Tag: diabetes

Diabetes in Dogs and Cats, Part 3: Treating Diabetes

For many pet parents, the thought of treating diabetes in their pet is overwhelming.   Up to 40% of cats and 60% of dogs will be euthanized within a year of diagnosis.  Treating a diabetic animal is challenging, but pets with diabetes can have an excellent quality of life with proper care.

Initial stabilization and treatment

The period of time immediately after a pet is diagnosed with diabetes may be particularly challenging.  Pets with complications of their diabetes, like ketoacidosis, or pets that also have other diseases may need to be hospitalized.  Most veterinarians put newly diagnosed pets on twice daily insulin injections.  With some types of insulin, once-daily injections may be possible.  Veterinarians adjust the dose based on blood glucose control.  Control is assessed using blood glucose curves.  This means that your veterinarian will assess blood samples at various times after your pet is fed and treated with insulin to determine how long the insulin is acting iand how well the dose controls the peak blood sugar.  Glucose curves may be done in the clinic or at home.

Just as it is in people, diet is a very important part of treating diabetes in pets.  Your veterinarian will most likely recommend a high-protein, low carbohydrate diet for a cat, or a high-fiber diet for a dog.  Exercise is also key.  Exercise helps your pet’s body use glucose more efficiently.  Increase your pet’s activity level gradually once diabetes is stabilized.

For the initial treatment phase, you will need syringes and insulin, and perhaps a blood glucose monitor and strips.  You may need to purchase a special diet for your pet.  Be prepared for frequent visits to your veterinarian during this time.  This period can be expensive, but there are options to decrease costs.  Pets with Diabetes is a good resource for parents of diabetic pets.

Treating diabetes in the long term

After your veterinarian stabilizes your pet and the dose is adjusted, you will need to continue to monitor your pet’s blood sugar frequently.  Some cats will experience diabetic remission.  This means that they will no longer require insulin.  Dogs will need to remain on insulin for life.  There are some non-insulin, oral therapies available for people with type 2 diabetes.  Unfortunately, no oral treatment has been approved for animals yet.

A number of other diseases may affect your dog’s response to insulin.  For this reason, it is necessary for your vet to monitor your dog’s health closely.   In  both cats and dogs, diabetes can lead to other health problems that pet parents should watch for.  Even welll-controlled diabetic dogs may develop cloudy eyes, or cataracts.  Cats may develop weakness in their legs, especially the hind legs. .Although it is commonly believed that a well-controlled diabetic dog or cat may have a normal life expectancy, there isn’t a lot of research on this topic.  It is certainly true that both cats and dogs with diabetes may live a full and happy life, just as people with this disease do.

If you dog or cat is diagnosed with diabetes, talk to your veterinarian and share your concerns openly. Your vet can help you find the support you need to provide the best possible treatment for  your pet.

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Diabetes in Dogs and Cats Part 2: Diagnosing diabetes

What does diabetes look like in a dog or cat?  Diagnosing diabetes in our pets is relatively straightforward.  Diagnosis is based on clinical signs and laboratory tests.

Clinical signs of diabetes

See your veterinarian if you notice the following clinical signs.

Increased drinking

Increased urination

Dehydration

Frequent urinary tract infections

As we learned in the first part of this series, diabetes causes excess blood sugar.  When there is so much sugar that the kidneys can’t reabsorb it, the sugar is excreted in the urine.  The sugar brings a lot of water from the body along with it.  This causes your pet to drink more to compensate for the loss of body water.  Your pet may even become dehydrated.  Sugar in the urine makes an excellent environment for bacteria to grow, and urinary tract infections are common in diabetic animals.

Excessive hunger

Losing weight in spite of good appetite

Decreased activity or even lethargy

Vomiting

Decreased appetite

Sweet-smelling breath

Because the cells of the body can’t utilize sugar for energy in a diabetic animal, the brain will continue to send hunger signals even after a full meal.  Your pet may eat more.  However, your pet may still lose weight as the body uses proteins and fats to produce energy.  The process of breaking down, or metabolizing, fats may lead to a build up of certain types of chemicals, ketones, in the body.  Veterinarians refer to this condition as “ketoacidosis.”  Ketones in the body may be excreted in the breath.  You may notice that your pet’s breath smells sweet or fruity.   Lack of fuel, breakdown of body fats and proteins, and ketoacidosis can lead to an obvious decrease in your pet’s activity level.  In some cases, you may even notice that your pet seems lethargic.  Ketoacidosis may also cause your pet to vomit, and your pet’s appetite may decrease.

Cataracts

Increased sugar in the blood also causes increased sugar in the fluids of the eye.  This sugar acts to cause clouding of the lens.  Your pet’s pupils will seem less transparent and even gray or white.  A majority of dogs with diabetes may develop cataracts within 4-6 months of diabetes diagnosis (Beam, 1999).  Cataracts are rare in cats with diabetes.

Frequent Skin Infections

The increased blood sugar and debilitated state of pets with diabetes can lead to increased infections.  Often, dogs with diabetes have other problems at the same time that may cause skin issues or a decreased immunity to infection.

