Canine Diabetes

Diabetes mellitus is a disease caused either by a lack of insulin, or an inadequate response of the body to this hormone. After your dog has eaten, the digestive system breaks-down the food into various parts. One of these is carbohydrates which are further converted into simple sugars such as glucose. Glucose is absorbed from the gut into the blood where it is transported around the body. Insulin, which is produced by “beta cells” in the pancreas, helps in the process of moving glucose into the cells of the body where it is converted into fuel. If there is insufficient insulin available, or the body responds inadequately to insulin, glucose is unable to enter cells and can build up to high concentrations in the bloodstream. The resulting condition is called hyperglycemia. As a result, an animal may behave as if it is constantly hungry (the cells are not producing fuel), but may also appear malnourished, again because the cells are unable absorb glucose.

Damage to the beta cells in the pancreas can be either temporary or permanent. The damage may be caused by a virus, infection, trauma, some medications (steroids), or even from over-work after too much sugar or carbohydrate consumption.

Diabetes mellitus is often divided into two types, depending on the origin of the condition:

Type 1
Diabetes mellitus Type 1, sometimes called “juvenile diabetes” or “insulin-dependent diabetes”, is caused by the destruction of beta cells in the pancreas. Because the destruction of the cells is not reversible, the animal must be treated with an exogenous (external) source of insulin. Both dogs and cats can suffer from Type 1 diabetes.

Type 2
Diabetes mellitus Type 2, sometimes called “”adult-onset diabetes” or “non-insulin-dependent diabetes”, is characterized by high blood sugar due to the body being resistant to insulin and a relative lack of insulin. Type 2 diabetes is not found in dogs but it is found in cats.

RISK FACTORS AND INCIDENCE

There is evidence that canine diabetes has a seasonal connection (similar to that in human Type 1 diabetes). The primary cause of canine diabetes is unknown, however, the major risk factors are thought to include
• Genetics
• Autoimmune disease
• Other insulin-resistant disorders, e.g. Pancreatitis
• Obesity
• Certain medications

Between 0.2% to 1.0% of dogs develop Type 1 diabetes. This incidence is expected to increase in the future. The disease typically affects middle-aged (6 to 9 years) and older dogs, especially females that have not been spayed.

Some breeds are at greater risk of developing the disease. These include Australian Terriers, Poodles, Dachshunds, Standard and Miniature Schnauzers, Samoyeds and Keeshonds. Other breeds show a lower risk than normal. These include Boxer, English Springer Spaniel, German Shepherd, Golden Retriever, Staffordshire Bull Terrier and Weimaraner.

Juvenile diabetes can also occur; Golden Retrievers and Keeshonds are particularly susceptible.

DETECTION

Diabetes is one of many conditions that cause visible changes in behavior which the owner can detect. Usually, there is a gradual onset of the disease over a few weeks. By knowing the signs of diabetes, you will be able to detect the disease earlier and thereby seek an early diagnosis and treatment. The following are indications your dog may have diabetes. If your dog shows any of these, speak with your veterinarian about the possibility of diabetes:
• Excessive thirst/drinks more water than usual (polydipsia)
• Urinates more frequently or in greater volumes (polyuria) or perhaps loses urinary control
• Consistently acts hungry (polyphagia) but maintains or loses weight
• Unusually sweet-smelling or fruity breath (from ketone production)
• Lethargy
• Dehydration
• Urinary tract infections
• Vomiting
• Chronic skin infections
• Cloudy or misty eyes

DIAGNOSIS

To diagnose diabetes, your veterinarian will initially conduct a test for the presence of glucose and ketones in the urine. If necessary, a blood test will then measure your dog’s blood glucose concentration. A diagnosis of diabetes is confirmed if glucose is present in the urine and its also at a persistently high concentration in the blood.

MANAGEMENT

The objective in managing diabetes is to regulate glucose concentrations by avoiding peaks and troughs, and to reduce or eliminate the symptoms of diabetes, such as excessive thirst and urination. With daily insulin injections, changes in diet and lifestyle, the disease can be successfully managed. Currently, dogs diagnosed with diabetes and receiving appropriate treatment, have the same, or similar, life expectancy as non-diabetic dogs of the same gender and age.

Insulin
Managing canine diabetes often requires daily insulin injections to restore your dog’s insulin level and control blood glucose concentrations. Each individual diabetic dog’s requirements are different, so you and your veterinarian will need to find the appropriate dose and treatment regimen. Your dog may need to stay at the veterinary clinic for several days so that your dog’s response to treatment can be closely monitored. The prescribed insulin product may be specifically for diabetic dogs, or a human insulin product. The size of insulin dose will depend on several factors, including the weight of the dog.

If your dog needs daily injections, you will have to learn how to do this. It can be a daunting task and at first you may feel nervous about this. This is common, but, it is easier than you probably think. After a while, you will learn how to administer daily injections without stress for your pet or you.

Monitoring
It is an important part of diabetes management to monitor your dog’s blood glucose concentrations. The method of monitoring will depend on you and your diabetic dog. Methods include urine glucose (and ketone) test strips, or, blood glucose meters.

Diet
Diet is vitally important in helping to regulate your dog’s diabetes. If your dog is more stable when first diagnosed, the first treatment might be a high-fiber diet to normalize blood glucose levels. Once the levels are stabilized you should aim to feed your dog exactly the same diet every day and at the same time(s) of day.

The diet is likely to have a low fat content, a good-quality protein, complex carbohydrates and dietary fiber to help slow absorption of glucose from the gut. Your diabetic dog’s insulin injection should be given in conjunction with the regular meals – usually just afterwards. This allows increased nutrients in the blood to coincide with peak insulin levels. This will reduce the tendency for your pet’s blood sugar levels to swing either too high or too low. Overall, the diet should be palatable, nutritious, and minimize fluctuations in blood glucose. In addition, it should help maintain a healthy weight for your dog. Avoid feeding diabetic dogs treats that are high in glucose.

Exercise
For diabetic dogs, exercise should be regulated because activity affects blood glucose concentrations. Create a consistent exercise routine to avoid any sudden requirement for energy or glucose.

Checkups
It is important to get regular veterinary checkups to identify possible changes in your pet’s diabetic condition. Diabetes affects dogs differently over time. Changes may even occur after a long period of stabilization. If diabetes progresses, dogs can develop secondary health concerns such as cataracts and severe urinary tract problems. Ultimately, untreated diabetes can cause coma and death.

THE FUTURE

Although it is often stated that canine diabetes can not be cured, in February 2013, Type 1 diabetes in dogs was successfully cured using pioneering gene therapy.