Diabetes is a disease that most people have heard of but not a lot of people know that our pets can also become diabetic and it is actually a common illness that we treat.
What is diabetes?
Diabetes is caused by an abnormality in the way our bodies use sugar. The cells in our bodies use sugar (glucose) for energy. In diabetics, the body’s ability to use glucose is impaired. Normally the pancreas secretes the hormone, insulin, into the bloodstream which helps to regulate blood sugar levels. In normal metabolism, insulin pulls the glucose into cells so that they can use it. In a diabetic, however, insulin is impaired in some way from doing this job and so cells cannot get the glucose they need.
As the cells cannot get the glucose, the body is tricked into thinking it is starving and so instead it switches to a different kind of metabolism and uses proteins, starches and fats for energy, leaving glucose to build up in the bloodstream. Normally the kidney is able to prevent glucose loss in the urine but when there is so much glucose in the blood it gets overwhelmed and glucose spills into the urine. Glucose draws water into the urine with it which causes an excess urine production. Increased urine production leads to increased thirst.
What are the symptoms?
From the above information we can see why diabetes causes these main clinical signs:
- Excessive eating – as the body believes it is in starvation mode
- Weight loss – as the body metabolises the fats and proteins instead of glucose
- Excessive urination – due to glucose drawing water into the kidneys
- Excessive drinking – due to excess urine loss and increased thirst
As in humans, there are two types of diabetes that we see in pets: Type 1 insulin dependent and Type 2 non-insulin dependent. Type 1 diabetes is the more common form seen in dogs and occurs due to the loss of the cells in the pancreas that secrete insulin and results in an overall lack of insulin in the body. This type of diabetes requires management with daily insulin injections. Type 2 diabetes is the most common form seen in cats where there are enough insulin-secreting cells but for some reason, there is still an insufficient production of insulin, a delayed response to secreting insulin or in many cases of obesity, insulin resistance. This type is usually managed by insulin injections at first but in some cats with proper diet management and weight loss, there is the potential for them to go into remission.
How is it treated?
Insulin injections are used to manage diabetic pets and are given once or twice daily depending on the insulin that is used. The dose is different for each animal and so it may take some time and monitoring with your vet to get the dose just right for your pet. Also, as time goes on this amount may need adjusting due to weight gain/loss or hormone changes in your pet and so it is crucial that owners work with their veterinarians to maintain regular blood glucose monitoring. Home monitoring can easily be taught to owners and there are now options for continuous glucose monitors that make the process much easier on your pet.
It is important to remember though that regulation of this complex disease is best achieved using a balance of insulin, diet, and exercise together. There are specifically formulated therapeutic diets for diabetic pets but unfortunately, they are not always the most appetising choice. These diets are ideal though, so they should always be offered to see if your pet will like them. If your pet is a picky eater and isn’t a fan of the formulated diets, there are other diet options that can be discussed with your vet. Mostly, for cats, this includes a low carbohydrate, high protein diet. In dogs, higher fiber diets seem to be helpful. Foods to avoid include soft, moist supermarket diets as they often have a higher sugar content. We also need to avoid giving them foods like bread or sweet treats from our own plates. Talk to your veterinarian and they can help you to choose the best option for your pet.
Low blood sugar (insulin overdose)
If your pet appears wobbly or is walking around like they have had one too many beers, their blood sugar level may have dropped too far. The best thing to do if you notice this is to try to get them to eat. If they won’t eat try rubbing some honey onto their gums and get them to the emergency room ASAP so that their blood sugar levels can be monitored. Different types of insulin last for different amounts of time in the bloodstream and so your pet will need to be monitored until the insulin wears off and then a more appropriate dose can be determined.
Also known as diabetic ketoacidosis (DKA), a diabetic crisis can be life-threatening for your pet. Unfortunately, a lot of the DKA cases we see coming in the door of the emergency room are patients that have not been previously diagnosed with diabetes. This life-threatening condition occurs in diabetic patients that have another inflammatory condition causing further problems with using insulin and these patients end up very unwell. If your pet shows signs of excessive thirst, frequent urination, nausea/vomiting, abdominal pain, weakness or you notice a fruity smell to their breath they need to be seen by your vet ASAP.
It is very important for diabetic pets to have their teeth cleaned regularly. This means keeping up with their annual dentals. Tartar build-up on teeth allows bacteria to enter the bloodstreamm more easily. With higher blood sugar levels animals become more vulnerable to infections within major organs such as the kidneys and heart.
Diabetes is a condition that will need lifelong management but many pets can achieve the same quality of life as before their diagnosis with proper management and monitoring.