Diabetes Mellitus
What is Diabetes Mellitus?
Diabetes mellitus occurs when the body either lacks insulin or cannot use it effectively. Insulin, a hormone produced by the pancreas, helps cells absorb and use glucose, which provides energy.
In diabetic states, the body cannot utilise glucose, so it begins breaking down proteins and fats for energy. This breakdown produces ketones, leading to ketoacidosis. If untreated, ketoacidosis causes severe illness and can be fatal.
Humans have different types of diabetes based on insulin production. In dogs, 100% have type 1 diabetes, meaning they depend on lifelong insulin injections. In cats, some may develop type 2 diabetes, where insulin dependence is lower. These cats may go into remission, and in some cases, vets may reduce or stop their insulin injections.
What are the clinical signs?
The main clinical signs of diabetes mellitus are:
- Excessive eating
- Excessive thirst
- Excessive urination
- Weight loss
What testing is needed to diagnose, and then treat, diabetes?
When animals show the appropriate clinical signs, vets use blood and urine tests to diagnose diabetes. Diabetic animals have elevated glucose levels in their blood, which also spills into the urine. Additional blood tests are necessary since many diabetic animals also have other medical issues, such as urinary tract infections, pancreatitis, or hyperadrenocorticism.
Once diagnosed, the animal usually requires hospitalization for treatment, with serial blood glucose tests performed throughout the day. These tests help adjust insulin therapy effectively. Serial blood glucose curves are typically used for newly diagnosed or poorly controlled diabetic animals.
At home, owners can monitor their pet’s urine for glucose or ketones. Consistently high glucose or the presence of ketones in the urine means the animal needs to be rechecked by the veterinarian.
What treatment is needed?
Most insulin treatment plans combine insulin, diet adjustments, and exercise. What works best varies between individual animals and is often unpredictable at the beginning. Insulin serves as the cornerstone of diabetes mellitus therapy. Newly diagnosed diabetic dogs are insulin-dependent.
It’s extremely rare for diabetic dogs to go into remission unless they’re older, entire, non-desexed females or have a condition called hyperadrenocorticism. However, 10-40% of cats may experience remission after initial treatment.
Most diabetic dogs and cats can lead healthy, happy lives with insulin injections. There is no one-size-fits-all dose (based on weight, breed, or gender), and no single type of insulin works for all pets. Most diabetic pets respond best to twice-daily insulin injections. However, the first regimen may not be immediately effective, and adjustments through trial and error are necessary to establish an effective protocol. Treatment is an ongoing process of refinement, and continuous monitoring is crucial. Although giving injections may seem intimidating at first, most owners and pets quickly become comfortable with the procedure.
See also Treatment of Diabetes Mellitus.
