Diabetes in dogs affects millions of man’s best friends worldwide. Just like humans, our four-legged friends can also develop this complex metabolic disorder, which demands attention, understanding, and proactive management from pet parents.
Learning what diabetes entails is crucial for ensuring your furry friend lives a happy and healthy life. In this article, we explore the ins and outs of this condition to help equip you with the knowledge needed to keep our canine companions thrive.
What is diabetes mellitus
Diabetes in dogs is a complex chronic metabolic disease characterised by an inability to regulate blood sugar levels effectively. This disorder arises when the pancreas, an organ located near the stomach, fails to produce sufficient insulin or when the body’s cells become resistant to insulin.
Insulin is a hormone responsible for helping glucose (sugar) from the bloodstream enter the cells, where it’s used as energy. When insulin is lacking or ineffective, glucose builds up in the blood, leading to hyperglycemia (high blood sugar levels) that deprives the cells of the energy (glucose) they need to function properly.
Signs of Diabetes In Dogs
Increased Appetite
Specialized cells in the brain control appetite. Those cells, like all the others, need sugar via insulin to function. When these brain cells begin to “starve” without sugar, they produce a signal demanding that the individual eat more to supply them with energy.
However, the problem is not that crude energy is failing to be consumed. Nor is the problem that this crude energy is failing to be refined into sugar. The problem is a lack of insulin.
Weight Loss
Although cells in the brain are demanding that more and more food be consumed, other cells in the body respond to their “starvation” by demanding that fat and muscle in the body be broken down.
The breakdown of muscle and fat usually causes obvious weight loss. Breakdown products of fat and muscle can be converted to sugar by the liver. This sugar could supply the energy needs of cells.
Once again, regardless of the source of crude energy and sugar (through eating or through breakdown of fat and muscle), the key that would allow the use of this energy source is missing.
Increased Urination
If the sugar being refined from ingested food and from breakdown of fat and muscle is not taken up by cells for energy, it begins to accumulate in the bloodstream.
When too much sugar accumulates in the blood, it begins to overflow or “leak” into the urine. The urine of healthy individuals never contains sugar. Sugar cannot appear in the urine by itself. Rather, sugar draws water into the urine just like a dry sponge draws water.
Therefore the individual with sugar in the urine produces large urine volumes because of the water being excreted as well. This process can eventually create tremendous water losses.
Increased Drinking
In response to this excess urine volume, dogs with sugar in their urine begin to drink excessively in an effort to maintain water balance (hydration). These responses to the simple lack of insulin are natural and instinctive. They are unavoidable.
All individuals (people, dogs, cats, etc.) with an insulin deficiency (diabetes mellitus) have the same signs: they all eat excessively, they all lose weight, they all drink excessively, and they all urinate excessively.
Forms Of Diabetes
There are two common forms of diabetes mellitus that exist in people.
Type I diabetes – insulin-dependent diabetes mellitus (IDDM) – require insulin
Type II diabetes – non-insulin-dependent diabetes mellitus (NIDDM) – an individual has some insulin but either does not have enough insulin to supply all cells when it is needed or they have a condition that interferes with insulin action.
Virtually 100% of diabetic dogs have type I disease. Although changes in diet, weight loss, exercise, and oral drugs can be used successfully in managing many people with type II disease, insulin administered by injection remains the best treatment for all dogs diagnosed as having diabetes mellitus.
How Is Diabetes In Dogs Diagnosed?
The diagnosis of diabetes mellitus is extremely straightforward. A thorough history and the typical clinical signs such as weight loss and/or excessive urination, drinking, or eating give us a high suspicion that diabetes might be probable.
A diagnosis is confirmed by performing a urinalysis and blood tests. Finding sugar in the urine and an abnormally increased blood sugar concentration confirms diabetes.
How Is Diabetes Treated?
The treatment of diabetes in dogs involves a combination of medical management, diet management, and regular monitoring. The primary goal is to regulate blood sugar levels and prevent complications associated with the condition. Insulin Therapy is the main treatment required for the control of diabetes.
The most important concept to remember is that most diabetic dogs treated with insulin lead healthy and happy lives. The specific type and dosage of insulin are determined by your vet based on the individual dog’s needs.
We will recommend a dose and frequency of administration (once or twice daily). Although most diabetic pets seem best controlled when receiving insulin given twice daily, once daily injections may work and once daily regimens are often used initially just to have owners become familiar with the process.
Then, if needed, a second injection each day can be recommended. The goal to regulate blood sugar levels can be tricky to achieve. We need to choose the correct insulin, dose, and frequency of administration. It is always safe to assume that the first regimen chosen may not be as effective as you might like.
