Pittsburgh Veterinary Specialty & Emergency Center
Diabetes Mellitus
INDUSTRY INSIGHT
VETERINARY SERVICES
SPONSORED CONTENT
of Dogs and Cats
By Tracey Peterson , DVM , DACVIM Internal Medicine Specialist at Pittsburgh Veterinary Specialty and Emergency Center ( PVSEC )
The initial clinical signs are innocent enough . Brittany , your five-yearold 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
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 .
Pittsburgh Veterinary Specialty & Emergency Center
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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