Managing Diabetes Mellitus

If your cat or dog has been diagnosed by a veterinarian with diabetes mellitus, as a pet owner, you have a very challenging and sometimes overwhelming disease to manage. In understanding the process by which diabetes develops, the proper steps to managing the disease and how to recognize signs of an unstable pet, you can help your pet have a better quality of life while dealing with diabetes.

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What is diabetes mellitus? Diabetes mellitus is a disease of the pancreas. The pancreas produces insulin which is a hormone that regulates blood sugar (glucose) in the body. A pet’s body requires insulin to help intake glucose into the cells to be used as energy. The pancreas of a pet with diabetes mellitus will not produce sufficient amounts of insulin to keep the blood glucose level in the body regular. Without sufficient insulin production the cells cannot intake glucose and the excess stays in the bloodstream resulting in diabetes mellitus.

How do pets develop diabetes mellitus? Although some pets are genetically predisposed to the disease, overweight pets are at an extremely high risk of developing diabetes. Properly managing your pet’s weight is key to prevention of diabetes.

What are the symptoms of diabetes mellitus? Signs that may indicate your pet is diabetic include:

• Increased hunger
• Increased thirst
• Increased frequency of urination
• Lethargy
• Gradual weight loss
• Poor coat condition
• Difficulty using hindquarters

If your pet is exhibiting any of these symptoms, have them checked out by your veterinarian.

How is diabetes mellitus treated? Treatment of the disease involves administration of insulin daily, proper nutrition and weight control and monitoring of the pet’s blood glucose at home.

1.  Administration of insulin: Once your veterinarian has prescribed insulin, they will show you the proper way to administer it at home. Insulin is administered daily at doses and intervals advised by your veterinarian, which vary from pet to pet. The administration of insulin requires the pet owner to be comfortable giving injections under the pet’s skin. It is important to know that for a diabetic pet, blood glucose usually cannot be stabilized without the use of insulin. Although in some instances a pet’s diabetes can go into remission, initially they will likely require insulin treatment and may only be weaned off on the advice of their veterinarian. For pet owners this is the biggest consideration as to the treatment of the disease. It takes a huge personal commitment on the part of the owner to maintain a strict schedule in order to keep their pet stable. Insulin must be given at the same time every day. Insulin should be given following a meal and NEVER if the pet is not eating and/or has been vomiting. Remember, insulin helps to intake glucose (from ingested food) into the body’s cells for energy. Therefore if insulin is administered and no food has been consumed and/or the pet has been vomiting, this will render the pet’s blood glucose too low (hypoglycemia).

2.  Proper nutrition and weight control: The nutritional requirements of a diabetic pet differ from those without the disease. If proper nutrition is exercised, the diabetic pet will be easier to keep stable. In some cases, when diabetes begins to go into remission, pets can be without insulin as long as a strict diet is followed when it is advised by their veterinarian. For cats, a low-carbohydrate and high-protein diet is required for managing their blood glucose levels. Canned food is recommended to meet these requirements, specifically those that contain less than 10% of metabolised energy from carbohydrates. Dry or semi-moist foods should be avoided as they contain the highest amount of carbohydrates. However, if the cat is a picky eater and must have a dry diet, use only those recommended for the management of diabetes which can be provided by your veterinary professional. It is recommended to have food available to diabetic cats at all times although the pet owner must maintain the correct portion size as advised by their veterinarian. In order to keep the canned food moist throughout the day, mix in some water. For dogs, diets that are high in fibre are recommended. High fibre diets are generally lower in sugar and tend to be digested slowly so that the dog does not have to process large amounts of sugar at one time. Timed feedings with measured portions is the recommended method for feeding a diabetic dog. Ideally the dog should be fed in the morning and evening followed by the administration of insulin. In the case with both cats and dogs, if the pet owner follows feeding instructions set out by their veterinarian, weight control can be achieved and their pet will be a more stabilized diabetic.

3.  Monitoring the pet’s blood glucose: While this can be the most challenging aspect of managing a pet’s diabetes, it is also the most useful way a pet owner can determine if their pet’s blood glucose is stable. Your veterinary professional will need to demonstrate how this test is done. It is easier to check a cat’s blood glucose than a dog’s. A cat’s blood glucose can be checked by pricking it’s ear vein with a needle to draw blood, however a dog’s blood glucose needs to be checked by withdrawing blood from a leg vein. The latter requires more skill, two people and a tolerant dog. Once a pet owner has been properly shown how to check their pet’s blood glucose, this can be done at times when the pet seems to be exhibiting unusual symptoms which may be indicative of a high or low blood glucose. Although a large range, a blood glucose of about 4-8mmol/L is considered normal for a pet. Slightly lower or higher readings can be considered normal as long as the pet is not exhibiting unusual symptoms.

What are the complications of diabetes mellitus? Two common complications can occur; diabetic shock and diabetic ketoacidosis.

If your pet has been diagnosed with diabetes and is on insulin, you may encounter an episode of diabetic shock. Diabetic shock occurs when the pet’s blood sugar becomes too low (hypoglycemia).

Signs of hypoglycemia include:

• Lethargy
• Ataxia (stumbling around)
• Muscle twitching
• Seizures
• Coma

Hypoglycemia commonly occurs when the pet is not eating well and the insulin is still administered, if the insulin is improperly administered, or if the amount of insulin as required by the pet is incorrect or has changed. If you see these signs in your pet, seek veterinary attention immediately. If your pet is alert and able to swallow, you can try to administer corn syrup. Try rubbing some on their gums, or giving a teaspoon at a time. If your pet takes the syrup willingly, try mixing some in canned food and encouraging them to eat. Do not administer insulin again without speaking to a veterinary professional.

It is possible for the blood sugar to be too high (hyperglycemia), which also requires veterinary attention as the pet’s insulin dose may need to be adjusted.

Signs of hyperglycemia include:

• Increased thirst
• Increased urination
• Ataxia (stumbling around)
• Anorexia

If any of the signs of hypo/hyperglycemia are noticed, the owner should do a blood glucose test to identify if high or low, and take appropriate measures.

Diabetic ketoacidosis is another complication of diabetes and is a medical emergency.  Fat in the body of a diabetic is broken down in the attempt to be used as energy when glucose is not available due to insufficient insulin. The breakdown of fat produces a substance called ketones which are acidic and in excessive amounts influences the acid-base balance of the body. This in turn affects the kidneys, the body’s ability to maintain fluid and electrolyte balance and can lead to death if untreated.

Both diabetic shock and ketoacidosis require immediate veterinary attention and hospitalization in order to stabilize the pet. For pet owners, this can be very costly and therefore proper management of diabetes is essential in avoiding these complications. Even with proper management, sometimes these complications can occur.

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It is extremely important for pet owners to have a proper diabetic consultation with their veterinary professional before treatment of their pet begins. Make sure you are given written instructions as to the insulin administration, diet and if advised blood glucose testing at home. Have your veterinary hospital and animal emergency hospital phone numbers handy so that you may contact someone for advice if needed. If you suspect that insulin has been given improperly or a dose has been missed or given twice, contact a veterinary professional immediately for assistance.

Tagged as: cat, diabetes, diabetes mellitus, dog, feline, k9, pet