However, with adjustments, a treatment protocol can typically be established that will provide your pet with a happy and almost normal existence. You need to try to be as patient as possible because nature sometimes doesn’t read the textbook.
If you do begin to give insulin twice daily, do not think that the timing needs to be exact. Rather, giving insulin at convenient times is fine and if these times vary by 30, 60, or even 90 minutes each day, your pet will be fine.
Regular monitoring of blood sugar levels is essential to ensure that your dog’s diabetes is well-managed. Although insulin is the mainstay of treatment, other management strategies can help our diabetic dogs:
Diet Management
A well-balanced and consistent diet is crucial for diabetic dogs to maintain an ideal body weight.
Therefore if your pet is too thin, weight gain is important and if your pet is overweight, weight loss will improve insulin effectiveness. Our vets recommend twice daily feeding of diabetic dogs…
Consistency in the type and timing of meals is essential for effective blood sugar control. If your pet eats at specific times, it is ideal to feed first, wait until your pet has consumed the meal, and then administer insulin.
Because insulin works by allowing cells to utilize sugar, it is important for that insulin to have sugar present. Administering insulin to a pet that then refuses to eat means that the pet is now predisposed to developing a blood sugar level that might be too low or dangerously low.
In general, we recommend a high-fiber, complex carbohydrate diet with moderate fat and protein content.
Regular Exercise
Regular, moderate exercise is beneficial for diabetic dogs as it helps improve insulin sensitivity and aids in weight management. However, exercise routines should be consistent and not excessive, as fluctuating activity levels can impact blood sugar levels.
Weight Management
Unlike cats, obesity doesn’t tend to result in insulin resistance in dogs, however, it can increase the risk of pancreatitis and inflammation-mediated destruction of pancreatic beta cells that produce insulin. Our vets can assist you with ensuring your dog is of good weight.
Handling Insulin and Injection Technique
Giving your pet injections is an intimidating prospect for most, and there is no doubt that dogs can feel the needles. Once you’ve been injecting for a few weeks, you will become competent and your pet will accept the tiny pin pricks.
Don’t give up! Dogs do learn to accept this treatment without changes in behavior or personality.
“The single most common cause for a diabetic dog or cat to appear “insulin-non-responsive” and to remain symptomatic is owner error.”
Mistakes in handling or injection of insulin are unfortunate but fact. It’s important to maintain a strict protocol to avoid mistakes:
Store insulin on the door of your refrigerator right side up.
Insulin should not be left at room temperature for prolonged time periods because it might lose potency. If the insulin freezes, you should obtain a new bottle. Prior to removing insulin for each and every dose, the insulin should be mixed. This is best accomplished by making a fist around the bottle and then slowly rotating your wrist back and forth a few times.
How to measure the correct dosage.
You will be taught how to draw insulin into a new unused syringe for each injection by first pulling back on the syringe plunger to the dose, turning the bottle completely upside down, placing the needle into the center of the stopper, injecting the air in your syringe into the bottle to avoid creating a vacuum, and then drawing the correct amount into the syringe.
While the syringe needle is still in the upside-down bottle, tap the syringe to force any bubbles or air to the top, squirt those back into the bottle and again draw out the insulin to the correct dose. Then remove the needle from the bottle.
How to give an injection.
Most owners gently pinch a small amount of skin with the thumb and index finger of one hand behind your pets’ neck or somewhere along their back. The needle target is NOT between your fingers rather it is in the hollow you have made just below your fingers.
Place the needle at a 45-degree angle through the skin below your fingertips and push the needle in as far as it will go (these needles are usually quite short). Remember do not place your thumb on the plunger during needle insertion.
Once the needle is fully inserted through the skin, move your thumb to the plunger and press the plunger all the way down. Once you have pushed the plunger all the way down, pull the needle out of the skin.
Complications of Diabetes In Dogs
Diabetic Ketoacidosis (DKA):
This occurs when the body’s cells cannot effectively use glucose for energy due to a lack of insulin, and the body starts breaking down fat as an alternative energy source.
This process produces ketones, which are acidic byproducts that can accumulate in the blood, leading to a dangerous condition known as ketoacidosis.
DKA requires immediate veterinary intervention, which may include hospitalization, fluid therapy, insulin treatment, and supportive care.
Insulin Underdose
If your pet is underdosed with insulin, symptoms of diabetes tend to persist. Therefore if your pet continues to exhibit excesses in hunger, thirst, and urine volume as well as continuing weight loss, one likely explanation is under dosage.
