Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis
ABSTRACT A 7‐year‐old intact female mixed‐breed dog weighing 15 kg with a 4‐week history of polyuria, polydipsia, polyphagia, and weight loss was presented for severe anorexia and lethargy. Physical examination revealed severe dehydration, with a heart rate of 120 beats/min, respiratory rate of 24 b...
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Wiley
2025-07-01
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| Series: | Veterinary Medicine and Science |
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| Online Access: | https://doi.org/10.1002/vms3.70477 |
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| author | Youngjae Yoo Dohee Lee Yeon Chae Taesik Yun Byeong‐Teck Kang Hakhyun Kim |
| author_facet | Youngjae Yoo Dohee Lee Yeon Chae Taesik Yun Byeong‐Teck Kang Hakhyun Kim |
| author_sort | Youngjae Yoo |
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| description | ABSTRACT A 7‐year‐old intact female mixed‐breed dog weighing 15 kg with a 4‐week history of polyuria, polydipsia, polyphagia, and weight loss was presented for severe anorexia and lethargy. Physical examination revealed severe dehydration, with a heart rate of 120 beats/min, respiratory rate of 24 breaths/min, and rectal temperature of 37.5°C. Clinical assessment and laboratory tests confirmed diabetic ketoacidosis (DKA) characterised by severe hyperglycaemia, ketonemia, and metabolic acidosis with an increased anion gap. Electrocardiogram (ECG) findings were significant, showing regular sinus rhythm, negative QRS complexes in multiple leads, and an unusually shifted mean electrical axis at –101°, indicative of extreme axis deviation (EAD). This rare finding highlights the need to evaluate EAD as a potential complication in dogs with DKA, particularly among those presenting with severe metabolic disturbance. Serum cardiac troponin I levels were elevated (0.5 ng/mL; reference interval: 0.03–0.07 ng/mL). Emergency echocardiography revealed no abnormalities. Intravenous fluid therapy and a precisely calibrated continuous rate infusion of insulin were initiated, with treatment dynamically adjusted based on continuous blood glucose monitoring and the dog's response. After the resolution of DKA, the ECG returned to a normal cardiac axis and T wave amplitudes, indicating the reversibility of the myocardial and ECG abnormalities. The serum cardiac troponin I level also normalised, confirming the resolution of myocardial injury. This case report describes the first documented instance of EAD associated with DKA in a dog, as well as its potential reversibility, thereby emphasising the necessity for assessing this rare electrocardiographic abnormality in dogs with life‐threatening DKA. |
| format | Article |
| id | doaj-art-9d0015dee1f7445cb262f7d229db9e1c |
| institution | DOAJ |
| issn | 2053-1095 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Veterinary Medicine and Science |
| spelling | doaj-art-9d0015dee1f7445cb262f7d229db9e1c2025-08-20T02:50:09ZengWileyVeterinary Medicine and Science2053-10952025-07-01114n/an/a10.1002/vms3.70477Transient Extreme Axis Deviation in a Dog With Diabetic KetoacidosisYoungjae Yoo0Dohee Lee1Yeon Chae2Taesik Yun3Byeong‐Teck Kang4Hakhyun Kim5Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaLaboratory of Veterinary Internal Medicine, College of Veterinary Medicine Chungbuk National University Cheongju Chungbuk South KoreaABSTRACT A 7‐year‐old intact female mixed‐breed dog weighing 15 kg with a 4‐week history of polyuria, polydipsia, polyphagia, and weight loss was presented for severe anorexia and lethargy. Physical examination revealed severe dehydration, with a heart rate of 120 beats/min, respiratory rate of 24 breaths/min, and rectal temperature of 37.5°C. Clinical assessment and laboratory tests confirmed diabetic ketoacidosis (DKA) characterised by severe hyperglycaemia, ketonemia, and metabolic acidosis with an increased anion gap. Electrocardiogram (ECG) findings were significant, showing regular sinus rhythm, negative QRS complexes in multiple leads, and an unusually shifted mean electrical axis at –101°, indicative of extreme axis deviation (EAD). This rare finding highlights the need to evaluate EAD as a potential complication in dogs with DKA, particularly among those presenting with severe metabolic disturbance. Serum cardiac troponin I levels were elevated (0.5 ng/mL; reference interval: 0.03–0.07 ng/mL). Emergency echocardiography revealed no abnormalities. Intravenous fluid therapy and a precisely calibrated continuous rate infusion of insulin were initiated, with treatment dynamically adjusted based on continuous blood glucose monitoring and the dog's response. After the resolution of DKA, the ECG returned to a normal cardiac axis and T wave amplitudes, indicating the reversibility of the myocardial and ECG abnormalities. The serum cardiac troponin I level also normalised, confirming the resolution of myocardial injury. This case report describes the first documented instance of EAD associated with DKA in a dog, as well as its potential reversibility, thereby emphasising the necessity for assessing this rare electrocardiographic abnormality in dogs with life‐threatening DKA.https://doi.org/10.1002/vms3.70477Cardiac troponin Idiabetic ketoacidosisdogelectrocardiogrammyocardial injury |
| spellingShingle | Youngjae Yoo Dohee Lee Yeon Chae Taesik Yun Byeong‐Teck Kang Hakhyun Kim Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis Veterinary Medicine and Science Cardiac troponin I diabetic ketoacidosis dog electrocardiogram myocardial injury |
| title | Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis |
| title_full | Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis |
| title_fullStr | Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis |
| title_full_unstemmed | Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis |
| title_short | Transient Extreme Axis Deviation in a Dog With Diabetic Ketoacidosis |
| title_sort | transient extreme axis deviation in a dog with diabetic ketoacidosis |
| topic | Cardiac troponin I diabetic ketoacidosis dog electrocardiogram myocardial injury |
| url | https://doi.org/10.1002/vms3.70477 |
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