Diabetes in Pets

Your pet has been diagnosed with diabetes, a disease that will
necessitate conscientious treatment on your part for insulin
administration, diet control and monitoring. Since your animal
cannot control his blood sugar, you will play an important role
in providing insulin and maintaining a good quality of life.

Normally, food is ingested and broken down into basic units, one
of which is sugar (glucose). When sugar levels begin to rise in
the blood, the body responds by secreting insulin from the
pancreas. Insulin allows the blood sugar to go into the body’s
cells where it is needed. When an animal has diabetes, the
pancreas is not able to secrete enough insulin. There is too
much sugar in the blood and too little in the cells. This
results in a dog/cat that drinks a lot, urinates a lot, and eats
a lot but loses weight. Since the body thinks it’s starving, it
mobilizes fat which is broken down into ketones. This will
eventually make the untreated diabetic animal very ill.

Treatment A”healthy” diabetic pet is one which is eating and
still feeling well. Treatment consists of starting on insulin
injections to control blood sugar levels. There are several
different types of insulin. Because each individual responds
differently, the type and amount of insulin to achieve control
must be tailored to meet your pet’s individual needs. You will
need to give insulin as an injection under the skin 2 times
(about 12 hours apart) daily to allow adequate control of blood
glucose levels. We will instruct you in the proper method of
injecting the insulin.

An “ill” diabetic pet is one that is vomiting, has diarrhea or
has a poor appetite. These animals are often “ketotic”, an
imbalance in the body that must be corrected. As insulin
treatment is started, this pet must be hospitalized for
intravenous fluid treatment and medications to stabilize before
managing at home with insulin therapy.

Insulin types include: animal derivatives such as pork and beef
and human based insulin types. Insulin and insulin needles are
readily available from most outside pharmacies or through our
hospital. Your veterinarian can call this prescription in for
your pet.

Oral drugs such as glipizide or glucophage, which are commonly
used to treat human diabetes, are rarely effective in managing
diabetes in dogs or cats and thus, are not commonly used.

Meals

Meals should be given at the same time when the insulin is
given. This allows you to note your animal’s appetite. It is
important that your pet eats with a good appetite to receive its
insulin injections and often, injections can be coordinated to
occur at meal times. In that way, you know that your pet is
eating well, and the pet, distracted while eating, pays little
attention to the injection.

It is important to give the insulin only when she/he eats. If
your pet is not eating and/or is acting ill, you should not give
the insulin and contact your veterinarian as soon as possible.
If insulin is given when your animal is not eating, its blood
sugar becomes too low. This can cause weakness, staggering,
lethargy, muscle tremors or seizures.

If you see these signs, give your pet a sugary substance such as
Karo syrup or Nutrical for a quick absorption of sugar or simply
feed him if he is willing to eat. Note that signs of
hypoglycemia can occasionally spontaneously occur, especially in
cats, and even well-regulated diabetic cats can suddenly show
signs of low blood sugar. In cases of suspected hypoglycemia,
contact your veterinarian immediately.

All cats and some dogs should have some dry food accessible all
day to nibble on in addition to the 2 times a day meals given
with insulin. High fiber foods such as Hill’s Prescription w/d
for dogs and cats or high protein foods such as Purina DM diets
for cats are considered amongst the better diets for diabetics.
These are prescription foods and available only through your
veterinarian. But remember that the best food is what your pet
will consistently and enthusiastically eat.

It is important for both the insulin and the feedings to be
consistently given at regular times and for your pet to follow a
mild exercise routine. Erratic feedings and insulin
administration at variable intervals complicate control of the
diabetic pet, and excessive exercise alters the body’s insulin
needs.

Regulation

After starting an animal on insulin, the amount may need to be
increased or decreased, depending on your pet’s response. If
your pet is not spayed, it is recommended the procedure be done
since the heat cycles will interfere with the control of
diabetes. It is important to note that even well controlled
diabetics will tend to have higher blood sugar levels than
non-diabetic dogs and cats. If control is not obtained, your
veterinarian may recommend doing further tests to rule out other
concurrent diseases such as Cushing’s or urinary tract
infections.

Monitoring

Blood glucose curves- After first starting on insulin or
changing insulin levels, your veterinarian may ask you to bring
your dog/cat back to the hospital to be left for part of the
day. Frequent checks of your pet’s glucose levels are done
throughout the day (every 2 hours) in order to evaluate its
response to insulin. This procedure may need to be periodically
repeated to ensure the type and amount of insulin prescribed is
adequate, and even for an apparently well controlled diabetic,
it should be done yearly at a minimum.

Fructosamine levels- In addition to serial blood glucose checks,
another helpful blood test is fructosamine levels. This gives a
reading indicates average blood sugar level over the prior few
weeks. However, it does not substitute for a blood glucose curve
since it doesn’t reflect the high and low levels throughout the
day. This is additional information to help control your pet’s
diabetes. However with some cats, especially those that are
stressed or fractious in the hospital, it may not be feasible to
do a glucose curve. In these cases your veterinarian may rely on
fructosamine levels and the signs seen at home that indicate
control (no excessive urination or water consumption or weight
loss). Other tests

Because diabetics almost always have some sugar in their urine,
they are very prone to urinary tract infections. For this
reason, your veterinarian may need to check your pet’s urine for
infection. Symptoms of a urinary tract infection include:
inappropriate urination, having “accidents” in the home, an
unusually strong urine odor, or presence of blood in the urine.
However, often, a pet may have an infection but not show these
symptoms.

If your pet appears to be insulin resistant, there is concern
for concurrent diseases such as hyperadrenocorticism (Cushing’s)
and most veterinarians may recommend doing tests to rule this
out (we use dexamethasone suppression test/ACTH stimulation
test).

Observations

Although these blood and urine tests are helpful, careful
monitoring at home is important too. Thus, by monitoring your
animal’s appetite, water consumption, urine output, and
maintenance of weight, these are indications of control of your
pet’s diabetic condition. For the purpose of monitoring cats’
and small dogs’ weights, it may be worthwhile buying a baby
scale that measures not only pounds, but also ounces. Large dogs
can be weighed on the hospital’s scales at any time at no cost.

Your veterinarian relies on your observations as to whether your
pet is drinking and urinating excessively or losing weight since
this reflects the degree of control of the diabetes. Variations
from an animal’s normal habits should be reported.

If you have questions regarding this disease or its treatment,
don’t hesitate to contact your veterinarian.

The above is general veterinary information. Do not begin
any course of treatment without consulting your regular
veterinarian. All animals should be examined at least once every
12 months.