DIABETES MELLITUS - DOGS

Dogs more commonly develop Type 1 Diabetes Mellitus where there is insufficient production of the insulin hormone.  Insulin is required for the body to use the glucose that is available in the bloodstream. When insulin is not available, there is excess glucose in the blood stream, but the body’s cells are starved as they are unable to access this source of energy.

The most common early clinical signs seen in dogs are weight loss, increased appetite, increased drinking and increased urine output. If this condition is left untreated, the body begins to break down fat as fuel. This process produces a buildup of acids in the bloodstream called ketones, eventually leading to diabetic ketoacidosis which is a serious life threatening medical emergency.

A general blood profile, fructosamine and urinalysis tests are normally performed to diagnose diabetes. The tests will show a very high level of glucose in the blood, and in the urine. Depending on the results, your Veterinarian will advise you of the treatment plan.

DOSING AND TREATMENT REGIME

Treatment often requires numerous types of lifestyle changes such as medical (insulin injections) and dietary changes. Regular visits to the Veterinarian for revisits, blood tests and urine tests are required.

• Types of insulin available (your Veterinarian will advise which is appropriate for your pet):
   
  • Dog-specific insulin (Caninsulin) - purchased from KSAH, is the recommended first option as it is specifically made for dogs and cats.
  • Human insulin (eg Glargine) - purchased from the chemist; only use this if Caninsulin is ineffective.
• Insulin is to be given by subcutaneous injection under the skin every 12 hours with their meal. 

• Additional supplies to purchase:

  • Syringes (purchased from KSAH or a chemist), your Veterinarian will advise the appropriate syringe specific to the type of insulin used.
  • Yellow sharps disposal container (purchased from chemist; full containers can be disposed of by any participating chemist).

  When you have obtained your supplies of syringes and insulin, your Veterinarian will schedule a time with you to show you how to administer the doses safely and correctly.

MONITORING

Fructosamine Blood Test

• After 14 days from the start of insulin therapy, your pet will return to us for a revisit and fructosamine blood test to assess their initial response to therapy.
• Once the insulin dose has been established (which may take a few months), a fructosamine blood test is performed every 3 months to monitor for any lapse in control of the diabetes.
• Your pet is not required to stay a full day in hospital for this test.

Clinical Improvement

• In conjunction with blood test monitoring, we also assess your pet’s clinical signs.
• Some of the factors we monitor:
  Weight: stable diabetics should have a stable weight (unless on a weight loss plan).
  Appetite: stable diabetics should continue to eat well but not be ravenous.
  Water intake reduced back to normal levels (and therefore normal urine output).

Glucose Curve

• If the diabetes is not stabilising as anticipated, we will recommend performing a glucose curve. This tracks the blood glucose through the day, allowing us to assess how your pets body reacts to the dose of insulin.
• Your pet needs to arrive at 7:40 am with it's breakfast and morning dose of insulin packed (NOT GIVEN YET).
• We will take a blood glucose reading just before feeding and administering the first dose of insulin.
• Blood glucose readings will be taken at 2-3 hourly intervals throughout the day to monitor your pet’s response to insulin.
• This information is used to adjust the insulin dose to suit your pet.
• This test may need to be repeated over the following weeks as we adjust the insulin dose to find the best control for your pet.

DIETARY MANAGEMENT

If your pet initially has reduced appetite, you may start with some soft foods.
However, for the long term avoid soft moist foods as they normally cause severe post-prandial (post-mealtime) hyperglycaemia (and increase risk of dental disease).

• Aim for a high insoluble fibre and palatable diet (eg Hills w/d, Hills r/d, Royal Canin Diabetic).
• The diet must remain consistent (i.e. they should consume the same amount of calories at the same times each day). 
• Feed half the daily intake twice a day coinciding with insulin injections.
  Thin dogs: avoid further weight loss as starvation increases ketone production.
  Regular weight dogs: Diet that your pet will eat reliably and keep calorie intake consistent.
  Overweight dogs: Reduce intake to 60% of requirement of ideal body weight.

NOTE: If your pet is not eating, please do not give their insulin injection and contact us.

• It is important to avoid feeding additional food/treats throughout the day as each time they eat, there is a spike in their glucose levels which can then result in poorer diabetic control and increased risks of complications.
  

EXERCISE

• We recommend low intensity, short duration, regular exercise at the same time each day.
• Monitor for hypoglycaemia (blood glucose too low) eg behaviour changes, weakness, seizures.
• Avoid exercise 6-8 hours after insulin injections as that may result in hypoglycaemia.

INSULIN OVERDOSE

A diabetic pet needs insulin to survive. But, too much insulin can also be deadly. Too much insulin can result in hypoglycemia (low blood sugar). This can occur when a dog accidentally receives a too high a dose, too many doses, or is not eating. Early signs of low blood sugar include weakness, lethargy, or disorientation. If this happens, seek veterinary attention immediately. You may be advised to put a small amount of sugar syrup on your pet's gums to be able to safely get them to the hospital.

If your pet experiences any of the following, seek veterinary attention immediately:

• Seizures
• Coma
• Lack of appetite
• Changes in behaviour
• Depression
• Incoordination