Diabetes Mellitus

Diabetes Mellitus

Happy New Year Everyone! Dr. Christina Martini here. Anyone else still recovering from the Holiday sugar coma?

This month I want to talk to you about a common and important health issue in pets – Diabetes Mellitus. About 1 in 300 dogs and 1 in 230 cats in the US have diabetes. Almost all dogs have type-1 diabetes, like children, while almost all cats have type-2 diabetes like adult onset in humans.

In dogs, the diabetes is actually caused by the immune system attacking the beta cells in the pancreas that make insulin. Even though we almost never think of diabetes as an auto-immune disease like rheumatoid arthritis – it actually is! Since females are more prone to auto-immune diseases than males, female dogs have twice the risk of diabetes as males! This means that all dogs with diabetes are insulin dependent, so they will need insulin twice daily for the rest of their lives, even if they lose weight and get healthy.

Cats on the other hand become diabetic through an unhealthy lifestyle of too many carbohydrates, obesity and lack of exercise. Their pancreas simply wears out over a lifetime of overuse and stops producing insulin. This means that cats can sometimes go into remission from their diabetes if it is caught early and they go on a strict diet.

Signs of diabetes in pets are excessive thirst, urination, acting abnormally hungry and weight loss (often after being overweight). To diagnose diabetes the veterinarian needs to perform a blood and urine test. Blood work will show an abnormally high blood sugar as well as abnormal glucose in the urine. This is because when pets become diabetic their pancreas is not secreting insulin which is needed to metabolize the sugar and carbohydrates they eat. Blood work may also show high liver values due to inflammation and high cholesterol.

Diabetes must always initially be treated with insulin, even in cats. This is given by twice daily injections in the scruff of the neck by the pet parent. The insulin pushes the excess sugar in the blood into the cells of the body where is can be used. Diet and weight loss are also important. There are several prescription diets the veterinarian may recommend. These contain complex carbohydrates which are not easily broken down into sugar and healthy fiber to promote weight loss. Moderate consistent exercise is also important. Practically, this means at least 30 minutes of sustained physical activity (walking around the neighborhood) at least 5 times per week for dogs. Cats are a little trickier – they can sometimes be convinced to play with feather toys or laser pointers. Many cats actually enjoy walks outside on a leash and harness with a bit of patience.

Diabetes is monitored with various blood tests. The newest way to manage diabetes is with the use of a continuous blood sugar monitoring device just like in people! The veterinarian places the device on the pet’s shoulder, and it reads their blood sugar over a two week period. This can help the veterinarian decide if the amount of insulin given needs to be adjusted. Pet parents are a very important part of the team and help their veterinarian understand how their pet is feeling at home – do they have more energy? Are they less thirsty? Are they urinating more normal amounts?

Sadly, almost all dogs with diabetes will eventually develop cataracts and become blind, even with appropriate treatment. Luckily, the cataracts can be removed by a skilled veterinary ophthalmologist (eye doctor) and the dog will regain vision.

The prognosis of pet’s diagnosed with diabetes is 2-3 years on average. However, some live much longer, and since most pets are not diagnosed until middle age or older, they can often lead normal healthy lives with appropriate treatment.

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