Nonketotic hyperosmolar syndrome

Nonketotic hyperosmolar syndrome, also known as hyperglycaemic, hyperosmolar non-ketotic (HHNK) syndrome,, or hyperglycemic hyperosmolar syndrome (HHS) is an uncommon complication of untreated diabetes mellitus. It is an emergency. It is characterized by extremely high blood glucose levels. It results in hyperosmolality--dehydration on a cellular level. There is minimal ketosis; that is little or no ketones show in the urine. The brain is affected and coma may result.

Animals with this syndrome need:

• IV rehydration, more so than with diabetic ketoacidosis.
• Replacement theraphy for potassium and phospate losses.
• A slow reduction in their blood glucose levels.

Unfortunately, the prognosis for recovery from the syndrome is poor.

Further Reading

• Intervet information on HHNK in cats.
• The story's of Inka's bout with nonketonic hyperosmolar syndrome
• Diabetic Crisis in Cats & Concurrent Disease-North American Veterinary Conference-2005

• Intervet information on HHNK in dogs.
• Dog ear infection
• Pancreatitis in dogs
• Ivermectin for dogs

• Wikipedia article on hyperosmotic diabetic coma