Post by DogGoneGood on Aug 14, 2009 18:33:32 GMT -5
How To Care For The Diabetic Dog
by Jeff Grognet, D.V.M., B.Sc.(Agr.)
by Jeff Grognet, D.V.M., B.Sc.(Agr.)
Dogs In Canada
August 2009 issue
For some dogs, a diagnosis of diabetes can be fatal. This is because their caregivers can't take on the challenge of treatment, or can't cope with the expense of this disease. But, thankfully, these are more the exception than the norm. Most diabetic dogs get the chance to change from lethargic and sickly to the exuberant, healthy friends they once were.As well, owners of diabetic animals repeatedly say that managing their dog's illness is incredibly rewarding for them.
The The first step in managing a diabetic dog is being able to recognize one. The symptom most people notice is excessive urination. Their dog may not be able to make it through the night and will ask to go out. Some spayed bitches become incontinent due to the pressure of the large bladder. The water bowl also empties faster than it did before.
Diabetic dogs always have weight loss. This is because diabetes is a catabolic (as opposed to anabolic) condition - the fat, and later muscles, just melts away.
Because many diabetics start out overweight, some owners are initially please that their dog is shedding pounds. However, if the weight loss is not planned, look for a reason. It could be diabetes or another disease.
Cause
Diabetes is caused by an inability of the pancreas gland to produce insulin. Without insulin, sugar can't enter the cells of the body. As a consequence, sugar (glucose) builds up in the bloodstream and spills over into the urine. Glucose in the urine draws water along with it, ramping up urine volumes.
Of course, with all this sugar lost, the dog must eat more to meet its daily energy needs. However, most can't keep up to the calories lost through the urine and continue to drop weight.
Most importantly, untreated diabetic dogs do not feel well. The cells are starving for glucose, and the dog becomes weak and mentally dull. Ironically, as sugar metabolism becomes impared, appetite falls, worsening the situation. Dogs can progress into diabetic comas and eventually die.
Diagnosis
The good news is that diabetes can be treated and successfully to boot. When we think of diabetes in people, we think of complications. This is not the case in dogs. The most common canine complication is cataracts, and even those are treatable.
Diabetes is easy to diagnose. A simple urine test shows high levels of glucose. A blood test reveals a high blood sugar. Veterinarians often perform other tests to confirm the disease and ensure that there are no complications, but the focus quickly turns to treatment.
Dogs do not get the type II diabetes typical of older people, which can be controlled with diet and exercise. By the time a dog is diagnosed with diabetes, the insulin-producing cells have already shut down and the dog is insulin-dependent.
Ironically, the first patient to ever recieve insulin was a dog. Researchers Banting and Best treated a diabetic dog called "Dog #33" in 1921 with an extract from the pancreas. They achieved long-term survival. This ultimately led to the development of insulin preparations for humans. However, it wasn't until 1950 that the first dog was treated by a veterinarian. Since then, we have learned a lot about diabetes and how to control it in our canine patients.
What makes dogs prone to diabetes?
A study in dogs showed that the prevelence of the disease rose from 19 cases per 10,000 admissions in 1970 to 64 cases per 10,000 in 1999. This mirrors the increase in diabetes cases seen in people, but the mechanism of why it is occurring is unknown.
It could be a tendency to obesity, but current thinking is that there are faulty genes that predispose a dog to developing the condition. These genes could spur the immune system to attack and destroy the pancreatic beta cells (the ones that produce insulin). The trigger for the reaction is thought to be any of several of drugs, toxins, pregnancy, infections, as well as diet and exercise habits.
Insulin for dogs
The decision on which insulin to use is a science unto itself. The best one for dogs is an insulin extracted from pig pancreas. The porcine insulin molecule is an exact match for canine insulin. Human insulins (grown in cell culture) are a little different. The pork product works better and there is also less chance of it initiating an immune reaction.
Treatment
Even 20 years ago, many owners faced with the prospect of twice-daily insulin injections still considered euthanasia the more practical alternative. As well, many veterinarians lacked the knowledge in treating this disease. But, that is not the case today. Every veterinarian can now tell you about the legion of canine diabetics under treatment.
The key in managing diabetes is being able to commit to a regular routine. You want insulin injections, exercise and feeding to happen at the same time each day. If the schedual is chaotic, blood sugar levels are also unpredictable and this means an unregulated dog.
Insulin is normally given twice daily to dogs. Initially the dose is very low. If too much is given, all the sugar rushes into the cells and blood sugar levels drop precipitously low. This hypoglycemia causes weakness, possibly seizures, and death.
We want to avoid hypoglycemia because it is so serious. Even when sugar levels have fallen and the dog is stable, veterinarians are not as aggressive as physicians in lowering blood glucose levels. They satisfy themselves with levels being stable and safe rather than perfectly controlled.
If a hypoglycemic crisis occurs, the solution is to give glucose. This may be an intravenous injection by your veterinarian, or a high-sugar syrup rubbed on the gums by the owner.
Many owners regulate their diabetic dogs at home. A portable glucometre allows the right dose to be given, but just as importantly, trends can be spotted. For example, if blood sugar is rising and the insulin dose has not changed, there could be another problem going on, such as an infection.
Infections cause insulin resistance - the blood sugar rises because the insulin is not working as it should. Most veterinarians would check the urin right away because diabetics are prone to bladder infections.
Diet plays an instrumental role in managing diabetics, making regulation of blood sugar easier. The best diet is one high in fibre. It delays food digestion and flattens the spikes in blood glucose. Another dietary requirement is a low glucose. Another dietary requirement is a low glycemic index. This is often done by limiting or eliminating grains, the ingredient that tends to push blood sugar up. However, a grain-free food may not be the right one for your diabetic dog if it contains another high-glycemic ingredient such as potato. Several prescription foods designed for diabetic dogs work very well.
When a dog is well regulated on insulin, you can expect to see several things. The most obvious is that drinking and urinating fall off dramatically. Over time, the dog will put on weight. Next, there's an improvement in hair coat as it changes from unkempt to luxurious.
Managing a diabetic dog is not a task taken lightly, and it takes commitment. However, the bond between a diabetic dog and its owner is as wonderful as it gets. Making your dog feel good again is rewarding.
Internet Resources:
www.caninediabetes.org/pdorg
www.caninediabetes.org
www.petdiabetes.com
A multi-published writer, Jeff Grognet, D.V.M., B.Sc.(Agr.), runs a veterinary
practice in Qualicum Beach, B.C., along with his wife, Louise Janes, D.V.M.
