Animals get diabetes too?
Yup, dogs and cats can develop diabetes. In this post we'll be discussing the basics of diabetes, the diagnosis, and how to manage it. More complicated diabetes will be covered in a future post.
Diabetes, or Diabetes Mellitus to be specific, is a condition in which the pancreas no longer makes enough of the hormone insulin for proper health. Insulin is a hormone essential for the body to efficiently use carbohydrates, fats, and proteins.
Another essential function of insulin is efficient use of glucose, the body's energy source. When there is not enough insulin in the body, glucose isn't used properly so body cells starve and the glucose leaves the body through urine. Starving cells need some sort of energy, so if glucose isn't available muscle and fat can be used, which is not healthy and leads to quick weight loss and other metabolic issues. Glucose leaving in the urine causes water to leave quicker too causing extreme thirst and urination.
How would I know if my pet has diabetes?
There are some clinical signs, or symptoms, you may notice at home. Extreme thirst and urination is definitely something to let your veterinarian know about. There are several reason for this to happen and diabetes is one of them. A pet that is always hungry can also be a warning sign. Since the body is not using glucose properly it feels hungry. Loosing weight is also a red flag. Sudden, extreme weight loss without a decreased appetite can indicate diabetes.
Here's a good info-graphic from Vetsulin to see if your pet is experiencing symptoms of diabetes.
What are the usual diagnostics run?
In order to know for sure a simple blood test is done at the veterinarian. A blood glucose (BG) is done, and a glucose level above 180 mg/dL indicates diabetes. This is about the level when glucose starts to 'spill' into the urine and all the symptoms of diabetes are noticed.
It is common to do a full chemistry and cbc panel, a urinalysis with or without a urine culture, and an abdominal ultrasound to make sure there aren't any concurrent diseases that would make the diabetes harder to treat.
What causes diabetes?
In dogs and cats there are a couple of predisposing factors:
Chronic pancreatitis has also been associated with diabetes. It makes sense since insulin is produced by the pancreas, so if you have chronic inflammation then cells are destroyed including the cells producing the insulin.
Glucocorticoids have also been associated with diabetes. Glucocorticoids can cause insulin resistance, which leads to higher blood glucose levels, which can lead to glucose toxicity, which can lead to further destruction of insulin producing cells. This is the reason long term steroid use is not recommended for patients, especially cats.
What is the treatment for diabetes?
Because the patient is not producing enough insulin, we must supplement it for them. At this time, there are no good oral medications for dogs and cats so we use injectable insulin. This injection is given subcutaneously, or under the skin, usually in the scruff area on the back of the shoulders. Insulin is made from a few different sources, but a common veterinary insulin is made from pig insulin hormone.
The most common insulins are given every 12 hours (twice a day). Insulin is measured in units. So, your veterinarian may say to give 2 units of insulin twice a day. This is measured on an insulin specific syringe. Your veterinarian will provide a prescription for the type of syringe recommended for the insulin they are prescribing.
It is extremely important to NOT interchange the syringes. They are labeled as either U-40 or U-100. Basically 2 units on a U-40 syringe is not the same amount of insulin as 2 units on U-100 syringe. If you use the wrong syringe you can give the wrong dose of insulin, and potentially give an overdose of insulin to your pet. The unit measurement is always written on the syringe. You can see each syringe labeled in the picture below.
It is recommended to give the insulin after your pet has had a meal and as close to every 12 hours as possible. Changing the time frequently can make it difficult to regulate your pet.
It is also recommended to feed the same food each day. Whatever diet is recommended by your veterinarian is what you should follow as different patients have different needs. This includes treats. Make sure your veterinarian knows what type of treat and how many your pet gets each day.
I usually tell owners it is okay to give treats as long as you give the same amount of treats and food every day and your veterinarian approves of the treats. There are diabetic prescription diets available and if your pet is overweight, a diet may be recommended to help with diabetes regulation. Speak to your veterinarian about what diet they recommend for your pet.
How do you know the dose of insulin is correct?
When first diagnosed, it can be difficult to know what dose to start with. Be prepared for several recheck appointments to see how your pets body is responding to the new insulin. Adjusting the dose typically occurs during the first few months as the body figures out how to use the new insulin you are providing.
When treating diabetic patients, the goal is keep the BG from getting too low or too high. A diabetic patient will not have a BG level that is static. It is completely expected for the BG to look like a bell curve for a diabetic patient due to the nature of the insulin injection. The BG will be the highest at the time of the insulin injection and the lowest at the time of nadir (this literally means the lowest point). The nadir is usually about 6 hours after the insulin injection is given, but it can vary slightly in each patient which is why a curve is done.
A BG curve is typically done over 12 hours and the glucose is measured every 1-2 hours during that time to see what the BG is doing, and depending on those results the insulin dose can be adjusted by the veterinarian interpreting the results.
Another test a veterinarian may run is called a fructosamine. This measures the amount of glycemic control in a pet over the previous 2-3 weeks. This does not tell us if a pet has gone too low, but it can tell us if the pet is averaging too high.
What are some important things to look for?
Too much insulin can cause low blood sugar, or hypoglycemia. It is important to monitor for these signs:
To help prevent an accidental overdose of insulin, we recommend keeping a daily log to indicate when the insulin has been given. You'd be surprised at how many times we've seen diabetic patients come in on an urgent basis because one owner gave the insulin and then when the other owner came home they fed the pet and gave insulin. Don't let this happen to you, keep track of the doses either on a calendar or by using our Weekly Treatment Tracker that you can get for free just for signing up to our newsletter. Either way, we recommend a written record.
Recommended supplies for parents of diabetic patients
Want to learn more?
Look for Diabetes Part 2 in a future post. We'll discuss how pancreatitis effects diabetes, and we'll discuss serious complications such as diabetic ketoacidosis (DKA) that can be life threatening.
Here is list of a few outside references for pet owners:
We can recommend the Vetsulin website. Vetsulin is a pet specific insulin product. They have great information for owners of diabetic dogs and cats. Visit them here: www.vetsulin.com
Another good website is from the manufacturers of Alphatrak. If your veterinarian recommends having a glucometer at home, this is the brand we recommend. Here is a link to purchase your own Alphatrak from Amazon: https://amzn.to/2CoPYmO
Yvonne Brandenburg, RVT, VTS (SAIM) is a Registered Veterinary Technician practicing in California and obtained her Veterinary Technician Specialty in Small Animal Internal Medicine in 2016. She is the founder of InternalMedicineForPetParents.com. For more about Yvonne visit her author page here.
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This website is NOT a substitute for veterinary care with a veterinarian. We recommend you follow the advice and treatment plan as prescribed by your veterinarian, and only after discussing anything found on this website with your veterinarian, with their approval, implementing advice found here.
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