Diabetes is a common condition in both dogs and cats. In humans, there are two types of diabetes mellitus. Both types are similar in that there is a failure to regulate blood sugar, but the basic mechanisms of disease differ somewhat between the two. “Type I Diabetes Mellitus is the most common type of diabetes in dogs.” Diabetes in dogs and cats can occur at any age. However, diabetic dogs are usually 4 – 14 years of age and most are diagnosed at roughly 7 – 10 years of age. Most diabetic cats are older than 6 years of age. Diabetes occurs in female dogs twice as often as male dogs. Breeds that appear to be at increased risk of developing Diabetes mellitus include Keeshond, Poodle, Samoyed, Daschund, Alaskan malamute, Miniature schnauzer, Chow chow, Beagle, Doberman pinscher, Labrador retriever, Puli, Old English Sheepdog, Golden retriever, Miniature pinscher, English Springer spaniel, Rhodesian Ridgeback, Schipperke, Finnish spitz, West Highland white terrier, Cairn terrier. Pedigree analysis has apparently identified a genetic predisposition in Keeshonds and Samoyeds.
- Increased urination (known as “polyuria”) and increased thirst (known as “polydipsia”), increased appetite (known as “polyphagia”), and weight loss
- Enlargement of the liver (known as “hepatomegaly”)
- Cataracts—common finding in more long-term (known as “chronic”) cases or in dogs that have had poor control of their diabetes mellitus
- Sluggishness (lethargy), depression, decreased appetite, lack of appetite (known as “anorexia”), and vomiting may occur, but only in pets with ketoacidosis (a condition in which levels of acid are increased in the blood due to the presence of ketone bodies secondary to diabetes)
Diabetes mellitus is diagnosed by the presence of the typical clinical signs (excess thirst, excess urination, excess appetite, and weight loss), in addition the presence of a persistently high level of glucose in the blood stream, and the presence of glucose in the urine. The normal level of glucose in the blood is 80-120 mg/dl (4.4-6.6 mmol/l). It may rise to 250-300 mg/dl (13.6-16.5 mmol/l) following a large or high-calorie meal. However, diabetes is the only common disease that will cause the blood glucose level to rise above 400 mg/dl (22 mmol/l). Some diabetic dogs will have a glucose level as high as 700-800 mg/dl (44 mmol/l), although most will be in the range of 400-600 mg/dl (22-33 mmol/l). Diabetic dogs have excessive amounts of glucose in the blood, so it will be present in the urine. After the blood sugar reaches 180 mg/dl, the excess blood sugar is removed by the kidneys and enters the urine. This is why dogs and people with diabetes mellitus have sugar in their urine (called glucosuria) when their insulin is low.
- Aim for loss of 1-2 % body weight every week
- Encourage a gradual increase in exercise
- Owners should aim for a daily routine of consistent, moderate exercise
- Strenuous and sporadic exercise should be avoided
- If strenuous exercise is to occur, reduce insulin by 50% to avoid hypoglycaemia
- The most important principle when feeding a diabetic dog is the diet MUST BE CONSISTENT; the dog should consume the same caloric intake morning and night and from day to day.
- Diabetic dogs should be fed a diet that provides appropriate calories for the pet’s ideal body weight; your pet’s veterinarian can provide feeding recommendations
- Obese diabetic dogs—reduce the caloric intake to achieve the desired target, ideal body weight over 2–4 months; a high-fiber, low-calorie diet will help in achieving restricted caloric intake (this type of diet helps in weight control, but has no role in improving diabetic control)
- Feed the pet half its daily food every 12 hours if it is receiving twice-daily insulin injections or medications administered by mouth to decrease blood glucose or sugar (oral hypoglycaemic agents); feed pets on once-daily insulin injections their total daily diet divided into two to three meals within the first 6–8 hours after insulin dosing
- No snacks should be given to the pet, unless the snack has no calories
- Discuss the dietary needs and feeding protocol with your pet’s veterinarian
Short-acting insulin (eg, regular insulin, insulin lispro) is predominately used in the hospital for
clinically ill diabetics or DKAs, as increased potency increases risk for hypoglycaemia.
- Intermediate-acting insulin is the common choice, as it results in the best glycemic control.
- Human recombinant neutral protamine Hagedorn (NPH) insulin. Comparable with NPH insulin, Lente insulin is currently unavailable.
- Long-acting insulin effectively reduces the blood glucose level but varies in absorption, time to nadir, and duration of action, increasing risk for hypoglycaemia and Somogyi effect.
- Insulin detemir, insulin glargine, and protamine zinc insulin (PZI).
- Treatment should be initiated q12h, although starting doses differ forinsulin types.
The two most effective insulin formulations in dogs are NPH and Lente insulins. Use of human recombinant insulin or pure pork insulin, appear to avoid the complications that can occur due to development of anti-insulin antibodies in dogs treated beef/pork insulin. Starting dose and dose range for insulin products used in diabetic dogs.
|Insulin||Starting dose||Median dose||Dose range|
|NPH||0.25-0.5 U/kg||0.5 U/kg||0.2-1.0 U/kg|
|Lente||0.25-0.5 U/kg||0.7 U/kg||0.3-1.4 U/kg|
|PZI||0.5 U/kg||1.0 U/kg||0.4-1.5 U/kg|
|Glargine||0.5 U/kg||0.6 U/kg||0.1-1.1 U/kg|
|Detemir||0.1-0.2 U/kg||-||0.07-0.23 U/kg|