Diabetic neuropathy

Cats with diabetes may develop a problem with the nerves in their lower legs, most often the rear legs.  The legs may be weak and the cat may walk in a crouched position instead of on the toes.

Diagnosing diabetes with laboratory tests

If your veterinarian suspects that your pet has diabetes, she will recommend laboratory tests to confirm the diagnosis.  These tests include bloodwork for sugar levels.  Bloodwork will also rule out ketoacidosis or other diseases.  Your veterinarian will also test your pet’s urine.  In order to be considered diabetic, your pet must have elevated sugar in both the blood and the urine.  Your veterinarian may ask for a urine culture to make sure your pet does not have a urinary tract infection.  Early diagnosis and treatment is critical for the diabetic pet, so make sure you see your veterinarian as soon as possible when you notice clinical signs.

In Part 3 of this series, we will look at treatment options for cats and dogs with diabetes.

Beam S. et al, A retrospective cohort study on the development of cataracts in dogs with diabetes mellitus: 200 cases, Veterinary Ophthalmology, 1999; 2:169-172

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Diabetes in Dogs and Cats Part 1

Diabetes in dogs and cats is an important health problem that often leads to early death.  Up to 30% of cats and 20% of dogs diagnosed with diabetes are euthanized within one year of diagnosis.  Of those, up to 10% of dogs and cats are euthanized immediately after diagnosis and are never treated.  That’s a high death toll for a treatable disease.  Insulin therapy is available for both cats and dogs.  In this series, we’ll take a closer look at pet diabetes.  How is diabetes in pets different from diabetes in people?  What treatment options are available?  What are factors that influence the decision to treat or not to treat?

Understanding diabetes

Diabetes mellitus is a metabolic disease in which the body cannot properly use sugars.  In a healthy person or pet, the pancreas produces a hormone called insulin. Insulin helps sugars in the blood enter cells, where it can be used to make energy to power the body.  If the pancreas does not make enough insulin, or if the cells are not responsive to insulin, sugars become elevated in the blood.  This is called hyperglycemia.  When there is too much sugar in the blood, the kidneys excrete it into the urine.  And when the kidneys excrete sugar into the urine, water follows.  This causes increased urination and increased drinking.

Because the cells don’t take up sugars, there isn’t enough energy for them to function normally.  The body uses proteins and fats for energy, and the body is said to be in a state of metabolic starvation.  For this reason, many people and animals will lose weight when they have diabetes, even though they may be eating more.

In people, diabetes is classified as Type I when the pancreas does not produce enough insulin.  When the cells of the body can’t use insulin properly, this is classified as Type II diabetes.  Diabetes in dogs and cats is sometimes classified similarly, although the distinction in pets is not as clear as it is in people.

Diabetes in Dogs

In dogs, diabetes tends to be similar to Type I diabetes in humans.  That is, the pancreas does not make enough insulin.  Generally, diabetes in dogs begins later in life.  Most dogs are diagnosed between the ages of 7 and 10 years.  Certain breeds may be at risk.  A 2000 cohort study of 43,003 dogs (221 with diabetes) found that Samoyeds, Miniature Schnauzers, Miniature Poodles, Pugs, and Toy Poodles had increased risk of developing diabetes (Hess, 2000).  A 2007 study of 182,087 insured dogs found that Australian Terriers, Samoyeds, Swedish Elkhounds and Swedish Lapphunds were at increased risk of developing diabetes (Fall, 2007).  In this study, hyperadrenocortical disease and female sex were other risk factors for diabetes.  The differences in breeds identified is probably due to the differences in the populations studied in different countries.

In dogs, obesity does not appear to be a significant risk factor for diabetes.  Even in Golden Retrievers, a breed known for a tendency to gain weight, obesity is not associated with diabetes (Davison, 2017).  Obesity contributes to other diseases in dogs, and parents should maintain a healthy weight in their pets.

Diabetes in Cats

Diabetes in cats is more like Type II diabetes in people.  This means that, at least early in their disease, the pancreas makes enough insulin. The problem is that the cells are insulin-resistant.  High blood sugar levels causes damage to the pancreatic cells that make insulin, leading to insulin deficiency.   In contrast to people, most cats are already insulin-dependent by the time of diagnosis.

Obesity is a risk factor for diabetes in cats.  This is one reason why it is not ok to allow a cat to eat excessively and gain too much weight.  Acromegaly, a disease in which excess growth hormone is produced, and inflammation of the pancreas, pancreatitis, are other risk factors (Rand, 2013).

Part 2 of this series will discuss diagnosis of diabetes in dogs and cats.  Future posts will consider treatment options and disease outcomes.

Davison et al, The canine POMC gene, obesity in labrador retrievers, and susceptibility to diabetes mellitus, JVIM, 2017; 31: 343-348.
Fall et al, Diabetes mellitus in a population of 180,000 insured dogs: incidence, survival, and breed disposition, JVIM, 2007; 21:1209-1216
Hess et al, Breed disposition of dogs with diabetes mellitus admitted to a tertiary care facility, JAVMA, 2000; 216: 1414-1417
Rand, JS, Pathogenesis of feline diabetes, Veterinary Clinics of North America Small Animal Practice, 2013; 43:221-231

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