INDUSTRY INSIGHT
VETERINARY SERVICES
Diabetes Mellitus
SPONSORED CONTENT
of Dogs and Cats
By Tracey Peterson, DVM, DACVIM
Internal Medicine Specialist at Pittsburgh Veterinary
Specialty and Emergency Center (PVSEC)
T
he initial clinical signs are innocent enough. Brittany, your five-year-
old maltese, urinated in the living room. She has always been well
house-trained so this is puzzling. Now that you think about it, you have
noticed that you are refilling her water bowl more frequently. Maybe it’s the
hot weather or maybe she’s stressed about the home renovations. She is
still active and interactive. Her appetite is still good. In fact, her appetite is
great. She never misses a meal and is more eager for treats than she ever has
been. This goes on for a few weeks. She has more accidents in the house. You
just can’t seem to keep her water dish full. Even though she has a ravenous
appetite, you notice that somehow, some way, Brittany appears to be losing
weight. Increased water consumption and urination frequency with weight
loss in the face of a normal-to-increased appetite are all telling signs that
Brittany has developed diabetes mellitus.
Diabetes mellitus occurs when the pancreas fails to produce enough insulin
for the body’s daily requirements. Insulin is the hormone required to move
glucose from the blood into the cells where it is used for energy. Without
insulin, regardless of the caloric intake, the body’s tissues are in a constant
state of starvation, resulting in weight loss. Without insulin, glucose cannot
be shuttled into the cells. As a consequence, there is an excessive amount of
glucose in the bloodstream. The kidneys are responsible for excreting this
excess glucose, resulting in excessive urination and thirst. If left undiagnosed
and untreated, diabetes mellitus can have severe, life-threatening metabolic
consequences.
Unlike many other endocrine (hormonal) diseases, diabetes mellitus is
relatively easy for your veterinarian to diagnose at the initial evaluation. In
dogs and cats, the diagnosis of diabetes mellitus is made when there is a
documented elevation in blood glucose with a concurrent glucose in the
urine. Certain drugs and stress can cause an elevation in a blood glucose
reading but rarely result in glucose leakage into the urine. If there is any
question whether your dog or cat has diabetes mellitus, before starting
treatment, additional testing may be recommended. This may be re-checking
the blood and urine glucose in a few days or submitting an additional blood
test called a fructosamine. Fructosamine is a marker of glucose concentration
over the previous 1-3 weeks and should not be affected by drugs or stress.
An elevation in the fructosamine level supports the diagnosis of diabetes
mellitus.
Unlike people, dogs diagnosed with diabetes mellitus cannot be managed
with oral medication and/or diet and exercise. Dogs are considered to be
insulin dependent. They will require a subcutaneous injection of insulin every
12 hours for the rest of their life. There are both veterinarian and human
insulin therapy options that can be used for diabetic management. Your
Pittsburgh Veterinary Specialty
& Emergency Center
veterinarian can discuss these options in detail. Diet is a critical factor in
canine diabetic management. It is more important to make sure your dog is
consistently eating a full meal so insulin can safely be administered.
Cats are not small dogs. Cats with diabetes mellitus do have similarities to
people with diabetes mellitus. Although the majority of cats (70%) diagnosed
with diabetes required daily insulin injections, some can be managed with
diet alone. There are commercially available, specially formulated high protein,
low carbohydrate diets that can regulate the blood glucose. In addition,
some cats initially diagnosed with insulin dependent diabetes mellitus can
achieve diabetic remission and have their disease managed by diet alone.
This remission can be transient or permanent. It is important to note, that
although feeding a diabetic diet can help with diabetic management, it is not
100% necessary. There are many cats happily eating grocery store-brand food
that still have good management of their diabetes. As with dogs, for those
cats with insulin dependent diabetes, it is most important for your cat to be
consistently eating so insulin can safely be administered. Diet and insulin
options for your cat can be discussed in detail with your veterinarian.
Although at home blood glucose monitoring for your diabetic pet is an
option, scheduling a follow-up appointment with your veterinarian for a blood
glucose curve and fructosamine is recommended. This involves feeding and
administering insulin at the regular time then obtaining a blood glucose
reading every 2 hours. The goal of a blood glucose curve is to determine the
current dose of insulin’s duration of effect and when the peak effect occurs.
Therapy recommendations can be made based on these results. It is critical to
never increase an insulin dose based on a single blood glucose reading, as a
single high reading could mean your pet is over-regulated (receiving too much
insulin) and not under-regulated (receiving too little insulin). This is because
if the blood glucose is too low, the body quickly adjusts to increase the blood
glucose. If the single reading is taken during the time of adjustment, this high
glucose reading would be incorrectly interpreted to mean a higher dose of
insulin is necessary. Inappropriately increasing the insulin dose could result in
life-threatening hypoglycemia (low blood sugar). An insulin dose should never
be adjusted without the advisement of your veterinarian.
What does a diagnosis of diabetes mellitus mean for your pet’s quality
of life and longevity of life? Often the prognosis depends on the owner’s
commitment to treating the disease. Concurrent illness, like kidney disease
or pancreatitis, can make good regulation challenging. Administering too
much or too little insulin can have life-threatening consequences. Dogs with
diabetes mellitus can develop cataracts, which will require treatment. That
being said, if diagnosed early and treated and monitored appropriately, a
good quality of life can be maintained for years with this disease.
South Hills location: 1535 Washington Road, Washington, PA 15301, 724.809.2000
North Hills location: 807 Camp Horne Rd., Pittsburgh, PA 15237, 412.536.5248
Web site: PVS-EC.com
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