Diabetes In Dogs: All You Need To Know - Causes, Symptoms, Treatment and Management

Can diabetes in dogs be prevented? 

Diabetes mellitus is one of the most common hormone-related conditions diagnosed in dogs, so even if the risk factors mentioned above are minimised, there is unfortunately no guarantee that your dog would be entirely immune to developing diabetes.

What are the types of diabetes that dogs can get?

There are 2 types of diabetes in dogs, Type I and Type II:

• Type I diabetes: Also known as “insulin deficiency diabetes” or “insulin-dependent diabetes”. For dogs, Type I diabetes is more common than Type II diabetes. Dogs with Type I diabetes are completely unable to produce insulin in the presence of high glucose levels, leading to high blood glucose levels and very low insulin levels.
• Type II diabetes: Also known as “insulin resistance diabetes”. Type II diabetes is more common in cats but may still develop in dogs. While dogs with Type II diabetes are able to produce insulin, the insulin is insufficient for the demand. Additionally, their cells are less responsive to insulin, meaning even higher insulin levels are required to encourage the cells to absorb glucose and bring the blood glucose levels down to a normal range.

What are the symptoms of diabetes in dogs?

Unlike us, dogs can’t explain when they’re feeling unwell. This can make detecting health problems quite difficult. Here are 5 key symptoms of diabetes in dogs to look out for:

• Increased thirst (polydipsia): Dogs with diabetes tend to drink more water than their usual amount. To help you keep track of your dog’s daily water intake, remember that dogs typically drink about 50-100ml/kg of body weight each day and keep in mind how often you refill their water bowl.
• Increased frequency of urination (polyuria): Keep an eye on how often your dog urinates. If possible, take note of the approximate volume of urine and compare that with their normal amount.
• Increased appetite (polyphagia): Diabetic dogs may begin to eat more than usual. In the short term (acute diabetes), their weight may be normal. They may even be obese. In the long term (chronic diabetes), however, you might notice weight loss despite your dog’s increased appetite.
• Cataracts (or “cloudy eyes”): As the diabetes develops, there may be noticeable bluish-grey opacities (cataracts) in your dog’s eyes. For diabetic cataracts, usually both eyes are affected. Your dog’s vision could be unaffected at the beginning but this may worsen over time as the cataracts develop.

If you suspect that your dog is showing any of the symptoms listed above, Felcana recommends that you bring him/her to a vet as soon as possible. The consequences of diabetes could be dire if left untreated.

How does a vet diagnose dog diabetes?

If your vet suspects that your dog is diabetic, he/she may perform the following diagnostic tests:

• Urinalysis: Your vet may ask to take a urine sample from your dog to check for the presence of glucose in the urine (glucosuria), and ketones (chemicals the liver produces when the body burns fat instead of glucose for energy) in the urine (ketonuria).
• Blood test: Your vet would then take a blood sample from your dog and check for the presence of high levels of glucose in the blood.

What would happen to my diabetic dog if left untreated?

If left untreated, uncontrolled diabetes in dogs leads to complications such as:

• Cataracts: As explained above, cataracts are the clouding of the eyes. Cataracts are the most common complication of diabetes in dogs. Diabetic dogs often develop cataracts rapidly because the extra glucose directly affects the normal glucose levels within the eye. Diabetic cataracts could eventually lead to blindness in dogs if uncontrolled.
• Urinary tract infections (UTIs): Bacterial infection of the bladder (bacterial cystitis). Diabetic dogs have frequent UTIs because the excess glucose in the urine provides an ideal environment for bacteria to grow.
• Recurrent bacterial infections: Diabetic dogs are also prone to frequent bacterial infections of the skin, gums and other parts of the body. This is because bacteria thrive on glucose, and excess glucose allows them to grow rapidly.

Treatment of diabetes in dogs

There is no complete cure for dog diabetes. Rather, therapy involves controlling the condition by making appropriate lifestyle changes, which may involve medication.

The goals in controlling dog diabetes are to:

• Consistently maintain blood glucose levels within the normal range or just slightly higher than that.
• Avoid spikes and drops in blood glucose levels throughout the day.
• Correct or reduce the symptoms of diabetes.

While lifestyle changes may seem daunting, most diabetic dogs are much happier, healthier more energetic after, making it all worthwhile.

Does my diabetic dog need insulin injections?

Every dog diagnosed with diabetes responds differently to treatment, so therapy must be tailored to each individual. The decision for medical treatment for diabetes in dogs is based on 5 main factors:

• The severity of the symptoms
• The diagnostic test results
• The presence of other health issues that could complicate the disease and/or the therapy
• The owner’s ability to commit in terms of time and care
• The owner’s ability to shoulder the financial costs of medical treatment

What’s the daily insulin injection routine like?

