What is diabetes?
During digestion in the intestines, food is reduced to components that can
be used by the body: carbohydrates are converted into sugars, glucose
being the most important one. Glucose is resorbed from the intestines into
the blood to provide the body cells with energy. Cells can only absorb
glucose when insulin induces them to do so. When an insulin shortage
exists, too much glucose remains in the blood and this condition is callled
diabetes. Diabetes is therefore really an insulin shortage.
Insulin
Insulin is produced by certain cells (islet cells) situated in the pancreas.
Some of these cells cannot produce sufficient insulin and sometimes none
at all. This condition is usually found in older bitches and castrated male
cats, but diabetes can be seen in young dogs as well. In some breeds the
number of cases exceeds the average.
What are the symptoms?
When blood contains a high concentration of glucose, the kidneys will
start to excrete this into the urine, (the kidney threshold is exceeded).
This takes an extra amount of fluid, and therefore the patient will drink
and urinate more. Because glucose is an important fuel (energy source)
and is being lost, the affected animal will eat more but still lose weight.
The condition of the coat will fall back and the animal is generally off colour.
Diagnosis
The symptoms observed will indicate diabetes, but they also be seen
in other diseases. A definite diagnosis is made by demonstrating too high
glucose levels in blood and urine. The determination of blood levels is more
reliable than the determination of levels in urine.
Treatment
Administration of Insulin
Diabetes is caused by an insulin shortage. Therefore, this shortage should
be replenished daily, at a fixed time (regularly) by injecting insulin. This may
seem dreary to you, but once you are used to doing it you'll find it's not so
difficult after all.
Because the extent of the insulin shortage is unknown, a proper dosage needs to
be assessed. The daily dose needs to be balanced to the insulin need of your pet.
The institution of Caninsulin therapy
Your vet will establish the amount needed, based on the weight of your pet.
He will show you how to draw insulin from the vial and how to administer the injection.
Once you can do this correctly (and is really a lot easier then it seems) your vet
will provide everything you need to care for your pet at home. At first, you will have
to check the urine 3 times a day for the presence of glucose: before breakfast, at noon
before lunch and a bit later in the evening. This test is simply done by dipping a colour
changing strip in the urine. During this period it may also be necessary to have the vet
examine blood samples taken 1 hour before the second meal. Once the insulin therapy
has been stabilized, your pet will rapidly recover.
The animal will become livelier and its coat condition will improve. The frequency of
drinking and urinating will also decrease. The urine may now be tested less frequently.
Regular examinations remain necessary because the need for insulin can change.
Adjustment of the daily dose may then be necessary. Once your pet is on an adequate
maintenance dose, it can lead a completely normal life.
Food and Exercise
Because the daily dose is adjusted to the amount of energy (glucose) your pet needs
every day, regularity in feeding and exercise is important. That is why your pet
always needs to be fed always at the same time with the same amount of the same diet.
Also the amount of exercise needs to be the same. When your pet suddenly uses a lot
more energy (a long walk, excitement about visitors) it will burn more glucose.
Sometimes this leads to a blood sugar level which is too low, and too little energy is
available for the brain. The animal may even lose consciousness. If that happens you
must immediately administer glucose by mouth.
Sterilization
If diabetes is diagnosed in a bitch, she will have to be sterilized as soon as possible.
One of the female hormones, progesterone, has a negative effect on sugar metabolism.
In cases where diabetes has been present for only a short time, removal of the ovaries
may lead to complete recovery. A regular blood sugar test is necessary because the
need for insulin may rapidly decrease after sterilization. Because progesterone-like drugs
are used to stop a bitch coming into season, this treatment needs to be stopped as well.
Expectations
After being stabilized on insulin, most patients are able to lead a normal life. The most
important complication is a too low blood sugar level. Although this is a rare complication,
it is important for you to know how to deal with such cases.
Hypoglycemia
Too-low blood sugar levels
When the blood sugar level is too low, the brain will not receive enough energy (glucose).
This could lead to a potentially fatal situation and it is therefore important to be able to
recognize the symptoms. The following symptoms may be seen:
unrest, trembling or shivering, strange movements, strange behaviour,
muscle twitching and even unconsciousness (coma). What to do:
1. Give food immediately.
2. If the animal refuses to eat, administer a glucose solution as quickly as possible.
1 gram per kilogram body weight. This solution should be poured carefully into
the cheek pouch. If the animal is unable to swallow, rub the glucose powder onto
the gums (especially under the tongue).
As soon as recovery is seen: give food.
Keep an eye on the patient in case signs return.
Note: It is wise to always keep an amount of glucose ready for use.
3. If the condition of the animal becomes worse, (muscle-twitching, unconsciousness)
call your vet immediately.
What you will need for the treatment of diabetes:
1. Caninsulin (insulin for dogs and cats)
2. Insulin syringes 40 internation units (I.U.) per ml
3. Test strips for testing urine for glucose
4. Glucose or glucose water
5. Complete commercial food