Diabetes mellitus in dogs and cats

from Federica Porta

Diabetes mellitus is a disease caused by the complete or partial deficiency of insulin, the hormone secreted by the pancreas and responsible for regulating the amount of sugar in the blood, resulting in the inability of the tissues to assimilate glucose as an energy source. This leads to an increase in the level of glucose in the blood and, therefore, persistent hyperglycemia.

The most common form of diabetes mellitus in dogs is type I, characterized by the reduced availability of insulin that occurs as a result of the destruction of specific pancreatic cells; although the causes are not fully known, they are probably attributable to autoimmune reactions.

In cats, on the other hand, type II diabetes is more common in which to the reduced production of insulin is added a lower sensitivity of the tissues to the action of the hormone. Numerous studies have shown how obesity and incorrect nutrition predispose the cat to a greater possibility of the genesis of the disease.

Diabetes mellitus generally affects middle-aged dogs, with a peak in subjects between 7 and 9 years of age and predominantly spayed females.

Symptoms of diabetes are:

  • polyuria – increased urine output;
  • polydipsia: aumento della thirst;
  • polyphagia – increased hunger;
  • weight loss.

Furthermore, diabetic cats can present numbness, dehydration, poor coat quality; among the evident manifestations of diabetic neuropathy are the weakness of the hind limbs, the decrease in the ability to jump and a plantigrade posture in the quadrupedal station or during walking.

THE DIAGNOSIS

Diagnosis is made through a blood or urine testcapable of detecting an increase in glucose levels: in the case of diabetes, blood sugar exceeds the renal reabsorption threshold and, therefore, the presence of traces of glucose in the urine (normally absent) is detected.

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Further analysis of fructosamines, molecules that are formed from the combination of a sugar and a protein, confirms persistent hyperglycemia.

Once diabetes has been diagnosed, it is important to check for the absence of other factors that may have favored the onset of insulin resistance or poor insulin production such as, for example, Cushing’s syndrome, pancreatitis or elevated progesterone levels in the dog.

THE THERAPY

As for humans, the therapy involves the administration of insulin, a specific diet for diabetic animals and the treatment of any pre-existing pathologies.

There are different types of insulin and the veterinarian will be able to identify the most suitable one based on the method of administration and duration; the therapy must be carefully calibrated according to the characteristics of the individual patient, observing the reaction to the initial dose which must then be modified in the long term, through the evaluation of periodic analyzes of the glycemic curve.

Diet plays a fundamental role: it is necessary to significantly reduce carbohydrate intake and increase that of proteins, in order to lower both blood sugar and body weight, as being overweight is one of the most common causes of insulin resistance. The quantity and composition of meals should be the same every day in order to keep the body’s demand for insulin constant. Since this can be difficult with home diets, it is usually preferable to use prepackaged diets.

A DISEASE NOT TO BE OVERLOOKED

Diabetes, especially if untreated, can lead to very serious complications, such as diabetic ketoacidosis, urinary tract and skin infections, cataracts (frequent in dogs but rare in cats) and peripheral neuropathies.

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In the course of therapy, on the other hand, a state of hypoglycemia may occur due to the administration of an excessive dose of insulin, or insufficient glucose intake. Hypoglycemia is life-threatening, therefore it is advisable to contact the veterinarian immediately if symptoms such as restlessness, tremors, drowsiness and loss of consciousness should occur. A useful tip: give honey, even spreading it under the tongue or on the gums, if the animal has difficulty swallowing.

Diabetic disease is generally not curablehowever, the therapy guarantees the patient a longer and better quality life. Clinical remission of diabetes can still occur and is much more frequent in cats (in certain breeds the probability is up to 50%) than in dogs. Animals with diabetes mellitus need about two to three months to achieve adequate glycemic control and will still have to undergo periodic clinical checks throughout their life. Regular urination and thirst, increased appetite, alert and active attitude and stable body weight indicate a good state of metabolic control of the animal. In the initial phase of the diagnosis, the animal will have to undergo frequent checks which will reduce over time; in principle, Clinical assessments are scheduled weekly for the first 4-8 weeks and then every four months thereafter.

In some cases it may occur that, following insulin therapy, the patient no longer needs the administration of the hormone, especially if there are other diagnosed and resolved diseases at the base of the diabetes, such as hormonal syndromes, pancreatitis or elevated progesterone levels, or if the condition of hyperglycaemia is of recent onset. For this reason it is absolutely essential to diagnose diabetes as quickly as possible, in order to adopt a therapy that allows the animal to lead a good quality life.

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