Insulin is injected under the dog’s skin (subcutaneously). It’s usually injected twice a day, about 12 hours apart, although your vet may have a different treatment plan based on your dog’s individual response to the insulin injections.

It takes time and some trial and error to establish the most appropriate insulin type, dosage and routine for your dog, but cooperation and good communication with your vet can help speed up the process.

It’s vital to always give your dog the insulin injections at the same time everyday and to give your dog his/her regular meal with the injection. This ensures that your dog’s blood glucose is balanced with the insulin, reducing the chances of dangerous spikes or dips in glucose levels.

Generally, giving insulin after your dog has eaten is the safest. Giving insulin before food or at the same time runs the risk of low blood sugar (hypoglycaemia) if your dog decides not to eat.

However, there are some dogs that won’t be hungry until insulin is given, as that brings the blood glucose down to a level that stimulates their appetite. Therefore, take note of how your dog responds to the timing of insulin injections and discuss this with your vet. If your diabetic dog refuses his/her food after an insulin injection more than once, please inform your vet!

How do I prepare insulin injections for my diabetic dog?

To give you an idea of what the process is like, here’s a quick guide to the preparation step of insulin injections: 

1. Retrieve the insulin bottle from the fridge.
2. Mix the insulin solution gently by carefully rolling the vial back and forth between the palms.
3. Clean the rubber stopper with rubbing alcohol.
4. Insert a fresh syringe needle into the rubber stopper.
5. Turn the bottle upside down to draw up the prescribed volume in a fresh syringe. Turning the bottle upside down helps to reduce air bubbles.
6. Find a good spot that allows you to inject just under your dog’s skin. Some well-tolerated locations include 2.5-5cm from the middle of the back, near the shoulder blade or hip bone.

How do I give insulin injections to my diabetic dog?

Here’s a great video demonstration by the American Animal Hospital Association (AAHA) that shows the entire process of administering insulin to your dog, from start to end:

It’s perfectly understandable to be nervous about having to give injections. Feel free to voice your concerns to your vet and request for a demonstration by the vet or a vet nurse, and to be supervised when trying it out for the first time.

What should I watch out for when giving insulin injections to my diabetic dog?

Please take care to properly dispose the used syringes and needles – don’t throw them into the general waste bin!

Your vet should help you with setting up proper arrangements for waste disposal, including waste bins specially intended for the disposal of sharp objects.

Dog diabetes diet and management

How do I manage my dog’s diabetes?

As mentioned above, diabetes in dogs is best managed with lifestyle changes that will protect them from having spikes or dips in blood glucose levels throughout the day, and keeping a record to constantly monitor the progression of diabetes in between vet check-ups. Here’s a more detailed list of tips that you can consider:

• Exercise:
  • Diabetic dogs are encouraged to exercise regularly, and there’s no reason to restrict it. Felcana Go makes it easy for you to monitor your dog's activity levels, and fitness progress! 
  • Exercise helps to control weight, preventing obesity. You can track your dog’s weight on Felcana’s mobile app.
  • Exercise also encourages rapid insulin absorption, as blood circulation increases and the insulin is more readily taken up.
  • However, consistency is key – longer than usual or unusually vigorous exercise sessions could cause blood sugar levels to drop dangerously low, causing hypoglycaemic episodes.
  • You should bring a sugary snack or oral glucose gel with you on walks in case your dog experiences a hypoglycaemic episode.

• Logbook:
  • Use a simple notebook, calendar, or computer spreadsheet to document your dog’s diabetes progress.
  • Examples of information to record include changes to:
  • Diet
  • Exercise
  • Injections
  • Appetite
  • Any glucose measurements taken at home
  • Weight
  • Appearance
  • Water intake
  • Urination frequency
  • Mood
  • Routine prescribed by your vet

• Dental care:
  • As previously mentioned, dogs with diabetes are prone to bacteria build up, causing dental disease.
  • Brush your dog’s teeth everyday to prevent plaque from accumulating.
  • Have your vet do a quick dental examination during check-ups to monitor your dog’s dental hygiene.
  • Bring your dog in for scaling and polishing to keep his/her teeth pearly white.
  • Have a look at our other article for more vet advice about pet dental care!

• Spaying: Spaying is key in the management of diabetes in female dogs. 

What’s the best dog diabetes diet?

