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Diabetes

Canine Diabetes

Diabetes is a disease of glucose (blood sugar) regulation due to either lack of insulin production by the pancreas or lack of insulin effectiveness in the body. 

 

When dogs become diabetics the symptoms include:  

  • Increased water consumption and excessive urination.
  • Increased appetite and food consumption.
  • Weight loss in spite of the food intake.
  • Blindness due to cataracts and nerve damage.
  • Eventually, coma and death.

 

Fortunately, we usually diagnose diabetes in dogs before they get to the coma and death stage!   Diabetic dogs usually are what we call Type I diabetics, meaning that they have little if any insulin production.  Diabetes in dogs, therefore, will require lifetime treatment to control the disease.  Treatment for your pet may consist of one or all of the following:

 

  1. Hospitalization:  If your pet is critically ill due to diabetes we may need to keep him or her in the hospital for several days to get them out of danger before we send him or her home.
  2. Laboratory evaluation:  It is very important that we initially do some lab work to see how severe a problem is with your pet.  This initial blood work, urinalysis and urine culture may point out the need to check for other underlying diseases that can cause diabetes such as Cushing’s disease (an adrenal gland problem in which too much cortisone is produced in the body). 
  3. Diet:  All diabetic dogs need to be on a diet that is very high in complex carbohydrates.  Several diets are available that fit that description and we will recommend one for you to try.  Typically, we will want you to make sure you’re your pet eats a meal twice a day BEFORE you give him or her insulin.  Giving insulin when an animal is not eating can result in hypoglycemia (too low of a blood sugar) which can be fatal. 
  4. Insulin:  EVERY dog needs to be initially started on insulin twice a day to lower blood sugar levels. We will explain the dose of insulin, type of insulin, and how to give injections before use. It is important to remember to NEVER SHAKE insulin – just roll it in the bottle to mix it or it will not work well.  The insulin must be kept in the refrigerator and not frozen.  Injections are VERY EASY to do and the needle is so tiny that your pet will probably not even know you are giving him or her an injection.
  5. Clinic monitoring:  This is EXTREMELY CRITICAL.  Remember, our goal is to take your pet who is drinking excessively, urinating excessively, and eating excessively, and by diet and insulin shut these symptoms down and prevent the various side effects of diabetes.  Once we start them on insulin we will have you bring them back into the clinic 2 – 3 weeks later.  We will schedule this on a Monday or Thursday (our long days).  We want you to feed your pet and give the insulin before you come in.  We will keep them all day checking the blood sugar levels about every 2 hours.  This will allow us to adjust the insulin as needed. 
  6. Home monitoring:  It is very important that you pay attention to various symptoms. We want you to report any change in your pet’s health that is different such as a decreased appetite, vomiting, diarrhea, lethargy, etc.  Always be on the watch for low blood sugar as well.  This would show up as seizures and/or passing out.  If this occurs, see if your pet can lick a little honey or karo syrup and call us immediately for instructions on what to do. Fortunately, this rarely happens when you are administering insulin properly and is eating well. 

 

  • Watch urine production.  Ideally, urine production should return to normal levels once we have the diabetes under control.  A sudden increase in urine production or a desire to go outside and urinate frequently could signal lack of good blood sugar control or a bladder infection. 
  • Watch water consumption.  Water consumption, like urine production should reduce once the diabetes is under control.  A sudden increase in water consumption suggests a need for us to find out the reason why.  Remember, other diseases such as kidney disease can cause a lot of urine production so large amounts of urine do not necessarily mean that pet’s diabetes is not under control.  Only lab tests at our clinic can tell the difference.
  • Watch food consumption.  Once again, when your pet starts eating normal amounts that usually signals that the diabetes is well controlled.  A sudden increase in appetite would tell us we need to see what the problem is.
  • Blood testing at our hospital is another method of monitoring we need to do.  We will schedule you to come in at various intervals for blood work.  This will vary as to how well our control is doing.

 

 

 


 

 

 

 

Feline Diabetes

Diabetes is a common in cats and is a disease of glucose (blood sugar) regulation due to either lack of insulin production by the pancreas or lack of insulin effectiveness in the body.  Interestingly, unlike dogs, this disease in cats is very similar to the disease in humans.  When cats become diabetics the symptoms include:

 

  • Increased water consumption and excessive urination.
  • Increased appetite and food consumption.
  • Weight loss in spite of the food intake.
  • Blindness and nerve damage.
  • Eventually, coma and death.

