Pet obesity is an epidemic, which is bad, but obesity also causes other serious diseases, which is worse. Diabetes is a growing concern among vets in the UK, and USA and dogs and cats are fairly equally affected. Diabetes is a chronic disease that can’t be cured. It requires lifelong treatment, and close management and monitoring.
What is diabetes mellitus in dogs and cats?
Pets suffer from similar forms of diabetes mellitus as people. Type 1 diabetes most commonly affects juveniles. It occurs when the pancreas is unable to produce sufficient insulin to maintain healthy blood glucose levels. It’s also called insulin-dependent diabetes and is more common in dogs than cats. Type 2 diabetes affects adults and is usually caused by lifestyle. It occurs when the body develops a resistance to insulin and can no longer absorb it properly. This type of diabetes is more common in cats than dogs. Without enough insulin, cells can’t absorb sugar, amino acids, electrolytes and fatty acids, which essentially means that the cells starve.
Other terms include insulin-deficiency diabetes (IDD) and insulin-resistance diabetes (IRD). IDD is when pets lose beta cells and can’t produce sufficient insulin to maintain healthy glucose levels. IRD is when insulin no longer functions as it should, as a result of illness, medication and diestrus. It affects unspayed females only and is the result of continuously high levels of progesterone.
Are certain breeds at greater risk of diabetes mellitus?
While older cats of all breeds are at risk of diabetes, there are certain types who are at greater risk than others. Burmese cats, for example, are more likely to suffer from diabetes than other cat breeds.
When it comes to dogs, diabetes is more common in the middle to senior years. It’s also more common in females and neutered males.
Certain dog breeds are also more vulnerable to diabetes than others, including:
- Alaskan malamute
- Siberian husky
- Miniature pinscher
- Springer spaniel
- Cairn terrier
- Miniature schnauzer
- Labrador retriever
- Golden retriever
- Old English sheepdog
- West Highland White terrier
- Bichon Frise
What causes diabetes in cats and dogs?
Pancreatic disorders are common causes of diabetes. These disorders can be genetic or environmental or result from overstimulation of the immune system (which can result from over vaccination and a diet rich in processed foods).
Certain conditions (Cushing’s disease) can also contribute to insulin resistance as can overuse of steroid drugs (prednisone). High levels of progesterone in unsterilised females can cause gestational diabetes. Usually gestational diabetes only lasts as long as the progesterone levels are high, once they are normalised the diabetic symptoms go away.
Diabetes is often referred to as a lifestyle disease. It’s caused primarily by obesity, usually as a result of poor (high fat, high carb) diets. These diets are high in grains (corn, wheat, rice, roy, millet and even quinoa) and carbs, and low in quality proteins. When these ingredients break down, they turn into sugar, which requires a lot of insulin for cells to absorb any nutrients.
Eventually this affects the body’s ability to produce and absorb insulin and the cells can’t access any of the nutrients around them.
Most commercial dog and cat food is high in carbs and uses meat derivatives as opposed to real meat, so the quality of the protein is poor. Pets who eat a lot of high-fat table scraps have sugar rich diets that affect insulin production and absorption.
Pets who lead sedentary lifestyles are more prone to diabetes than dogs and cats who get plenty of aerobic exercise. It’s not enough for your dog or cat to be able to roam the garden or the neighbourhood, even a leisurely stroll around the block is not enough for your dog. It’s estimated that dogs and cats need to elevate their heart rate through 20 minutes of aerobic/cardiovascular exercise a day. That means a good run and explore, a good fetch and tug session, a good gave of running hide and seek – anything that will get their (and your) blood pumping.
Symptoms of diabetes in dogs and cats
The signs of diabetes in dogs and cats are very similar and include:
- Increased urination: When your pet’s cells can’t absorb nutrients and blood sugar levels escalate, the only thing for them to do is exit the body through urine. Your pet has no choice but to urinate more often and this can lead to ‘accidents’ in the house.
- Increased thirst: With increased urination comes increased thirst, so if you need to fill your pet’s water bowl more often you should keep an eye open for some of the other signs of diabetes. Increased urination and thirst can also indicate other illnesses, so it may be a good idea to go to the vet anyway.
- Greater appetite: Because your dog’s or cat’s cells aren’t absorbing nutrients, they feel hungry all the time, so they eat more. They are essentially malnourished because they can’t absorb nutrients.
- Weight loss: Again, even though your pet is eating more, the inability to absorb any nutrients makes the lose weight rather than get on the fast track to obesity.
- Lethargy: And again, the lack of nutrients results in a lack of energy, so your dog or cat doesn’t want to do anything other than sleep. So if your dog shows no interest in any activities she used to love, including playing fetch or hiking, there may be cause for concern.
- Vision problems: Dogs with diabetes are more likely to have vision problems, including cataracts and blindness, than cats. But that doesn’t mean that cats can’t also get diabetic cataracts.
