What is Diabetes?
Did you know there are actually two forms of diabetes?
- Diabetes insipidus is the failure to concentrate urine due to a problem with antidiuretic hormone.
- Diabetes mellitus is the common ‘sugar diabetes’ where blood sugar levels are high due to a problem with insulin. From now on we’ll use the word ‘diabetes’ to refer to just this one.
Diabetes is a disease of high blood sugar levels. This blood sugar, glucose, is a by product of digestion and one of the primary sources of fuel for the body.
Diabetes is caused by either a lack of the hormone insulin or an inadequate response to it. Insulin is responsible for moving glucose from the blood stream into cells to be used as energy. Without sufficient insulin or response to it, glucose remains in the blood, leading to high blood sugar levels, called hyperglycemia.
When blood sugar levels get higher than the kidney’s ability to prevent it, glucose spills into the urine. This pulls more water with it through a process called osmotic diuresis. The excess water in the urine produces the characteristic sign of excessive urination, followed by an excessive thirst to keep up with the water loss.
Persistent hyperglycemia, if left untreated, has profound negative effects on the body, including dehydration and weight loss.
Why do animals get diabetes?
The exact underlying disease process is unknown. Contributing factors include:
- Genetics (check your cat’s or dog’s risk by following the links)
- Certain medications (eg cortisone)
- Other diseases (eg Cushing’s syndrome, chronic pancreatitis)
Who gets diabetes?
Diabetes is generally a disease of middle-aged to older animals. Although some breeds have a higher risk, we see it in all breeds of dog and cat.
In cats, Burmese may be more at risk, and males are more commonly affected.
In dogs, females are more commonly affected, with some breeds such Miniature Schnauzers, Samoyeds, Tibetan Terrier and Cairn terrier being genetically predisposed to the condition.
How Do I Know If My Pet Has Diabetes?
The most common symptoms you may notice if your animal has high blood sugar are:
- Urinating more frequently (polyuria)
- Drinking more (polydipsia)
- Weight loss (due to loss of glucose in urine)
- Increased hunger (polyphagia- compensatory mechanism due to inadequate glucose entering the brain)
Other symptoms may include:
- Sweet smelling breath (ketones)
- Urinary tract infections
- Cataracts, blindness
- Skin thinning and hair loss
- Hind limb weakness in cats
- Coma in severe ketoacidosis
If you notice any of these signs in your pet, please get them checked by your vet.
How do we diagnose diabetes?
After a thorough history collection and clinical examination, if there is any suspicion of the disease we will recommend performing a blood test. Urinalysis is also useful, but the diagnosis of diabetes must be confirmed with blood testing.
Once we have our diagnosis, we can then commence treatment.
How do we treat diabetes?
This disease is one requiring lifelong treatment and management. It requires great commitment from the owner, can be expensive, especially initially, as well as labour intensive, however it can also be very rewarding, with many diabetic animals living long, happy lives.
The treatment of diabetes is essentially based around supplementing the animal with an exogenous insulin (by injection) at a suitable dose to regulate the animal’s blood sugar levels within the appropriate range.
Finding this correct insulin dose is where the challenge lies. This generally requires a succession of blood glucose curves, whereby the animal is given a dose of insulin, then a series of blood glucose readings are collected over the day, and the next insulin dose adjusted accordingly.
In some animals, this dose is relatively quick and easy to get to; in others the journey can be less predictable and may therefore take longer. Depending on the state of the animal at diagnosis, or if the animal has any other concurrent health issues complicating their condition, hospitalisation may be required, for several days or longer while insulin therapy is started and blood glucose levels are closely monitored.
The reason that initiation of insulin therapy is done with such great caution is that while persistent hyperglycemia is bad, even short hypoglycemic episodes can be catastrophic, potentially leading to seizures and even death. Thus while we are treating hyperglycemia, we are also careful to avoid inducing hypoglycemia during the process.
Regulating the ideal blood glucose range can be tricky business, but we’re here to help you through it from start to finish.
Success of treatment and long-term management
There is no ‘cure’ for diabetes; even the hopeful idea of remission in cats is only temporary, at best. However, these animals can still enjoy a good quality of life, provided that their condition is well managed by both their vets and owners.
Management includes feeding a consistent diet (in dogs) twice daily at 12 hourly intervals, at the same time everyday (paired with the insulin injection), which can require significant planning and commitment on the owner’s part. In cats it’s a little easier, as variations in diet does not affect blood glucose levels in the same way that it does in dogs.
The other crucial, and often overlooked, component of diabetic management is monitoring. At home monitoring of diabetic animals includes recording weight, changes in appetite, measuring water intake, urine output, checking for glycosuria (glucose in the urine) with a dipstick and even possibly checking blood glucose levels, depending on the situation. Every diabetic animal is unique and an individual plan will be tailored to your pet’s needs- just book an appointment to discuss with us today.
Lastly, it’s important to remember that even once a diabetic is considered “stable”, continued management and monitoring is critical to maintain this status, as diabetes is a dynamic disease, and things can change even with the best, most consistent care. That’s why it’s important to check in with your vet regularly, even if your pet seems well, so that we can intervene early if needed.