title: Point-of-care β-hydroxybutyrate measurement for the diagnosis of feline diabetic ketoacidaemia.
abstract: OBJECTIVE
  To evaluate accuracy and precision of a hand-held ketone meter measuring β-hydroxybutyrate and to determine its diagnostic performance to rule out ketoacidaemia in diabetic cats.
  
  
  METHODS
  The ketone meter was validated by calculating within-day precision at different β-hydroxybutyrate concentrations and by comparison with a laboratory method. To determine its diagnostic performance to diagnose ketoacidaemia, 217 sets of data (venous blood gas analysis and β-hydroxybutyrate measurements) were retrospectively analysed. Sensitivities and specificities were calculated with the help of receiver-operating characteristic curves.
  
  
  RESULTS
  The ketone meter reliably detected β-hydroxybutyrate at concentrations >0·1 mmol/L and reproducibility was acceptable. Measurements highly correlated with laboratory results (r=0·97; P<0·001), but a significant negative bias was found at high concentrations. A β-hydroxybutyrate concentration of >2·55 mmol/L had a sensitivity of 94% and a specificity of 68% for diagnosing ketoacidaemia. Many cats with high β-hydroxybutyrate concentrations and normal blood pH had an elevated chloride gap suggestive of superimposed hypochloraemic metabolic alkalosis.
  
  
  CONCLUSIONS
  The commercially available point-of-care ketone meter Precision Xtra is a valid tool to measure β-hydroxybutyrate in diabetic cats. Concentration <2·55 mmol/L enable ketoacidaemia to be excluded and should lead to redirection of differential diagnoses.
authors.affiliation: Clinical Department for Small Animals and Horses, University of Veterinary Medicine, Veterinaerplatz 1, Vienna, Austria.
authors.forename: F K
authors.initials: FK
authors.lastname: Zeugswetter
authors.forename: L
authors.initials: L
authors.lastname: Rebuzzi
mesh_terms: D020155:3-Hydroxybutyric Acid / Q000097:blood*; D000818:Animals; D002371:Cat Diseases / Q000097:blood* / Q000175:diagnosis; D002415:Cats; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000175:diagnosis / Q000662:veterinary*; D003937:Diagnosis, Differential; D005260:Female; D008297:Male; D019095:Point-of-Care Systems; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D020155:3-Hydroxybutyric Acid