Symptoms of diabetes in dogs | Causes | Diagnosis | Treatment

What are symptoms of diabetes in dogs? 

Symptoms of diabetes in dogs are an increase in water intake, excessive urination etc. Diabetes mellitus is a common chronic endocrine disorder of dogs and cats. It is characterized by the low production of insulin by pancreatic beta cells. you know that Diabetes in dogs can not be cured, but it can be managed very well with proper medication, diet and regular physical activity.

How is blood glucose maintained in the body?

In healthy animals, as we know that the blood glucose level is maintained by two important hormones, Insulin and Glucagon. When blood glucose is high, the pancreas secretes insulin to lower the blood glucose. When blood glucose is low, pancreatic alpha cells secrete Glucagon to raise blood glucose levels. Both hormones work together to maintain blood glucose homeostasis. In diabetes in dogs, this mechanism is disturbed.

What are the types of Diabetes in Dogs?

Diabetes mellitus is classified into two types based on the cause of the disease.

• Insulin-dependent diabetes mellitus also called Type 1 Diabetes mellitus
• Insulin resistance diabetes mellitus also called Type 2 Diabetes mellitus

Insulin-dependent diabetes is more common and in this type, the animals’ own immune system destroys insulin-secreting pancreatic beta cells. The pancreas does not make enough insulin. In type 2 diabetes, pancreatic cells are making insulin for the body. But the pet’s body can not utilize it properly. This type of diabetes is more common in older and obese pets.

In both types of diabetes in dogs, the end result is the same. It results in low blood insulin levels which impair normal metabolism of carbohydrates, lips and proteins. Then the body starts breaking down fats and proteins to fuel the cells. This phenomenon can result in a blood acid-base imbalance. This condition is called diabetic Ketoacidosis. It is a life-threatening condition and should be addressed immediately.

Which breed is more susceptible to diabetes in dogs?

Diabetes is not breed-specific. It can occur in any breed. But some pure breeds are more susceptible to diabetes-like Pugs, Samoyeds, Keeshonds Dachshunds, miniature Poodles, Bichons Frises, Miniature Schnauzers, Puli, Australian Terriers, Fox Terriers, and Beagles.

When can a dog get diabetes?

It is a middle-aged dog’s and cat’s disease. Intact female dogs are more prone to Diabetes mellitus.

What causes diabetes in dogs?

In type 1 diabetes mellitus, the pet’s own immune system destroyed the Beta-cell of the pancreas. It results in a low level of insulin in the blood.

In type 2 diabetes mellitus, Secondary factors like chronic pancreatitis, long term use of steroids, viral disease destroy beta cells.

Some factors can make your pets more susceptible to diabetes:

• Overuse of steroids
• Overweight
• Chronic pancreatitis
• Some other concurrent diseases like autoimmune disease or viral diseases
• Intact female dogs are more prone to diabetes

What are the symptoms of diabetes in dogs?

• Increase in urination
• Increase in water intake
• Weight loss
• Lethargy
• Depression
• Lack of energy
• Recurring urinary tract infection
• Loss of eyesight
• Change in appetite
• Rear hind leg weakness, especially in cats

How is diabetes diagnosed in dogs?

• Your veterinarian will take through history, and do a physical exam on the pet. Some common blood and urine tests are done to rule out other diseases with similar symptoms.
• Complete blood count (CBC): will show  an increase in the number of red blood cells in the body
• Chemistry: high blood glucose
• High liver enzymes like ALT and ALP
• High blood cholesterol
• Increase in blood lipids level
• The high content of glucose in the urine due to high blood glucose than the kidney threshold
• Presence of ketone bodies in the urine in some completed cases of diabetes.

How do you treat a dog with diabetes?

The treatment protocol depends upon the overall condition of the patient, if it is an uncomplicated diabetes mellitus, then out-patient treatment is tried. But if it is Diabetic ketoacidosis, then the patient is hospitalized in the clinic.

Treatment Protocol for uncomplicated diabetes mellitus in dogs:

 Treatment and management of diabetes in dogs involve medication, diet and exercise and depend upon symptoms of diabetes in dogs.

