Part 2: Canine Diabetes

In Part One of our dog diabetes mini-series, we talked about what dog diabetes is, its two different types, symptoms, and diagnosis. In this Part Two of the series, the Felcana veterinary team will be covering how dog diabetes is treated as well as its management and prevention.

The goal in managing dog diabetes is to keep blood glucose (i.e. blood sugar) levels close to normal, avoiding spikes and drops, and to reduce or eliminate signs of diabetes (e.g. excessive thirst and urination). Although diabetes in dogs cannot be cured yet, the condition can be successfully managed with appropriate changes to diet and lifestyle and in some situations insulin injections. In other words, it means your dog can still lead a happy, heathy, and active life – which in fact, most diagnosed diabetic dogs do!

Medical Treatment

Each dog diagnosed with diabetes will respond differently to treatment and thus therapy must be tailored to individual dog, very much like us humans. Treatment for diabetes in dogs is based on two main factors:

  1. How severe the symptoms and lab works are
  2. Whether there are any other health issues that could complicate the disease and/or the therapy

Some dogs may be seriously ill when first diagnosed and will require intensive care and hospitalisation for several days to regulate their blood sugars. On the other hand, dogs that are more stable upon diagnosis may respond to oral medications or a high-fibre diet.

Insulin therapy

In some situations, dogs may require insulin injections to maintain their glucose levels within the normal ranges. A complete discussion of insulin therapy for dogs is beyond scope, but here are a few key points to know.

Just like with humans, insulin is injected under the dog’s skin – usually twice a day, after meals, about 12 hours apart. There are many different types of insulin; your vet will decide on the most appropriate insulin type and dosage for your dog. However, bear in mind that it may take time to establish the correct regime.

The thought of giving your dog needle injections might sound daunting at first – it’s perfectly normal. But you’ll be glad to hear that it’s easier than you think and almost all owners are capable of properly administering insulin to their dogs. Insulin needs to be stored in the fridge. Mix the solution gently before administration by carefully rolling the vial back and forth between the palms. WebMD has a more in-depth step-by-step guide with some tips. Or alternatively if you’re more of a visual person, you might find this video by VCA Animal Hospitals easier. It’s important to properly dispose the used syringes and needles – don’t throw them into the rubbish! Your vet should help you set up proper arrangements and waste bins for sharp disposals.

It’s important to always give your dog their insulin at the same time everyday and feed them regular meals along with their medication. This will make sure their blood sugar levels are in line with their insulin levels and thus reduce the chances of their sugar levels swing either too high or too low. Together with your vet, you can create a feeding schedule around your pet’s medication time. You can refer to Felcana’s previous post on creating a balanced dog diet for some tips. Remember, don’t feed your diabetic dog with treats that are high in sugar!

Management

As with humans, checking blood sugar levels regularly is critical to monitoring and treating diabetes. Your vet will work with you and help you set up a schedule for checking your dog’s blood sugar. Testing also lets you know how well the current treatment programme is working.

There are many non-medical interventions that form part of a diabetic dog’s management and should be implemented alongside their insulin therapy:

  • Exercise. This not only has a positive effect in terms of your dog’s weight loss, it also helps lower their blood glucose levels. Consistency is key – long or vigorous exercise sessions can cause blood sugar levels to drop dangerously low.
  • Diet. Most vets recommend a diet low in fat and high in fibre. The latter slows the glucose entering into the blood stream. This may satisfy dog’s appetite sooner to encourage satiety and weight loss.
  • Weight. Weigh your diabetic dog regularly and monitor their weight.
  • Spaying. This is recommended for female dogs as sex hormones can have an effect on blood sugar levels.
  • Logbook. Use a simple notebook, calendar, or computer spreadsheet to document your diabetic dog’s progress e.g. changes in blood sugar levels, appetite, weight, appearance, water intake, urination frequency, and mood etc. as well as any management changes your vet makes.

Semi-moist dog foods are best avoided as they generally contain more refined carbohydrates than other dog foods.

Diabetic emergencies

The two key conditions to watch out for in your diabetic dog on a day-to-day basis are:

1. Ketoacidosis – when there are harmful levels of ketones in a dog’s blood. This is caused by prolonged high levels of sugar in the blood (i.e. hyperglycaemia – when blood glucose levels when blood glucose levels are above the top end of the recommended normal level). Signs of ketoacidosis include:

Call your vet immediately if you notice any of the above. If your dog is alert and well hydrated, hospitalisation may not be required. Your vet will start insulin therapy to reverse the high levels of sugars and ketone bodies as well as revitalising your dog with fluids and electrolytes.

2. Hypoglycaemia – when blood sugar levels are critically low, which is often linked to insulin overdose. If you notice any of the symptoms of hypoglycaemia, immediately check your dog’s blood sugar level if you have the kit at home. As a quick corrective measure at home, you can rub maple syrup or any high-sugar foods that are quickly absorbed into the bloodstream on your dog’s gums and inside of their cheeks. Then call your vet immediately to report the episode and receive further instructions.

Complications of dog diabetes

The most common complication in dogs with diabetes is cataracts, which is clouding of the lens of an eye. Diabetic dogs often develop cataracts rapidly because the sugars affect their eyes. Surgical intervention is available but most dogs do cope well with the loss of sight as their other senses are much more acute than ours!

Hardening of the arteries, kidney disease, retina disease, or nerve disease may also develop over time. Urinary track infections can become a common problem due to the excess sugar in their urine which helps breed bacteria. As bacteria thrive on a high-sugar diet, diabetic dogs are prone to gum, skin, and other infections as well. It is therefore important to have their teeth cleaned as and when necessary. Read Felcana’s article about pet dental care for more detail.

Prevention

There are several risk factors that can increase a dog’s risk of developing diabetes:

  • Breed. Mixed-breed dogs seem to be more prone to diabetes than purebreds, where the risks vary greatly between different breeds.
  • Gender. Female dogs and neutered male dogs are more likely than intact males to get diabetes.
  • Weight. Apart from negative health effects, obesity in dogs is known to make cells resistant to insulin.
  • Diet. A high-fat diet may contribute to pancreatitis (inflamed pancreas), which is a risk factor for dog diabetes.

A diagnosis of diabetes is undoubtedly going to present challenges, but it’s a challenge that can be successfully met. It is a treatable disease in dogs and most diabetic dogs can lead very high-quality lives. However, if diabetes progresses without being treated, dogs can develop secondary health problems and ultimately, coma and death. Remember, always contact your vet for advice immediately if you are worried or your dog seems unwell.

Use the Felcana Kit to monitor your dog's eating and drinking patterns, keeping an eye on their diabetic symptoms.

Dr Jenny Lee, 18/12/17