Page 2714 - Cote clinical veterinary advisor dogs and cats 4th

Diabetes Insipidus 1409

Diabetes Insipidus
VetBooks.ir History of PU/PD

Confirm PU/PD
• Quantify daily water consumption
• Morning USG

Abdominal ultrasound Urine culture Serum bile acids
CBC/biochemical profile/urinalysis (±T4, Rule out: Rule out: Rule out:
leptospiral serology) • Pyelonephritis • Pyelonephritis • Congenital liver
Rule out: • Pyometra • Other UTI disease (if young
• Diabetes mellitus • Hypoadrenocorticism • Hyperadrenocorticism dog/cat)
• Chronic kidney disease • Hypercalcemia • Liver disease
• Hyperthyroidism • Hypokalemia
• Liver disease • Renal glycosuria
• Hyperadrenocorticism • Pyometra
• Leptospirosis

ACTH stimulation test and/or LDDS Endogenous creatinine clearance or
Rule out: SDMA
• Hyperadrenocorticism (if suspected) Rule out:
• Nonazotemic renal failure
(if persistent isosthenuria)

Modified water deprivation test
Rule out:
• NDI
• CDI
• Psychogenic polydipsia

USG 1.030 with water USG 1.030 with water USG 1.030 with water USG 1.030 with water
deprivation: psychogenic deprivation; 50% deprivation; 50% increase deprivation; <15% increase after
polydipsia increase after ADH after ADH administration: ADH administration:
administration: partial CDI complete CDI NDI

ACTH, Adrenocorticotropic hormone; ADH, antidiuretic hormone; CBC, complete blood count; CDI, central diabetes insipidus;
LDDS, low-dose dexamethasone suppression test; NDI, nephrogenic diabetes insipidus; PU/PD, polyuria/polydipsia; SDMA,
symmetric dimethylarginine; USG, urine specific gravity; UTI, urinary tract infection. Clinical Algorithms
UPDATED AND EDITED BY: Leah A. Cohn, DVM, PhD, DACVIM
ORIGINALLY WRITTEN BY: Sarah L. Naidoo, DVM, MSc, DACVIM

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