Diabetes Mellitus (DM)

Having diabetes myself, I know it can be managed.  Dogs are pretty resulant and once they realize the meds are helping them, are usually more than willing to cooperate.  The key is make things like shots and paw pricks a treat opportunity.  If your dog is already obese, this is still do-able...green beans, piece of carrot, a nuget of dog food, or playing with a toy is a great reward.  This is not something that you should ignore.  We had a puppy owner that let the dog get obese, and all the signs were there - they just didn't put it together.  Eventually he went partially blind from the diabetes so it's important to get treatment as soon as you suspect something isn't right. 

Diabetes mellitus (DM) is a life-threatening disease that is diagnosed by high blood glucose. Canine diabetes is further divided into two groups like human diabetes - Type 1 DM (insulin deficiency diabetes) or Type 2 DM (insulin resistance diabetes). ... Diabetes is considered an autoimmune disease and is hereditary in dogs (though letting your dog get really really fat can also bring on a tendency).

The conversion of food nutrients into energy to power the body’s cells involves two things:

• Glucose: essential fuel for the body’s cells. When food is digested, the body breaks down some of the nutrients into glucose, a type of sugar that is a vital source of energy for certain body cells and organs. The glucose is absorbed from the intestines into the blood, which then transports the glucose throughout the body to individual cells.

• Insulin: in charge of fuel delivery. Meanwhile, an important organ next to the stomach called the pancreas releases the hormone insulin into the body when something is eaten.. Insulin acts as a “gatekeeper" that tells cells to grab glucose and other nutrients out of the bloodstream and use them as fuel.
  Without insulin, or if the cells have a resistance to insulin, the food (glucose) can't get into the cells.

With diabetes, the glucose-insulin connection isn’t working as it should:

• Insulin-deficiency diabetes—This is when the dog’s body isn’t producing enough insulin. This happens when the pancreas is damaged or otherwise not functioning properly. Dogs with this type of diabetes need daily shots to replace the missing insulin.  This is the most common type of diabetes in dogs.
• Insulin-resistance diabetes—This is when the pancreas is producing some insulin, but the dog’s body isn’t utilizing the insulin as it should. The cells can't absorb glucose from the blood and into the cells. This type of diabetes can especially occur in older, obese dogs.
• Gestational diabetes - Female dogs can also develop temporary insulin resistance while in heat or pregnant.

Whatever the type of diabetes, the negative effects on the body are the same. Excessive sugar builds up in the dog’s bloodstream, and yet the body’s cells that need that sugar can’t access it. So the “bad" effects that diabetes add up:

• Cells are starved for vital “fuel." Muscle cells and certain organ cells are deprived of the glucose “fuel" they need for energy. In response, the body starts breaking down its own fats and proteins to use as alternative fuel.

• High sugar level in the bloodstream damages many organs. Without insulin to help convert the glucose in the bloodstream into fuel, high levels of glucose build up in the blood. Unfortunately, this abnormal blood chemistry acts like a sort of poison and eventually causes multi-organ damage. This often includes damage to the kidneys, eyes, heart, blood vessels, or nerves.

Early Signs and Symptoms of diabetes in dogs?

 

The owner will sometimes notice certain symptoms that can be early signs of diabetes:

Excessive thirst. The dog may drink frequently and empty the water bowl more often.

Increased urination. The dog may ask to go outside frequently and may start having “accidents" in the house. Increased urination (and increased thirst) happens because the body is trying to get rid of excess sugar by sending it out through urine, along with water that bonds to the sugar.

Weight loss. The dog can lose weight despite eating normal portions. This is because the dog isn’t efficiently converting nutrients from its food.

Increased appetite. The dog can be very hungry all the time because the body’s cells aren’t getting all the glucose they need, even though the dog is eating a normal amount.

If the early signs are ignored or missed, the blood sugar rises causing more and more damage.  The dog will become lethargic, because he doesn't feel well.  This can affect his appetite, attitude and even cause vomiting. Eventually uncontrolled diabetes can lead to devastating effects on the dog’s body, which is why early detection and proper treatment are crucial. Effects of diabetes on the dog’s health can include:

• Cataracts (leading to blindness)
• Enlarged liver
• Urinary tract infections
• Seizures
• Kidney failure
• Ketoacidosis, a potentially life-threatening acute condition that can be accompanied by rapid breathing, dehydration, lethargy, vomiting, or sweet-smelling breath; can be triggered by factors such as stress, surgery, fasting, infection, or an underlying health condition combined with low insulin level. Owners of diabetic animals should always have on hand ketone testing sticks and should test their dog’s urine if any of the above occurs. If the dog’s urine tests positive for ketones, an emergency vet should be called immediately.

