DIABETES MELLITUS IN YOUR PET

by Rita Ruple, D.V.M.
published in the Northeast Times - August 2008

Did you know that Diabetes Mellitus affects 1 in 400 pets?  Seems like a small percentage of the pet population, however it becomes more serious when it is your own pet affected. 

Diabetes Mellitus, commonly known as diabetes, literally translates to "sweet urine".  Diabetes is a syndrome characterized by abnormally high blood sugar resulting from insufficient levels of the hormone insulin or the inability to use insulin provided by the body.  Glucose, or blood sugar, is one of the most common components used for fuel in the body.  It is broken down by the hormone insulin so that the smaller parts can be absorbed and used by the body.  When glucose cannot be broken down because there is no insulin or the insulin cannot be used, it circulated freely in the blood and excess is eliminated from the body through urine.

  As briefly mentioned above, there are two types of diabetes -- type 1 and 2.  In general, most dogs and a few cats experience thype 1 diabetes, in which the pancreas is no longer able to produce insulin or poduces too little to breatk down appropriate amounts of glucose.  A majority of cats experience type 2 diabetes, in which there is an insulin resistance or decreased sensitiity to insulin by cell receptors (in effect, the body tries to produce more insulin in  hopes it will eventually bind to the receptors and the pancreas is overwhelmed trying to produce so much insulin).   Type 2 diabetes is commonly associated with obese cats.  Diabetes can also be induced in a pet with certain drugs that inhibit insulin production.  These effects are often temporary but can be a very real risk, especially with long-term use of certain drugs (such as steroids). 

In dogs, diabetes commonly affects middle to older aged pets, or an oaverage age of 8-9 years of age.  It may happen in any breed, but is more common in smaller breeds such ad dachshunds, poodles, and schnauzers.  There also appears to be an increased risk in females than male dogs.  In cats, diabetes affects middle aged to older pets, with the average age being 5-7 years of age.  There is no specific increased risk for a particular breed or gender, however there is an increased risk in obese cats.

So, how do you know if your pet has diabetes?

At first, you may not be able to tell your pet has diabetes because a few signs can go on gradually for weeks unnoticed.  Some of the most common symptoms in cats and dogs include increased thirst, increased urination, increased appetite (in the begining) or refusal to eat (in later stages), weight loss, vomiting, diarrhea, depression, muscle wasting or weakness.  In advanced cases, dogs may develop cataracts and cates develop weakness or staggering of the rear legs (called diabetic neuropathy.)

If you suspect your pet is ill or notice subtle changes in their behavior like Fido goes outside more often to potty or Kitty likes to drink from the faucet or toilet a lot more, it may mean a trip to our veterinarian.  Together with history of your pet's problems and good physical exam, your veterinarian may recommend further diagnostics to determine if your pet may be diabetic.

If caught early, diabetes is a manageable disorder.  If left untreated, diabetes can lead to irreversible changes in your pet or death. 

The most common way to diagnose diabetes is a complete blood and urine analysis.  In cats, blood glucose levels can temporarily increase with stress, so if your kitty is unhappy at the veterinary hospital, repeated glood glucose levels may be needed to diagnose diabetes.  Elevated blood glucose along with glucose in the urine is highly suggestive of diabetes. 

Blood work and urine also helps our veterinarian tell if your pet is an "uncomplicated" or "complicated" diabetic -- simply stated, if youir pet has additional disorders other than diabetes that could complicate treatment.  Additional specialized blood tests may be recommended if complications are suspected based on preliminary blood and urine results.  Some complications include urinary tract infections (very common), pancreatitis (inflammation of the pancreas), bacterial infections, viral infections, dental disease, kidney disease, liver disease, gastrointestinal disease, cancer, hyperadrenocorticism (too much thyroid production), and  hypothroidism (too little thyroid production) to name a few.

If diabetes is left untreated or if a diabetic patient has a complicating factor like one listed above, they can go into a state of diabetic ketoacidosis, or DKA.  This means your pet's body is so sick that it begins to break down muscles and proteins for body fuel, which results in the production of harmful byproducts called ketones.  This creates an acidic environment, or negative energy balance in our pet and they become very ill.  This state is an emergency and your pet can die without hospital care.  Ketones can be detected with special blood and urine tests.

Treatment of diabetes may be as simple as modifying your pet's diet or may require multiple changes and medications to maintain a "healthy" diabetic patient. 

Diet is one of the most important changes.  Diets are chosen based on type of diabetes, the type of animal, the weight of the animal and the presence of complicating factors.  Many diabetic patients are overweight to obese and weight loss can help them regulate better and may reduce the amount of medication needed to maintain a healthy state.

In dogs, diets high in fiber and low calories allow the pet to feel "full" while providing fewer calories to promote weight loss. Cats, due to their different metabolism and type of diabetes, tend to do well when placed on diets low in carbohydrates and high in protein. 

In addition to diet, insulin injections may be needed to reduce glood glucose levels.  There are many types of insulin available and your veterinarian will determine which type is best to treat youir diabetic pet.  Insulin is administered with a small syringe under the skin twice daily, usually after meals.  It is relatively easy to give to your pet and many pets do not mind the injections due to the small needle size and small amounts of insulin given.

Once your pet is started on insulin, monitoring your pet becomes very important.  After 5-7 days, your veterinarian will recommend a glucose curve to make sure your pet is on an appropriate amount of insulin.  glucose curves entail taking blood glucose readings every 2 hours to evaluate levels of glucose and how they respond to insulin through the day.  Too little insulin does not effectively reduce the glucose levels and your pet may still show signs of diabetes.  Too much insulin can be harmful to your pet causing weakness, lethargy, depression, seizures, coma and even death in cases of large overdose.

More than one glucose curve may be needed to regulate your pet initially.  As your pet becomes accustomed to regular insulin doses, less may be needed as they begin to regulate their own body stores or lose weight from the diet.  Unique to cats, diabetes can go into remission with modified diet and they may no longer need insulin therapy. 

Long term glucose monitoring can be done by the owner with periodic visits to your veterinarian for testing once your pet's glucose levels are maintained in an ideal range.  Owners can be taught to use commercial blood glucose monitors on their own pets and keep a log of spot blood glucose checks at home.  

If your diabetic pet should become ill at anytime, they should be seen immediately by your veterinarian. 

While it is a complicated condition, diabetes can be managed and your pet can have a good quality of life.