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Name
Diabetes Mellitus, Canine
Short Description
Diabetes mellitus
Affected Animals:
The average age range for the development of
diabetes mellitus in dogs is four to 14 years, with the majority of
cases occurring at seven to nine years of age. Although males do
develop diabetes, females dogs are twice as likely to be affected by
the disease. A genetic disposition towards diabetes is suspected in
breeds including the Keeshond, pulik, cairn terrier, and miniature
pinscher. In addition, dachshunds, miniature schnauzers, poodles,
and beagles also are frequently diagnosed with the disease. However,
any dog can develop diabetes mellitus.
Overview: Characterized by high concentrations of glucose
in the blood and urine, diabetes mellitus is one of the more common
hormonal disorders of the dog, and the disease almost always
requires lifelong insulin treatment. In addition, chronic high
glucose in the blood and urine can cause severe complications
including infections, cataracts, diabetic ketoacidosis, nervous
system disorders, pancreatitis, and kidney disease. If left
untreated, diabetic dogs will suffer from complications and an early
death.
Diabetic dogs are treated with insulin injections, dietary
modification and exercise. Some people with diabetes can use oral
hypoglycemic drugs, but these medications typically are not helpful
in dogs. In order to regulate their blood glucose levels, diabetic
dogs require frequent veterinary office visits in the initial stages
of treatment, followed by periodic examinations for proper
maintenance thereafter.
Initially, it may be difficult for some owners to give daily insulin
injections, but the majority of dog owners find this task to be
manageable. With proper treatment and monitoring, many diabetic dogs
can enjoy an excellent quality of life.
Clinical Signs: Commonly reported signs include polydipsia,
polyuria, polyphagia, and weight loss. Depending on the stage of the
disease, physical findings may include obesity, cataracts,
dehydration, lethargy, weakness, and ketone halitosis.
Symptoms: Common symptoms noted in diabetic dogs include
excessive thirst, increased volumes of urine, and urinary accidents.
Affected dogs often have weight loss despite an increased appetite.
Other symptoms may include loss of vision, tiredness, and weakness.
Description: Diabetes mellitus is characterized by high
concentrations of glucose in the blood and in the urine. The disease
usually results from either decreased production of insulin by the
pancreas, or impaired insulin function within the body tissues. With
either problem, the dog's system becomes unable to regulate the
glucose that is circulating in the bloodstream. If the condition is
left undiagnosed and untreated, it can progress to severe illness
and possibly death. However, diabetes mellitus sometimes can be
reversible when noted in the intact female dog.
Although there are two types of diabetes mellitus in dogs,
insulin-dependent and non-insulin-dependent, the latter occurs
rarely. This discussion is limited to insulin-dependent diabetes
mellitus, IDDM. Just like humans with IDDM, dogs affected by this
form of the disease will require lifelong administration of insulin
in order to keep their blood glucose levels under control.
Some dogs accept and respond to treatment successfully. Others will
not respond with even the most aggressive treatment, especially if
multiple disorders are present.
Diagnosis: The presence of the classic signs of diabetes
usually prompts laboratory testing. The key diagnostic clues are
high levels of glucose in the blood and in the urine. A more
advanced and critical stage of diabetes is sometimes denoted by the
presence of ketones in the urine. This complicated form of diabetes
is called diabetic ketoacidosis.
The examining veterinarian may run tests, including a CBC, or
complete blood count, a serum biochemical profile, and a urinalysis
to rule out the possibility of other diseases that may cause signs
similar to those seen in diabetes. In some cases, the initial test
results may indicate the need to do more specific tests.
