Diabetes Mellitus in Dogs and Feline diabetes.
Dogs and Cats and Birds each have very different very different types of Diabetic syndromes. The veterinary treatment of diabetes in pets is managed according to species.
Diabetes in dogs
A dog is an omnivore- in nature preferring offal to pure meat – Diabetic Dogs still have relatively normal insulin sensitivity. Canine diabetics start out with normal pancreatic islet activity, ie normal insulin production and – some “lesion” or disease –that causes the islet cells of the pancreas to decrease insulin production and this results in the clinical syndrome of canine diabetic –An ABSOLUTE INSULIN DEFICIENCY – TYPICAL CANINE DIABETIC – type 1 –it is often thought to be immune mediated – “Ripley believe it or not” in the UK diabetes in dogs has a seasonal incidence and currently thought to be viral disease that “catalyzes” or causes “islanditis” inflammation of the insulin producing pancreatic cells..
There is a Breed predisposition in dogs – DM in dogs is most common in, Samoyed, Tibetan and Carin terrier breeds . Occasionally estrus or hormonal Diabetes mellitus occurs in intact females esp in collies
DM Hardly ever occurs in boxers and GSD , Golden retrievers – why ??
Obesity in dogs does not predispose dogs to canine DM as in Baboons, cats and People – which is so interesting !!.
Diabetes in Cats
A cat is a carnivore –like “human children” don’t like vegetables !
Feline Diabetes is Usually as a result of insulin resistance – IE; there is a “fortune” of insulin produced; an over production on insulin, the pancreas Islet cells are hyperactive , and it leads to Islet “exhaustion” or depletion as they try to maintain normal blood glucose. This somehow results in pancreatic islet damage, variably reversible, and eventual insulin deficiency. There is also a genetic predisposition. Eventually the cats loose insulin secreting capacity.
Causes of feline diabetes – obesity, and any disease increasing cortisol, catecholamine release etc. the majority of diabetic cats are chronically over weight .
Other causes of diabetes in cats are estrus, anxiety, altered metabolism with elevated fatty acids, any chronic stressor, and concurrent endocrine disease.
Breeds Burmese predisposed – Devon and Scottish Rex are not predisposed,
Cats when is it stress can get high glucose levels we need to differentiate = Diabetic felines from feline stress hyperglycemia
Typically signs of DM :
- PD Pu excessive urine and drinking
- increased apatite
- weight loss,
- and high fasting blood glucose.
If inappatant and not ketotic probably not DM.
Treatments of canine and feline diabetes
Lots of owner patient interaction – lot of owner effort
Anxious owners !!
About 12.5% of dog and cat patients are euthanized once the diagnosis is made
About 30% are euthanized in the first year.
Impact of the therapies on the owner’s quality of life – and a lot of effort
Vets need to manage owner’s expectations –
WE do not use oral; hypoglycemic agents in dogs !
Treatments of Canine and feline Diabetes Mellitus
Insulin and Diet
Caninsulin, or Lente Insulin or a porcine Zinc suspension – insulin glargine
All insulin last about 8 -16 hours in the dog or cat
They last for shorter times in cats than dogs than people
We use twice daily injections – for good control
Start of treatments for Canine Diabetes : Start with : 0.5 – 0.75 iu/kg/ 12hours of insulin for the dog
Start of treatments for Feline Diabetes 2-3 iu / cat /12h for a cat (protamine zinc a good first choice for cats)
Feed a standardized diet fed 12 hourly about 1 – 1.5 hours after the injection.
Send pet’s home as soon as possible.
Inject in flank on opposite sides morning and night – more reliable absorption than in neck
Feeding the diabetic patient
– must be matched with injections
Insulin lowers blood glucose – the meal raises the blood glucose – we need to match the two!
A balance for stable blood glucose
The stomach takes about 45 minutes to empty – most of calories are being absorbed within 45 minutes meal 45 – 90 minutes = don’t feed at the same time
Caninsulin start working maximally 2-3 hours later
Feed 60 – 90 minutes after the insulin injection!! For the best effect in getting good diabetic control.
Feed standardized caloric content and standardized diet – to body weight and metabolism. The Fiber in diet? Does not necessarily improve diabetic control.
What if they don’t eat?
If they usually do eat – must be something wrong
Illness or Insulin resistance – call your vet to review the case.
How close to normal range do we want out Diabetic pet to be? 8 – 12 mmol/l
Well controlled – blood fructosamine within 15 % of top normal.
Cats diet _>lower carbohydrate diet – chicken wings, hills MD
Dogs diet -> what you like consistently, fiber not important
Monitoring the diabetic veterinary patient,
Blood Glucose curves ideally being done at home – differences between hospital and home glucose curves in about 50% of cases. Stab ear at side. Look at the average blood glucose – and lowest and highest.
Fructosamine – glucose binding irreversibly to albumin depends on albumin stable concentration and glucose concentration.
Twice daily insulin injections
Diet feed about 1 hour after injections
Home glucose monitoring
Besides insulin – in a cat – oral hypoglycemic like glipizide 5 mg tabs twice daily 1 hour before meal takes about 2 weeks to work. Does not work in dog