Diabetes doesn’t just affect humans – increasingly, cats and dogs are developing this chronic illness too. It’s important to know how to reduce the risk, what symptoms to look out for and how to manage the condition.
By John Helps, BVetMed CertSAM MRCVS, veterinary surgeon and senior technical manager, MSD Animal Health UK
A familiar expression – “love me, love my dog!” rang very true when I met my partner Sara and her scruffy lurcher-type rescue dog, Dink, some 10 years ago. Being a vet myself, I’d owned and loved dogs of various types and sizes over the years but, I had to admit Dink and his owner were indeed special! Like all devoted pet owners, we were therefore concerned when at around 14 years of age, he started needing to wee in the middle of the night, and despite a very good appetite (he had an obsessive love for carrots and sausages), he also started to lose condition.
After a simple urine test had a positive result for glucose, I suspected diabetes was the likely cause, which was sadly confirmed by subsequent blood tests. While many of us may know someone affected by diabetes or even be personally affected, it often comes as a surprise to those without a veterinary background that the dogs and cats who share our lives and modern lifestyles are increasingly at risk of diabetes too.
WHAT IS DIABETES AND HOW TO SPOT THE SIGNS
Diabetes mellitus most commonly affects middle-aged or older dogs and cats and is caused by a lack (or poor function) of the hormone insulin, which results in high levels of blood sugar (glucose) within the bloodstream and in the urine.
As we saw with Dink, a clue that your pet might have diabetes is if they start passing more urine. As a result, you are also likely to notice them drinking more too. In cats, who tend to be more secretive, this may mean that you see them drinking from new water sources. In addition, unexplained weight and body condition loss is likely to be seen despite often being a lot hungrier.
Finally, since the diabetic animal is unable to use the raised blood sugar for energy, you would expect to see a less active, more lethargic pet.
SHOULD YOU TREAT AND HOW DO YOU CARE FOR A DIABETIC PET?
It is always a shock to learn your pet is diabetic, particularly when the best outcome will partly depend on your own commitment as well as learning some new information and skills. I was used to supporting diabetic pets when in practice but with Dink, I was now in my client’s own shoes as we weighed the implications of the diabetes diagnosis.
The good news is the options available to monitor and manage the condition continue to evolve in many positive ways, thanks to the continuing strides we see in human diabetes. Treatment almost always involves administering regular injections of insulin which for many cats and nearly all dogs will be lifelong. Some lifestyle changes will be needed to ensure insulin injections, exercise and feeding are consistent and appropriate, but many cases of pet diabetes can be successfully managed.
When it came to our decision with Dink, we knew he continued to give us so much and we owed it to him to support him to the best of our ability!
The overall outlook for treatment can be affected though by other health problems. In Dink’s case, underlying pancreatitis issues did make things more complicated at times. Insulin doses should also be increased cautiously based on sound decision making principles to avoid overdoses which might drive blood glucose too low, episodes known as ‘hypos’ (short for hypoglycaemia).
Our pets don’t live as long as us, so fortunately they develop fewer of the longer-term complications that can occur in poorly controlled diabetes in people. This can limit the need to control glucose quite as tightly as in human patients. Specifically in diabetic dogs, as ultimately occurred in Dinks case, cataracts commonly do form over time, but in many cases the dogs either cope well with these or the cataracts can be removed.
Of course, the sad alternative to treatment is euthanasia since without appropriate care, the health of affected pets would continue to deteriorate due to a toxic build-up of chemicals we call ketones. This results in worsening appetite, dehydration, severe depression, coma and ultimately death. Ups and downs aside, Dink was given another two years of a life full of his favourite things before we had to say goodbye – though we would have wished it could have been longer we were thankful that we had been able to give him our best support in his final years.
REDUCING THE RISKS
As in humans, there are different triggers for diabetes but are there ways we might be able to prevent pets developing the disease? Genetics plays an important role in pet diabetes. Although many breeds can be affected, certain terrier, spaniel, poodle and collie breeds appear more prone (whilst others such as the boxer and German Shepherd breeds seem to show a much lower risk). In cats, a number of oriental and exotic pedigree breeds are at greater risk including Burmese, Tonkinese and Norwegian Forest Cats.
Pets won’t be changing their genetic make-up anytime soon but knowing they have a family or breed history will help provide context for other factors that you may be able to influence. Obesity and inactivity is one important risk factor in cats. In dogs, it is commonly a lack of insulin production by the pancreas that is the initial problem, whereas many cases in cats arise due to individuals becoming insulin resistant, thanks in part to their weight.
A healthy weight for an average adult cat varies but for a typical ‘moggie’ it is around 3.5kg. However, a recent survey suggested that some 44% of UK pet cats are overweight or obese, so it is little wonder that feline diabetes is becoming more common! Studies show that overweight cats within the 4-5kg weight band carry more than a three times increased risk and cats that weigh over 7kg have a nearly 20-fold increase risk of diabetes!
What you feed may be as important as how much you feed, and again especially for cats. Cats remain closely related to their wild ancestors, having only been domesticated around 8,000 years. Feeding controlled amounts of a higher protein, lower carbohydrate diet which is closer to their wild diet can be better attuned to their metabolism and help reduce the risk of obesity and potentially diabetes. Your vet is well placed to advise on the best diets.
Neutering also reduces the risk of diabetes in female dogs as diabetes occurrences for them can be related to pregnancy or after a season. Of course, there are a variety of pros or cons to neutering, depending partly on age, so talk to your vet before making such a decision.
In both dogs and cats, insulin resistance may also be triggered or complicated by other underlying diseases or certain medicines such as steroids and other hormones. Common complicating disorders vary in in dogs and cats but may relate to other hormone or inflammatory disorders from pituitary and adrenal disorders to inflammatory conditions such as pancreatitis, which if identified and successfully managed, can very much improve the outlook.
PROTECTING YOUR PET’S LONG-TERM HEALTH
For most of us one of the biggest barriers to caring for a pet’s long term health condition is not having sufficient funds. Despite being a vet myself, I was working outside practice and therefore there were many ongoing costs to cover still. So, it was fortunate that we had good pet health insurance in place. Diabetes is but one of a number of long-term health conditions for which costs can be unpredictable and can quickly mount up.
Insurance may not always be seen to provide value for money while your pet is young and healthy, but the reality is that like ourselves, many pets develop costly, long-term health conditions as they age. To my mind therefore, there is little doubt that insuring the health of your dog or cat with a good quality lifetime policy from a young age, renewed annually throughout its life, can be one of the best ways of ensuring you can offer your treasured dog or cat the very best medical care later in life.
For more information: Diabetes in dogs msd-animal-health-hub.co.uk Diabetes in cats msd-animal-health-hub.co.uk
