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Understanding Diabetes In Pets
This entry was posted on 2019-09-30.
Diabetes is relatively common disease seen in small animal veterinary practice. Yet so many pet owners are absolutely amazed, or in disbelief, when this diagnosis is made.
TO BEGIN WITH:
There are two types of diabetes. The more common one is Diabetes Mellitus, in comparison to the far rarer Diabetes Insipitus. This article is going to focus on uncomplicated Diabetes Mellitus. Furthermore it must be mentioned that the human classification of Type I (insulin dependent) and Type II (non-insulin dependent) is not very useful in veterinary medicine since nearly all animals with Diabetes mellitus require insulin treatment, regardless of the underlying cause of the disease.
WHY DO OUR PETS GET DIABETES IN THE FIRST PLACE?
There is unfortunately no simple answer to that question, except that I cannot overemphasise the importance of keeping your pets slim and trim. Diabetes is very often seen in middle-aged, about 8 years-old, overweight animals. It is a syndrome of many facets, rather than a single disease entity and affects almost every pathway in your pets body.
Diabetes is a disease of the pancreas. The pancreas is a gland organ that is located close to the stomach and is involved with two main functions namely the exocrine function of digestion and the endocrine function of regulating blood sugar.
Thus a simplified explanation of Diabetes Mellitus would be a relative or absolute deficiency of insulin, which then results in a decreased ability of the body to use glucose, amino acids and fatty acids, especially in the liver, muscles and fatty tissues. This failure of glucose uptake by these cells, then results in too much glucose in the bloodstream, which is called hyperglycaemia. Once the amount of glucose in the bloodstream is more than the kidneys can deal with, one will see glucose in the urine, and this is called glucosuria.
Primary cause of Diabetes Mellitus include things like chronic pancreatitis, amyloidosis and destruction of parts of the pancreas needed for insulin production, which is thought to have an auto-immune component.
Secondary causes of Diabetes Mellitus include; first and foremost obesity, causing down regulation of insulin receptors. Secondly, the blocking of insulin by other hormones caused from other diseases such as hyperadrenocorticism (adrenal gland or brain tumour or cortisone problem), progesterone and growth hormone (unsterilised bitches mainly) and acromegaly (brain tumour problem). And thirdly the blocking of insulin by certain drugs such as steroids which in turn affect cortisone levels and progesterones which can affect growth hormones. By looking at the drugs that affect insulin and the diseases that affect insulin, we can see that they are very closely related and that there will never be a simple cut and dry scenario for either.
WHEN SHOULD ONE BE CONCERNED THAT YOUR PET COULD HAVE DIABETES?
By understanding that your pet is basically starving when it has too much glucose in its bloodstream and that this glucose will then overflow into the urine, pulling water, electrolytes and glucose with it, we can see the cascade of events that this disease will cause.
Your pet will initially not seem ‘sick’ as it will be hungry all the time, yet it will start losing weight. It will be drinking lots and lots of water and weeing all the time, yet it will eventually start dehydrating. These symptoms will usually occur over a few weeks. Eventually the starving body and excessive urinating will result in the body breaking down other tissues such as fats for energy and things called ketones will start forming. The accumulation of ketones will lead to different symptoms like depression, anorexia, vomiting and rapid dehydration. This is called Complicated Diabetes Mellitus with ketoacidosis, which is an emergency state that leads to coma and death if not treated aggressively. Thus one can see from the progression of the disease that it is important to realise that something is not right with your beloved companion sooner rather than later, to have a favourable outcome.
IS THERE A DIFFERENCE IN DOGS VS CATS?
Dogs seem to have a genetic predisposition in some breeds and it seems to occur more frequently in unsterilised female dogs due to hormones related to progesterone, in comparison to males.
In cats this is slightly different; one sees it more often in overweight male cats than in females.
WHAT TREATMENT OPTIONS ARE AVAILABLE FOR WHAT PETS?
Treating a diabetic animal is much easier said than done. Not all animals respond to treatment equally. Diabetic animals take patience, time, commitment and money. It is not just a single diagnosis, a few blood tests and the problem is quickly solved, but rather ongoing decisions regarding treatment, monitoring and more often than not, hospitalisations.
Once the initial diagnosis is made, which should include a full blood count, full biochemistry panel with electrolytes and a urine analysis, the real treatment plan can begin. This will vary depending on the results obtained, as different stages of the disease will cause different problems or symptoms that need to be addressed.
In Uncomplicated Diabetes Mellitus, an initial dose of insulin is calculated for your pet, depending on its body weight. This dose will have to be injected twice daily 12 hours apart, just under the skin. The insulin will need to be kept in the fridge. I often find its best to clip the hair on the back of the neck to make injecting under the skin easier while one learns how to master the art. Your pet will also then need to be fed with these injections, as this is the best time for the body to be able to utilise glucose and it is the only time there will be insulin because of the injection.
The initial dose will then need to be checked by your vet, by doing something called a glucose curve a few days later, depending on initial readings and response to the drug. Because the dose can only be changed in small increments, this process of dose adjusting may have to be repeated until the correct unique dose for your pet is found. Hopefully with following a treatment plan, the correct dose is found and then your pet will most likely lead a happy, symptom-free life.
WHY DOES TREATMENT NOT ALWAYS WORK?
As emphasised earlier, treatment can never be simple, as the disease itself is not a single entity and therefore will always be complicated. A favourable outcome will firstly depend on the underlying cause of the disease, the stage at which your pet is diagnosed and whether other diseases are playing a role or not. Secondly, one should be aware that there are a number of different types of insulins and that all have their advantages and disadvantages, but that not 1 type is perfect. Meaning that the responses to the insulin will also vary depending on the animal. And thirdly compliance from the owner's side is of utmost importance to control this disease. And it really can be exceptionally challenging, regarding time, emotion and finances. Failure in being able to control this disease does not mean that all the best efforts were not made.
Also remember that successful treatment is not where the blood test and results are perfect, as in most cases they never will be. But where we have a maximum insulin dose with minimal clinical signs without making the animal go hypoglycemic (low blood sugar).
HOW CAN I PREVENT THIS COMPLICATED DISEASE?
The age-old saying that prevention is better than cure is very applicable to this disease. And it all comes down to one thing we can control: obesity.
The only way one can prevent this complicated, difficult to diagnose and manage, expensive and emotionally draining disease, is by not overfeeding our pets. Do not show your pet love in the form of treats and food. Show your love by feeding a good, healthy nutritionally balanced diet, do regular exercise and keep your pet slim and trim. Even if it is true that not all fat pets get diabetes, it just makes the chances of them getting it so much higher, and it's just an unnecessary risk factor.
If you feel like your pet could be overweight and in danger of diabetes you should seek medical advice immediately. Browse some great food options on the site.