Diabetes Mellitus in Dogs

Diabetes occurs when there is insufficient insulin in the body. As insulin is required for glucose uptake into tissues, low levels of insulin leads to high levels of circulating glucose in the bloodstream.

Glucose (sugar) is normally the first energy source used by cells and tissues. When lack of insulin makes glucose unavailable, fats and proteins are metabolized to meet energy requirements. Excessive breakdown of fats produces high levels of ketones, which give the breath a strong odor similar to fingernail polish remover.

Diabetes mellitus is one of the most common hormone disorders in dogs. It is a serious disease that can lead to secondary conditions, including the life-threatening condition, diabetic ketoacidosis, if left untreated.

With early detection and treatment, dogs have a good prognosis.Treatment can be cumbersome as daily injections and repeated veterinary visits are for monitoring and medication adjustments are required. When treatment is delayed, secondary conditions are more likely and medical management becomes more complicated.

Diabetes is typically diagnosed in middle-aged dogs. Additional risk factors for the development of diabetes in dogs include:

• Intact females
• Certain breeds (Cocker spaniels, Samoyeds, miniature schnauzers, Cairn terriers, and Yorkshire terriers)
• Obesity

Excessively high levels of circulating glucose can negatively impact vision by disrupting the clarity of the lens. This disruption of lens clarity leads to cataracts and blindness in almost all unregulated diabetic patients.

Other common conditions that develop as a result of high circulating glucose levels include:

• Urinary tract infections
• Skin and ear infections

Insulin injections are the cornerstone of therapy for diabetes, but dosing must be precise. Low blood sugar (hypoglycemia) is the most common complication of treatment for diabetes.

Hypoglycemia warrants immediate veterinary consultation as it can be fatal.

In uncontrolled, advanced stages of diabetes, a potential severe, life-threatening complication is diabetic ketoacidosis. These patients often appear lethargic, are unwilling to eat, and require immediate veterinary attention.

In addition, diabetes can be caused by immune-mediated destruction of the insulin-producing cells in the pancreas. This is often genetically-linked.

Diabetes is diagnosed based on symptoms and blood glucose levels after fasting. Glucose may also be detected in the urine when blood levels are consistently high.

Tests a veterinarian may perform to diagnose diabetes, as well as detect other commonly associated conditions, include:

• Physical exam
• Blood work
• Urinalysis

Unlike humans, all dogs require insulin injections for treatment for diabetes. After the correct type and dose of insulin are determined by a veterinarian, injections can be easily administered from home with instruction. Injections are typically administered twice daily, after a meal.

It is important not to alter the insulin type or dose without veterinary consultation as there are different types of insulins, and insulin doses are patient-dependent.

Dietary management is also important in diabetic patients to avoid spikes in glucose throughout the day. A high fiber diet and minimizing treat intake may be recommended to regulate blood sugar levels.

Diabetes is associated with increased incidence of urinary tract infection, and any source of infection interferes with glucose metabolism. Ongoing diagnostics and treatment for associated conditions are an additional consideration in successful diabetes management.

The management and treatment of diabetes mellitus is life-long. From determining the dose of insulin required, to intermittent blood glucose monitoring (in-clinic or at home), and potential readjustment of insulin dose in the future, multiple follow-up visits are required.

Many factors, including genetics, likely contribute to the development of diabetes in dogs.

Preventing risk factors such as obesity, spaying female dogs, and having regular veterinary visits to detect diabetes early may help prevent the severity of disease.

Diabetes mellitus is common in dogs.

• Insulin injections
• Dietary management
• Weight loss
• Spaying female dogs