Caring for a Pet with Diabetes
What is Diabetes?
Diabetes, also called diabetes mellitus, is a condition that occurs when your pet’s body can’t use glucose the way it should. Glucose, which is a type of sugar, is the main source of energy for the cells in the body. The amount of glucose in the blood is controlled by a hormone called insulin, which is created in the pancreas.
When your pet eats, sugars are absorbed into the intestines and transported into the cells that line the intestines. Once in the cells, the sugars are converted into simple sugars including glucose, which is then absorbed into the bloodstream where they enter the tissues and cells of the body. Insulin is produced to help transfer glucose to the cells. Without enough insulin, glucose buildups in the blood, resulting in hyperglycemia. This occurs when the body doesn’t produce enough insulin, or when the body can’t use the insulin produced by the pancreas (insulin resistance).
At a certain point, the high levels of glucose in the blood will cause glucose to overflow into your pet’s urine, taking a lot of water out of the body with it—which is why many diabetic pets drink more water and urinate more frequently.
While it seems counterintuitive, during hyperglycemia the cells of the body are actually being deprived of glucose. As a result, the cells don’t have enough energy to function normally, and a state of metabolic starvation causes the body to break down fat and muscle tissue for energy, leading to weight loss. If this state of metabolic starvation goes on for a period of several days to weeks without treatment, serious complications secondary to build up of acids and ketones in the blood can occur.
In humans, there are two different types of diabetes, commonly referred to as type 1 and type 2 diabetes. The same is true in pets. Insulin-deficiency diabetes (type 1 diabetes) occurs when your pet’s body isn’t producing enough insulin. It usually occurs when the pancreas is damaged or not functioning properly. This is the type of diabetes we commonly see in dogs. This type of diabetes is almost never reversible, since the pancreas is no longer able to make insulin. Insulin-resistance diabetes (type 2 diabetes) occurs when your pet’s pancreas is producing some insulin, but your pet’s body isn’t utilizing the insulin properly due to other hormones in the body which cause the insulin to be less effective. This type of diabetes is more common in cats (rare in dogs) and typically occurs in obese cats or cats that have been on steroid medications. In some cases, this type of diabetes is reversible with proper treatment and removal of the conditions that cause insulin resistance.
Symptoms and Causes of Diabetes
Common symptoms of diabetes include:
- Excessive thirst
- Frequent urination
- Decrease appetite
- Weight loss, even though your pet may have a larger appetite than normal
- Chronic or recurring infections
- Cloudy eyes
Diabetes can affect dogs and cats of any age, but it usually affects dogs between the ages of 4 and 14 and cats older than 6. Female dogs are more likely to be diagnosed with diabetes than male dogs, and certain breeds of dogs seem to be predisposed to the condition.
One of the biggest risk factors for diabetes in cats is obesity. Age plays a role in diabetes, because pets can develop other endocrine diseases or diseases of the pancreas that predispose to diabetes. Concurrent diseases such as heart disease, adrenal gland conditions such as Cushing’s disease, hyperthyroidism, pancreatitis, dental disease, and infection can complicate control diabetes. Pets who have been on medications containing corticosteroids for a long time are also at an increased risk for diabetes.
Diabetes is treated with insulin, which is administered by injection under the skin twice daily. These injections will be given at home after your pet’s meal and you should be taught how to give these injections by your veterinarian. Though it may seem like a daunting task, most owner’s find it is actually easier to give injections to their pets than given oral medications twice daily!
Insulin dose and type will be adjusted based on your pet’s response to treatment and the results of your monitoring of the condition. Glucose curves, in which the blood sugar is checked every 2 hours, will be performed by a veterinarian to determine the “highs” and “lows” of the blood glucose level throughout the day. After diagnosis, it typically takes several weeks to a couple of months to determine the ideal dose for a particular pet. Treatment may be different for every pet with the condition. Treating diabetes in pets requires a lot of patience during the initial weeks and months of diagnosis, requiring frequent visits to your veterinarian. Over time, the rechecks will be less frequent (a few times a year). Nearly all dogs with diabetes will require insulin for the rest of their lives; however, some cats will go into remission with aggressive and early treatment of their diabetes and over time may not require insulin injections. Special low carbohydrate diets are an important part of the management of diabetes in both dogs and cats.
Managing Diabetes at Home
Diabetes in pets, much like with humans, requires lifestyle changes, as you will need to give meals and insulin about 12 hours apart each day. You should closely monitor your pets for changes in weight, appetite, thirst, and urination and for other symptoms such as weakness, wobbly walking or acting drunk. Some owners choose to monitor blood sugar levels at home, though this is not a requirement and most pets can be successfully treated without their owner’s having to check blood sugar at home. There are veterinary specific glucometers that can be purchased for at home use. Human glucometers are not accurate for dogs and cats.
Some other things you will need to do for your pets include:
- Changing to a diabetes appropriate diet. For dogs, this is generally a high-fiber, low carbohydrate diet. For cats, veterinarians usually recommend a high-protein and ultra-low carbohydrate diet.
- Including exercise in your pet’s daily routine. Your veterinarian can help you come up with an exercise regimen that is appropriate for a pet with diabetes. This process may be more difficult for cats.
- Spaying female pets that are diagnosed with diabetes
- Maintaining a regular feeding and insulin schedule.
- Monitoring blood glucose curves (most people do this through their veterinarian, some do this at home)
- Visiting the veterinarian regularly.
Pets with diabetes are also at risk for a variety of complications related to the disease, including hind leg weakness (diabetic neuropathy, primarily seen in cats), cataracts (dogs), and infections. Nearly all dogs with diabetes will eventually develop cataracts which can lead to blindness in some dogs. Surgical removal of cataracts can be performed if this occurs.
With proper management, pets with diabetes can live long, healthy lives. Working with a veterinarian can ensure that your pet’s diabetes is being managed properly. If you are in the Houston area and your pet has been diagnosed with diabetes, ask for a referral to GCVS Internal Medicine. We can be reached at 713-693-1111.