Diabetes

Diabetes is caused by a deficiency in insulin. Insulin is needed to turn blood sugar (glucose) into energy.The glucose doesn’t get converted to energy, so this will make a diabetic dog hungry all the time!

Dogs who suffer with diabetes, will need Veterinary treatment. Regular testing of the urine for glucose or using pin pick blood glucose test kits. Vets will give guidance on how to work out the insulin levels based on the results. The dog must be fed before the injection is administered to ensure they have eaten and not refused food. If your dog only eats half of its meal, AND is in a safe glucose range of 11 mmol/l or above then half of the usual dose would be given. If you need to encourage your dog to eat, try adding a few enticing pieces of food on top of the meal such as tuna (in spring water) or some little bits of chicken mixed in, grated cheese. Get Veterinary advice i your dog still wont eat or seems unwell or is vomiting.

Ideally you should aim to maintain a range of around 6 or 7mmol/L – 15 mmol/L for as much of the day as possible. Your dog can safely go down to 5 mmol/L however, it is preferable to go no lower than around 6-7 mmol/L s. If it goes below 5mmol/L then your dog will be at risk from collapse and seizures. Hypoglycaemia means to have blood sugar levels that are too low. Hypoglycaemia is anything below 4 mmol/L and if left untreated can be fatal.

Insulin needs to be given at the same time every day (some animals are injected once a day and others need it twice a day). The insulin lasts for 11 – 12 hours so you need to ensure the times are logged. The next injection can be an hour either side of the timed 12 hourly slot. NEVER before 11 hours.

*TIPS*

Insulin should be kept in the fridge 2-8°C, ideally NOT in the door as the temperature of the fridge door fluctuates. Get yourself a fridge thermometer, so you can monitor the temperature to make sure your insulin is kept correctly. The bottle of Insulin should be mixed thoroughly before its first use so that the suspension is uniformly milky. Subsequent withdrawals, you should gently roll the bottle before withdrawing the required dose. Using this method (shaking throughly on first use, rolling for each subsequent) then the glucose levels are less likely to be erratic.

When using a bottle of Insulin – mark it with the date the vial was opened – work out when 40 days is up as you will then need to start a new vial. It is important to always be aware of when you need to order a bottle of insulin in time before you actually need it.

The glucose and insulin dose and meals should be kept logged in a notebook for reference.

ALWAYS BE PREPARED

Keep a pot of ketostix to check your dog’s urine for ketones.

Keep spares! Batteries for blood glucose monitors, an extra bottle or two of insulin in case of breakage, syringes, test strips, honey.. you can never have too much!

Compare prices online or ask your vet to pricematch. Otherwise, you can ask for a prescription for insulin. Your vet can not refuse you. You can expect a script to cover a period of between 3 and 6 months. Syringes do not need a script.

Signs of Diabetes

Drinking more water
Peeing more often
Eating more
Losing weight
Vision problems/cloudy eyes
Obesity can cause diabetes
No energy
Thinning or dull hair
Vomiting
Depression

Diet

The diet you choose for diabetic dogs is very important. Your first port of call is your vet, to guide you with appropriate diet which looks at the nutritional levels. The diet needs to be low in carbohydrates (slow release glucose) and high in protein. It is important to feed your dog at the same times every day, then give the required insulin dose no longer than one hour afterwards as you will know exactly how much food your dog has eaten. You may have to alter the food to accommodate food spikes. Food should always be weighed to create consistency and help with the dogs stability.

Diets to try are Hills W/D, Royal Canin and Purina Vet Diets, Many diabetic dogs do well on Chappie original tinned food. Ideally, we should feed a food no higher than 12% fat on a dry matter basis due to diabetic dogs being a higher risk of pancreatitis. You should avoid clear brands containing sugars, simple carbs and fruits. It will be a case of working to find the right diet for your dog. Noting that changes in flavours can bring different nutritional analysis quantities, be mindful of those variations and monitor the glucose as you may then see different glucose ranges.

The fat content in the diet is important as diabetic dogs are also likely to suffer with pancreatitis. A high fat diet can aggravate the pancreas causing acute pancreatitis which is not only very painful but can be life-threatening. We should ideally feed a diet no higher than around 12% fat on a dry matter basis.

Fibre is important in a diabetic dog’s diet as it helps to slow down the entrance of glucose into the bloodstream and helps your dog to feel full. You must assess if your dog is overweight or underweight as high fibre diets are generally given to dogs who need to lose weight. Therefore a diet high in fibre wont help your put on weight. Consideration to fibre levels in relation to your dogs weight must always be kept in mind as weight is likely to fluctuate.