• Take your pet on a moderate consistent exercise. Regular exercise helps in maintaining a normal level of blood glucose all the time. Avoid heavy exercise.
• Diet plays a very important role in maintaining blood glucose in the blood in diabetic pets. Special diets are available for diabetes mellitus patients. They are specially made to maintain blood glucose. 
• They include complex carbohydrates, high-quality protein and high fibre. Feed your pet two times daily at the time of insulin injection. Give meals at the scheduled time, try to keep a fixed interval in both meals.
• Do not overfeed your pet. Do not feed table scrap to the pet
• A spay is recommended in intact female dogs
• Weight reduction is advised in obese patients. Special diets for weight reduction are available at the veterinary clinic, consult your veterinarian for the best advice.
• Insulin injections are also equally important to other measures. Different types of formulation of insulin are available in the market. It is best practice to follow your veterinarian’s recommendations regarding handling and type of insulin syringe use. Do not change insulin type or insulin syringe without your veterinarian’s advice. 
• Lente Porcine zinc or NPH insulin @ 0.5 IU/kg SQ every 12 hours to 24 hours depending upon the patient’s need. Your veterinarian is the best person to decide which insulin is best for your pet.
• Glargine or PZI is preferred in cats @ 1-3 IU/cat SQ.

How long does it take to regulate a diabetic dog?

It depends on the pet to pet and symptoms of diabetes in dogs. Some common steps are followed to assess the success of the treatment.

Most important is to assess the improvement in clinical signs like urination and water intake.

Your veterinarian can perform a glucose curve to check the insulin response in maintaining blood glucose. You can perform the glucose curve at your home or your veterinarian can perform it in the clinic. All you need is a glucometer to perform the glucose curve.

How to perform a Glucose curve?

Feed and inject insulin at home at the scheduled time. Then check blood glucose at every 2 hours at home by the owner with a glucometer or at the vet clinic for 12 hours. If the pet is getting insulin every 12 hours, for 24 hours if insulin is once daily.

Blood glucose level should be between 100-250 mg/dl or 5.5-13.5 mmol/L on the curve. In case, blood glucose drops below 100 mg/dl or 5.5 mmol/L, the decrease in the amount of insulin you were giving. If blood glucose is higher than 250 mg/ml or 13.5 mmol/L on the curve, then give insulin every 12 hours if it was not before. If it is already twice daily then increase 25 % dose of insulin.

ALERT: always consult your veterinarian before changing insulin dose.

A diabetic ketoacidosis is a complicated form of diabetes. It needs aggressive management strictly under your veterinarian’s supervision. 

Treatment protocol of complicated diabetes in dogs.

NaCl 0.9 % intravenous fluid to maintain hydration at the clinic.

Give regular insulin at 0.2 IU /kg Intramuscular at an interval of 2 hours and checks blood glucose every 2 hours. When blood glucose level drops between 150-250 mg/dl. Then start 5 % Dextrose Normal Saline (DNS) with potassium Chloride @ 5 meq/L and inject regular insulin @ 0.5 IU/kg SQ every 6 hours.

When the patient starts eating and urine is negative for ketones, then change regular insulin to intermediate insulin( Lente or NPH) and now treat the patient like uncomplicated DM.

How to monitor diabetic dogs at home?

Check your dog’s weight regularly. and monitor any change in appetite, increase in thirst and urination. Regular check your dog’s blood glucose with a human glucometer. Glucose may go up after meals. Too low blood glucose level is more dangerous than high blood glucose. If glucose is too low, give honey or corn syrup orally immediately and rush to your veterinarian.

How to convert mmol/l to mg/dl blood glucose?

In some counties, blood glucose value is measured in mg/dl. In other countries, blood glucose is measured in mmol/L. Multiply by 18 to mmol/L value to get value in mg/dl.

Some other important articles:

IMHA in Dogs

Cushing’s disease in Dogs

Pyometra in Dogs

Pancreatitis in Dogs

This information is NOT intended as a substitute for veterinary consultation for any of your pet’s diseases. Always consult your veterinarian for a diagnosis and treatment plan.

References:

• Blackwell’s Five-Minute Veterinary Consult: Canine and Feline by Larry P. Tilley, Francis W. K. Smith
• Saunders Manual of Small Animal Practice by Robert G. Sherding and Stephen J. Birchard
• Emergency Procedures for the Small Animal Veterinarian by Signe J. Plunkett
• Merck Veterinary Manual by  Susan Aiello
• 100 Top Consultations in Small Animal General Practice by Peter Hill, Sheena Warman, Geoff Shawcross
• Plumb’s Veterinary Drug Handbook by Donald C. Plumb
• Veterinary Emergency and Critical Care Manual, 3rd Edition by Karol A. Mathews
• Veterinary Guide for Animal Owners, 2nd Edition by C.E. Spaulding, D.M.V. Jackie Clay 
• Small Animal Emergency and Critical Care for Veterinary Technicians Third edition by Andrea M. Battaglia, LVT, Andrea M. Steele, MSc, RVT, VTS (ECC)