Caring for a diabetic dog

Caring for a dog with diabetes mellitus is a real commitment. When the organ responsible for producing insulin - the pancreas - fails, it's up to the owner to provide the hormone and monitor the dog's blood sugar levels. Developing a routine to do the job of a major organ isn't easy, but it's a challenge many owners face.

Vet Grant Petrie, who works at the London Vet Clinic, explained that diabetes is a common condition in dogs. "Research suggests that around one in 300 dogs may have the disease," said Grant, who is a former British Small Animal Veterinary Association (BSAVA) president. "The immune system can damage the beta cells in the pancreas, reducing or stopping the production of insulin. These dogs need insulin injections for survival. Some breeds, such as the Samoyed, are prone to the disease, although diabetes is not just a pure breed phenomenon. Cross-breeds can get it."

While the disease has side effects, the prognosis remains positive. "Cataract development is the most common complication in diabetic dogs," explained Grant. "I warn owners that there is a distinct possibility that their dog will get cataracts and may become blind.

"Most dogs die with diabetes, rather than from it. It can be treated effectively, the clinical signs can be controlled, and most dogs enjoy a good quality of life."

What is diabetes mellitus?

• When your dog eats, food is broken down into substances the body can use for energy, such as glucose - a type of sugar. The pancreas releases insulin which allows sugar to be taken from the blood into the body's cells.
• In dogs with diabetes mellitus the pancreas does not produce enough insulin. Without insulin the body cannot utilise the glucose and the blood sugar levels increase. If this is not recognised and treated, the body turns to alternative sources of energy, such as fat. The by-products of breaking down fat are acids called ketones which can be very toxic and left untreated can cause dogs to fall into a coma or even die.
• In humans, there are two forms of diabetes, type one and type two. In type one the pancreas produces little or no insulin. In type two the pancreas produces insufficient amounts and the body's cells do not respond to the insulin. The most common form of diabetes in dogs is similar to type one in humans and is known as insulin deficiency diabetes.

What are the causes and signs of diabetes in dogs?

• There is no known exact cause for the disease but certain breeds do appear to have a genetic pre-disposition. Although the condition can occur at any age it is more common in middle-aged to older dogs.
• Obese dogs are more likely to get it too. Diabetes is linked to immune disease where the immune system attacks its own cells. The disease can result from other conditions such as pancreatitis, where the pancreas becomes inflamed.
• The most common sign of diabetes is excessive drinking and urinating. When a dog has an abnormally high level of blood sugar, the glucose spills into the urine and sucks out water. The affected dog then needs to drink more to replace the lost water. He might also be ravenously hungry in the early stages or be off his food if the disease is more advanced.
• Other symptoms include weakness, collapse, vomiting, and susceptibility to urinary infections.

Diagnosing and managing diabetes in dogs

• If your vet suspects your dog may be diabetic he will examine your pet and take a sample of his urine. Diabetic dogs have high levels of glucose in their urine and sometimes ketones. The blood is also tested to see if levels of glucose are consistently high to confirm the diagnosis.
• Diabetes is treated by injecting insulin. Injecting their dogs can be a daunting prospect for owners but the vet, or nurse, will explain what needs to be done and teach them how to inject safely.
• Finding the right amount of insulin can take time. Each dog is different and blood sugar levels need to be closely monitored to try to stabilise the pet.
• Regular feeding times and a strict diet are an important part of gaining the balance and injections are usually given after meal times.
• Diabetic dogs still require regular exercise to maintain a healthy weight and an active lifestyle can also help the insulin work more effectively.
• Other ongoing conditions can complicate treatment. The effect they have on insulin can make it more difficult to stabilise blood sugar levels. Once a dog has been stabilised he will need regular blood tests for the ongoing management of the disease.
• Vets can test for an indication of the average blood sugar level over a period of time or test for an indication of the current glucose level. A glucose curve may be required where the blood sugar level is recorded and charted over a day to see the impact of the dosage of insulin. Any changes in lifestyle or just general ageing can impact the disease.

Side effects and complications of diabetes in dogs

• Diabetes can have a range of side effects. If your dog appears unsteady on his feet or off colour his blood sugar may have dropped dangerously low - called a hypoglycaemia. This is usually the result of an overdose of insulin. Contact your vet immediately and they will advise you how to treat the problem. Usually it is managed by giving the dog something containing sugar. They may also ask you to come in to find out what caused the episode and see if there are any underlying problems.
• In dogs that have undiagnosed or poorly controlled diabetes, ketones can reach life-threatening levels. If your dog displays signs of anorexia, lethargy, nausea, breathing difficulties, or collapse he may have ketoacidosis, so seek veterinary help immediately.
• The condition can have other longer-term side effects. Diabetic dogs can develop cataracts, a cloudiness of the lenses which can cause blindness. Good sugar control can slow their progression but many dogs do lose their sight. 
• Other side effects include kidney disease, nerve damage, and an increased susceptibility to infections, particularly urinary infections.

Caring for a dog with diabetes demands commitment. An owner must be able and willing to make their dog's routine and treatment a priority. Often this leads to an even closer bond with their pet, who can still enjoy an active and happy lifestyle.