1.Diabetes Mellitus (DM) results when glucose or blood sugar metabolism is not properly regulated in the body. This is the most common type of diabetes that dogs, cats (and people!) get diagnosed with. First, it is important to be aware that there are 2 forms of diabetes mellitus:
- Type 1: due to a lack of insulin production
- Type 2: due to the body becoming unresponsive to insulin even when it is present
DM can happen for a number of reasons:
- pancreatitis: inflammation of the pancreas (due to dietary issues such as a high-fat content in diet, infection, etc)
- genetics: especially seen in young animals
- obesity: increased fat in the body can interfere with the function of insulin
- certain drugs or hormones:
- Steroid drugs can interfere with the function of insulin.
- Hormones released during pregnancy can also interfere with insulin, which can cause a “gestational diabetes” (pet is diabetic during pregnancy; this can resolve after pregnancy, or become a permanent change depending on if long-term damage occurred).
In either case, blood sugars are not metabolized properly, and there is less sugar placed into the tissues to use for energy.
So, what does insulin actually do? Insulin reduces sugar in the bloodstream, allowing it to move into tissues, where it can be used as an energy source or be stored for future use.
The clinical signs of DM are: increased drinking, increased urination, increased appetite with weight loss. These signs typically start gradually, and get worse over a period of months to years.
Over time, DM can also lead to a number of complications, including:
- cataracts (more common in dogs, leads to blindness)
- mobility issues (more common in cats, usually seen as weakness and an unusual gait in their back legs, and muscle loss)
- DKA (diabetic ketoacidosis): can occur in either dogs or cats, results in multiple organs shutting down, and is often fatal
Diagnosis: what should you do if you think your pet may be diabetic? You should bring your animal to your veterinarian promptly. The veterinarian will start with a physical exam, and will likely recommend bloodwork. DM is fairly easy to diagnose on blood and urine testing.
Treatment: if your veterinarian does determine your pet is diabetic, they will discuss a treatment plan with you. This plan typically consists of:
– insulin injections, usually twice daily. These are given under the skin, and are very easy for most owners to learn how to do. Veterinarians and their staff will discuss the specific instructions, storage/handling, monitoring the pet and other details during a diabetic consult.
– diabetic diet: just as with people, eating sugar (otherwise known as carbohydrates) will increase blood sugar, making DM harder to manage. Luckily, there are a number of veterinary diets available to specifically manage DM. These will also be discussed with your veterinarian.
What about oral drugs? In humans, oral drugs are commonly prescribed to manage DM (especially type 2). However, in our animal species, these drugs are not as effective, and typically have a greater number of side effects than in people. Therefore, they are not as commonly used, even when DM is type 2 (insulin-resistant).
As with any long-term illness, monitoring how the pet is doing with the treatment is very important. Your veterinarian will discuss monitoring recommendations, as well as the various options available once treatment is started.
It is also important to know that with type 2 DM (more common in cats), it is possible for the cat to become non-insulin dependent again, so monitoring your diabetic patient is very important.
- Diabetes Insipidus (DI) is a much rarer type of diabetes, often called “non-sugar” diabetes (as it has nothing to do with blood sugar). Instead, it has to do with a hormone called ADH (anti-diuretic hormone). Just as with Diabetes Mellitus, Diabetes Insipidus has 2 forms:
- Type 1 DI: lack of ADH
- Type 2 DI: ADH-resistant
So, what does ADH actually do? ADH is responsible for water balance in your body. For example, ADH will tell your body to conserve water (i.e. reduce urination amount) to avoid becoming dehydrated. So, for DI, there is either a lack of ADH telling your body to conserve water, or the body becomes resistant to ADH effects.
The primary concern with DI is becoming dehydrated (as your body does not conserve water as it is supposed to). The main clinical sign of DI is drinking more and urinating more.
Diagnosis: if you notice your pet drinking or urinating more (asking to go outside at night, having urinary accidents, urinating outside the litter box, having to clean the litter box more often, etc), you should bring your animal to your veterinarian. As with DM, we will check blood and urine tests to look for the cause of the issue.
To diagnose DI specifically, we often have to rule out other issues, before concluding DI is the most likely cause.
Treatment: as with DM, your veterinarian will discuss a treatment plan if DI is suspected. Also similar to DM, giving replacement hormone (ADH) would be the main treatment. As with DM, this treatment would typically be needed for life. Monitoring will also be needed to make sure the dose and treatment is effective.