Article By Dr. Stan Kunin In Collaboration With Diana Kunin
The purpose of this article is to provide the reader with a generalized scope of a commonly seen disease, diabetes.
Typically, Diabetes Mellitus (DM) is seen in middle-aged and older dogs, rarely occurring in a younger animal. Early signs of DM include excessive drinking, excessive urination, and weight loss. If left untreated, it can lead to severe complications such as kidney disease, urinary tract infection, liver disease, and ultimately coma and death.
Diabetes Mellitus (DM), is a very complex disease caused by a deficiency of the hormone insulin, which is produced by the pancreas. There are many different causes of DM. Initially, genetics can be a factor, with Labradors, Keeshond, Poodles and Schnauzers being breeds that are most commonly diagnosed. Secondly, obesity seems to play a role as a predisposing factor in contributing to DM. A third contributor can be from an hormonal imbalance. This can include female dogs who are unspayed and those with excess cortisone in the body. Excess cortisone can be due to either drug treatments or another disease known as Cushings Syndrome where the adrenal glands are producing too much cortisone. In rare cases, another contributing factor can be pancreatitis (inflammation of the pancreas).
Diagnosis is done through blood tests and a urinalysis. If the dog has DM, blood tests will show an elevated glucose (sugar) level and the urine will show glucose and possibly ketone along with infection. Ketone in the urine usually means the DM has progressed to an advanced stage.
Treatment entails hospitalization and will involve the administration of intravenous fluid treatment, along with antibiotics and insulin. There are many different types of insulin. Most of the time, we use human insulin which is usually sufficient for control. Sometimes a change of insulin is needed. Once in a while a glucose curve is done. This is a test where blood is taken every 2 hours or so and graphed. This can help with deciding the required dosage of insulin. If there is difficulty in controlling DM, then an underlying disease must be researched and ruled out. A female dog must be spayed in order to have better control of the glucose level. This is done once the dog is stable enough to undergo surgery.
Diet is very important to help control Diabetes Mellitus. Veterinarians have prescription diets such as W/D, which is usually sent home along with the insulin. Food like W/D has an increased fiber content that can help control diabetes. Many times a prescription is written for the owners to pick up insulin from a human pharmacy. Once the owner gets used to it, giving insulin injections becomes easy. The dogs don't feel the injection.
Diabetic dogs need to have their blood drawn periodically to figure out the optimum insulin dose. A few owners like to do at-home glucose tests and treat accordingly. However, discuss this option with your veterinarian to see if both you and the dog are the right candidates to undertake this at home. If you decide home-care is for you, it is still advised to have blood drawn and checked at your veterinarian's office periodically. A general blood test should also be run two or three times a year to make sure no other issues arise.
Unfortunately, with DM, many dogs eventually develop cataracts and become blind. It is very difficult to control a diabetic dog 24 hours a day. 24 hour monitoring is not possible and therefore there will likely be a 4-6 hour window of unregulated glucose which can eventually produce wear and tear on the dog's body, especially the eyes. The good news is that these dogs tend to respond very well to the cataract surgery.
Complications can happen while treating with insulin. Hypoglycemia or low blood sugar can happen at any time, especially if the dog is not eating regularly or has other medical problems, such as vomiting and diarrhea. Low blood sugar can lead to insulin shock where the dog exhibits drunk-like behavior and will stagger around glassy eyed. All owners of diabetic dogs should have honey or Karo syrup on hand in case this type of emergency arises. Honey and Karo syrup have a high concentration of sugar, so many times you can reverse the insulin shock by giving the honey/karo syrup orally. If, however, the dog loses consciousness, you cannot give the sugar orally as you risk aspiration pneumonia. These dogs must be brought to a veterinary facility immediately before brain damage and/or death occur.
With proper management and a good relationship with your veterinarian, four-legged patients can enjoy a good quality of life.
About Dr. Stan Kunin
Stan Kunin DVM graduated from UC Davis in 1978 and has had his own practice in Woodland Hills, California since 1986. Dr. Kunin is a special veterinarian who was born 80% deaf, but the weakness in his hearing has helped to give him a 6th sense about animal care and the wellbeing of his patients.
In a regular series of articles for the Jason Debus Heigl Foundation, Dr. Kunin shares his thoughts, opinions and advice on animal matters.