Earlier this week, one of my clients brought their feisty, 12-year-old Chihuahua, named Gizmo, in for a nail trim. My veterinary technician noticed that Gizmo had lost two pounds since his last visit in September. This weight loss was a concern given that it was a 15 percent drop in his body weight. Gizmo's owner reported that he was drinking more water, urinating more frequently and had an increased appetite. My technician recommended that they make an appointment to see me, their veterinarian, as soon as possible.
Three days later, I examined Gizmo, whom I found surprisingly more agreeable than usual. (Gizmo is a 12 pound killer!). He did not try to attack me when I approached him. Gizmo even let his mother put his muzzle on without biting her. Both these accepting behaviors were a red flag that Gizmo was not feeling well. Gizmo's physical examination was relatively unremarkable except for his stable heart disease and two ear infections. I suggested to the owner that we perform a complete blood count (CBC), chemistry profile, and a urinalysis. These tests evaluated his white and red blood cell count, liver, blood sugar, electrolytes, kidneys and bladder.
Gizmo's parents thought his recent increased water intake and urination was due to the diuretic he was taking for his congestive heart disease. However, their assumption was incorrect. The blood work revealed that Gizmo had an elevated blood sugar level of 709 mg/dl. A healthy pet's blood sugar level should be between 75 and 150mg/dl. The urinalysis revealed that Gizmo had a tremendous amount of sugar in his urine, which should not be present in the urine of healthy pets. I diagnosed Gizmo with Diabetes Mellitus (otherwise known as Sugar Diabetes).
Coincidently, November is Diabetes Awareness Month in humans. Diabetes mellitus affects over 26 million children and adults in the United States. I thought this was a perfect time to increase the awareness of diabetes in pets. Diabetes mellitus occurs at an alarmingly high rate of approximately one in every 200 cats. In dogs, diabetes is less common, and occurs in approximately one out of every 500 dogs.
When a pet ingests a meal, carbohydrates are broken down to simple sugars and are absorbed into the blood stream. Sugar is an energy source for the body's billions of cells. Sugar needs insulin, a carrier agent, to enter the energy deficient cells. When insulin is not present, the cells are unable to utilize the sugar found in the blood stream and they starve.
In cats, obesity and high carbohydrate diets are frequently triggering factors for precipitating a diabetic pet. Although the most common cause for diabetes mellitus in the dog is unknown, a strong genetic predisposition exists. There is a higher incidence of diabetes in Samoyeds, Australian Terriers, and Swedish Elkhounds and is almost non-existent in Boxers. It is believed that diabetes mellitus has an autoimmune component in the dog that may be environmentally triggered, like an infectious agent or toxin. To date, none are known.
In most diabetic cats, the pancreas may produce insulin but their cells may not adequately respond to it. In human medicine this is called Type II diabetes. In a majority of diabetic dogs, their pancreas does not produce enough insulin and they would be labeled as having Type I diabetes. Despite these significant differences in underlying pathology, both dogs and cats are controlled with diet, exercise and insulin. For cats, I recommend a high protein (greater than 50 percent) and low carbohydrate (less than 10 percent) diet. For dogs, I recommend a high fiber and usually a restricted caloric diet. Both pets need to optimize their body condition to minimize their insulin needs.
Insulin injections in both dogs and cats are given underneath the skin usually two times per day to maintain healthy blood sugar levels. I find my most successful diabetic pet parents are the ones that are more relaxed about dose frequency and not consumed by giving it at the exact time every day. If you're late by an hour or two, I strongly doubt it will have catastrophic consequences. Clients less obsessed with their pets' diabetes are happier and less overwhelmed by their pet care. They tend to persevere well through their pet's illness.
I recommend giving insulin to your diabetic pet after a meal. This prevents you from giving insulin to a pet who is not eating and may be ill. There are a number of different types of insulin products available and your veterinarian will choose the most appropriate one for your pet. Unfortunately, the common oral hypoglycemic (sugar lowering) drugs available in human medicine have yet to be effective in controlling elevated blood sugar levels in our pets. At this date, I do not recommend giving them to pets.
In cats, if diabetes is caught early in the course of the disease a short-term insulin usage may put your pet's diabetes into remission. A high protein diet (greater than 50 percent protein on a dry matter basis) and good weight management may be the only two steps necessary to sustain your cat's remission. Unfortunately for dogs, once diagnosed with diabetes, they are insulin dependent for life despite placing them on a high fiber diet.
If you notice that your pet is drinking more water, urinating more frequently, eating well but losing weight, please take your pet to your veterinarian as soon as possible. A diagnosis of diabetes mellitus may be the reason for your pet's ill health. The good news is that this disease can be successfully controlled with medication (insulin) and diet. Don't be overwhelmed by the diagnosis. A great majority of my clients find giving their pet's insulin is not as frightening as they have previously thought. Most are very happy that they are actively involved in helping their pets live an enjoyable life. To help avoid diabetes, feed your pet a nutritionally balanced diet to meet his/her caloric needs and exercise daily.