By Angela Mazza, DVM
Angell General Medicine Service
Your dog is suddenly drinking water out of the toilet. Your cat’s litterbox is flooded with urine and she lost weight. You are worried that something might be wrong with your beloved pet so you head to your veterinarian. After a thorough history and physical exam is performed, labwork is submitted and the results are in. Your pet has diabetes, or more specifically, diabetes mellitus. This can be both sad and scary for you the pet owner, but if you work closely with your veterinarian, diabetes is a treatable disease and your pet can live a happy, long life.
Diabetes mellitus (DM) results when there is either not enough insulin or ineffective insulin resulting in hyperglycemia or high blood sugar. Without insulin, your body’s cells cannot utilize sugars or glucose for nutrition. The body must break down fat, stored starches, and protein to supply calories for the hungry cells. If left untreated, diabetes can cause serious complications that affect multiple organs and body systems.
The most common presenting clinical signs associated with diabetes include increased thirst and urination, increased appetite, and weight loss. Less commonly acute onset of cataracts can be the first thing a pet owner notices, though this tends to occur only in dogs. Cats can present with a neuropathy associated with their hind legs that is called a plantigrade stance. In these cases, the cat’s hocks drop due to nerve damage so it looks as though they are walking on their hocks.
Diabetes is often diagnosed with basic labwork including a general profile, complete blood count, and urinalysis. The telltale sign of diabetes is an increase fasted blood glucose and the presence of glucose in the urine. Cats in particular can have a pronounced stress response that can cause transient high blood sugar so we need to differentiate this from diabetes. Other testing that will often be employed to get a comprehensive assessment of your pet’s health if we are concerned about diabetes include a urine culture to look for a UTI (urinary tract infection) and more specific blood tests such as a fructosamine level which gives us an idea of the average blood sugar over a several week period.
The goals of our treatment are to reduce or eliminate the clinical signs of high blood sugar, to prevent or slow the development of cataracts and other diabetic complications, and to avoid causing low blood sugar caused by the administration of too much insulin. The mainstay of treating diabetic pets is the administration of insulin, however nutritional alterations are also important. Your veterinarian will discuss with you the best option for insulin and/or diet for your pet. Most often, insulin is administered twice daily with a small insulin syringe that tends to be very well tolerated by our cat and dog patients. Insulin dosing is started at a standard dosebased on your pet’s weight, however, most cases require alterations in the dosing depending on how your pet responds. The initial stabilization period does require close monitoring of your pet, as well as frequent communication and regularrecheck appointments with your veterinarian.
One of the more common complications of treatment is administering too much insulin to your pet which can cause low blood sugar. This can cause your pet to be weak and wobbly and in severe cases to have seizures. Another complication is difficulty in regulating your pet’s sugar . This often is because there is another underlying disease process that is affecting the insulin regulation. Some pets also become unregulated over time for no apparent reason. You should never adjust an insulin dose without consulting your veterinarian.
Diabetes can be overwhelming for owners and even for veterinarians! But with good education, close communication with your veterinarian, patience, and perseverance, diabetes is a treatable disease and you and your pet can maintain a good quality of life.
For more information, or to book an appointment with Angell's General Medicine Service, call 617-524-5653 or visit www.angell.org/generalmedicine.