Diabetes mellitus in dogs
- What is diabetes mellitus and what causes it?
- I have heard about diabetes insipidus; is this the same as diabetes mellitus?
- What signs do dogs with diabetes typically show?
- What do the terms polyuria, polydipsia, and polyphagia mean?
- My dog is having problems holding its urine; does that mean it has diabetes?
- How is diabetes diagnosed?
- Are all dogs susceptible to diabetes?
- What other problems can be associated with diabetes?
- What other diseases have the same signs as diabetes?
- Did I do something to cause the diabetes?
- What is the difference between type 1 and type 2 diabetes?
- What is the expected lifespan for a diabetic dog?
- My dog was recently diagnosed. What advice would you give me?
- Is diabetes in animals similar to that of humans?
- Are there other dog owners I can talk with?
Vetsulin® (porcine insulin zinc suspension)
- Where on my dog’s body should Vetsulin be injected?
- Can I still use a vial of Vetsulin if it freezes?
- Can I still use a vial of Vetsulin if it was forgotten outside the refrigerator between doses?
- What else should I know about Vetsulin?
- How do I dispose of insulin syringes?
Management of diabetes mellitus in dogs
- What must I do if I know that I missed a full dose or part of an injection?
- What should I do if I have or think I have given too much insulin?
- What should I do if I think that my dog has very low blood sugar (hypoglycemia)?
- How much water should I let my dog drink?
- What is the importance of making sure my dog is regulated?
- How long does it take to regulate a diabetic animal?
- My dog is ill and not eating. Should I still give him/her an insulin injection?
- Should I feed my dog before or after an injection?
- What can I give my dog as a treat?
- What does the typical diet consist of?
- What is a blood glucose curve?
- What are some problems with blood glucose curves?
- How often should a blood glucose curve be done?
- What is stress hyperglycemia?
- What is fructosamine?
Diabetes mellitus in dogs
What is diabetes mellitus and what causes it?
Diabetes mellitus is caused by an absolute or relative deficiency of insulin. Animals with an absolute or relative deficiency of insulin are called diabetics.
Insulin deficiency can develop for different reasons:
- Disorders of the pancreas—the pancreas is unable to secrete enough insulin.
- Other diseases or the presence of other hormones—may be antagonistic to insulin or cause resistance to insulin. Insulin is unable to function normally in the body.
I have heard about diabetes insipidus; is this the same as diabetes mellitus?
No. Diabetes insipidus, also known as water diabetes, is caused when large amounts of dilute urine are produced. It is a far less common condition than diabetes mellitus. Diabetes insipidus is caused by problems in part of the brain or in the kidneys. There is no glucose present in the urine of animals with diabetes insipidus.
What signs do dogs with diabetes typically show?
The most common signs of diabetes mellitus are:
- Increased drinking
- Increased urination
- Increased appetite
- General signs, such as lethargy and poor coat condition
What do the terms polyuria, polydipsia, and polyphagia mean?
- Polyuria is the production of large amounts of urine in a given period (eg, per day)
- Polydipsia is chronic excessive thirst
- Polyphagia is great hunger
My dog is having problems holding its urine; does that mean it has diabetes?
No, your dog could have a bladder or kidney infection, or some other medical problem. If your dog is having problems holding its urine, you should schedule a trip to your veterinarian as soon as possible.
How is diabetes diagnosed?
Your veterinarian will measure your dog’s blood glucose and test your dog’s urine for the presence of glucose and ketones.
Persistently high blood glucose levels along with glucose in the urine usually means that your dog has diabetes mellitus.
Are all dogs susceptible to diabetes?
Dogs of all ages can get diabetes. Diabetes most typically occurs in older dogs. Obesity, genetics, and other conditions can contribute to the development of diabetes.
What other problems can be associated with diabetes?
Problems associated with diabetes are generally seen in long-standing cases; they include cataracts in dogs and chronic infections.
What other diseases have the same signs as diabetes?
Dogs with diabetes mellitus drink and urinate a lot. They may also have a good or increased appetite but usually lose rather than gain weight. Other common diseases where some or all of these signs are also seen include:
- Cushing’s disease (hyperadrenocorticism)
- Exocrine pancreatic insufficiency
- Kidney disease
To reach a definitive diagnosis of diabetes mellitus, your veterinarian will test your dog’s blood glucose levels and for the presence of urine glucose and ketones.
