Nonketotic hyperosmolar syndrome

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Nonketotic hyperosmolar syndrome, also known as hyperglycaemic, hyperosmolar non-ketotic (HHNK) syndrome,, or hyperglycemic hyperosmolar syndrome (HHS) is an uncommon complication of untreated diabetes mellitus.

  • It is an emergency.
  • It is characterized by extremely high blood glucose levels.
  • It results in hyperosmolality--dehydration on a cellular level.
  • There is minimal ketosis; that is little or no ketones show in the urine.
  • The brain is affected and coma may result.


Animals with this syndrome need:

  • IV rehydration, more so than with diabetic ketoacidosis.
  • Replacement theraphy for potassium and phospate losses.
  • A slow reduction in their blood glucose levels.

Unfortunately, the prognosis for recovery from the syndrome is poor.

[edit] Further Reading



  • Intervet information on HHNK in dogs.


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