Understand that an underdose may occur because your pet simply needs more insulin. However, under dosage also can be caused by using insulin that turns out to be less than ideal for your pet.
The most common cause of under dosage is that the person giving the insulin is doing something incorrectly.
Insulin Overdose
An overdose of insulin causes the blood sugar concentration to decrease too far.
This can cause a variety of different problems.
Signs include:
- profound weakness,
- the pet may appear drunk
- seizures.
If low blood glucose is ever suspected, it is best to feed your dog immediately and then bring them straight to the hospital.
If your pet loses consciousness:
- Be certain your pet is not in danger of being hurt (near the edge of a deck or the edge of a swimming pool, for example)
- Glance at a clock and note the exact time
- Place honey or sugar directly onto your pet’s gums.
- Bring them to the hospital for assessment.
Other symptoms of overdosage can be confusing. Some overdosed dogs and cats simply sleep more.
Some overdosed dogs and cats act as if they are underdosed! This common occurrence is the result of low blood glucose triggering glucose to rebound to levels well above normal. The increased blood glucose in this situation can persist for several days.
An overdose may occur because your pet simply needs less insulin. However, overdosage also can be caused by using insulin that turns out to be less than ideal for your pet.
‘The most common cause of overdosage is that the person giving the insulin has given an excess of insulin.”
What Should Be Done if an Insulin Dose Is Missed or if a Mistake Is Made During an Injection?
Sometimes someone may forget to give insulin. Other common occurrences include your pet moving suddenly during an injection or you simply make a mistake and are not certain if your pet received the correct dose of insulin, if your pet received no insulin, or if your pet received a portion but not all of the dose.
None of these situations should be unduly worrisome. The correct response to any of these occurrences is to simply give the correct dose of insulin when it is next scheduled. If an entire dose is missed, your pet will be fine.
However, if a portion of a dose was given and then you give another dose immediately, there is a risk of overdosage.
“A missed dose or an underdose is always preferred to an overdose.”
Can diabetes be cured?
It is extremely rare for a dog with diabetes to be cured. In only two situations is there even a chance of a cure: dogs pregnant at the time of diagnosis and dogs with a condition called Cushing’s syndrome.
Most of these dogs, however, are not cured of their diabetes even with appropriate care. In total, far less than 1% of dogs with diabetes mellitus have their disease state resolved.
Can my pet be treated with pills rather than with injections?
Unfortunately, insulin is almost always given by injection. Dogs with diabetes mellitus virtually never respond to oral diabetes treatments. Oral medication, as the sole treatment for diabetes, should not be given to diabetic dogs, even on a trial basis.
Monitoring Insulin Therapy
Numerous methods of monitoring diabetic dogs and cats exist to better improve the chances of a successful outcome. No one method is better than another and most complement each other. The most important tool in determining if your pet is responding to therapy appropriately is your opinion.
The goal of treating a diabetic dog is to have an owner pleased with their pet’s response. It is not reasonable to expect your pet to be 100% normal in all aspects, but it is reasonable to have your pet be comfortable, interactive, and relatively healthy.
Most diabetic pets urinate more than normal and most maintain an excellent (ravenous) appetite. Certain tests may be required periodically in order to ensure your dog’s blood glucose levels are being well managed.
These include checking blood sugar concentrations throughout the day in hospital. We may request you to check the urine of your pet at home periodically for sugar and substances called ketones.
Finally, some blood tests allow us to assess the average blood sugar levels over the preceding weeks. Each of these tests should complement your opinion regarding response to treatment.
Cataracts
Almost all diabetic dogs develop some degree of blindness within the first year after diagnosis due to the development of cataracts in the lens (in the center of the eye). Cataracts are opaque and do not allow light from the outside to enter the back of the eye for vision. This side effect of diabetes is virtually unavoidable.
Blind dogs do quite well, especially indoors in a familiar environment. Cataracts can be surgically removed to restore sight in most dogs. Some dogs will be blind even if cataracts are removed and others have cataracts that cannot be removed.
What should be done if my pet refuses to eat?
This abnormality is reason for concern. We recommend that you contact us immediately. It is better to bring your pet to us unnecessarily than to ignore a serious complication.
Dogs with Diabetes Live Long Lives
Treating a dog for diabetes can be challenging but it can also be extremely rewarding. Most of our patients can be well-managed and live happy and healthy lives for many years. If you have any concerns or are not clear on anything regarding your dog’s treatment please don’t hesitate to contact us on 02 9416 1300.
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