In diabetes mellitus the pancreas loses its insulin producing cells with a consequent loss of insulin production. Glucose levels increase in the blood and eventually glucose is passed out in the urine. This causes the dog to drink excessively and begin to lose weight.

INVESTIGATION

Diabetes can occur secondary to other diseases, such as thyroid or adrenal problems. On suspicion of diabetes, we perform a full blood test to check for concurrent problems. We examine a urine sample and check for infection as many diabetics have urinary infections at the time of diagnosis. In elderly or overweight individuals or in cases where we suspect concurrent disease, we will also check blood pressure.

TREATMENT

Most dogs require treatment with insulin. However, female dogs develop resistance to their own insulin at the heat period. Any un-neutered female showing signs of diabetes should be spayed at the earliest opportunity. On occasion, this alone is curative. For other dogs, treatment is based on diet and insulin therapy for the rest of their lives.

DIETS

Many dogs are very happy to eat the same food every day. This means that the diet has a consistant calorie content. High fiber diets, such as Waltham Weight Control /Diabetic Diet or Hill’s W/D, slow absorption of food and minimize peaks and troughs in blood glucose. Although expensive, these foods allow better diabetic control and make life simpler for the owners of diabetic dogs. All diabetic dogs should be fed a proprietary high fiber diet.

The amount of food to be given should be calculated from the manufacturer’s guidelines and weighed out for each meal. A simple way is to weigh the calculated amount of food and put it into a clear plastic cup or mug. The jug can then be marked with a line to give the amount to be fed at each meal.

If insulin is used once daily, the dog is usually fed half the food immediately after the morning insulin injection and the other half of the food 8-9 hours later when the lowest blood glucose levels are expected. If the dog does not eat all the food, leave it down – if the pet’s blood glucose dips too low it will become hungry and will finish it off. With twice daily insulin injection, a little food can be held back and fed last thing at night. It is important to avoid giving your pet treats (especially sweet foods).

INSULIN INJECTIONS

Although the thought of injecting a pet seems a little frightening, it is a technique that is quickly learned. Within days, most people manage injections without difficulty.

We normally use Insulin Lente with a starting dose of about 1iu/Kg bodyweight. Initially, we like to check the blood glucose every day at a time just before the evening meal (this is called the nadir blood glucose).

It is very important that insulin is stored and handled correctly, since poor handling can cause serious deterioration. The dog should be injected in the armpit or over the ribs – if injected into the thick skin of the scruff the insulin may not be absorbed. The bottle should be inverted a few times to suspend it prior to the insulin being withdrawn. The bottle must not be vigorously shaken. A fresh syringe should be used for each injection. Insulin should always be stored in the fridge and used before its expiry date

Please return used syringes to the practice for safe disposal. Please note -veterinary Insulin is Prescription-Only and is not freely available across the counter.

The key to successful control of DM is regular monitoring. We do this by monitoring levels of blood glucose and fructosamine. We no longer use urine glucose measurements to monitor diabetics.

INITIAL STABILISATION - At first, we like to check the nadir blood glucose every day at a time just before the evening meal. After this has been stable for 4 days in a row, we perform a 24 hour blood glucose curve. Your pet is admitted to hospital and the blood glucose measured every 2 hours during the day and every 4 hours at night. We can thus ensure that the blood glucose is kept within normal limits during the entire day.

CHECK UPS – We examine our diabetic patients at intervals of 2 months. The check up is carried out at an evening surgery before the time of the evening meal. We request that you bring along a fresh urine sample from your pet. A blood sample is taken and sent for fructosamine measurement. Fructosamine measures the blood glucose levels over the previous few weeks. The nadir blood glucose is checked using a glucometer. The urine sediment for signs of infection. The sample must be less than 2 hours old (6 hours if stored in the fridge after collection).

LOSS OF DIABETIC CONTROL – From time to time problems will occur with any diabetic dog that results in loss of control of the disease. For example, severe stress or infection will cause resistance to the insulin injections. This is not necessarily a major problem, but indicates that further investigation and re-stabilisation is required.