 

Fortunately, we usually diagnose diabetes in cats before they get to the coma and death stage!   Diabetic cats usually are what we call Type II diabetics, meaning that they have some insulin production but it is decreased and what is produced isn’t working too well.  About ½ of the cats get to the point that they will always need insulin injections, however, WITH AGGRESSIVE TREATMENT, OVER ½ OF THE DIABETIC CATS CAN BE TAKEN OFF OF INSULIN AND MANAGED BY DIET ALONE!!!!  The key is early diagnosis before the pancreas cells that produce insulin are completely destroyed.  Treatment of diabetes in cats may consist of one or all of the following:

 

1)      Hospitalization:  If you kitty is critically ill due to diabetes we may need to keep him in the hospital for several days to get him out of danger before we send him home.

 

2)      Diet:  All diabetic cats need to be on a VERY HIGH protein diet that has very low carbohydrates.  Interestingly, cats secrete insulin from amino acid (protein) stimulation of the pancreas rather than sugar stimulation.  We will want you to keep dry food out all of the time so that your cat is never in a position of not being able to eat.  A small amount of canned food given once or twice a day with insulin injections is a good idea as well.

 

3)      Insulin:  Almost EVERY cat needs to be initially started on insulin to lower blood sugar levels.  High blood sugar levels are toxic to the pancreas cells that produce insulin and unless we get that sugar down fast the risk of needing insulin FOREVER greatly increases.  We will explain the dose of insulin, type of insulin, and how to give injections before you go home with for cat.

 

4)      Oral hypoglycemic drugs:  5 – 30% of the diabetic cats can be controlled with diet and oral medication (instead of insulin) such as Glipizide.  Even if we are using these drugs we will start initially on insulin to get that blood sugar down.

 

5)      Home monitoring:  This is EXTREMELY CRITICAL.  Remember, our goal is to take your cat who is drinking excessively, urinating excessively, and eating excessively, and by diet and insulin shut these symptoms down and hopefully be able to eventually wean your kitty off of insulin completely.  As this is happening we want to REDUCE THE INSULIN DOSAGE AS THE SYMPTOMS SUBSIDE.  IF YOU DO NOT REDUCE YOUR CAT’S INSULIN AS HE STARTS MAKING HIS OWN, YOU COULD CAUSE HIS BLOOD SUGAR TO DROP TOO LOW WHICH COULD BE FATAL!!! This would show up as seizures and/or passing out.  If this occurs, see if your cat can lick a little honey or karo syrup and call us immediately for instructions on what to do. We would much rather your kitty’s blood sugar be a little on the high side than the low side.  In cats that will resolve and not need insulin (about ½ of them), the need for insulin will usually disappear in 1 – 4 weeks.  We want you to monitor as follow:

 

a)      Measure urine production.  You do this by changing the litter every day and paying attention to how much urine is produced.  Usually, a kitty will go from flooding the litter box when the diabetes in not under control to a normal production of urine once control is achieved.  We want you to gradually decrease the dose of insulin as the urine production becomes normal.  

 

b)      Measure urine glucose.  You do this by placing a few chips of “glucotest” paper in the litter according to the directions on the packet.  You only have to use a few chips and then you can seal the package to keep the others fresh.  If the chips tell you that your cat’s urine is NEGATIVE for glucose it is very important that you give less insulin.  If your cat is one of the cats that ends up not needing insulin, you will discover that you will gradually have to decrease the insulin you are using over a period of time.  Eventually you will just stop the insulin if your kitty can be controlled by diet alone. 

 

c)      Measure water consumption.  Measure your cat’s water consumption over each week.  A level of 10 ml/pound/24 hours is indicative of excellent control and certainly an indication to drop the insulin dose.  Levels over 40 ml/pound/day are indicative of poorer control and a possible need to increase the insulin dose.  NEVER do this without talking to us first.  Remember, other diseases such as kidney disease can cause a lot of urine production so large amounts of urine do not necessarily mean that cat’s diabetes is not under control.  The urine sugar test in “b” above should help differentiate excess urine from uncontrolled diabetes (it will have high sugar) from other causes of excess urination. 

 

d)     Measure food consumption.  Once your cat starts eating normally and starts gaining weight we need to start reducing the insulin.

 

e)     Blood testing at our hospital is another method of monitoring we need to do.  We will schedule you to come in at various intervals for blood work.  This will vary as to how well our control is doing.

 

Remember, diabetes is a very treatable disease and with proper control your faithful companion should live a happy and healthy life.  Call us at 266-4090 if you have ANY questions.

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