Diabetes in Pets:

What To Expect
When You Go To
The Vet

first draft...please be patient
Diabetes in Cats and Dogs: 
What to expect when you go to the vet
(Of course, your veterinarian may handle similar cases differently)

We treat quite a few pets for diabetes. 

Sometimes we suspect diabetes because of your pet's symptoms which include a history of drinking and urinating a lot more than usual. 

More often we find out your pet has diabetes from the routine blood work we often do when you bring a pet in because it's sick ... cause unknown.

This discovery of diseases we wouldn't otherwise detect is why the expense and trouble of running blood work is often worthwhile.  And that, of course, is why we run them.

While increased urination and drinking are the most famous of symptoms, diabetes affects almost every organ...eyes, skin, heart, etc...as well as every process; wound healing, circulation, and disease resistance. 

So all kinds of symptoms, from vague to obvious are possible.

Here's what to expect if you brought a pet into our clinic:

Exam and History:

As indicated above, we often get suspicious of diabetes with just a history.  Other clues are early onset of cataracts, obesity, mouth ulcers, and the odor of the breath.

Sometimes in cats, the posture is changed due to neuro disease caused by the diabetes...they walk with their hocks touching the ground. 

Pets with diabetes often come in with depression, nausea, and weakness because diabetes can cause a condition called ketoacidosis...the diabetes may have been around for a while but the ketoacidosis and the signs it causes are new. 

And since diabetes so often causes other problems we will be examining everything thoroughly. 

Expect us to find a multiple list of health problems and don't be surprised if the diagnostic picture is confused at first. 

Once again; diabetes is associated with all kinds of secondary problems with infections, circulation disorders, digestive problems and so on.

Lab work:

A.  Blood work: Diabetes is mainly confirmed by lab work; a complete blood count, blood chemistry, and a urinalysis.   In particular, we're looking for elevated blood glucose and evidence of glucose in the urine ... but the other tests are important because once again, there are often multiple problems going on at the same time.

One note of caution:  Sometimes an elevated blood sugar is not due to diabetes but due to anxiety and stress... especially in cats:  a cat's blood sugar can sometimes go sky high due to the stress of being in the clinic and getting a blood sample, so we won't necessarily jump to immediate conclusions, but will likely retest and if necessary sedate a little and retest later after being calm for a while.    In general though, if the glucose is high in both the blood AND the urine confirms the disease.

Other vets might confirm the disease with more accurate serum insulin concentration tests or intravenous glucose tolerance tests.

B.  Urinalysis:  it's important to see glucose elevated in both the blood and the urine to make the diagnosis.  Plus, we don't want to miss a bladder infection...which is common in diabetic patients. 

C.  Thyroid testing.  Thyroid disease is sometimes associated with diabetes in both dogs and cats 

Treatment Options to Consider:

1.  Stabilize the sick patient:  Since a lot of pets that we discover have diabetes are brought in because they are suddenly so ill (keto-acidosis), the first thing is to stabilize these patients.  This usually means hospitalization, IV Fluids, steroid and antibiotic therapy, insulin injections, supportive therapy and repeated tests until the patient is doing a lot better (or dies). 

This is a serious disease...I didn't mean to be insensitive, but despite treatment, diabetic keto-acidosis is often fatal. 

2.  If the patient is successfully stabilized (or not especially sick when we make the diagnosis), then we control the disease the best we can with:

A.  Diet; some patients are so well controlled with high fiber, low carb diets  (and with feeding smaller, more frequent meals) that some diabetic patients don't need insulin.  Hill's Prescription WD, and Purina's DM diets are often successful
Therapeutic diets designed for treating diabetes are a major part of treating this disease.  Click here to go to my page about the diets and supplements I recommend for treating diabetes in dogs and cats.

B. Weight loss:  some patients are managed easier or may even be able to get off insulin therapy if you can get their weight down.

Hill's has a fairly new weight loss diet that seems to be working better than any other diet I've recommended.  It's called M/D diet (Metabolic Diet).  

C. Insulin Injections.  This is not as difficult as you might imagine...luckily the needle is extremely tiny and even cats will often allow you to inject them with a minimum of fuss.  Needs to be done 1-2 times daily.  

Results are quite different for each patients; a lot of our patients live long, fairly normal lives and others have major complications from their disease despite treatment.

This is true in human medicine too...diabetes is a major killer.  Insulin can kill if too much is given and the dose frequently needs to be adjusted so you have to be willing to retest your cat or dog  every 1-14 days until the patient is nicely stablized. 

Some vets insist on keeping the patient for the first 3-14 days to monitor and regulate their insulin injections until they get it just right, but this is expensive and often not needed in my opinion, but nonetheless, each case is different...be prepared for some expense and the hassle of repeated asscessments and treatment changes. 

D.  Referral:  Referral to a specialist should be considered.  If you can afford the care of a specialist, they are better suited to complicated cases than most general practitioners.

E.  Fairly frequent rechecks to include blood chemistry every 3-12 months depending on the case to keep an eye out for the other problems associated with diabetes such as pancreatitis, kidney and liver disease.

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What to expect when you go to the vet with a pet with diabetes

When we eat, our digestive systems break down the proteins, fats, starches, and sugars into compounds needed by our bodies, one of which is glucose. 

Glucose is the primary source of energy for our cells, but before the cells can use glucose, it must move from the bloodstream into the individual cells.

This process requires insulin which is normally made by the pancreas.

The panceas is a small, spongy organ attached to the upper intestines and it's main jobs are to produce digestive enzymes and insulin

Dogs with diabetes tend to produce no insulin (insulin dependent) and will need insulin therapy to survive.

Cats often have a type of diabetes where they continue to produce at least some insulin and can sometimes be treated with special diets and not need life long insulin therapy.

Our Page about Diets and Supplements designed for treating Diabetes in Cats and Dogs

The typical diabetic dog or cat is middle aged and FAT

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Cataracts and  glaucoma are common side effects of having diabetes
Intro to Metabolic Diseases
Obesity (adipose tissue is a major
metabolic organ and a producer of harmful hormones)
Addison's Disease    Cushing's Disease    Hyperthyroidism     Hypothyroidism    
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