Diabetes mellitus,or sugar diabetes, occurs when insufficient insulin is produced by the pancreas.  Since insulin normally drives the glucose (sugar) from the blood into the cells to be used, lack of insulin results in hyperglycemia (high blood sugar levels).  The hyperglycemia is seen as increased thirst and urination.  Since the cells are deprived of their primary energy source (glucose), they begin to breakdown other substances and produce ketones (acids) as by-products.  The lack of glucose in the cells also produces hunger and weight loss.  As the disease progresses, ketone accumulation makes the animal feel very depressed, weak, nauseous, and can affect many of the vital organs.  The liver may become diseased as the body tries to use fat as an energy source, and the fat accumulates in the liver cells.  If the diabetes can be regulated with diet and medication, most pets will do very well.  Their need for insulin is usually lifelong.  Many patients can be adequately controlled but unfortunately, not every patient.  Some animals have complicating factors that are present initially or develop after the patient has been doing well for some time.  Infections, corticosteroids, overactive adrenal glands, growth hormone excess, hyperthyroidism, gastrointestinal disease or even diet change can complicate the control of diabetes mellitus and must be addressed on an individual basis.

Attempts to control the hyperglycemia consists of insulin administration by injection, usually twice daily.  Various forms of insulin are available and your pet may need different forms and doses at different times.  Occasionally, cats can be managed with an oral medication or diet control.  If your pet is happy and eating, initial control may be done on an outpatient basis with frequent rechecks to confirm adequate response.  If your pet is not eating or is otherwise sick, initial management will be done in the hospital with intravenous fluid support.  A very sick patient may stay up to two weeks in the hospital.  Our goal is to get them feeling better, eating, drinking and not vomiting before they go home.  After they go home, periodic elevations of weight and blood sugar levels are recommended as a patient’s needs can change.

The goal is not to achieve “perfect” glycemic control.  To do so, risks a hypoglycemic event.  It is better to have mild hyperglycemia (high blood sugar levels) than significant hypoglycemia (low blood sugar levels).  Hypoglycemia is seen as weakness, wobbliness, or seizures.  If this occurs, attempt to put karo syrup on the gums and report the problem immediately.  Do not stick you fingers in your pet’s mouth during these episodes as they may inadvertently bite you.   Seizuring patients usually require intravenous glucose administration and should be seen immediately.  Other concerns such as resurgence of thirst or appetite, weight loss, loss of appetite, or depression should of course also be reported to us.

If your pet fails to eat, skip the insulin injection for that dose.  Alert the office if this persists for more than one meal.  If you are not sure if all the insulin went in, do not adminster more.  In dogs, a high fiber, low fat diet is generally preferred.  In cats, a high protein, low carbohydrate diet is generally used.  Weight loss in obese patients can be quite helpful in controlling diabetes mellitus.  Treats or snacks can seriously impact diabetic control and should be avoided.  Unlimited free access to water is recommended.  We hope this handout is helpful in understanding the disease affecting your pet.

PLEASE ASK THE NURSE FOR ADDITIONAL INFORMATION AND INSTRUCTIONAL HANDOUTS ON HOW TO ADMINISTER INSULIN TO YOUR PET.

4/09  If you have internet access, you may go to BDdiabetes.com for more information.  The main page has a section titled “Diabetes and pets”.  If you select the link, you may view a slideshow demonstration of how to administer an insulin injection.  In addition, you may visit vetsulin.com for similar information.  Please bear in mind that the type and concentration of insulin your veterinarian has prescribed may not be the same as is referred to on these sites.  Please verify this information with the veterinarian PRIOR to any insulin administration.