HELPING YOUR PET LEAD A HAPPY

HELPING YOUR DIABETIC PET LEAD A HAPPY, HEALTHY LIFE

Pictures of two Maple Veterinary Hospital diabetic patients
	*Sneezer*	*Rudy*

It can be a bit of a shock to learn that your pet is suffering from diabetes mellitus. Fortunately, diabetes in dogs and cats can be managed successfully with daily, consistent care that is fairly easy to administer. The following information is designed to give you an overview of diabetes, including the treatments used, and to outline what you can expect when managing diabetes.

What is Diabetes Mellitus?

Diabetes mellitus is most common in middle-aged to older dogs and cats, but is occasionally seen in young animals. During digestion, food is broken down into smaller components for use by the body. Carbohydrates are converted into various sugars, including glucose. Glucose is absorbed from the intestines into the blood and provides the body’s cells with energy. However, glucose can only enter into most cells if the hormone known as insulin is present. Insulin is produced by specific cells in the pancreas. In diabetic animals, these cells in the pancreas produce little or no insulin. When this happens, glucose cannot enter into the body’s cells and begins to accumulate in the blood, causing the condition known as diabetes mellitus. Simply put, diabetes results from a shortage of insulin.

Insulin Fast Facts

Insulin is a hormone that keeps your pet's glucose concentration at a normal level.

Insulin is produced by certain cells in the pancreas.

In diabetic animals, these cells produce little or no insulin.

Can Your Dog Be Cured?

In general, diabetes cannot be cured. However, if you establish a consistent lifestyle for your pet , including treatment with insulins such as Vetsulin™ or Lantis, your dog or cat will most likely be capable of leading a happy, healthy life.

What Are the Signs of Diabetes?

The signs associated with diabetes are the result of high levels of glucose in the blood and urine. Animals with diabetes become very thirsty, drink excessive amounts of water and urinate more frequently. Your pet may eat more but still lose weight, and the condition of his or her hair coat may also deteriorate. Signs of diabetes include:

Excessive thirst (Polydipsia)
Excessive urination (Polyuria)
Excessive appetite (Polyphagia)
Weight loss despite good appetite
Glucose in the urine (Glucosuria)
Ketones in the urine (Ketonuria)
Cloudy eyes and vision loss (Diabetic cataracts)

Diagnosis

The above signs certainly suggest diabetes, but they can also be seen in other diseases. The diagnosis is confirmed when there is elevated glucose levels in both the blood and urine. At the time of your pet's diagnosis, your veterinarian will perform a thorough physical examination to determine if your pet is suffering from other infections or diseases in addition to diabetes. This is very important, as infections and concurrent diseases can make the treatment of diabetes more difficult.

CONTROL AND TREATMENT

Female Dogs

If your dog has not been spayed, your veterinarian will recommend that she be spayed as part of the treatment. This is because one of the female sex hormones, called progesterone, can interfere with the normal action of insulin. In order to remove the source of progesterone, spaying intact female dogs diagnosed with diabetes is essential.

About Insulin Administration

Because diabetes is caused by a shortage of insulin, your pet will need treatment with insulin such as Vetsulin™ (porcine insulin zinc suspension) made specifically for dogs or PZI or Lantis insulins made specifically for cats. Your veterinarian will help you find the correct dose and tailor your pet’s prescription accordingly.

Once you have the correct prescription, it is extremely important that you administer the insulin treatments at the same time every day. Just like any routine, getting used to this treatment schedule will, at first, take a little time. But once you and your pet acclimate, you’ll both find the process fairly simple, painless and quick.

Starting Vetsulin Therapy

After diagnosis, your veterinarian will determine your pet's starting dose based on his or her weight. Next, your veterinarian will show you how to draw insulin from the container vial, administer the injection, and monitor the blood glucose level.

During the first days of treatment, you and your veterinarian will monitor the effects of the prescribed dose based on clinical signs (water and food intake, activity, etc.), blood glucose levels, and urine glucose levels.

Based on the results of these findings, your veterinarian will adjust the insulin dose, if necessary, and again monitor the blood glucose level until the correct dose is established. This time period can vary from one week to one or two months. Remember that patience is the key to success. It is also important to note that trying to regulate a diabetic too quickly can cause other complications, such as low blood sugar.

