Diabetes and Your Pet

Diabetes (also known as Diabetes Mellitus) is a state of hyperglycemia (high blood glucose or blood sugar). It is caused when the pancreas stops producing enough insulin, a hormone that keeps the glucose in check.

Genetics play a role, which explains why certain breeds of dogs, such as Miniature Schnauzers, are over-represented. Animals that are overweight are prone to inflammation of the pancreas (pancreatitis), which makes them more disposed to developing diabetes in the future.

Almost all dogs and cats are treated with twice daily insulin injections, given every 12 hours. Oral hypoglycemic medications are used in humans but tend to not be very effective in animals so are rarely used. Diabetic pets will also be placed on a diet that is higher in protein and lower in carbohydrates (sugars), to help their body metabolize their food more efficiently.

If left untreated, the pet will eventually become ketoacidotic and they will die from this disease. Without insulin in the body, the blood sugar that is present after eating a meal cannot be utilized. Thus, the body responds in a way as if the glucose is not even there. Ketoacidosis is a condition that occurs when the body has gone prolonged periods of time without adequate glucose (blood sugar), whether that is because of starvation or because of a lack of effective insulin and glucose in the body.

Insulin should be stored in your refrigerator. When you are ready to give it, gently roll the vial between your palms and invert it a few times. Do not shake the vial, unless it is Vetsulin. Vetsulin insulin is the exception, as it is meant to be shaken.

This is something we will demonstrate for you. The best place to give insulin to a dog or cat is behind the neck, between the shoulder blades (i.e. the scruff). The injection should be given under the skin (subcutaneously). The injection could technically be given subcutaneously anywhere on the body, but we choose the back of the neck because that area has the most loose skin and is the best tolerated.

It is not necessary to clean the skin prior to injection. To inject into the subcutaneous space, pull up the skin with your thumb and finger to make a skin tent. Insert the insulin needle into the long axis (parallel to the pet’s spine) of the fold or skin tent. If you put the needle in the opposite direction you may accidentally go all the way through the skin. Pull back on the plunger of the syringe to assess where your needle has inserted. If you get air, you may have gone all the way through the skin. If you get air or blood, pull the needle out and try again. If not, inject the insulin.

For a small fee, we can supply you with a sharps container for disposal of used needles. When it is full, simply bring it back to us for safe disposal.

This is a tricky question. The glucose may never be in a normal range, and often the stress of coming to the vet will falsely elevate the blood glucose, which we must take into account. We also must consider the time of day in relation to when the pet received its last injection. We like to focus on the whole picture. Is the pet still drinking or urinating more? Is the pet’s weight stable? Is the pet active, eating well and acting normally? We will tell you whether your pet’s glucose is acceptable or if an adjustment is needed. Even if the number(s) may be higher than the reference range, your pet may still be regulating well. So how long will it take to regulate? Each pet is different. Some animals can regulate on their starting dose, for others it can take weeks to months, possibly longer.

The most common symptoms are increased thirst, increased urination, and weight loss. A lack of appetite, lethargy, and vomiting can also be seen. If your diabetic animal has any of these symptoms a dose increase may be needed and the pet should be seen by their vet. Increasing the insulin dose too much can be more harmful than giving too little insulin, which is why it is very important to contact us before dose changes are made.

Weakness, staggering (often described as acting drunk), ataxia, twitching or seizuring, lack of appetite (notice this is also a symptom of hyperglycemia).

As long as the dog is able to swallow, rub some Karo syrup on the pets gums or give it orally (1-2 tsp or 5-10 ml). If you do not have Karo syrup, you can give honey or some sugar-water instead. After giving the syrup, call us immediately. If the pet is seizuring, do not attempt to put syrup into the mouth, just head straight to our clinic or an emergency animal hospital.

It is not considered reversible in dogs. There is a possibility it can be reversed in cats (for example, if an obese cat loses weight). However, most cats will also need insulin for life.

This will be based on the individual patient. Typical follow-up tests may include:

• Spot blood glucose
  This is one glucose reading where the blood is ideally drawn 4-6 hours after morning insulin.
• Blood glucose curve
  Your pet stays at the clinic and gets glucose readings throughout the day. This gives us a better idea of daily trends (peaks and troughs) than just one glucose reading.
• Fructosamine level
  This tests for a protein that is directly related to the average glucose concentration over the preceding 1-3 weeks, and isn’t influenced by acute changes in glucose. Results will list the patient’s glucose control as good, fair, or poor. This test is used most often for long-term monitoring on stable diabetic patients.
• Urinalysis
  This tests a urine sample for infection, glucose, ketones, and other factors. This is done when the patient is diagnosed, but often needs to be repeated as Diabetic patients are more prone to urinary tract infections. The excess blood sugar in their body overflows in their urine and attracts bacteria.

This is something our veterinarian will tell you based on the individual animal. Often we will put diabetic patients on a prescription diet to aid in regulating the glucose (examples are Purina DM or DCO, Hills w/d or r/d, etc.). Absolutely no table scraps should be given. Treats should be kept to a minimum and only used when necessary to reward the pet for sitting still for the injection. The best treats are low carb, low fat, and low calorie. You do not need to give the pet a treat with every injection. Dogs generally will still behave for the injection even if only rewarded with a treat once or twice a week.

In general, we recommend giving the insulin injections with or after meals (breakfast and dinner). The feeding increases the blood sugar, while the insulin lowers it, which tends to balance things out well. If your pet tends to graze dry food throughout the day instead of meal-feeding, this is OK but regulation will be best if you can give a small amount of an acceptable food, canned or dry, twice a day at the time of the insulin injection.

No. Insulin syringes come in U-30, U-50 or U-100. Using the wrong syringe could cause a life-threatening overdose or under dose of insulin.

No. Only your veterinarian should change your pet’s insulin dose based on an actual glucose measurement. Other conditions can mimic the symptoms of diabetes. Additionally, the symptoms of hyperglycemia can mimic those of hypoglycemia (not wanting to eat, lethargy, etc.) and well-intentioned pet owners can adjust the dose in the wrong direction, potentially making things worse.