Diabetes in Pets

 Your pet has been diagnosed with diabetes, a disease that will necessitate conscientious treatment on your part for insulin administration, diet control and monitoring. Since your animal cannot control his blood sugar, you will play an important role in providing insulin and maintaining a good quality of life.

Normally, food is ingested and broken down into basic units, one of which is sugar (glucose). When sugar levels begin to rise in the blood, the body responds by secreting insulin from the pancreas. Insulin allows the blood sugar to go into the body's cells where it is needed. When an animal has diabetes, the pancreas is not able to secrete enough insulin. There is too much sugar in the blood and too little in the cells. This results in a dog/cat that drinks a lot, urinates a lot, and eats a lot but loses weight. Since the body thinks it's starving, it mobilizes fat which is broken down into ketones. This will eventually make the untreated diabetic animal very ill.

Treatment A"healthy" diabetic pet is one which is eating and still feeling well. Treatment consists of starting on insulin injections to control blood sugar levels. There are several different types of insulin. Because each individual responds differently, the type and amount of insulin to achieve control must be tailored to meet your pet's individual needs. You will need to give insulin as an injection under the skin 2 times (about 12 hours apart) daily to allow adequate control of blood glucose levels. We will instruct you in the proper method of injecting the insulin.

An "ill" diabetic pet is one that is vomiting, has diarrhea or has a poor appetite. These animals are often "ketotic", an imbalance in the body that must be corrected. As insulin treatment is started, this pet must be hospitalized for intravenous fluid treatment and medications to stabilize before managing at home with insulin therapy.

Insulin types include: animal derivatives such as pork and beef and human based insulin types. Insulin and insulin needles are readily available from most outside pharmacies or through our hospital. Your veterinarian can call this prescription in for your pet.

Oral drugs such as glipizide or glucophage, which are commonly used to treat human diabetes, are rarely effective in managing diabetes in dogs or cats and thus, are not commonly used.

Meals

Meals should be given at the same time when the insulin is given. This allows you to note your animal's appetite. It is important that your pet eats with a good appetite to receive its insulin injections and often, injections can be coordinated to occur at meal times. In that way, you know that your pet is eating well, and the pet, distracted while eating, pays little attention to the injection.

It is important to give the insulin only when she/he eats. If your pet is not eating and/or is acting ill, you should not give the insulin and contact your veterinarian as soon as possible. If insulin is given when your animal is not eating, its blood sugar becomes too low. This can cause weakness, staggering, lethargy, muscle tremors or seizures.

If you see these signs, give your pet a sugary substance such as Karo syrup or Nutrical for a quick absorption of sugar or simply feed him if he is willing to eat. Note that signs of hypoglycemia can occasionally spontaneously occur, especially in cats, and even well-regulated diabetic cats can suddenly show signs of low blood sugar. In cases of suspected hypoglycemia, contact your veterinarian immediately.

All cats and some dogs should have some dry food accessible all day to nibble on in addition to the 2 times a day meals given with insulin. High fiber foods such as Hill's Prescription w/d for dogs and cats or high protein foods such as Purina DM diets for cats are considered amongst the better diets for diabetics. These are prescription foods and available only through your veterinarian. But remember that the best food is what your pet will consistently and enthusiastically eat.

It is important for both the insulin and the feedings to be consistently given at regular times and for your pet to follow a mild exercise routine. Erratic feedings and insulin administration at variable intervals complicate control of the diabetic pet, and excessive exercise alters the body's insulin needs.

Regulation

After starting an animal on insulin, the amount may need to be increased or decreased, depending on your pet's response. If your pet is not spayed, it is recommended the procedure be done since the heat cycles will interfere with the control of diabetes. It is important to note that even well controlled diabetics will tend to have higher blood sugar levels than non-diabetic dogs and cats. If control is not obtained, your veterinarian may recommend doing further tests to rule out other concurrent diseases such as Cushing's or urinary tract infections.

Monitoring

Blood glucose curves- After first starting on insulin or changing insulin levels, your veterinarian may ask you to bring your dog/cat back to the hospital to be left for part of the day. Frequent checks of your pet's glucose levels are done throughout the day (every 2 hours) in order to evaluate its response to insulin. This procedure may need to be periodically repeated to ensure the type and amount of insulin prescribed is adequate, and even for an apparently well controlled diabetic, it should be done yearly at a minimum.

Fructosamine levels- In addition to serial blood glucose checks, another helpful blood test is fructosamine levels. This gives a reading indicates average blood sugar level over the prior few weeks. However, it does not substitute for a blood glucose curve since it doesn't reflect the high and low levels throughout the day. This is additional information to help control your pet's diabetes. However with some cats, especially those that are stressed or fractious in the hospital, it may not be feasible to do a glucose curve. In these cases your veterinarian may rely on fructosamine levels and the signs seen at home that indicate control (no excessive urination or water consumption or weight loss). Other tests

Because diabetics almost always have some sugar in their urine, they are very prone to urinary tract infections. For this reason, your veterinarian may need to check your pet's urine for infection. Symptoms of a urinary tract infection include: inappropriate urination, having "accidents" in the home, an unusually strong urine odor, or presence of blood in the urine. However, often, a pet may have an infection but not show these symptoms.

If your pet appears to be insulin resistant, there is concern for concurrent diseases such as hyperadrenocorticism (Cushing's) and most veterinarians may recommend doing tests to rule this out (we use dexamethasone suppression test/ACTH stimulation test).

Observations

Although these blood and urine tests are helpful, careful monitoring at home is important too. Thus, by monitoring your animal's appetite, water consumption, urine output, and maintenance of weight, these are indications of control of your pet's diabetic condition. For the purpose of monitoring cats' and small dogs' weights, it may be worthwhile buying a baby scale that measures not only pounds, but also ounces. Large dogs can be weighed on the hospital's scales at any time at no cost.

Your veterinarian relies on your observations as to whether your pet is drinking and urinating excessively or losing weight since this reflects the degree of control of the diabetes. Variations from an animal's normal habits should be reported.

If you have questions regarding this disease or its treatment, don't hesitate to contact your veterinarian.

The above is general veterinary information. Do not begin any course of treatment without consulting your regular veterinarian. All animals should be examined at least once every 12 months.

About the author:

Linda Mar Veterinary Hospital and its cat-only affiliate, Coastal Cat Clinic, are small animal practices located in Pacifica, California.

 Linda Mar Veterinary Hospital