 How is Diabetes in Dogs Diagnosed?

Your veterinarian can do simple tests to check for diabetes, including testing for excessive glucose (sugar) in the blood and urine. Blood tests can also show other indications of diabetes, such as high liver enzymes and electrolyte imbalances. The sooner diabetes is diagnosed and treatment begun, the better chance the pet has of a normal life.  Risk factors for developing this include:

• Age. While diabetes can occur at any age, it mostly occurs in middle-aged to senior  dogs. Most dogs who develop it are age 5 or older when diagnosed.
• Gender. Unspayed female dogs are twice as likely as male dogs to have diabetes.
• Chronic or repeated pancreatitis. Chronic or repeated pancreatitis (inflammation of the pancreas) can eventually cause extensive damage to that organ, resulting in diabetes.
• Obesity. Obesity contributes to insulin resistance and is a risk factor for pancreatitis, which can lead to diabetes.
• Steroid medications. These can cause diabetes when used long-term.
• Cushing’s disease. With Cushing’s disease, the body overproduces steroids internally, so this condition also can cause diabetes.
• Other health conditions. Some autoimmune disorders and viral diseases are also thought to possibly trigger diabetes.
• Genetics. Diabetes can occur in any breed or mixed-breed, and it seems genetics can play a role in either increased or reduced risk. A 2003 study found that overall, mixed-breeds are no less prone to diabetes than are purebreds. Among purebreds, breeds vary in susceptibility, some with very low risk and others with higher risk. Some that may be at higher risk include miniature Poodles, Bichons Frises, Pugs, Dachshunds, Miniature Schnauzers, Puli, Samoyeds, Keeshonds, Australian Terriers, Fox Terriers, Cairn Terriers, and Beagles.

Treatment of diabetes in dogs

• Diet. Your veterinarian will recommend the best type of diet for your diabetic dog. Usually this will include some good-quality protein, as well as fiber and complex carbohydrates that will help to slow absorption of glucose. The vet may also recommend a diet with relatively low fat content to help control obesity.
• Exercise. To help avoid sudden spikes or drops in glucose levels, it is especially important that diabetic dogs maintain a moderate but consistent exercise routine.
• Injections. Most diabetic dogs will require daily shots of insulin under the skin, something that the owner will have to learn to do. Although it’s understandable to be apprehensive about doing this, it’s not as hard as it might sound. It can become a quick and easy daily routine that isn’t traumatic at all for either dog or owner.

Monitoring and managing your dog’s diabetes

Although some cases may be more challenging, canine diabetes can be usually managed successfully without complications. From giving injections to monitoring glucose levels daily, you will play the primary role in your dog’s care, and your commitment to keeping up with his daily shots and monitoring is very important to keep him feeling well.  Your dog can't tell you how he feels...and I know it's important to be on top of things.  When blood sugars go low, he may become disoriented and crabby, when high he could become sleeping and lethargic.  These are things you'll want to report to your vet.  Actually maintenance of a diabetic dog is so much easier than a person - we eat a variety of foods - whereas generally they eat one standard food that can be measured.  This makes care ultimately so much easier than a human.

Your veterinarian will work with you to determine the best management plan for your dog. At the start of treatment this may involve frequent visits to the clinic for testing and medication adjustments, but hopefully the right combination of medication, dosage, diet, and home monitoring will  enable you to keep your dog’s blood sugar consistent.  Products to manage pet diabetes are varied and reasonably priced (especially compared to human versions).  Most do need a prescription however.

Your dog’s diabetes management plan provided by your veterinarian will probably include information about:

• insulin medication for your dog and how to give the injections
• diet and exercise recommendations
• a daily glucose-monitoring system that will work best for your dog
• any warning signs to watch out for

If your pet is diagnosed with diabetes, don’t panic. With good veterinary support, you should be able to provide the right care for your pet and ensure he lives a long and happy life.