When choosing a diet for your diabetic dog, while nutritional composition is important to consider, ensuring that the meal is palatable such that the dog eats consistently is even more crucial.

In terms of nutritional composition, avoid semi-moist dog foods which are high in sugars.

If your dog isn’t a greedy eater, provide free access to dry food (ad-lib) to help avoid low blood sugar.

Most vets would recommend a diet that is:

• Low in simple sugars: Large amounts of simple sugars would cause a spike in blood glucose after the meal.
• High in complex carbohydrates (starch) and high quality protein: Having these as an energy source instead allows for a slow, controlled release of glucose into the bloodstream.
• High in fibre: Fibre slows down rate of glucose absorption by the body, further maintaining the slow release of glucose. Fibre is also a bulky ingredient which can fill your dog up faster, another benefit for overweight diabetic dogs. Please note that high fibre diets are not suitable for thin diabetic dogs, as it causes more weight loss!

Can I give my diabetic dog treats?

Giving treats is an amazing way to strengthen the bond between you and your dog, and diabetes shouldn't stand in the way of that. Suitable treats for a dog with diabetes are those that are low in sugar.

Remember, as hard as it may be, try not to give in to those puppy dog eyes too often, as the meals should make up 100% of their daily nutritional requirements!

Diabetic emergencies

It’s important to be well-informed of the possible emergencies that diabetic dogs could have. The 2 key conditions to watch out for in your diabetic dog on a day-to-day basis are:

1. Diabetic ketoacidosis (DKA)
2. Diabetic hypoglycaemia

What is Diabetic Ketoacidosis (DKA)?

Diabetic Ketoacidosis (DKA): Accumulation of too many ketones in the blood, together with high levels of blood glucose.

In diabetes, the insufficient insulin means that cells won’t be absorbing enough glucose from the blood for energy. This leads to the body burning fat to produce fatty acids for energy instead. In the liver, fatty acids are converted to ketones, which then circulate around the body.

Ketones can also be used as an energy source. The problem is that, similar to glucose, insulin is also necessary to turn ketones into energy. Hence, without enough insulin, the ketones accumulate in the blood, while blood glucose levels are still high, leading to diabetic ketoacidosis.

Signs of diabetic ketoacidosis include:

• Weight loss
• Weakness (lethargy)
• Nausea
• Vomiting
• Loss of appetite (anorexia)
• Increased frequency of urination (polyuria)
• Dehydration

If you notice any of the above, Felcana recommends that you call your vet immediately.

Your vet will most likely start giving your dog insulin to reverse the high levels of sugars and ketones in the blood.

He/she will also give your dog fluids. Apart from rehydrating your dog, fluids also replenish the electrolytes that your dog might have lost due to dehydration.

If your dog is bright, alert and well-hydrated, hospitalisation may not be required.

What is Diabetic Hypoglycaemia?

Diabetic hypoglycaemia: Severely low blood sugar.

An overdose of insulin may cause a severe dip in blood glucose, below the normal range. The brain and spinal cord (that make up the central nervous system) rely entirely on glucose for normal function.

If blood glucose drops drastically, causing diabetic hypoglycaemia, the brain and spinal cord may be severely affected.

Signs of diabetic hypoglycaemia include:

• Anxiety
• Shaking and twitching of the muscles (muscle tremors)
• Confusion
• Loss of control of bodily movements, such that movements are uncoordinated (ataxia)
• Collapse
• Seizures
• Coma
• Sudden death

If you suspect your dog is experiencing diabetic hypoglycaemia, Felcana recommends that you call your vet immediately to report the episode and receive further instructions.

Instructions may include:

1. Rubbing maple syrup (or any other food that is high in simple sugars) on your dog’s gums and on the inside of their cheeks. This allows the sugar to be absorbed quickly into the bloodstream to rapidly provide more glucose for the brain and spinal cord.
2. Measuring your dog’s blood sugar level if you have a blood glucose checker on hand.

What’s the prognosis for diabetes in dogs?

All in all, a diagnosis of diabetes in your dog is undoubtedly going to present lots of new challenges. The knowledge that dog diabetes is a condition that can’t be completely cured, and needs to be managed for life, is definitely nerve-wracking. 

When you’re feeling overwhelmed, remember that the prognosis for diabetes in dogs is very good. This means that your dog with diabetes can have a decent life expectancy. Take comfort in knowing that many dogs diagnosed with diabetes can achieve good to great control of their blood glucose levels and live high-quality lives.

With some lifestyle changes, dedicated monitoring of your dog’s diabetes, great communication between you and your vet, as well as a positive outlook, you too can take back control over your dog’s diabetes.