- Hind limb weakness: Plantigrade stance (weakness in rear limbs) is a symptom of diabetes that affects cats only. If your cat starts walking on her back ankles instead her foot pads, you should go to the vet. Strength will return to your cat’s back legs with successful diabetes treatment.
- Urinary tract infections: All of the sugar in the urine can lead to bacteria growth in the bladder, which can cause urinary tract infections.
- Kidney failure: Kidney failure is another symptom of diabetes that is more common in cats than dogs. It’s also caused by the excess sugar in their urine.
How to diagnose diabetes
If your dog or cat shows any of these symptoms, you need to visit your vet for a proper diagnosis. There are two primary ways in which veterinarians test for diabetes:
- Urine test: A urine sample is tested for glucose and other signs of infection. Glucose in the urine is a good indicator of diabetes.
- Blood test: Blood is also tested for glucose. Elevated levels of glucose or sugar in the blood are a good indicator of diabetes.
Other tests for diabetes in dogs and cats include checking for ketones or protein in urine, increased liver enzymes, high cholesterol and triglycerides, enlarged liver, and high white blood cell count that may result from secondary infections.
Your vet will also conduct a physical exam to see if there are any other infections or conditions that could either mimic diabetes or affect treatment.
Secondary conditions or complications in your diabetic pet
Certain conditions, which can arise from diabetes, can complicate treatment. Dogs and cats can suffer from the same or similar complications, while some are unique to each species. Complications include:
Diabetic nephropathy is a kidney problem that is more common in cats than dogs. Signs of nephropathy include hyperalbuminuria (high levels of albumin in urine), increased protein-to-creatinine ratio, and high blood pressure. It can be treated by stabilising blood glucose levels.
Gum disease affects more diabetic dogs than cats. Regularly cleaning your dog’s teeth will remove excess sugar and dental tartar, which will help prevent mouth infections and also decrease the chances of infection in other internal organs, such as the kidneys and heart.
Liver disease very often goes hand-in-hand with diabetes, as a result of the change in the way fat is metabolised for energy.
Hypoglycaemia happens when blood glucose levels drop too low. Glucose or blood sugar levels can drop if your pet is getting too much exercise and using too much energy, or if your pet isn’t feeling well and vomits after a meal, or if their insulin dosage has been adjusted and is too low.
A significant drop in glucose levels can be fatal, so you need to keep an eye open for the following symptoms:
- Excessive lethargy and sleeping
- Trembling/muscle twitching
It’s important to react immediately to correct glucose levels. See if you can encourage your pet to eat something. If your pet won’t eat then give them a dose of glucose solution (glucose powder and water). According to Pet-Diabetes.co.uk, you should give 1g of glucose per kilogram of weight. Syringe the solution into your pet’s cheek. If your pet has reached the stage when they can’t even swallow then rub the glucose powder into their gums and under their tongue. You can use honey if you don’t have any glucose powder in the house. Once the glucose has pepped up your pet you can try giving them food again.
Contact your vet for further advice.
Diabetic ketoacidosis (DKA)
Diabetic ketoacidosis (DKA) is when fat is broken down for energy instead of glucose. This produces ketone acids in the blood which leads to DKA.
DKA is a risk for pets who have been diabetic for a long time but who haven’t received any treatment, or even a diagnosis. It can also occur when the insulin dose is too low or when there are other illnesses or medications that counteract the effects of insulin therapy.
DKA requires emergency veterinary treatment, including IV fluids and insulin.
Hyperglycaemic hyperosmolar non-ketotic (HHNK) syndrome
Hyperglycaemic hyperosmolar non-ketotic (HHNK) syndrome is uncommon but it also constitutes an emergency and requires immediate care. It’s caused by extremely high blood glucose levels, which may occur when your pet doesn’t receive any diabetic treatment or when their insulin dosage is too low. Your pet becomes weaker, appetite decreases and they may drink less, to the point where they become dehydrated. Eventually pets go into a coma and die.
Vets need to administer IV fluids as soon as possible to lower glucose levels.
Diabetic cataracts are more common in dogs than cats. They are caused by high levels of glucose in the bloodstream, which allows water to diffuse into the eye lens and causes swelling and disrupts the lens’s structure. Surgery is the only way to remove the cataract and restore vision. It’s important to control glucose levels and successfully treat diabetes to ensure that your dog doesn’t develop cataracts again.
Treating your diabetic pet
Insulin therapy involves injecting your dog or cat with insulin once or twice a day, either before or after meals, to control blood sugar levels and effectively manage diabetes. Some lucky dogs and cats go into clinical remission after just a few weeks or months of insulin treatment. Clinical remission is usually only seen in pets who still have functioning insulin producing cells in their pancreas.
Bringing their glucose levels into check enables cell functioning to resume, but it doesn’t mean your pet is cured. Unless you remove all the risk factors from your pet’s life, there is always the chance that diabetes will come to the fore again.