Did I do something to cause the diabetes?
No. Diabetes mellitus is due to a lack of insulin produced by the pancreas. It is not caused by a virus or infection. Diabetes in dogs is thought to be an autoimmune disease.
What is the difference between type 1 and type 2 diabetes?
Insulin is produced by the beta cells in the pancreas. Type 1 diabetes is due to the destruction of the beta cells with progressive and eventual complete loss of insulin secretion. This type always requires insulin therapy. Type 2 diabetes is characterized by dysfunctional beta cells (irregular insulin production) or the other cells of the body not responding to insulin properly. Type 2 diabetes may or may not require insulin therapy. In general, all diabetic dogs have type 1 diabetes and require insulin to control their disease.
What is the expected lifespan for a diabetic dog?
It is only recently that dogs were treated aggressively for diabetes. Sadly, not many years ago these animals would have automatically been euthanized. Today, studies suggest that, if a dog is kept well regulated and does not have any other health problems, he or she should be able to have a normal life expectancy.
My dog was recently diagnosed. What advice would you give me?
Learn everything you can about diabetes—talk to your veterinarian. Your dog's quality of life will depend on what you know and how well you manage its diabetes. You will need to work closely with your veterinarian, and offer your input. Do not be afraid to ask questions, or ask for training from your veterinarian on giving injections and monitoring blood glucose levels.
Yes, it is very similar. Your dog will be using similar medications, equipment, and monitoring methods as human diabetics use.
Are there other dog owners I can talk with?
Where on my dog’s body should Vetsulin be injected?
Injections should be given subcutaneously (under the skin) about 1 to 2 inches below the spine or backbone. Constantly vary the injection location from behind the shoulder blade to just in front of the hip bone, and alternate injections between the dog’s left and right sides. Your veterinarian can help guide you as to the recommended locations for injections. Download the Administration Sheet for instructions on how to administer Vetsulin to your dog.
No, freezing will damage the insulin molecules and reduce the efficacy of the product. If a vial of insulin accidentally freezes in the refrigerator, it should be discarded and a new vial should be used.
Ideally, Vetsulin should be stored upright, protected from light, between 2°C and 8°C (35°F and 46°F). After the vial has been used, it can remain at room temperature, not to exceed 25°C (77°F), for up to 42 days.
What else should I know about Vetsulin?
- Always have a spare vial on hand.
- Keep it in the box to protect it from light.
- Keep it refrigerated.
- If it has gotten too hot, or frozen, discard it immediately.
- Discard 42 days after first vial puncture of use.
The guidelines for each community are different. You will need to check with your own. All syringes should be disposed of in an appropriate sharps/biohazard container.
Management of diabetes mellitus in dogs
If you missed a dose or part of a dose, it is best to wait until the next insulin dose is required and then continue as normal. A brief period of high blood sugar (hyperglycemia) due to too low an insulin dose is not as serious or as dangerous as the possibility of causing low blood sugar (hypoglycemia) by administering too much insulin.
Contact your veterinarian and explain the situation.
Monitor your dog carefully for signs of low blood sugar (hypoglycemia):
- Very quiet or sleepy
If you see any of these signs, try to encourage your dog to eat a small meal or if this fails, rub some corn syrup on your dog’s gums.
The following signs may indicate hypoglycemia:
- Trembling or shivering
- Unusual movements or behavior
- Unusual quietness or sleepiness
- Loss of consciousness (coma)
If your dog is conscious, rub approximately one tablespoon of corn syrup on your dog’s gums. When it is able to swallow, feed its usual meal and contact your veterinarian. If your dog is unconscious or having a seizure, this is a medical emergency. CONTACT YOUR VETERINARIAN.
In the meantime, you should immediately treat your dog rather than delaying management. Pour a small amount of a sugar solution (eg, corn syrup) onto your finger and then rub the sugar solution onto your dog’s gums. The sugar is absorbed very quickly and your dog should respond in 1 to 2 minutes. The sugar solution should never be poured directly into your dog’s mouth since there is a risk that the solution will be inhaled into the lungs. Once your dog has responded to the sugar administration and is sitting up, it can be fed a small, high-protein meal. Once the dog has stabilized, it should be transported to your veterinarian for evaluation.
