For years public health officials have reported a diabetes epidemic among America’s children and adults. At the same time, the rate of diabetes in America’s pets has more than tripled since 1970, so that today it affects about 1 in every 160 dogs. But while many human cases are caused and can be treated by diet, canine diabetes is a lifelong condition that requires careful blood sugar monitoring and daily insulin injections.
What Is Diabetes?
The medical term for the illness is diabetes mellitus (mellitus is a Latin term that means “honey sweet,” reflecting the elevated sugar levels the condition produces in urine and blood). The mechanism of diabetes is relatively simple to describe. Just as cars use gas for fuel, body cells run on a sugar called glucose. The body obtains glucose by breaking down carbohydrates in the diet. Cells then extract glucose from the blood with the help of insulin, a hormone made by the pancreas in specialized cells called beta cells. (The pancreas, an organ situated behind the stomach, produces several hormones.) In diabetes mellitus, cells don’t take in enough glucose, which then builds up in the blood. As a result, cells starve and organs bathed in sugary blood are damaged. Diabetes is not curable, but it is treatable; a dog with diabetes may live many happy years after diagnosis.
What Type of Diabetes Do Most Dogs Get?
Diabetes can be classified as either Type 1 (lack of insulin production) or Type II (impaired insulin production along with an inadequate response to the hormone.)
The most common form of the disease in dogs is Type 1, insulin-dependent diabetes, which occurs when the pancreas is incapable of producing or secreting adequate levels of insulin. Dogs who have Type I require insulin therapy to survive. Type II diabetes is found in cats and is a lack of normal response to insulin.
Several factors raise a dog’s risk of developing diabetes. These include breed, age, gender, weight, diet, virus infections, an inflamed pancreas, chronic inflammation of the small bowel, Cushing’s disease (excess production of the hormone cortisol) and long-term use of progesterone-like drugs or steroid drugs.
- Breed. A study published in the Veterinary Journal in 2003 examined diabetes rates in thousands of American dogs and found that overall, mixed-breed dogs were more prone to diabetes than purebreds. Among purebreds, breeds varied greatly in their susceptibility.
- Age. Dogs most often develop diabetes during middle or old age.
- Gender. Female dogs and neutered male dogs are more likely than intact males to get diabetes.
- Weight. Obesity can make cells resistant to insulin, but it’s unclear whether it actually causes diabetes in dogs.
- Diet. A diet high in fat may contribute to pancreatitis (inflamed pancreas), a risk factor for diabetes.
What Are the Symptoms of Diabetes in Dogs?
Diabetes can be a silent disease. Your veterinarian may discover your dog’s diabetes through routine bloodwork, but before that, you are likely to notice some of its symptoms: greater than normal hunger and/or thirst, weight loss, and frequent or copious urination . The following symptoms should be investigated as they could be indicators that your dog has diabetes:
- Change in appetite
- Excessive thirst/increase in water consumption
- Weight loss
- Increased urination
- Unusually sweet-smelling or fruity breath
- Urinary tract infections
- Cataract formation, blindness
- Chronic skin infections
A blood test that measures your dog’s blood glucose level is the most common diagnostic tool, but a high glucose level does not always mean diabetes. Because other diseases sometimes raise these levels, your vet may run additional tests to rule out such causes.
Once your dog is diagnosed, her veterinarian will obtain a “serial blood glucose–concentration curve” by measuring her glucose level repeatedly over many hours. The results will help the vet choose an appropriate insulin, dose and dosing schedule.
After treatment starts, your dog will need to be routinely tested to see how well the protocol is working. Most commonly, either a fructosamine test or a glycated hemoglobin test, which reveal average control over the previous one to three weeks (fructosamine) or two to four months (glycated hemoglobin) is used. In contrast, the daily blood glucose measurement is a snapshot, an indication of your dog’s glucose level at one specific moment.
Diabetes treatment is based on how severe the symptoms and lab work are and whether there are any other health issues that could complicate therapy. Each dog will respond a little bit differently to treatment, and therapy must be tailored to the individual dog throughout his life.
Some dogs may be seriously ill when first diagnosed and will require intensive hospital care for several days to regulate their blood sugar.
Dogs who are more stable when first diagnosed may respond to oral medication or a high-fiber diet that helps to normalize glucose levels in the blood.
For most dogs, insulin injections are necessary for adequate regulation of blood glucose. Once your pet’s individual insulin treatment is established, typically based on weight, you’ll be shown how to give him insulin injections at home.
Spaying your dog is recommended, as female sex hormones can have an effect on blood sugar levels.
Your vet may also show you how to perform glucose tests at home.
You are not alone. You can manage diabetes just like thousands of other pet owners. Diabetes can usually be controlled by simply learning to give your dog daily insulin injections. Vetsulin
® (porcine insulin zinc suspension) is the only veterinary insulin approved by the FDA for dogs and is a good insulin choice for your dog. If your dog has other problems as well, your veterinarian will suggest the appropriate management.
Along with insulin therapy, your veterinarian will set up a management program that will include recommendations for feeding your dog (type of food, quantity, and timing of meals) and regular exercise.
Daily insulin injections are essential to control the blood glucose level in your dog. Your veterinarian will work with you to determine the right dose of Vetsulin. This process may take a few weeks, but the end result is very manageable. Some diabetic dogs may require only one injection per day, while others may require twice-daily injections.
