Ask Your Vet: Vet: Diabetes Mellitus By Stefanie Wong, DVM

Does your pet have increased thirst, increased urination and seems to be losing weight despite the fact that they are ravenous or hungry all the time? If so, they may have Diabetes Mellitus (also known as DM).  

What is diabetes?
The pancreas is an organ that sits behind the stomach. It is important for producing several different things - it produces digestive enzymes, so we can digest our food. It also produces a hormone called insulin, which helps to regulate our blood sugar (keeps it in the normal range). The medical term for blood sugar is glucose. Insulin allows our cells to absorb and use glucose.

After your pet eats, carbohydrates are broken down into sugar or glucose. The pancreas will respond by producing insulin, which allows glucose to enter the cells and tissues. Insulin is the key that opens the door between the bloodstream (where the glucose is sitting) and the cells. Without insulin, the cells cannot absorb or use glucose.

Diabetes mellitus is essentially a shortage or complete absence of insulin. Without insulin:

• Cells cannot absorb or use glucose, so it continues to sit in the bloodstream

• This causes blood sugar levels to skyrocket

• The body is unable to detect the glucose, so it thinks it is starving

• This causes excessive hunger or increased appetite

• Protein, starch and fat are broken down and even more sugar pours into the bloodstream (still unable to get into the cells or tissues as there is no insulin)

• This causes weight loss, weakness and lethargy

• This excessive level of sugar overwhelms the kidneys and some of it gets dumped into the urine

• This causes increased urinating and drinking to compensate

What are the symptoms of diabetes?

• Increased drinking, excessive thirst

• Increased urination, urinary accidents

• Increased hunger

• Weight loss

• Weakness

• Cloudy eyes – dogs in particular can be prone to forming cataracts as a result of the excess sugar depositing itself into the lens of the eye

• Lethargy

• Thinning fur, poor hair coat

How is it diagnosed?

Diabetes is typically diagnosed with a combination of blood work and urine testing. If your pet has an excessively high glucose (blood sugar) on blood work, along with glucose in their urine, that typically is enough to make the diagnosis. Urine testing is also helpful because many diabetics can have urinary tract infections – all the sugar within their urine provides the perfect breeding ground for bacteria.

How do you treat it?

1. Diet: For cats, we want them to be on a low carbohydrate, high protein diet. For dogs, a high fiber diet is best. For specific diet recommendations, talk to your veterinarian.
2. Weight loss: If your pet is overweight, weight loss is a very important part of the treatment plan. This is achieved by measuring out a predetermined amount for each meal, reducing or eliminating treats and increasing exercise
3. Insulin: daily insulin, given as injections under the skin, is very important to aid in control of diabetes – we can teach you how to give these at home

A special note for cats: with some cats, we are able to get them into remission after starting insulin therapy, which means they may not need life-long insulin. The key is getting them onto a diabetic diet, and transitioning them to twice daily feedings. It is dependent on each individual cat, but in some cases, within weeks to months, cats will no longer need insulin and can be maintained on diet alone. Unfortunately, this is not the case for dogs – once they are diagnosed, they will need insulin for life.

Can it be life threatening?
Diabetes can be life threatening if a complication of diabetes, called Diabetic Ketoacidosis (DKA) occurs. It is most often seen with undiagnosed diabetics, poorly regulated diabetics, or if there is another disease process that pops up to throw off their regulation (i.e. pancreatitis, urinary tract infection). It is diagnosed by looking for ketones within the urine.  If your pet is diagnosed with this condition, they will need to be hospitalized.

Prevention
Prevention is the best medicine. Obese patients are more prone to developing diabetes. Regular exercise, cutting down on treats and keeping your pet at a healthy weight is the best way to try to prevent against this disease.