Diabetes – Understanding and Management


November is National Diabetes Month. Are you aware of the signs and symptoms your dog or cat might display if they are diabetic? Do you have an aging and/or overweight pet? Are you curious about how a pet with diabetes is managed? Then take a few moments to read this week’s blog and grow your understanding of diabetes in dogs and cats.

Overview and Symptoms:
When a dog or cat is diagnosed with Diabetes mellitus, it means the body is unable to keep blood glucose levels down in the normal range. In typical physiologic conditions, an animal will maintain blood sugar levels through the action of a hormone called insulin. When an animal eats and the blood sugar starts to rise, the pancreas secretes insulin. The insulin helps to drive the sugar into cells where the sugar can be used as energy. In Diabetes mellitus, either there is a shortage of insulin, or the cells have become insulin-resistant. This causes the blood sugar to remain inappropriately elevated. Over time, the elevated blood sugar levels will be detrimental to the body. The pet will start to exhibit signs such as increased hunger, weight loss, increased thirst, increased urination, lethargy, increased risk for infections, or cataracts.

Diagnosing Diabetes mellitus early allows us to get the blood sugar levels down into a somewhat normal range more quickly, which will minimize the chances of secondary complications or emergency situations. If the diabetes is not identified and treated, the animal will continue to feel hungry because the cells are not getting the sugar that is circulating in the blood. Then, the body will turn to alternative energy sources and start to breakdown fat. Fat metabolism creates ketones, which can make the animal feel very sick as the ketone levels rise. If the ketone levels become too high, an animal can develop diabetic ketoacidosis (DKA), which is a life-threatening emergency situation.

Although we don’t know all the reasons that diabetes might develop, we know to watch out for this condition as animals get older. There can also be a genetic component involved. Any dog or cat exhibiting signs such as increased hunger, increased thirst, or increased urination should be evaluated by a veterinarian. Additionally, annual wellness bloodwork can help us catch the problem early, even before symptoms become severe. We do know that overweight animals can be at higher risk for developing diabetes. Working to keep your pet at a healthy weight throughout their life may help minimize the chances of diabetes.

Once a dog or cat is diagnosed with Diabetes mellitus, our major goal is to get blood sugar levels down as effectively and safely as possible. Some animals will present very ill or in a diabetic ketoacidotic crisis – these animals are hospitalized and treated with insulin, appropriate injectable medications, intravenous fluids, and supportive care. Some animals can be treated on an outpatient basis if their symptoms are not severe. Outpatient treatment involves the use of prescription diets formulated for diabetic animals in conjunction with insulin administration.
Diabetic patients should be offered unlimited access to fresh water at all times. They should be monitored for signs to suggest the condition is worsening. Typically, insulin is administered twice daily along with a meal. It’s important for owners to remember that insulin should be given at meal time after the animal has shown interest and eaten a good portion of the meal (if insulin is given and the animal does not eat, the insulin can cause the blood sugar to drop too much, leading to hypoglycemia). Finding the right insulin dose can take some time and patience. Insulin doses cannot be increased too quickly. Every 10 to 14 days after an insulin dose adjustment, we follow the animal’s glucose curve every two hours throughout the day. The decision to increase the insulin dose is made based on the veterinarian’s assessment of clinical signs and the results of the blood glucose curve. Thorough and regular communication with your pet’s veterinarian is critical to facilitate successful treatment outcomes.

Diabetes mellitus can occur as pets get older; keeping your pet at a healthy weight may decrease the risk of developing diabetes. Routine labwork screening can help catch the problem early. If diabetes is diagnosed, we have strategies and therapies to help your pet feel better. The process can involve a little time and patience, but working together we can give your pet the best chance of success!

Additional Helpful Resources:

Author: Dr. C. Noureddine, DVM, MS