K

K



Ketonuria



DEFINITION


Ketones (acetoacetate, β-hydroxybutyr-ate, acetone) in urine



TYPICAL NORMAL RANGE


Reported as negative or slight (1+), moderate (2+), marked (+3)



PHYSIOLOGY


Urine is normally negative for ketones. Their presence in urine is the result of increased fat/lipid metabolism and decreased utilization of carbohydrates as an energy source. The standard laboratory (dipstick) test only detects acetoacetate and acetone.



CLINICAL APPLICATIONS


CAUSES OF ABNORMALLY HIGH LEVELS: Diabetes mellitus, hypoglycemia, starvation


NEXT DIAGNOSTIC STEP TO CONSIDER IF LEVELS HIGH: Assess nutritional condition, evaluate for diabetes mellitus (serum glucose, ± fructosamine concentration), evaluate for disorders of glucose metabolism (especially in young patients).


DRUG EFFECTS ON LEVELS: False increases: streptozotocin, aspirin


LAB ARTIFACTS THAT MAY INTERFERE: Standard test does not detect β-hydroxybutyrate, considered the ketone excreted in the earliest stages of diabetes mellitus. Acetate tablet method (Bayer) is considered a more sensitive method and is recommended if ketonuria is suspected.

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Jul 24, 2016 | Posted by in SMALL ANIMAL | Comments Off on K

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