The veterinarian also may schedule in-hospital stays for the dog to
allow for serial blood glucose checks every one to two hours over a
12 to 24 hour period. This series of tests is called a blood glucose
curve, and ideally will provide information about the effectiveness
of the insulin doses and how long each remains active. Depending
upon the results of the tests, the examining veterinarian will
adjust the insulin type, dose, and frequency of administration so
that the dog's blood glucose level remains within a close-to-normal
range over a 24-hour period
Prognosis: The prognosis is dependent on a number of
factors. Whether the dog recovers will depend upon the owner's
willingness to treat the disease, the dog's ability to respond to
the insulin, the dog's age at the onset of disease, the presence of
concurrent disorders, and the development of complications of
diabetes. With dedicated care from the owner, recheck appointments
with the veterinarian, and a teamwork approach between the owner and
the doctor, many diabetic dogs can live healthy lives for several
years. For those pets that fail to respond to therapy, or whose
owners decline treatment, a shortened life span is expected.
Transmission or Cause: The cause of diabetes is believed to be
multifactorial. Causes to consider include genetic predisposition,
infection, drugs, pancreatic disease, obesity, estrus in intact
females, and concurrent illness.
Treatment:
The goals of treatment are to return the dog to
normal health and to prevent complications that can arise from a
high blood glucose level. Some possible complications include
infections of the urinary tract, respiratory system, and skin;
ketoacidosis or severe metabolic disturbance; cataracts which result
in vision loss; pancreatitis or inflammation of the pancreas; and
other less common disorders. Treatment protocols include proper
insulin administration, diet and exercise plans, and control of
concurrent disease. Intact female patients need to be spayed as soon
as their diabetes is stable to prevent disruption of diabetic
control due to fluctuating reproductive hormones. Also, some
unspayed diabetic dogs will have complete resolution of their
diabetes after an ovariohysterectomy.
The examining veterinarian will choose an appropriate type of
insulin for the dog. The most common insulin preparations are
derived from a combination of beef and pork, from purified pork, and
from recombinant human insulin. Many doctors now use this last form
since it is readily available. Insulin types include regular
crystalline, NPH, PZI, Lente, and Ultralente. The specific unit dose
of insulin the veterinarian selects will be based on several
factors, including body weight and type of insulin. The goal is not
to achieve perfect control from the onset, but rather to allow the
dog and owner to get used to the new routine of insulin injections
and dietary changes.
The dog usually is rechecked weekly. It is common for the
veterinarian to make adjustments in the insulin protocol during
these visits. Insulin doses should not be adjusted at home unless
the veterinarian has instructed the change. Blood glucose curves and
other tests are required throughout treatment to accurately assess
the animal's response to treatment. Some dogs can become regulated
with relative ease if they respond well to therapy. Other dogs can
take much longer, or never respond, especially if they have a
concurrent disease. A "honeymoon period" is noted in some dogs in
which they appear to respond initially to the insulin but then lose
control within the first six months of therapy.
Close monitoring of the dog's water consumption and urination will
alert the owner to problems with diabetic control; the veterinarian
should be notified if symptoms fail to improve or if they return.
Success of control is defined by the resolution of symptoms
including excessive thirst, excessive urination, stability of body
weight, normal behavior, and a normal blood glucose range noted in
the blood tests.
Many diabetic dogs are overweight. For optimal glucose control,
obesity should be corrected slowly in diabetic patients; it should
take several months for the dog to reach the ideal weight
recommended by the veterinarian. In addition, the veterinarian may
suggest a specific diet type. Commercial diets containing higher
amounts of fiber and digestible complex carbohydrates usually are
advised for diabetic animals because they help decrease the
fluctuations in blood glucose levels after a meal is consumed. The
total daily caloric intake should be divided into multiple meals and
given within the time frame of insulin action.
Exercise is highly encouraged due to its beneficial effects on blood
glucose control and weight loss. If the dog has not had a structured
routine, then it is recommended to start with short walks and slowly
increase to a tolerable level.
Prevention: It may not be possible to prevent diabetes
mellitus. However, maintaining a dog's ideal weight and initiating
regular exercise into its routine may be beneficial. Owners also
should pay close attention to the dog's drinking, eating, and
elimination habits. If any abnormalities are noted, the owner should
seek veterinary care. Early detection may lead to easier control or,
at least, avoidance of severe disease complications.
