Diabetes

Some pet owners are surprised to find that diabetes can be a problem for cats and dogs as well as people. In fact, the statistic is that about 1 in every 400 pets is diabetic.

Diabetes is the lack of insulin production in the pancreas or an inappropriate response to insulin in the tissues. Insulin is a very important hormone. It allows the transport of glucose (also referred to as blood sugar) out of the blood stream and into the body's cells.

Ideally, the process works like this: The pet eats, and the digestive process breaks the food down into the simple sugar glucose. The glucose moves from the digestive tract into the bloodstream, where the insulin then prompts it's uptake into the cells. You can think of insulin as the key that unlocks the cells so that glucose can get in.

In a diabetic pet, the glucose is not properly transported into the cells due to poor production of or response to insulin and the level of glucose in the blood stream (blood glucose) continues to rise.

As blood glucose continues to rise, it is spilled out into the urine and causes an increase in frequency of urination due to the higher concentration of solutes (sugar) in the urine. Increased frequency of urination results in increased water consumption. We refer to these two clinical signs as polyuria and polydipsea, two of the most common clinical signs of diabetes. We also look for a history of weakness or lethargy as well as weight loss despite normal or increased appetite due to the inappropriate use of food for fuel.

Diabetes is not necessarily a death sentence for a pet. In fact, once they have been regulated on the proper dosage of insulin, most pets can still have a long, happy life, with few of the detrimental side-effects seen in human patients.

To diagnose diabetes, a series of tests are performed, including both blood and urine analyses. The blood work confirms the high glucose levels and also gives us a picture of any other systemic changes that may be occurring. Because blood glucose levels may rise in response to stress and other stimulus (including the ride to the clinic) a urinalysis is performed to verify the spillover of glucose into the urine. It is also used to monitor for urinary tract infections secondary to diabetes.

Once diabetes has been diagnosed, we then determine the proper regimen to regulate the pet's blood glucose. This usually involves a diet change and careful prescription of the proper dose and schedule of insulin administration for each pet.

We commonly change diabetic patients to a high fiber diet. You may ask why we would start a pet that is already experiencing weight loss on a high-fiber diet. We do this for several reasons. Fiber slows down the digestion of food, so instead of having one great big dose of glucose hitting the blood stream all at once, it trickles in slowly. This prevents the blood sugar levels from skyrocketing and allows the body to process the glucose at a less frantic pace. Plus, fiber helps the pet feel more full, and they will eat less. When the glucose is not getting into the cells, the body sends signals that it is still hungry, which means diabetic patients will often eat more than they need to. When their belly if full of fiber, the "full" signals can cancel out the "hungry" signals and the food consumption will even out.

A major part of treating diabetes is regulating the administration of insulin. We start pets on a dose of insulin based upon their weight and other factors. We often test the pet by doing what is known as a glucose curve. After the morning dose of insulin, we hospitalize the pet for the day and test their blood sugar levels every 2 to 3 hours throughout the course of the day to monitor how the levels fluctuate. Based upon this information, we can adjust the insulin dose appropriately. It is important to repeat the glucose curve in several weeks to monitor response to the new dosage.

We continue to check the blood sugar levels periodically to make sure that the insulin is continuing to do what it is supposed to. Just as the human body changes as we age, so do the bodies of our pets. This means that down the road, their insulin dosage may need to be adjusted once in a while to keep everything in balance.

And, unfortunately, the fact that a pet is regulated on their insulin does not mean that they will never have any problems related to their diabetes. Pets with this condition are more susceptible to bacterial and fungal infections including urinary tract infections. A condition called insulin shock, resulting from lack of food intake before an injection or two insulin injections given too close together, can result in complications ranging from lack of energy to seizures or coma.

On the whole, diabetes is a very manageable disease. Most pets can continue to live a long, happy life if their condition is managed consistently and correctly. If you suspect your pet might have diabetes, please take the time to bring her or him in for an exam.