A very helpful tool is the Waltham Calorie Calculator as this enables you to work out the calories your dog needs. When entering the weight of your dog, you need to put in the weight that is ideal for the breed. This gives you the calories needed for the entire days worth of food.

The calories need to be divided between two meals. For example Molly is a 25kg dog needs 1230 calories a day (listed as “TYPICAL”). Two meals a day = 615 calories each meal.

If Molly is fed on chappie wet food, this contains 1.18 calories per gram. Therefore you would do the sum of 615 divided by 1.18=521grams. Molly would need 521 grams of chappie wet food twice a day.

You must check the packaging on the food, look up the calories per gram. Not all packaging gives this information so you would need to message the manufacturer to ask or you can enter the nutritional analysis from the label of your dog’s food into the PFMA Calorie Calculator.

Please note – With dry food, if the moisture content is missing you should enter it as 10%.

https://www.pfma.org.uk/dog-calorie-calculator-nrc-method

If you need to give a diabetic dog treats, you could give carrots, blueberries, broccoli, apples (without the core), natural fish jerky.

Home Testing – The Curve

Testing will become part of your daily routine, it does not have to be done by the vet. Home testing is the best way to keep your dog safe from hypoglycaemic episodes, give you peace of mind and help to get your pet’s diabetes regulated quicker. Home testing will give you a more accurate reading in a comfortable and familiar environment.

Blood glucose monitoring is the best and safest way to deal with your dog’s diabetes, regardless of what your vet says! If you can do it, you should do it.

When you are trying to determine a pattern or a spike with glucose levels you need to carry out blood prick tests throughout the day so that you can observe the levels to see how the dog is responding to the dose of insulin. This information enables you to know whether to adjust the insulin or the food accordingly It is helpful to run the curve before the AM and PM meals, then two hourly throughout a 12 hour period. Plotting the information on a graph will enable you to see the curve. By doing the curve test at home will give you the most accurate information possible as the dog is in his own home environment and will not be stressed out like he might be if he was at the vets for 12 hours having the series of blood prick tests performed.

Practical Advice.

Any owner will feel a little apprehensive about giving the injection to their own pet. Sometimes the dog will react to the injection which can cause you a little anxiety. A dog may have a reaction for a few reasons. They might be picking up on your nerves. Try to and remain upbeat but relaxed when administering the injection, once you have given the injection offer a small treat (that is suitable for diabetics) It helps you to know the injection can sting if it is given cold, so you can warm the insulin syringe by placing under your armpit SAFELY – with the needle cap still in situ this will help reduce the chances of the insulin stinging.

Look at the needle and look for the bevel. This is the part of the needle that is slightly flatter and sharper. The bevel needs to be facing upwards. Take a nice pinch of skin to create a “tent” and insert the needle at 45 degrees. Try and make a mental note of the location used each day so you are not using exactly the same area as the skin will become thickened with scar tissue. This will not help with the absorption of the insulin.

When you administer the injection don’t panic, just inject the insulin at a steady rate – do not rush or go too slow either.

DO NOT rub the injection site as this will affect the absorption rate of the insulin.

Once the injections become a regular routine for both you and your dog, things will settle and you will both feel more comfortable with them. Injecting in the flank, side of the belly and chest will allow for better absorption of insulin compared to the scruff.

IF you notice the fur is wet after the injection has been given you cannot assume to know how much insulin has been administered so you will need to wait until the next dose is due before you give any more insulin.

If you were to give a second injection you are risking hypoglycaemia. Your dog may have high glucose levels until the next dose is due because of the missed-leaked injection but a day of hyperglycaemia isn’t going to harm your dog whereas hypoglycaemia can kill. Just provide fresh water, wait until the next scheduled injection and continue as normal from there.

Causes of Insulin Shock – Insulin shock is seen in dogs with diabetes. If the dose of insulin is too high or calculated incorrectly this can lead to insulin shock resulting in low blood sugar.