It is very important that injections be given at the same time every day. Once you and your dog have established a routine, things will be easier and your dog will be healthier. The key to success is patience with the learning process. The payoff will be a noticeable improvement of your dog’s condition and quality of life over time.
About insulin administration
Because diabetes is caused by a lack or shortage of insulin, your dog will need management with insulin such as Vetsulin. Your veterinarian will help you find your dog’s correct dose and tailor your dog’s insulin dose accordingly. You may also have the chance to choose whether to administer Vetsulin to your dog using syringes or the VetPen® insulin pen. Once you have the correct insulin dose, it is extremely important that you administer your dog’s therapy at the same time every day. Just like any routine, getting used to this will take a little time. Once you and your dog acclimate, however, you’ll both find the process fairly simple, painless, and quick.
What Should I Know About Treating My Diabetic Dog at Home?
As your veterinarian will explain, it’s important to always give your dog insulin at the same time every day and feed him regular meals in conjunction with his medication. This allows increased nutrients in the blood to coincide with peak insulin levels, and will lessen the chance that his sugar levels will swing either too high or too low. You can work with your vet to create a feeding schedule around your pet’s medication time. It is also important to avoid feeding your diabetic dog treats that are high in glucose. Regular blood glucose checks are a critical part of monitoring and treating any diabetic patient, and your veterinarian will help you set up a schedule for checking your dog’s blood sugar.
Please also consult your vet about a consistent, daily exercise program and proper nutrition for your dog to help keep his weight in check.
How Can Diabetes Be Prevented?
Although a certain form of diabetes, the type found in dogs less than a year of age, is inherited, proper diet and regular exercise can be very effective in helping to prevent onset of diabetes in older dogs. Aside from other negative health effects, obesity is known to contribute to an ability to respond normally to insulin.
Concurrent disorders that can make diabetes more difficult to control include hyperadrenocorticism (Cushing’s disease), infections, hypothyroidism, renal insufficiency, liver insufficiency, cardiac insufficiency, chronic inflammation (especially pancreatitis), EPI, severe obesity, hyperlipidemia, and cancer.
With proper treatment, dogs with diabetes have survival rates very similar to those of non-diabetic dogs of the same age and gender, though their risk is greatest during the first six months of treatment, when insulin therapy is introduced and glucose levels are being regulated. Diabetic dogs are more likely to die of kidney disease, infections, or liver/pancreatic disorders than of diabetes itself. But once their condition stabilizes, diabetic dogs can lead happy, healthy lives.
My dog is regulated—what’s next?
Regulation or stabilization of clinical signs of diabetes often goes very well for years. It is recommended to see your veterinarian on a regular basis (2–4 times a year). On these occasions, a general examination will be performed and rechecking the blood glucose level may be advised. Unfortunately, your dog may suffer occasionally from stress, infections, dental problems, or other situations that can alter his or her diabetes. At that time, your dog will again show typical signs of diabetes (drinking and urinating more, for example), indicating you should consult your veterinarian.
What Can Happen If Diabetes Goes Untreated?
If diabetes progresses without being treated, dogs can develop secondary health problems like cataracts and severe urinary tract problems. Ultimately, untreated diabetes can cause coma and death.
Day to Day With Your Diabetic Dog
Keeping a logbook can help you monitor your diabetic dog’s progress. Every day, record blood glucose test results; any ketone test results; changes in your dog’s appetite, weight, appearance, water intake, urination frequency or mood; and any treatment changes your veterinarian makes. A simple notebook, calendar or computer spreadsheet works well.
Among the things to watch for on a day-to-day basis are hyperglycemia, when blood glucose levels rise above the top end of the recommended normal level (ask your vet what this is for your dog; since perfect control isn’t always attainable with current methods, vets generally try to keep most dogs below 200 mg/dl), and hypoglycemia, when the level drops to 60 mg/dl or less.
Hyperglycemia can lead to ketoacidosis (harmful levels of ketones in the blood), which qualifies as an emergency, and you should call your vet right away. Symptoms include drinking lots of water, urinating frequently or copiously, loss of appetite, weakness, vomiting, lethargy, ketones in the urine, or—in the most serious situation—coma. Test strips are available to detect ketones in your dog’s urine, and you should report the presence of ketones to your veterinarian immediately, even if your dog has no other symptoms.
In hypoglycemia, a range of symptoms may be present, including restlessness, lethargy, confusion, weakness, wobbliness, lack of coordination, shivering, sweaty paws, seizures or coma. Test your dog’s blood glucose level if these symptoms appear. If it is below the recommended level, rub maple syrup, Karo syrup or tube cake frosting—high-sugar foods that are quickly absorbed into the bloodstream—on your dog’s gums and the inside of her cheek, then call your vet to report the episode and get further instructions.
Modern medicine has made caring for a diabetic dog quite doable and certainly worthwhile. Although daily care can seem burdensome at first, once you get used to it, it becomes a routine part of the day, like feeding her or taking her for walks. Owners do not need to worry that shots and blood tests will take over their lives. Nor do they need to fear that their dog will not be happy. Almost all diabetic dogs can be treated at home and can enjoy a good life. A diagnosis of diabetes offers a challenge, but it’s a challenge that can be successfully met.