the topic:
https://todaysveterinarynurse.com/endocrinology/diabetes-hyperglycemic-hyperosmolar-syndrome/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9484192/
Moderators - please would you consider making this post a sticky, and including in information for new members? Maybe what happened to Pandora can save even just one other cat, and one other human the suffering of finding out about this too late.