The amount of insulin required depends on your pet’s weight and general health. It’s very important that your monitor your pet carefully during the first few days and weeks so you can see if the insulin is having any effect. There are different kinds of insulin (including intermediate-acting and long-acting insulin, porcine insulin, recombinant human insulin), so you and your vet may have to experiment a little to find the right type of insulin at the right dose.
You will have pay attention to how much your pet eats, drinks and urinates, as well as test blood glucose levels and possibly also test for glucose in your pet’s urine. Report back to your veterinarian, who will adjust the dosage if there is no progress. In severe cases, veterinarians may hospitalise dogs and cats for the first few days to monitor insulin treatment.
You will have to regularly carry out these tests for the rest of your pet’s life to ensure glucose levels remain stable. It’s also important to realise that any changes your pet undergoes, including weight loss of gain, increased or decreased exercise, other illnesses, can also change the insulin dosage required.
Store and use insulin properly
It’s important to store and use insulin properly so that it maintains its effectiveness. Store insulin in the fridge in an upright position. It needs to be fresh to work optimally, so don’t keep a bottle for longer than 6 – 8 weeks.
Ask your veterinarian to watch you give your pet an insulin injection to make sure you can do it properly. Keep a record of every injection you give your pet. This not only ensures that you keep to the schedule but it also helps you record your pet’s reaction after the injection so you can more easily monitor your pet’s progress or lack thereof.
Addressing your pets’ diet and helping them maintain a healthy weight is one of the best ways to prevent and treat diabetes. Remember that dogs and cats have different dietary needs, so your cat will need a diet that is almost entirely meat protein, while dogs need diets that combine meat protein and fruits and vegetables.
There are special diabetic diets for cats and dogs, including raw, wet and dry food. Many pet food manufacturers produce complete prescription diabetic dry and canned diets, but there are just as many people who prefer to feed their pets correctly balanced raw food diets, including good carbs that are low on the glycaemic index (which release glucose – energy – slowly and steadily throughout the day).
It’s important to stick to an eating timetable, so you feed your pet at the same time every day. You also need to feed the same amounts at every meal because over or underfeeding will change insulin and glucose levels. To maintain stable glucose levels, it may be necessary to give your dog or cat a midday snack or 3 or 4 small meals a day.
You can still use treats for training, or to reward diabetic dogs and cats for sitting still during the insulin injection. However, you need to choose your treats with care. Avoid semi-moist commercial treats. Dried meat treats (including bully sticks) are tasty and healthy. You can make your own treats using dehydrator or baking in a slow oven. Low glycaemic vegetables are also good snacks, including raw green beans, cauliflower, and carrots and steamed pumpkin. Tinned tuna and sardines work well, as do cheese, boiled eggs, chicken feet and freeze-dried liver.
Some supplements help diabetic pets, while others counteract medication and can complicate the illness, so always talk to your vet before you give any pet supplements. If you are going to use supplements, you may need to adjust the insulin dosage.
Omega-3 fatty acids are almost always a good supplement, no matter what your pet’s condition. You need to find the right dose for your pet’s size and for this you may need your vet’s help.
Probiotics are a good way to boost gastrointestinal health.
Digestive enzymes can help dogs with who have diabetes and pancreatitis.
Glucosamine is great for healthy joints and can help pets with diabetes and joint problems like hip dysplasia and arthritis.
L-Carnitine is an amino acid that boosts the metabolism, especially the metabolism of fatty acids.
Zinc – in moderation – is great for diabetic dogs. Too much zinc is toxic, so only ever use with the advice of your veterinarian.
If the most exercise your pet gets is waddling from one comfy bed to another, you need to introduce exercise slowly and gently. If your pet has been seriously ill due to diabetes, you need to build exercise slowly. In this case, a walk around the block is a good thing. You can extend it to two or three blocks and pick up the pace until you’re both out of breath. Don’t get so out of breath that you’re both doubled over and seeing stars.
Exercise naturally reduces blood sugar levels, so if you can get your dog exercising daily, you may be able to reduce their insulin dose. Always consult your vet about what kind of exercise is best for your dog – and your dog’s diabetes. For example, too much exercise in insulin resistant dogs can cause hypoglycaemia.
Living and caring for your diabetic pet
The earlier you catch diabetes the better the prognosis for your cat or dog. So, it’s vital to take your pet to the vet as soon as you notice any signs of the disease. Don’t give up if your pet is diagnosed with diabetes. A diabetes treatment programme can help them reach the usual life expectancy for their breed.
You have to make some lifestyle changes, and get used to giving your pet insulin injections. So if you are at all squeamish, get over it. Keep meticulous records detailing injections given, the reaction, and daily thirst, appetite, weight, and urination.
Finally, you will need to stick to an exercise schedule. Remember, play can be exercise if it’s aerobic enough. Commit to a diet that will help maintain healthy glucose levels. You might have to change your pet’s diet, or simply add (or subtract) a few elements. Bear in mind that a new diet might cost more, but some pet insurance providers cover prescription diets.
The bottom line is that diabetes is not a death sentence; with proper management and care diabetic dogs and cats can continue to live long and happy lives.