Symptoms of Dog Insulin Shock/Hypoglycaemia

Insulin shock will cause low blood glucose and a decreased body temperature. The dog will display symptoms such as:

Shaking and trembling
Hunger
Pale gums (white mucus membranes)
Slow heart rate
Salivating
Cold extremeties – Limbs
Agitated behaviour, barking to get your attention, panting, pacing.
Dilated Pupils
Reduced vision
Initially an insatiable appetite which progresses to not being able to eat.
Lethargy, quiet, weakness
Vomiting/Diarhoea
Loss of bladder control
Fitting
Disorientated and confused
Collapse and Coma in severe case

Problems that can occur as a result of diabetes :-

A dog with low blood sugar should receive emergency treatment which you can administer at home. The dog could have sugar, corn syrup, honey, maple syrup or jam. Rub the sugary syrup on the dog’s gums and go to the vets. Test the glucose every fifteen minutes until above 5mmol/L and repeat putting some honey on the gums, then test the glucose half hourly and continue to repeat the honey until the test level reaches 8mmol/L

If your dog has high sugar levels, then this is hyperglycaemia. This can lead to having ketones in the blood. When the animals body burns its own fat, the acid which is left are ketones. If there is insufficient insulin helping provide energy to the body’s cells. The problem is if it is untreated it can lead to ketoacidosis. Hyperglycaemia is not immediately life-threatening however, consistent episodes of hyperglycaemia can lead to Ketoacidosis which can be fatal and can also cause many other problems throughout the body.

Dogs with hyperglycaemia often have weight loss this is as a result of the energy not being converted from the glucose to energy, and therefore the animal is never being sustained nutritionally (ie the glucose is converted to energy in healthy animals). This is not the case for animals with hyperglycaemia so they are in a permenant state of hunger through an apparent lack of nutritional requirements. It can be a sudden onset or can occur over a progressive period of time.

Hyperglycaemia can also cause dehydration, pancreatitis, damage to nerves, kidneys and blood vessels and is the main cause of urinary tract infections in diabetic dogs. Signs of hyperglycaemia include frequent urination, sticky urine, excessive thirst, increased appetite, weight loss, cloudy eyes, blindness, stomach problems and lethargy.

Ketoacidosis

When there isnt enough insulin in the body, the body will look at using another source of energy instead, so as a result the fat reserves and muscles are used instead of using glucose to convert into energy. The liver converts fatty acids into ketones and releases them into the blood stream. If the dog continues have low levels of insulin, the ketones will increase and then along with high glucose levels this can escalate into Ketoacidosis. Diabetic ketoacidosis – this requires Veterinary assistance without delay.

The symptoms of Ketoacidosis are as follows –

Vomiting
Not eating
Dehydrated
An unusual smell on the breath – similar to the smell of pear drops
Deep laboured breathing
Rapid heartbeat
Confused and disorientated

You can watch for ketones in your dog’s urine by testing daily with ketostix bought from most chemists or online. If you have readings of more than a“trace” you must inform your vet straight away. If your dog has ketone levels between negative and trace, encourage drinking and urinating over the following 24 hours to help flush them through.

When the glucose levels are not maintained then the body will continue to look for an energy source. Using the fat reserves to source energy. A dog diagnosed with diabetes will struggle to gain weight when the glucose has not been stabilised. So no matter how much your dog eats, the body will carry on using fat and muscles for energy instead of utlisiing the nutrition from the food they consume, therefore causing weight loss. However if your dog is losing weight when the glucose levels have been maintained and stabilised then you have to consider the diet doesnt have a high enough calorific content for the ideal weight of the dog. Please also make a note of the fibre content when choosing the right diet for your dog. As they shouldnt have too high a fibre content even when the glucose is regulated.

Increased thirst is caused by high levels of glucose in the bloodstream, this makes the dog dehydrated and the dog will drink more. Increased drinking will result in excessive urination. Do NOT ever withhold water.

The increased thirst will revert back to normal once the glucose levels start to come down again.

Other problems can cause increased urination suchas urinary tract infections, kidney problems and Cushings Disease.

Bitches who suffer with diabetes can have the added complication that they are in season they will produce progesterone which will result in instability of glucose levels. It is therefore sensible to consider spaying an entire bitch to create a better hormonal balance rather than the fluctuations which occur seasonally.

Exercise is very important as it helps regulate the glucose levels, so you need to maintain a schedule so that you dont over do it, this will help create consistency.It is normal to have a drop in glucose with exercise, though in some dogs the glucose will rise. You need to know how exercise impacts on your dog – so checking the blood glucose before and after exercise will enable you to better understanding of how exercise effects your dog. It makes sense to avoid exercise at your dogs lowest levels, be prepared and take with you honey, biscuits, a (xylitol free) peanut butter sandwich, your glucose monitor, lancet and strips in case of a glucose low.

With appropriate management and support a diabetic dog should live for the exceed lifespan of a non diabetic dog.

Please note advice contained within this article is for guidance only.

(Much of the advice was taken from Diabetic Dogs UK).