Coping with Diabetes Mellitus in Pets

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How does Carbohydrate Metabolism Work?

  • After ingesting a high carbohydrate meal, the food moves from the mouth down the esophagus to the stomach and into the small intestine where the majority of the food is digested.
  • The simple sugars (monosaccharides) such as glucose are absorbed into the bloodstream and used for energy.
  • If there is excess monosaccharides in the bloodstream, the pancreas releases insulin which allows for transfer of glucose from the bloodstream into the tissues and organs, mainly the liver.
  • Through the anabolic process of glycogenesis, these simple sugars are turned into glycogen (a polysaccharide) and stored in the liver.
  • When blood sugar levels are low, catecholamines (epinephrine and norepinephrine) and glucagon signal the liver to release glucose through the catabolic process called glycogenolysis. The combination of these hormones regulate blood sugar levels and maintain balance in the body. 

What is Diabetes?

Diabetes Mellitus is an endocrine disorder that results from defects in insulin secretion and/or efficacy, which inhibits the body’s ability to regulate blood sugar levels. The two main categories include: insulin deficiency, type I and insulin resistance, type II. Type I diabetes results from an immune-mediated destruction of beta cells within the pancreas leading to a complete insulin deficiency. Type II diabetes results from an insulin resistance (decreased effectiveness), defects in insulin secretion and/or glucagon secretion. Left untreated, diabetes can be life-threatening!

Clinical Symptoms Include…

  • Polyuria/polydipsia (PU/PD) – increased urination and thirst
  • Polyphagia (increased hunger/eating)
  • Weight loss
  • Vomiting
  • Diarrhea
  • Dehydration
  • Anorexia
  • Lethargy and weakness
  • Chronic/reoccurring infections (ex: urinary tract infections)
  • High blood pressure (hypertension)
  • Cataracts
  • Seizures 
  • Coma

How is Diabetes Diagnosed?

Fasted Urine Sample

Pets with diabetes typically have high levels of glucose in their urine (glucosuria).

Blood Glucose Level / Blood Glucose Curve

A blood glucose level is measured on a glucometer. A minuscule drop of blood is placed on the side of the test strip and analyzed by the glucometer. The downside to a blood glucose is that it only provides the blood glucose level at the time of the reading. Therefore, a blood glucose curve is typically performed. This involves taking several blood glucose readings throughout the course of a day. 

Fructosamine

A fructosamine test requires a blood sample. It is the most accurate test for evaluating how well regulated a patient is as it represents the blood glucose level over a period of a couple weeks. 

What are the Treatment Options? 

There is no cure for diabetes, but it can be regulated through diet, insulin injections and monitoring blood sugar levels. The goal of regulation is to maintain relatively normal blood sugar levels. Hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar) are life-threatening conditions. Dogs typically are diagnosed with type I diabetes and will require daily insulin injections. Listed below are the different types of insulin available for dogs. Frequent monitoring is important! If you have a type I diabetic pet, I recommend buying a glucometer and taking and recording readings before and after meals. It is a very simple procedure to do at home and will improve the veterinarians overall ability to regulate your pet. 

  • Humulin R – concentration: U-100
  • Humulin N (NPH) – concentration: U-100
  • Vetsulin (Lente) – concentration: U-40

Cats with type II diabetes should be fed a high protein, low carbohydrate diet. If overweight, it is recommended that they go on a diet to lose weight. Cats with type I diabetes will require daily insulin injections. Types of insulin available for cats and dogs differ. Listed below are insulin options for a type I diabetic cat.

  • Humulin R – concentration: U-100
  • PZI Vet – concentration: U-40
  • Lantus (Glargine) – concentration: U-100

Insulin Administration

  • Unless otherwise instructed by your veterinarian, you’ll administer insulin after feeding (administering it before can cause low blood sugar known as hypoglycemia).
  • Insulin should be refrigerated. It typically expires in about 28 days; if the insulin is discolored or there are precipitates present, discard and do not use.
  • Before drawing up the dose, resuspend by gently rolling the bottle back and forth in the palm of your hands. Do not shake unless directed otherwise.
  • Clean rubber stopper with rubbing alcohol wipe, turn upside down and draw up prescribed dose with sterile syringe (make sure to use the appropriate syringe for the insulin concentration type, either U-40 or U-100)
  • Inject insulin subcutaneously (just under the skin) in a low-fat area, such as scuff (loose area of skin on back of neck) or shoulder region. Pinch skin together to create a fold and insert needle in the center. Once in, gently pull back on the plunger and check for blood. If there is blood in the syringe, it means you have hit a blood vessel and will need to reposition the needle. Before administering, make sure to check that the needle has not pierced through the other side of the skin fold. Once ready, push down on the plunger, remove needle and safely discard of syringe in a sharps or biohazard container. 

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