Diabetes Mellitus

https://tse2.mm.bing.net/th?id=OIP.VIxVJDxgl4gZJH1w4R0KEAHaDz&pid=15.1&P=0&w=328&h=169Diabetes Mellitus

Having a pet diagnosed with diabetes can be an overwhelming experience. The diagnosis comes with a plethora of new terminology, as well as alterations to your pet’s lifestyle and schedule.

Fortunately, when committed owners work closely with their pet’s veterinarian, this is a treatable disease. Below are some commonly asked questions about diabetes in pets.

What is diabetes mellitus?

Diabetes is a disease which occurs secondary to absolute or relative insulin deficiency. This means that either the body is not making enough insulin, and/or it is not responding correctly to the insulin in circulation.

 

The first situation is called type I diabetes and is more common in dogs. The second is called type II, and is more common in cats.

http://www.plantationpethealthcenter.com/wp-content/uploads/2016/07/Pancreas-Diabetes-1-2-dogs-cats-1024.jpg-horiz-copy-1024x370.png Insulin itself is a hormone produced by the pancreas. Primarily, it is responsible for allowing glucose (sugar) to leave the bloodstream and enter cells, where it can be used as an energy source.

Without insulin, glucose builds up in the circulation, a condition known as hyperglycemia. This leads to several effects. Excess sugar in the blood means that more sugar is lost in urine. This glucose in the urine pulls water after it, a process called osmotic diuresis. This causes dehydration and increased thirst.

Additionally, without access to sugar, the cells are essentially in starvation mode. This triggers the breakdown of muscle and fat for energy, causing weight loss.

Which pets are at risk for diabetes?

While diabetes can occur at any age, it is most common in middle aged dogs and middle aged to older cats. Female dogs are at higher risk than males.

http://i.dailymail.co.uk/i/pix/2007/08_02/fatdogR2008_468x379.jpg In dogs especially, diabetes is related to immune-mediated destruction of the pancreas. While the trigger for this condition is not completely understood, there is at least some genetic component.

Obesity is a risk factor for diabetes in both cats and dogs. An increase in body fat can lead to insulin dysregulation, and eventually insulin resistance.

Other diseases can also cause increased susceptibility to diabetes, especially chronic pancreatitis, hyperadrenocorticism (overactive adrenal glands), and hyperthyroidism (overactive thyroid glands). Chronic high dose glucocorticoids (steroids) can also increase the risk of diabetes.

What are the signs of diabetes in a pet?

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The earliest signs of diabetes are often increased thirst and increased urination. Owners may also note weight loss, even in the presence of an increased appetite. Cloudy eyes or vision loss from cataracts are common in diabetic dogs. Diabetic pets may also develop chronic or recurrent infections in almost any body system, especially the urinary tract and the skin. In advanced cases, diabetes can also lead to a decreased appetite and lethargy.

How is diabetes diagnosed?

Typically, diabetes is diagnosed by persistently high blood glucose levels, even while fasting. It also leads to glucose in the urine. Therefore, a veterinarian will typically run blood and urine tests (usually a serum chemistry and a urinalysis) in order to diagnose this condition. Additional tests may be necessary to rule out concurrent illnesses, such as a urine culture to check for a urinary tract infection.

Sometimes, other tests are needed, such as a serum fructosamine level. This test is used to measure long term trends in blood glucose levels. https://cdn.shopify.com/s/files/1/0582/0445/files/blood-sugar-levels-and-paleo_diagram_of_excessive_blood_glucose.jpg?14686865159083212781

How is diabetes treated?

 

Diabetes is typically managed with a combination of medical and dietary management. The mainstay of therapy is supplementation with exogenous insulin. This means that pets need regular injections of insulin, typically one to two times a day. It is very important that these injections be given at close to the same time every day, and that meals are on a predictable schedule. There are multiple types of insulin, and a veterinarian may need to try multiple ones on a pet to find the one which works best for him or her.

https://www.pets4homes.co.uk/images/articles/869/large/managing-the-diet-of-a-diabetic-dog-51caa4946e419.jpg

Most diabetic pets do best when fed a prescription diet. For cats, this is typically a high protein, low carbohydrate diet. Diets for diabetic dogs are usually high in fiber and complex carbohydrates.

It is vital that diabetic pets are not regularly fed treats or table scraps, as these can cause unpredictable blood sugar spikes.

Image result for overweight dogs exercising Regular exercise can also be helpful in managing diabetes. It is more important for this to be routine and reliable than for it to be high intensity. Rather than going on a five mile hike with a diabetic dog once a week, it is preferable to go on a shorter walk every day.

Image result for overweight cats exercising With a combination of dietary and medical management, many cats will achieve at least temporary diabetic remission. This means that they will not require insulin injections. While some cats will eventually relapse, achieving diabetic remission is a major goal for most owners of diabetic cats.

Dogs typically do not experience remission, but diet and exercise can allow lower insulin doses and better glycemic control.

What sort of monitoring is needed for diabetic pets?

Image result for glucose testing for pets at the vet Especially early on in the disease, most diabetic pets will need to be seen often by a veterinarian. Glucose curves are an important tool to guide treatment. This means that the pet spends the day at the hospital, and his or her blood sugar is checked several times throughout the day. Some vets will also supplement this with blood or urine glucose tests at home.

Even for well controlled diabetics, regular physicals and screening lab work are important. Ideally, diabetic pets should have a full physical performed at least two to four times a year.

What should owners watch for at home in diabetic pets?

Image result for lethargic dog and cat Pets that receive high doses of insulin can be at risk for hypoglycemia, or low blood sugar. This can cause wobbliness, tremors, weakness, seizures, and/or collapse. This is an emergency! If you are concerned that your pet is experiencing hypoglycemia, you may smear a small amount of corn syrup on their gums, while immediately bringing them to a veterinarian for assessment.

Diabetic pets should also be monitored for inappetence, vomiting, and lethargy. While these signs can be due to a variety of issues, they could be secondary to a life threatening condition known as diabetic ketoacidosis, which occurs secondary to chronically high blood sugar.

If a well-controlled diabetic pet develops an increased frequency of urination or begins urinating in inappropriate locations, he or she should be checked for a urinary tract infection.

Image result for cataracts in dogs Additionally, diabetic dogs should be monitored for difficulty navigating and/or cloudy eyes. Unfortunately, even well controlled diabetic dogs will often develop cataracts and subsequent blindness. If your diabetic dog develops cataracts, you may wish to talk to your vet about surgical options for treating them.

In conclusion, diabetes in cats and dogs is a multifactorial disease, and treatment involves both regular medication and alterations to diet and exercise. Managing diabetes in a pet takes patience, as well as the investment of time, emotion, and money. However, if well managed, many diabetic cats and dogs can live long and happy lives!

References

Bruyette, D. (n.d.). Diabetes Mellitus. Retrieved June 29, 2018, from https://www.merckvetmanual.com/endocrine-system/the-pancreas/diabetes-mellitus.

Rothrock, K., & Shell, L. (2018, March 2). Diabetes Mellitus. Retrieved June 29, 2018, from https://www.vin.com/Members/Associate/Associate.plx?from=GetDzInfo&DiseaseId=339.