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Diabetes Mellitus What is it? This is a disease that results in a low blood glucose level. It can be be caused by several problems, but is basically due to an insufficient level of insulin, either because the body cells stop responding to insulin and require a higher amount to extract the same response or because insufficient insulin is being produced. It is important not to confuse this condition with another called diabetes insipidus which is relatively rare in dogs and causes an excessive thirst but has no effects on glucose metabolism. Why does it occur? Insulin is produced by the pancreatic tissue and released into the blood as required, the insulin in the blood binds to the cells allowing them to absorb glucose. Diabetes can be caused by a failure to produce insulin in the pancreas perhaps as a result of diseases such as pancreatitis, immune problems, deficiencies of the islet cells that manufacture insulin, pancreatic cancer, or due to problems causing insensitivity to the insulin in the body tissues such as obesity or hormonal antagonism (high levels of some other substances act against insulin). In cases of hormonal antagonism if the substance which is causing the insulin insensitivity can be identified and removed then it may be possible to cure those cases, for example bitches at a certain stage of the reproductive cycle produce an excess of progesterone which acts against insulin, neutering these bitches at an early stage of the problem can be curative. Which animals are most likely to suffer from this problem? Middle and older aged animals are more likely to develop diabetes mellitus. Obesity is a major predisposing factor since it can induce insulin insensitivity. What are the presenting signs of diabetes? The major indication of diabetes is an increase in thirst and volume and/or frequency of urination, often leading to inappropriate house wetting, increased appetite, weight loss, sweet smelling breath and inability to exercise for a long period of time. Diabetic animals can develop cataracts leading ultimately to blindness. How can the diagnosis be confirmed? All untreated diabetic patients have a high blood glucose level and usually glucose in the urine. Urine glucose can however also be associated with kidney problems and blood glucose can also be raised by stress and some drugs. Your vet may wish to carry out other blood tests to investigate whether there is any other concurrent disease that may interfere with the treatment of the diabetes. How can diabetic patients be treated? Almost all canine diabetics require insulin which has to be given by once or twice daily injections. The insulin available for use in dogs is either short, intermediate or long acting. The preparation and regime most suitable for an individual animal is best decided by the vet and owner on an individual case basis. The amount and frequency of insulin administered is determined by regularly testing either blood or urine glucose levels. Diet modifications are essential in successful management of diabetic patients. Meals should be of a constant size and constituency and feedings times should not vary from day to day. Most standard pets food are acceptable and should be fed at around 1 to 1 and 1/2 times the normal requirement. Diets with high fibre and carbohydrate levels are best. In obese animals weight loss is an essential part of disease management. It is also advisable to neuter bitches to prevent hormonal interference with therapy. What are the likely complications of diabetes mellitus for my pet? Complications of diabetes therapy can involve the development of hypoglycaemia which is a low level of glucose in the blood and manifests as lethargy, weakness, inability to balance and coordinate movement and may progress to seizures The most serious complication of diabetes is the development of a ketoacidotic state which necessitates emergency treatment by your vet, this situation is created by a high glucose level and the overproduction of ketones which in turn causes electrolyte upsets in the blood and can result in the patient becoming dehydrated, the signs this is developing are lethargy, inappetance, vomiting, and can progress to the extent of the patient becoming comatose. Your vet will normally treat this situation by administering insulin and intravenous fluids as well as treating any concurrent disease. The longer term complications of diabetes mellitus include cataract formation which is irreversible, although treatment may be feasible in some cases. Neuropathies (nerve problems) can occasionally develop often interfering with the animals ability to walk properly. Relative uncommon problems with the retina in the eye, and with the kidneys can also occasionally develop. To try and reduce the likelihood of these problems occurring your vet will wish to regularly check your pet by blood sampling of blood glucose and fructosamine levels. |
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