What You Will Need to Manage Your Dog’s Diabetes:

Vetsulin™ (porcine insulin zinc suspension) insulin for dogs
U-40 syringes [40 international units (IU) per mL] with needles
Test strips (sticks) for testing urine for glucose
Honey, Karo syrup or corn syrup
Quality dog food

What You Will Need to Manage Your Cats Diabetes:

PZI or Lantis insulin for cats
U-100 syringes [100 international units (IU) per ml] with needles
Honey, Karo or corn syrup
Quality cat food ( canned or dry)

How to Give Vetsulin^TM, PZI or Lantis insulins:

Doses of insulin are measured in units.

U-40 insulin contains 40 units/mL (1mL = 1cc). Use Vetsulin with U-40 syringes only.
U-100 insulin contains 100 units/ml. Use only U-100 syringes with these insulins.

Your veterinarian will prescribe the best insulin for your pet and it should be administered according to your veterinarian’s instructions. Your veterinarian will determine the amount of insulin needed (based on the weight of the animal), the clinical signs such as water consumption and laboratory results. They will instruct you on proper storage and handling, show you how to draw the insulin from the bottle, and instruct you on how to administer the injection. Your veterinarian will provide you with everything you need to care for your pet at home.

Preparing the Insulin Dose

Wash your hands.
Remove the insulin bottle from the refrigerator and mix by gently rolling the bottle between your hands (do not shake).
Carefully remove the cap from the needle.
Using a U-40 insulin syringe/ U-100 insulin syringe, pull the plunger back to draw air into the syringe equal to the insulin dose.
Insert the syringe into the bottle and inject the air into the bottle.
Turn the bottle and syringe upside down. Making sure the tip of the needle is in the insulin and withdraw the correct dose into the syringe.
Before removing the needle from the bottle, check the syringe for any air bubbles. If bubbles are present, hold the syringe straight up and tap its side until the bubbles float to the top. Push them out with the plunger and withdraw the correct dose.
Remove the needle from the bottle, being careful to not inject yourself.
Injections should be given just under the skin (subcutaneously) and about one to two inches from the middle of the animals back , varying from just behind the shoulder blade to slightly in front of the hipbone.
The injection sites should be alternated between the left and right sides.
Using your free hand, pinch up a fold of skin, insert the needle into the center of the fold as instructed by your veterinarian, and push the plunger in as far as it will go.
Pull out the needle, being careful not to inject yourself.
Dispose of the syringe in an appropriate manner (sharps/biohazard disposal).

Food and Feeding Essentials

Your pet should be fed twice daily.
Food should be rationed half in the morning, the other half in the evening.
Establishing regular feeding times is essential.
A low-carbohydrate, high-fiber diet should be selected
Enough food to maintain weight, or to gain or lose weight if necessary, should be given.
Overweight animals should be put on a diet to reduce weight gradually.
Extra tidbits and treats should not be given! This requires cooperation from family and friends, too

Caution

A seven- to eight-hour interval must be observed between the morning injection and the second meal.
Feed your pet first before giving insulin. If your pet is not eating—no insulin should be given. When your pet has a reduced appetite and eats only half of its meal, reduce the daily dose of insulin by half. If the situation lasts more than two days (due to illness, for example), consult your veterinarian.

Exercise

The usual amount of exercise your pet receives should remain relatively unchanged. If your dog suddenly expends a lot more energy (longer walks, excitement about visitors, etc.), your pet will utilize more glucose. Too much activity can result in an extremely low blood sugar level, which may leave too little "fuel" available for the brain, to the point that your pet could even lose consciousness. If this happens, immediately administer glucose, like honey or Karo syrup.

Long-term Expectations

Although insulin is not a cure for diabetes, it can help control or eliminate many of the complications associated with the disease (such as excessive thirst, urination and weight loss) and prevent the development of life-threatening complications.

Response varies from dog-to-dog and cat-to-cat but can be quite dramatic.
In most cases, improvement can be seen within a few days.
If insulin is discontinued or not given as directed, signs of diabetes will likely return, and life-threatening complications may develop.

