Diabetes in Dogs

Diabetes mellitus is a disease resulting from the body’s inability to produce or use insulin. Insulin is a hormone released by the pancreas in response to protein digestion. Normally, proteins are converted to glucose which is then carried into the cells by insulin. When insulin is not produced or cannot be used, cells lose their main energy source and unused glucose builds up in the bloodstream (hyperglycemia). Untreated diabetes can lead to organ failure, blindness, coma and death. Diabetes mellitus occurs when the pancreas doesn't produce enough insulin. Insulin is required for the body to efficiently use sugars, fats and proteins. There are two types of diabetes, with the most common striking one of every 500 dogs. Veterinarians commonly diagnosis canine diabetes in patients that are middle-aged, female, and overweight.

Concerned pet parents who feel that their canine buddy is sick will consult the vet and ask, what are the symptoms of dog diabetes? The following behaviors are strong indicators that a pet may have the disease:

• Increased appetite
• Weight loss (with increased appetite)
• Excessive thirst
• Excessive urination
• Bladder or kidney infection

Signs that your dog has an advanced condition or is in the final stages of dog diabetes may be:

• Blindness
• Anorexia
• Lethargy
• Vomiting
• Cataracts
• Seizures
• Collapse

Types

Diabetes mellitus is grouped into two types based on disease pathology:

• Type I - The more severe of the two forms. The body is unable to produce insulin. Treatment is with daily injections of insulin. 99% of diabetes in dogs is Type I.
• Type II - In this form, the body produces insulin, however, the cells are unable to use the insulin. Type II can be treated with oral medications. Only 1% of dogs have Type II diabetes.

Approximately one in 500 dogs will develop diabetes. The exact cause is unknown, but certain dogs are at increased risk. For example, breed type can play a part. Pug diabetes is a common health concern. Age is often a factor. Diabetes in puppies is extremely rare; it is typically older canines who get the disease. When examining your dog for a diagnosis, the vet will take these factors into consideration:

• Obese dogs
• Female dogs (twice as likely to develop diabetes)
• Older dogs (7-9 years)
• Autoimmune disease
• Genetic predisposition (Cairn Terriers, Schnauzers, Dachshunds, Poodles, Pugs, Samoyeds)
• Drugs (glucocorticoids and progestogens)
• Pancreatitis
• Viral infection

If you note symptoms of diabetes in your pet, make an appointment with your veterinarian. Be sure to let her know when the symptoms started and any behavioral or physical changes your pet is demonstrating. A physical examination of the abdomen can detect an enlarged liver (often accompanying diabetes).

Laboratory Diagnostics

Blood diagnostics will test for high levels of glucose, indicating diabetes. High liver enzymes and electrolyte abnormalities may also be observed. A urinalysis that shows the simultaneous presence of glucose and ketones in the urine. Bladder or kidney infection often accompanies diabetes.

X-Ray and Ultrasound

Radiographs and ultrasound are good tools for visualizing the presence of kidney stones (seen in diabetic patients), pancreatitis or an enlarged liver and can rule out other causes of diabetes-like symptoms such as tumors or kidney disease.

Treatment of diabetes may be ongoing throughout the life of the pet. However, when diabetes is managed appropriately, the pet can lead a normal, full and enjoyable life. Dog diabetes treatment options will depend on the type of diabetes.

When your pet is diagnosed with diabetes, you will be instructed by your veterinarian on a home care routine. This routine will include timed daily insulin injections, timed feedings, a specific diet and exercise plan, and timed blood glucose monitoring sessions.  Your veterinarian is a crucial part of managing your dog's diabetes and is available to consult on the care concerns.

Insulin Injections

Oral medications are not available for Type I diabetes as they are for Type II. Insulin will be supplied by injection under the skin using a syringe or insulin pen (a pre-filled syringe). There are various types of dog diabetes insulin and syringes. Your veterinarian will let you know which type of insulin and syringe to purchase and train you how to inject your pet.

Insulin is a very delicate substance and must be stored in the dark in a refrigerator. It cannot be shaken but must be mixed delicately before each use. Injections are given using a very small (hair-thin) needle. Pets normally adapt well to daily injections. You may need to give 1-2 doses daily, at the same time each day.

Blood Glucose Monitoring

Your veterinarian will schedule blood glucose readings frequently in order to measure the effect of the insulin. Adjustments will be made to the insulin dose until the right dose is determined. Normally, your veterinarian will start your pet on a low dose and increase the dose as the blood glucose test indicates. The goal is to treat while avoiding overdose.

Your vet may schedule several all-day glucose curves that monitor blood glucose every 2 hours. You may also wish to purchase your own glucometer to read blood glucose levels and do curves at home.

Diet and Exercise

Diabetes will play a part in your dog's diet. A specific diet and regular exercise are required to control diabetes. Obesity can cause resistance to insulin therapy. Underweight animals will also need to reach a healthy weight as soon as possible. A high-fiber dog food is often prescribed as fiber slows the body’s absorption of sugars. Meals must be scheduled and fed at the same time each day according to your veterinarian’s instructions. They will often be offered twice daily, just before the insulin injections.

Never change a pet’s diet suddenly. The veterinarian will give you a detailed schedule on transitioning to the new diet and what to feed. Avoid giving high-sugar treats to diabetic pets.

Diabetes can be preventable in some pets with proper diet and exercise. Once diabetes has developed, it can be managed with a solid routine of insulin therapy, diet and exercise.

Administer prescribed medications as directed by your veterinarian. Watch for symptoms and if they continue or worsen, the insulin dose will need to be adjusted. Never adjust the dose without the veterinarian’s instruction.

Too much insulin is worse than not enough. Insulin overdose can result in low blood glucose, disorientation, weakness, collapse or seizures. Offer food immediately if you observe these symptoms. Rub Karo syrup on the gums of an unconscious pet and call your veterinarian as soon as possible.

There can be side effects of insulin use in dogs. Besides hypoglycemia, there is a risk of hyperglycemia; both can be serious and occur after the incorrect administration of the insulin. A dog with allergies can be allergic to porcine insulin. There can be drug interactions with insulin so ensure that you discuss all current medications and supplements that your dog is taking. Insulin resistance is a risk and may occur when there is a concurrent illness.

If your pet vomits its meal or won’t eat, call the vet for recommendations on whether or not to give insulin. Don’t give a full insulin dose to a pet that hasn’t eaten and don’t skip an insulin dose (call your veterinarian and follow instructions).

Keeping a log of your dog’s diet, body weight, glucose test results, and insulin doses will help you and your veterinarian manage treatment.