November is National Pet Diabetes Awareness Month.
Diabetes Mellitus is a condition that affects the concentration of glucose (or sugar) in the blood; dogs and cats become diabetic when their bodies do not make enough insulin or if the body is unable to use (is resistant to) the insulin that is produced. Insulin is a hormone produced in the pancreas, which regulates the amount of glucose in the blood. There are two types of Diabetes; Type I Diabetes is usually caused by a loss or dysfunction of the cells of the pancreas, meaning that it cannot produce insulin properly and Type II Diabetes, where the body develops an abnormal resistance to the insulin
When an animal eats, the food is broken down into very small components that the body can use some of these components are converted into several types of sugars including glucose. Glucose is absorbed from the intestines into the bloodstream, it then travels to cells in the body where it can be absorbed and used as a source of energy. Insulin is responsible for converting the glucose to energy in the cells; without insulin, the glucose cannot enter the cells and just builds up in the bloodstream (hyperglycaemia). This may lead a pet to act hungry all the time and eat constantly, but still be malnourished because its cells can’t absorb glucose for use in the body.
Pets At Risk
Diabetes affects 1 in 500 cats and dogs. It has been diagnosed in cats and dogs of all ages, both sexes, neutered and unneutered, and all breeds. It is, however seen more frequently in middle-aged to older pets and un-neutered bitches.
Whilst we do not know the exact cause of diabetes in pets, experts believe that it can be linked to several different factors including
- Lack of exercise
- Pre existing medical conditions; Pancreatitis and hyperthyroidism for example
- Genetic tendencies or predisposition; certain breeds are thought to be more likely to suffer from diabetes including Poodles, Dachshunds, Miniature Schnauzers, Beagles, Dobermans, Retrievers and West Highland Terriers, but this may just be because they are more popular breeds and so are seen more often by vets. It has also been noted that Burmese cats may have a higher predisposition than any other breed.
Symptoms Of Diabetes
If your pet shows any of the following signs speak with your veterinary surgeon about the possibility of diabetes:
- Drinking more water
- Urinating more frequently or has “accidents” in the house
- Always hungry or has changes in appetite with weight gain or weight loss
- Lethargy or sleeping more
- Thinning, dry or dull coat
- Has cloudy eyes (cataracts)
We sometimes see young puppies with diabetes and, although we do not know the exact cause, it is thought that it may be due to autoimmune disorders or damage to the pancreas by diseases such as parvovirus. Juvenile diabetes is thought to be an inherited trait in Golden Retrievers, so genetics may also play a role in this disease.
Signs of Juvenile Diabetes
- Improper growth, the puppy may be smaller than is normal
- Weight loss despite a ravenous appetite
- Paralysis – sometimes seen in hind legs
Diagnosis Of Diabetes
To test for diabetes the vet will thoroughly examine your pet and then examine a urine sample which will show us if any abnormalities are present, such as glucose or ketones. If the urine test shows that there is glucose and/or ketones present, then the next step is to take a blood sample from your pet. A blood sample will show the vet how much glucose is present in your pet’s blood as well as how well the other organs in your pet’s body are working, in order to rule out any other diseases or problems. A diagnosis of diabetes only becomes definite when glucose is found in the urine and at a persistently high concentration in the blood.
Treatment Of Diabetes
Although we cannot cure pet diabetes, we can treat it successfully and many pets can lead long and happy lives providing their diabetes is kept under control. Treatment will take a lot of commitment from you as the owner, as well as regular check ups for your pet with the vet and veterinary nurse. A fixed routine for your pet is the key to successful management of diabetes and any sudden changes in diet or exercise must be avoided.
Medication – Your pet may need once or twice daily injections of insulin in order to help keep the diabetes under control. This is not as scary as it sounds and owners can be shown how to do this properly and safely by a veterinary nurse. Some diabetic cats go into ‘clinical remission’ and no longer need insulin after a few months of treatment, and they can often be managed on diet alone (It is important to remember that remission doesn’t mean that he or she is cured and care must still be taken with the cat’s diet and lifestyle)
Diet – What your pet eats is extremely important in the successful management of diabetes. Food has a massive effect on the amount of glucose in the body and how quickly it is utilised. Your pet will need to be fed exactly the same food at the same time every day. Titbits and treats can be given, but again they must be the same every day. An ideal diabetes diet for dogs is usually restricted in fat content, has a high complex carbohydrate content and is high in fibre. Ideal diabetic diets for cats include high quality, highly digestible protein and restricted fat.
Exercise – This can also have a huge impact on glucose and energy levels. As with the diet, exercise should be consistent and given at the same time each day in order to avoid sudden changes in energy or glucose requirements. For dog owners this can take some getting used to as it means you will need to take special care if you are planning longer walks at weekends.
Regular monitoring – Your pet will need regular monitoring by you and the veterinary team, to ensure that the diabetes is controlled and your pet stays healthy. As well as giving any medication, you will need to monitor your pet daily for any signs that he or she is unwell. You may also be asked to regularly test your pet’s urine using a dipstick, or shown how to take pinprick blood samples from your pet in order to monitor glucose levels.
Your vet will monitor your pet by giving them health checks and taking regular blood samples in order to make sure that he or she is receiving the correct treatment at the right dose. Occasionally your pet may need a blood test called a ‘glucose curve’; this usually means that your pet stays at the veterinary practice for the day (and sometimes overnight) for a series of pin prick blood tests to check the glucose concentration in the blood every two hours. A glucose curve gives the veterinary team a really good indication of how well the insulin medication is working and helps them to change your pet’s dose if necessary.
Complications Of Diabetes
There can be complications if Diabetes is not carefully monitored and treated properly including
Hypoglycaemia (low blood sugar)
Hypoglycaemia can be caused by
- The pet receiving a normal dose of insulin but not eating its normal quantity of food (Not eating, vomiting the meal, or having diarrhoea).
- The pet being abnormally active or having more exercise than usual, leading to abnormally high energy (glucose) use.
- The pet accidentally being given too much insulin by injection (human error).
Hypoglycaemia can be fatal so it is extremely important that you are able to recognise these signs which may be some or all of the following
- Trembling or shivering
- Unusual movements or behaviour – some animals become very quiet and may stop eating.
- Muscle twitching
If your pet is showing any of the above signs, you need to act quickly and get some glucose into the pet. This can be achieved by feeding, syringing a glucose solution into the pet’s mouth or by rubbing glucose powder onto his or her gums.
Hind Leg Weakness in Cats
High concentrations of glucose in the blood may cause damage to nerves resulting in weakness and muscle wasting, usually of the hind legs.
High blood glucose levels cause changes in the lens of the eye and water diffuses into the lens causing swelling and disruption of the lens structure. When the lens of the eye becomes opaque, blindness results in the affected eye or eyes. Cataracts in dogs with diabetes are seen far more often than in cats with diabetes.
In very severe case, where diabetes has gone undiagnosed for a long period or if treatment is not working for a diabetic animal, the animal may develop diabetic ketoacidosis. Because of a lack of insulin the glucose in the body cannot be used as an energy source so the body starts to break down fat and muscle instead of using the glucose, this releases acids known as ketones into the bloodstream causing anorexia, lethargy, acetone-smelling breath, dehydration and nausea and may eventually lead to death.
Ketoacidosis is a veterinary emergency and you need to get your pet to a vet immediately.
If your pet is showing any of the above symptoms and you are concerned about Diabetes then please contact your veterinary practice to book an appointment.