title: Use of a constant rate infusion of insulin for the treatment of hyperglycemic, hypernatremic, hyperosmolar syndrome in an alpaca cria.
abstract: METHODS
  A 3-day-old 9.5-kg (21-lb) female alpaca cria was examined because of lethargy and anorexia.
  
  
  RESULTS
  Physical examination revealed hyperthermia, muscle fasciculations, and tremors of the head. Seizures were also observed, which indicated CNS dysfunction. Hyperosmolar syndrome (HOS) was diagnosed on the basis of hyperglycemia, hypernatremia, azotemia, high plasma osmolarity, and metabolic acidosis.
  
  
  RESULTS
  A constant rate infusion of regular insulin was administered with hypo-osmolar fluids to treat HOS, and blood glucose and sodium concentrations were successfully lowered. Neurologic deficits resolved with treatment, and the cria was discharged 11 days after admission.
  
  
  CONCLUSIONS
  Administration of insulin as a bolus in addition to hypo-osmolar fluids has been advocated in the management of neonatal camelids with HOS. Administration of regular insulin via a constant rate IV infusion was used to successfully manage a neonatal camelid with HOS. This form of insulin administration may allow more control of glucose kinetics in these patients.
authors.affiliation: Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA. tbuchheit@countrysidevetservices.com
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Buchheit
authors.forename: Carla S
authors.initials: CS
authors.lastname: Sommardahl
authors.forename: Nicholas
authors.initials: N
authors.lastname: Frank
authors.forename: Jerry R
authors.initials: JR
authors.lastname: Roberson
mesh_terms: D000818:Animals; D002161:Camelids, New World; D004334:Drug Administration Schedule; D005260:Female; D006943:Hyperglycemia / Q000188:drug therapy / Q000662:veterinary*; D006955:Hypernatremia / Q000188:drug therapy / Q000662:veterinary*; D007328:Insulin / Q000627:therapeutic use*; D009994:Osmolar Concentration; D013577:Syndrome
chemical_list: D007328:Insulin