Diabetes mellitus

Summary

Diabetes mellitus (DM) is a disorder where the body is unable to regulate blood sugar levels.

Blood sugar levels are controlled, in part, by insulin. Insulin is produced by the pancreas then secreted into the blood, where it travels throughout the body and helps regulate blood sugar. Insulin plays an important role in the body’s ability to use and store glucose.

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The body’s cells use glucose (which travels through the blood) as energy. In order for the body to use glucose, glucose must get inside the cell. Insulin attaches to receptors on the cell, which in turn allows glucose to pass from the blood into the cell.

In most cases, without insulin, glucose can not enter the cell. So the cell is “hungry” even though there are high levels of glucose in the blood. Under these conditions, the body gets signals to start using stored fat and protein as energy sources. A diabetic animal often eats extra food because it is trying to supply its body with additional energy. But the food is not used efficiently, so even though the animal is eating a lot it is still losing weight.

The body eliminates excess blood glucose by filtering it through the kidneys and passing it into the urine. Water must be used to flush this excess glucose out of the body, and this is why you see excessive urine volume in a diabetic. Because so much water is being used to flush the excess glucose out of the body, the animal is thirsty and drinks a lot.

Signs and Symptoms

The classic signs of diabetes are

  • polyuria (PU) - excessive urination

  • polydipsia (PD) - excessive thirst

  • polyphagia - excessive appetite or eating

  • weight loss

  • lethargy

As the disease progresses, the signs include anorexia (loss of appetite), depression, and vomiting.

Dogs are often diagnosed with diabetes because the owner notices the dog has suddenly gone blind. This is due to the rapid cataract development that often occurs in diabetic dogs.

Causes

  • genetic

  • immune-mediated destruction of the pancreatic beta cells

  • infectious viral diseases

  • drugs: glucocorticoids (steroids) and progestagens (reproductive hormones)

  • predisposing diseases: hyperadrenocorticism, acromegaly

Risk Factors

  • OBESITY - both obese cats and dogs are at risk for developing type II diabetes. Cats over 15 pounds are at high risk.

  • DIESTRUS in the unspayed female dog. The period of sexual inactivity after the female is receptive.

  • Breed predisposition: Samoyeds are about 12 times more likely to develop diabetes compared to mixed breed dogs.

Diagnostic Tests

A diagnosis of DM is made based on clinical signs, physical exam, and lab tests. Findings typically include persistent hyperglycemia (elevated blood sugar) and glucosuria (glucose in the urine). Often, ketones are present in the urine or blood.

Normal blood glucose values range from about 80-120 mg/dL. Diabetic animals can have blood glucose values that are moderately elevated, or extremely elevated (600+ mg/dL).

# References

Treatment Guidelines

Note: Treatment of animals should only be performed by a licensed veterinarian. Veterinarians should consult the current literature and current pharmacological formularies before initiating any treatment protocol.

Treatment is insulin. Oral Hypoglycemic agents are rarely used in canines. Typical treatment is two injections a day given 12 hours a part. There are several different types of insulin but it is always given subcutaneously (as an injection). You will work with your Veterinarian to determine the correct dosage and insulin for your dog. Each dog is unique in this.

Diet plays an important role in keeping your pet’s diabetes well regulated. Because insulin requirements change depending on the amount and type of food eaten, a consistent, high-quality diet that the pet will reliably eat is important. The healthier and more consistent the diet, the easier it will be to control the blood glucose. Many veterinarians will recommend using one of the foods that are made for Diabetic Dogs. These foods typically are very high in soluble fiber.

An excellent tool to help in regulating your dog, is to learn to test their blood glucose. Home blood glucose monitoring should be performed in consultation with your veterinarian.

Management

Diabetes can be controlled and your dog can live a long quality life however it does take significant commitment. The first few months are the worst and you need support. A Diabetes diagnosis will also demand a significant financial contribution, especially at first. Education, patience and commitment will make caring for your Diabetic Samoyed a rewarding experience.

Support Groups

http://www.caninediabetes.org/maillists.html

https://groups.yahoo.com/neo/groups/diabetespet/info

Rainbow Pets Diabetes list: To join send a plain text email to majordomo@netwrx1.com. Please note it is the number one and not an L at the end of netwrx. Leave the subject line blank. Write subscribe rainbowbridge in the body of the letter.

Suggested Links

http://www.caninediabetes.org/pdorg/ 2 bones

http://www.vetmed.wsu.edu/outreach/Pet-Health-Topics/categories/diseases/diabetes-mellitus 3 bones

Resource links page from petdiabetes.org 2 bones

http://petswithdiabetes.yuku.com/ 2 bones

Merck Manual Pet Health Edition. Disorders of the Pancreas in Dogs. 4 bones

Demo on how to inject insulin

http://www.lillydiabetes.com/Pages/about-diabetes.aspx 3 bones

http://www.vetsulin.com/ 2 bones

http://www.caninediabetes.org/ 2 bones

Caroline Levin’s book “Dogs, Diet and Disease An Owner’s Guide to Diabetes Mellitus, Pancreatitis, Cushings’s Disease & More“ is a godsend to the Diabetic pet caretaker.

1 bone 2 bones 3 bones 4 bones (full description of ratings)

Current Research

“Living with a Disorder” Journal Entries