Why Should I Bring my Pet to Willows for Diabetes Mellitus?
Willows is one of Europe’s leading small animal referral centres. Our state-of-the-art hospital is led by internationally renowned Specialists, committed to providing the highest standards of veterinary care. At Willows our Specialists in Internal Medicine have extensive experience in managing complicated diabetic cases and transforming the quality of life for the patients affected.
Our Internal Medicine service is supported by our multi-disciplinary team of Specialists across a number of disciplines including; Diagnostic Imaging, Soft Tissue and Ophthalmology. All of which is supported by our large, dedicated team of Nurses and clinical support staff available 24 hours a day, every day of the year to provide the best possible care for your pet.
What is Diabetes Mellitus?
Most food animals eat is turned into sugars to provide energy, the sugar in the blood then needs to get into the cells of the body to help them work. Insulin, produced by the pancreas, helps the sugar to get into the cells. Diabetes occurs most commonly in older dogs, and middle-aged overweight cats. In some cases it can develop when the animal is younger, due to a genetic predisposition.
What are the Most Common Causes of Diabetes Mellitus?
Diabetes mellitus develops when the body does not produce enough insulin. Insulin regulates blood sugar (glucose) levels, when the insulin levels are too low, blood sugar levels increase, resulting in diabetes. Diabetes is a potentially life-threatening illness, however it can be successfully treated in the majority of cases.
What are the Signs of Diabetes?
- Increased thirst
- Increased frequency and/or volume of urination
- Possible increased appetite
- Possible weight loss
- Possible smelly urine
- Possible lethargy/tiredness
How is Diabetes Diagnosed?
Assessment of the patient’s history, a physical examination, as well as blood and urine tests enables diabetes to be diagnosed. Excessive levels of sugar in the urine and blood are highly suggestive of diabetes, however a sick or anxious patient may have increased sugar levels. If there doubt as to the significance of a single high blood and urine sugar result, a special blood test (fructosamine) may be performed to access the blood sugar levels over several previous weeks.
Underlying causes of diabetes include; obesity, Cushing’s syndrome, pancreatitis or previous medications. If any underlying problems are found, they also need to be managed alongside the diabetes.
How is Diabetes Treated?
Diabetes is usually treated with insulin which administered as an injection under the skin twice a day. If your pet is diagnosed with diabetes, you will be carefully taught how to give insulin injections and how to look after the insulin and syringes.
There are several types of insulin, and the dose of is different for every patient. It is very important that the dose is not changed without instructions from a Vet. Most pets will require their insulin doses to altered over time, based on monitoring and blood tests. You may be instructed how to monitor blood or urine glucose/ketone levels at home. Urine should be checked regularly for the presence of ketones, as the presence of these for more than two days can indicate a complication of uncontrolled diabetes known as Diabetic Ketoacidosis. It is important that dogs continue to exercise regularly to keep their weight down. Exercise has also been shown to make insulin work better, resulting in more effective control of the blood sugar levels.
It may also be important to modify a patient’s diet, particularly if the pet is overweight, or has inflammation of the pancreas. These dietary changes will be directed by your Vet. Once stabilised, patients are fed regular amounts at regular times in relation to the insulin injections. The injections can be given before or after the food, different Vets will recommend slightly different times of the injection in relation to feeding. At Willows, our Specialist in Clinical Nutrition can be consulted regarding the specific dietary needs for your pet.
What are the Complications of Diabetes?
The better the stabilisation of the patient, the better these complications are likely to be controlled or prevented.
- Cataracts; many dogs develop cataracts within 6 – 12 months of developing diabetes. Specialist treatment is available, the majority of diabetic patients do very well after cataract surgery
- Retinal disease; degeneration of the sensitive area at the back of the eyes
- Neuropathy; disease of the nerves causing weakness
- Nephropathy; kidney disease
- Infections; it is common for infections to develop, especially of the bladder and kidneys, these occur without obvious clinical signs
- Ketoacidosis; in cases of uncontrolled diabetes, poisonous metabolites (natural break-down chemicals) are produced which can lead to illness, lethargy, coma and death.
There are many elements that can be monitored at home including; fluids drank, frequency and volume of urination, appetite, weight, behaviour and the presence of ketones/glucose in the urine. It is very helpful to keep a diary and share with your Vet at check-ups.
Frequent follow-up consultations may include a single blood test, or they may be followed by a short stay in hospital for a ‘blood glucose curve’ for several small blood tests throughout the day. This allows a pet’s blood glucose changes to be seen throughout the day which can be useful for adjusting a pet’s food intake and insulin dosing. It is also possible for dogs and some cats to have a special sensor (Freestyle Libre) applied to the back of the neck to measure blood glucose. This can be applied at Willows and enables a pet’s response to insulin to be monitored without multiple blood samples. This is particularly useful for animals where there is poor control of the diabetes and it is suspected that too much insulin is being given. The sensor can read the glucose concentration for up to two weeks. Please discuss this with your Vet if you feel this is something that might help your animal’s diabetes.
What is the long-term outlook?
Most pets are very amenable to treatment, and diabetic animals can have a very good quality of life. Diabetes in cats (and in rare cases dogs) can be temporary, affected cats may only require insulin for a limited time (3-6 months) if the underlying cause, such as obesity or pancreatitis, is removed.
Many dogs with diabetes eventually develop cataracts which can cause rapid onset blindness. Fortunately, most diabetic dogs with cataracts are good suitable for surgery, our Specialist Ophthalmologists are very experienced in treating cataracts.
Patients should be reassessed at regular intervals which will be set by your Vet. Pets that are having insulin treatment should also be reassessed if they:
- Become unwell
- Are losing weight
- Have a change in appetite
- Have excessive thirst or urination
- Become weak, wobbly or disorientated (this can be an emergency due to hypoglycaemia or severe diabetic ketoacidosis)
- Have ketones in their urine for more than two consecutive days
Find out more
To assist owners in understanding more about Internal Medicine we have put together a range of information sheets to talk you through the some of the more common Medicine conditions seen and treated by our Specialists.