Once stabilized on insulin, most animals are able to lead a happy, healthy life.

POSSIBLE COMPLICATIONS

Low Blood Sugar

The most common side effect experienced with insulin therapy is hypoglycemia (low blood sugar). Hypoglycemia can be caused by:

Giving too much insulin
Missing or delaying food
Change in food, diet or amount fed
Change (increase) in exercise
Infection or illness
Change in the body’s need for insulin
Diseases of the adrenal, pituitary or thyroid gland, or progression of liver or kidney disease
Interaction with other drugs (such as progestagen or glucocorticoids)

Signs of hypoglycemia may occur suddenly and can include:

Weakness
Depression
Behavioral changes
Muscle twitching
Anxiety
Seizures
Coma
Death

What to do in case of a diabetic emergency:

If your pet is unconscious or having a seizure, this is a medical emergency.

CONTACT YOUR VETERINARIAN.

Immediately treat your pet by pouring a small amount of a sugar solution (e.g., Karo Syrup) onto your finger and then rubbing the sugar solution onto your pet's gums. The sugar is absorbed very quickly and your pet should respond in one to two minutes.

Never pour the sugar solution directly into the mouth since there is a risk that the solution will be inhaled into the lungs.

Once your pet has responded to the sugar administration and is sitting up, it can be fed a small, high-protein meal.

Once your pet has been stabilized, it should be transported to your veterinarian for evaluation.

If your pet is conscious

Rub approximately one tablespoon of Karo syrup or honey on their gums.
When your pet is able to swallow, feed its usual meal
Contact your veterinarian.

Other Side Effects:

Other possible side effects include loss of effectiveness of the insulin and local or systemic allergic reactions. It is important to contact your veterinarian immediately if you think your pet has a medical problem or side effect from the insulin therapy. In particular, please contact your veterinarian if your pet shows any of the following:

Excessive water consumption for more than three days
Excess urination (including need to urinate at night for a dog that usually sleeps through the night or inappropriate urination in the house for a cat)
Reduced or complete loss of appetite
Weakness, seizures, or severe mental depression
Behavioral change, muscle twitching or anxiety
Constipation, vomiting, or diarrhea
Signs of a bladder infection (small, frequent urinations, straining, blood in the urine)
Swelling of the head or neck

How to Keep Your Pets Blood Sugar Stable

Your pet's diet should be consistent and appropriate.
A nutritionally complete, dry or canned pet food should be fed in consistent amounts at the same times each day.
"Treats" and changes in diet should generally be avoided unless recommended by your veterinarian.
Your pet's exercise should remain consistent.
Consult with your veterinarian if you expect a major change in activity.
Develop a schedule with your veterinarian for regular evaluations of your pet's diabetes.

Overdose or Missed Injection of Vetsulin

If any animal is given too much insulin, severe (life-threatening) hypoglycemia (low blood sugar) can result. Contact your veterinarian immediately. If your veterinarian is not available, seek other veterinary advice at once. Your pet may need to be hospitalized for observation or treatment.

If your pet receives less than the prescribed dose, or if you miss an injection, this may cause a temporary recurrence of signs (such as excess thirst and urination), but is not life-threatening. Contact your veterinarian as soon as possible for advice on your pet's next dose. If you cannot reach your veterinarian and your pet is eating and acting normally, give your pet the usual dose at the next regularly scheduled injection time.

How To Store Insulin

Insulin should be stored in an upright position under refrigeration (2–8 degrees Celsius/36–46 degrees Fahrenheit). Do not freeze and protect from light.

Continued Treatment and Monitoring

It is important that you learn to monitor your pet's blood glucose level correctly. This is done in one of two ways:

by measuring the glucose level in the blood itself
by checking the urine for the presence of glucose

Measuring the blood glucose level is clearly the most accurate way to monitor therapy, and your veterinarian will do this in the clinic. Checking the urine for the presence of glucose, although not quite as accurate, is something you can do at home.

CONTACT YOUR VETERINARY SUPPORT CARE TEAM FOR FURTHER QUESTIONS

MAPLE VETERINARY HOSPITAL 248-585-2622