If your dog is diabetic, and drinking excessive amounts of water, give him/her all it can drink. Your dog's body is trying to combat the high blood glucose level by expelling the excess sugar out of its body through the urine. Once your dog is regulated, this will stop.
If diabetes is left untreated or unregulated, it could cause many complications. These include cataracts, blindness, and in extreme cases, death.
Each dog's case is different. There is no way to put a specific time on it. Sometimes the regulation process will require you to try different dosages, diets, and one to multiple injections a day. Regulation can be achieved sometimes within a month, and in some cases, over a year from the time therapy first started. It is very important to work closely with your veterinarian during this process to avoid further complications. Even after your dog is regulated, you will still need to maintain this relationship with your dog's veterinarian. Frequent check-ups will be necessary to maintain good health.
If your dog is not eating—do not give Vetsulin! If your dog has a reduced appetite and eats only half of its meal, reduce the daily dose of insulin by half. If the situation lasts more than 2 days (due to illness, for example), consult your veterinarian.
It is very important that your dog eats before you administer the injection of Vetsulin. The safest method is to feed your dog first, then give the injection (about 20 minutes later).
Your veterinarian will be the best person to determine your dog's diet, as he/she best knows its needs. Ask about treats. He/she can probably help you find a restricted calorie treat for your dog.
To keep diet constant from day to day, it is best to use commercially produced rather than homemade diets. Certain high-fiber prescription veterinary diets can be a useful adjunct to Vetsulin therapy. These diets should be avoided in underweight diabetic dogs. If special diets are unavailable, or your dog does not eat the diets, then standard canned dog foods are acceptable.
This is where the blood glucose is measured every 1–2 hours through the day. The dog should be on the same food schedule as at home. For most dogs, a 10–12 hour curve is adequate but in some instances a longer curve may be needed. Insulin effectiveness, glucose nadir (the lowest glucose reading), and duration of insulin effect are the critical parameters one learns from a glucose curve. The dosage of insulin, frequency of insulin administration, and feeding times may be altered based on these results.
The results of the curve can be affected by several factors that may make the curve done at the veterinarian's office an inaccurate portrayal of what is occurring at home. Things such as inappetence (not eating) and stress (causing hyperglycemia) may occur at the veterinarian's office. Because some dogs refuse to eat at the veterinarian's office, the dog is fed at home first and samples are done until the next scheduled meal. This will give a more representative curve than a dog that has not eaten. In addition, it is not uncommon for curves to vary from day to day because many things can affect blood glucose levels such as appetite, digestion, metabolism, exercise, hormones, stress, etc.
Once regulated, probably minimally every 3–6 months, or more frequently if a problem is suspected. Your veterinarian will advise you on the frequency.
Stress hyperglycemia is caused when the animal is frightened or stressed. It is caused by the release of epinephrine (adrenaline). Glycosuria (glucose in the urine) is usually absent with stress hyperglycemia because the blood glucose does not stay high for a significant period and therefore does not spill into the urine. Stress hyperglycemia does not influence the diagnosis of diabetes because the blood glucose level does not stay elevated long enough to cause glucose to spill into the urine.
A type of protein in the blood that can be used to measure glycemic (glucose) control over a longer period. Unlike blood glucose measurements, fructosamine is not affected by stress or the timing of the insulin injection. Your veterinarian may recommend periodic measurements of fructosamine to evaluate how well your dog’s blood glucose level has been controlled over the last few weeks.
If healthy and well regulated, most experts recommend every 3 months. Talk to your veterinarian about how often they would like to see your dog.
It is perfectly safe for your diabetic dog to receive its vaccinations. In fact, this annual visit also gives your veterinarian a good opportunity to give your dog a complete check-up. By keeping your diabetic dog healthy, there will be fewer fluctuations in its insulin requirements.
Normally animals need to have an empty stomach before they are anesthetized. A diabetic dog that has not been fed needs far less insulin. Your veterinarian will advise you on how much insulin to give your dog before it is admitted or may wish to administer a reduced dose of insulin for you. Usually a diabetic dog is administered intravenous fluid therapy during anesthesia. This is a means of giving fluid to the animal when it cannot drink. Apart from needing a reduced amount of insulin and fluid therapy (which is also given to some non–diabetic animals undergoing anesthesia), your diabetic dog is not at any additional risk from anesthesia than a non–diabetic dog of the same age.