Q My dog has recently been diagnosed with diabetes and we are feeling overwhelmed and worried. How did my dog get this disease and how do I treat him? Does it predispose my dog to other health problems?
A; The actual name of the disease is diabetes mellitus (DM) so as not to confuse it with another condition with similar symptoms called diabetes insipidus.
DM is caused by a lack of insulin action, which makes your dog unable to use glucose for energy. Since your dog’s cells cannot use glucose, the cells actually cannot take it in, her blood glucose level increases. Glucose spills into the urine taking water with it, causing increased urine production.
To stay hydrated, your dog will begin to drink more water. Also, since glucose cannot be used for energy, fat and muscle will be broken down as an energy source. So even though your dog’s appetite may be increased they will begin to lose weight.
Dr. Henri Bianucci described this to a listener during our old radio show who asked why her dog was losing weight but eating more as “starvation in the face of plenty.”
Pets have the same forms of diabetes as we do, types 1 and 2. Type 2 is where you still make insulin, but your cells are not responding to it as they should; this is the more common form in cats. Dogs almost always have Type 1, where their pancreas stops making insulin. A dog may be genetically predisposed or acquire the disease.
Genetic predisposition to diabetes is most common in the following breeds: German shepherds, schnauzers, beagles and poodles. Golden retrievers and keeshonds are more prone to juvenile diabetes.
Acquired DM results from chronic inflammation of the pancreas where the normal functioning tissue is replaced by nonfunctioning scar tissue. Generally, diabetes occurs in dogs in middle age (6-9 years). Gender is also a factor in dogs, with females being three times more likely to develop diabetes than males.
Treatment involves insulin injections and a change in diet. Most dogs will require two daily injections of insulin under the skin (subcutaneous). People use the same needles and they are tiny and designed to minimize discomfort.
For pet parents not in the medical profession, giving an injection can be intimidating. However, over time, most people tell me they find giving the small injections are easier than trying to force them to take an oral capsule or pill.
In most dogs, a low-carbohydrate, low-fat, high-fiber diet is recommended. This type of diet prevents sudden spikes in glucose levels, making the DM easier to control.
Almost all dogs will require lifelong therapy. You have to be committed as the No. 1 cause of death in diabetic dogs and cats is not the disease itself, rather, it is the parent’s frustration with the disease.
They also will need periodic monitoring for their entire life to insure the insulin dose is correct.
When assessing a patient’s response, I (Perry Jameson) look at the following three things: the parent’s observations of how their dog is doing at home, are they maintaining weight and blood glucose levels.
I feel good if Mom and Dad think that their dog’s energy level is good and the excessive thirst and urination have improved. Maintenance of a normal weight indicates they are not breaking down muscle and fat stores but instead are able to use glucose for energy.
Finally, I will have the parents feed and administer insulin and then drop off for me to measure glucose levels every 2 hours throughout the day. We can graph these numbers creating a glucose curve to make sure levels are not too low or too high. These visits may be frequent at first but once stable only every 4 to 6 months.
Diabetic patients can be predisposed to other problems, especially when their disease is not well controlled. Their immune defenses are reduced, which can predispose them to secondary infections, commonly urinary tract infections.
They also have a high occurrence of pancreatitis, which can cause vomiting and diarrhea and temporarily disrupt their glucose control.
Additionally, most diabetic dogs will eventually develop cataracts in both eyes. This is a result of the disease and often cannot be prevented even with good regulation of diabetes. Fortunately, they can be removed and vision restored for most dogs.
My biggest concern when treating DM is dropping the blood sugar too low, hypoglycemia. This can manifest as weakness, fainting, coma, seizures and, if prolonged and low enough, even death. For this reason we do not regulate dogs as tightly as humans. It is also safer for dogs to run slightly higher glucose levels than people since dogs also rarely develop the vascular problems people do that can result in renal failure and amputations.
If you are willing to give the insulin injections, feed the appropriate diet and follow your veterinarian’s advice, your dog can have a good life despite being a diabetic.