The Other Diabetes  - Diabetes insipidus (DI)

This is the OTHER diabetes, which is not really diabetes at all but is a rare disorder that affects water metabolism, preventing the body from conserving water and releasing too much of it. This condition is characterized by increased urination, dilute urine (so-called insipid, or dull urine), and increased thirst and drinking.

Diabetes insipidus (DI) is a rare disorder that affects water  metabolism, preventing the body from conserving water and releasing too much of it. This condition is characterized by increased urination, dilute urine (so-called insipid, or dull urine), and increased thirst and drinking. This disease is not related to diabetes mellitus or 'nsulin diabetes'.

There are two main types of DI that affect dogs: neurogenic (or central diabetes insipidus) and nephrogenic diabetes insipidus. In neurogenic DI, the cause is due to a lack of the hormone vasopressin, which regulates the body's retention of water. The release of vasopressin is produced and regulated by the  hypothalamus (in the brain), so a dysfunction in its release may be due to a head injury, or to a tumor in the brain. Vasopressin is produced in the hypothalamus into the connected  pituitary gland, and is then released into the bloodstream. A lack of vasopressin may be due to a failure in the hypothalamus, or a failure in the pituitary gland. A significant number of cases is idiopathic, meaning the cause is unknown.

Nephrogenic DI, meanwhile, can be caused by a deficiency of antidiuretic hormone (ADH), which functions to stimulate the capillary muscles and reduce the flow of urine, effectively conserving water for the body's various functions. The cause is found in the kidneys and their inability to respond appropriately to ADH, allowing too much water from the body to escape into the urine

This is typically an acquired condition, and may be due to amyloidosis of the kidney, cysts on the kidney, or an imbalance of electrolytes.

Other common symptoms seen in dogs with DI include:

• Increased urination (polyuria)
• Increased drinking (polydipsia) - some dogs will guard their water or drink until you think they'll explode!
• Decreased urination with dehydration
• Housesoiling - accidents for no apparent reason
• Poor hair coat 

Some of the tests doctors commonly use to diagnose and determine the type of diabetes insipidus and in some cases, its cause, include:

• Water deprivation test. This test confirms the diagnosis and helps determine the cause of diabetes insipidus. Under medical supervision,the dog will be deprived of drinking fluids for a time so the vet can measure changes in  body weight, urine output and the concentration of  urine and blood when fluids are withheld. They may measure blood levels of ADH or administer synthetic ADH during this test. The water deprivation test is performed under close supervision to make sure no more than 5 percent of body weight is lost during the test.

• Urinalysis. Urinalysis is the physical and chemical examination of urine. If the urine is less concentrated — meaning the amount of water is high relative to other excreted substances — it could be due to diabetes insipidus.
  
  
• Magnetic resonance imaging (MRI).  The MRI to look for abnormalities in or near the pituitary gland such as tumors.

Treatment For Diabetes Insipitus

Treatment of diabetes insipidus depends on what form of the condition is present. Treatment options for the most common types of diabetes insipidus include:

• Central diabetes insipidus. Because the cause of this form of diabetes insipidus is a lack of anti-diuretic hormone (ADH), treatment is usually with a synthetic hormone called desmopressin. The synthetic hormone will eliminate the increase in urination.  If the condition is caused by an abnormality in the pituitary gland or hypothalamus (such as a tumor), the vet will first treat the tumor..

  Taking more desmopressin than needed can result in too much water retention and low sodium levels in the blood. Symptoms of low sodium include lethargy, headache, nausea and, in severe cases, seizures. In mild cases of central diabetes insipidus, an increase in water intake is all that may be needed.  Make sure the dog has ample opportunity to go out to potty and ALWAYS have fresh water available.

• Nephrogenic diabetes insipidus. This condition is the result of the kidneys not properly responding to ADH, so desmopressin is not a treatment option. Instead. The vet may prescribe a low-salt prescription food to reduce the amount of urine the kidneys make.  As above, make sure the dog has ample opportunity to go out to potty and ALWAYS have fresh water available
  
  
• Gestational diabetes insipidus. Treatment for most cases of gestational diabetes insipidus is with the synthetic hormone desmopressin. In rare cases, this form of the condition is caused by an abnormality in the thirst mechanism. In these rare cases, doctors don't prescribe desmopressin.
  
  
• Primary polydipsia. There is no specific treatment for this form of diabetes insipidus, other than decreasing the amount of fluid intake.