Dealing with Diabetes

When Tammy Saunders discovered her beloved cat Simone had diabetes, her first reaction was one of shock and fear. “I was afraid I was going to lose my best friend.”

Simone had developed signs quickly. When her cat suddenly started drinking more water than usual, Tammy thought it was just the summer heat. Next, Tammy noticed Simone was losing weight even though she was eating more than ever. “Then I found myself changing Simone’s litterbox very frequently, and she started having accidents in the house. I knew that something was wrong, and I took Simone immediately to the veterinarian,” Tammy recalls.

Based on Tammy’s concerns, her veterinarian suspected that Simone had diabetes, and a few simple tests confirmed his suspicions. Once the diagnosis was made, though, he was able to assure Tammy that with her help Simone could live a long and happy life.

A METABOLIC BREAKDOWN

Just like people, dogs and cats with diabetes have a problem with the hormone insulin. Produced by the pancreas, insulin is essential for maintaining blood sugar at an appropriate level. In pets with diabetes, most often the problem is that their body just does not make enough of it. As a result, the body cannot absorb and utilize its main energy source, called glucose.

Since it is not being utilized, glucose builds up in the bloodstream. When it reaches the kidney, the glucose carries a lot of extra water with it, leading to the extra urine production and the increased thirst that are the disease’s main symptoms. Infection of the urinary tract is common as well.

Other complications are caused as the body turns to other sources for energy, such as stored fat. Over time, the metabolism of fat will result in an unhealthy level of substances known as ketones accumulating in the blood. So, even though a pet with diabetes seems to be eating a normal amount of food—or even more food than normal—he may lose weight.

The cause of diabetes in dogs and cats is difficult to pinpoint. Numerous factors can contribute, such as genetics and obesity, as well as disorders of the pancreas and immune system. Left untreated or unregulated, diabetes can have serious consequences, including cataracts, blindness, kidney problems, liver problems, or death.

MAKING THE DIAGNOSIS

“Not all pets with diabetes display the obvious symptoms,” advises Dr. Wendy Brooks, Educational Director for a popular online resource for pet owners. “Other diseases could cause the same clinical signs.”

If diabetes is suspected in your pet, your veterinarian will take blood and urine samples to confirm the diagnosis. The urine sample is examined for excess glucose and ketones and signs of a urinary tract infection. The blood test checks the blood glucose concentration and looks for liver and kidney problems. Additional tests may be recommended if your veterinarian suspects another disease might be involved.

The good news is that diabetes is a very treatable condition. As in humans, diabetes in dogs and cats can be managed well. They can have essentially the same quality of life as they did before diabetes, providing you give them a little extra care.

A CONTROL ISSUE

The goal of treatment in diabetes is to help the pet maintain a normal glucose level. Treatment options vary. Diet is certainly a key component in the therapeutic approach. Your veterinarian can recommend one of the many specially formulated diets available to help pets with diabetes utilize insulin more effectively. Also, in cases of obesity, watching the pet’s diet and helping him return to a more normal weight is important as well, as it can have a big effect on reversing the body’s resistance to insulin.

Diabetic pets are usually placed into one of two categories:

• Those that are “insulin dependent” cannot regulate their glucose levels through diet and oral medications and require insulin injections to achieve control.

• Those that are “non-insulin dependent” do not require insulin injections to maintain control.

Almost all dogs are insulin dependent and need insulin injections to manage their diabetes. The same, however, is not true for cats. Many cats—according to some estimates, up to 50%—have a type of diabetes that can be controlled with oral medications called hypoglycemic drugs. (“Hypoglycemic” is just a fancy way of saying that these medications help lower the blood sugar.) The decision to start with oral drugs or insulin injections depends on numerous factors, including severity of signs and general health. Your veterinarian will work with you to identify the treatment options—diet, medication (oral or injectable), and exercise—that are best for your pet.

A SHOT AT GOOD HEALTH

Once a decision is made to start the pet on insulin injections, the next step is to figure out the correct dose. According to Dr. Debra Eldredge, a veterinarian, dog trainer, and writer from Vernon, New York, this can be more difficult to accomplish in pets than it is in people. “It’s not like your pet can say ‘my blood sugar is dropping; give me a cookie right now,’” she explains.

The insulin dose is based on several factors, such as diet, amount of exercise and activity, and whether other hormones are at normal levels. Each case is different, but the goal is to keep glucose within an appropriate range. Also, it can be a little more difficult to control insulin levels in cats than in dogs.

Treatment for insulin-dependent pets is pretty much like it is for people: Insulin is injected underneath the skin to get into the bloodstream. It usually takes about a month to regulate the dose and requires a weekly visit to the veterinarian. The type of insulin administered, the amount, and frequency may vary until your veterinarian is satisfied with your pet’s overall improvement, as well as the range of levels in the blood throughout the day (this is known as a glucose curve).

Owners should not be intimidated by the thought of giving their pet an injection. “It’s a piece of cake in my experience,” says Dr. Eldredge. “It’s a tiny needle, a small amount, and it is given under the skin.” According to Dr. Eldredge, some cat owners think it is even easier to give an insulin injection than it is to give their cats a pill.

THE SWEETEST REWARD

There is no “cure” for diabetes. Long-term management requires a strong commitment from pet owners. The dose and frequency of insulin may change based on the pet’s response and regular glucose evaluations, which are done in the veterinarian’s office. The return for such vigilance, however, can be years added to the life of a beloved pet.

Today, Tammy and her best friend Simone are doing great. She worked closely with her veterinary team to get Simone on the best dose of insulin for her, and she brings her back regularly for monitoring and checkups. Tammy also makes sure Simone eats a healthy diet recommended by her veterinarian. It’s been 2 years since Simone’s diagnosis, and Tammy is proud to report: “She is as happy and active as ever!”

THE DIET FACTOR

Diet is a critical component in the treatment of diabetes. Most veterinarians recommend a prescription diet or a premium commercial diet with fiber. Some animals respond well to high-protein, carbohydrate-controlled diets, whereas others respond better to high-fiber diets. Also, some pets just do not like the taste of a high-fiber diet. Different formulations are available, and your veterinarian will recommend a diet that is best for your pet’s specific needs.