Controlling Diabetes in Dogs and Cats

What is Diabetes?
Diabetes is a disease caused by too much sugar in the blood. The sugar directly damages the inside of blood vessels and nerves, and indirectly damages every organ in the body, leading to neuropathy, blindness and infection. The most common cause of diabetes is pancreatic failure to produce insulin, the hormone that acts on every cell in the body. Insulin instructs cells to allow sugar to pass from the blood into the cell where it is metabolized to energy or stored as glycogen for long-term use.

Other Causes of Diabetes

While pancreatic failure to produce insulin is the most common cause of diabetes, there are other causes: Cushing’s disease, pregnancy, pancreatic tumor, and drugs, especially prednisone.

What Happens to Diabetic Pets?

High blood sugar causes dogs and cats to feel ill. They become lethargic and many lose weight. Most develop increased thirst and increased urination called polyuria polydipsia (PUPD). The PUPD occurs because excess sugar in the blood flushes into the urine where the sugar pulls along water molecules, thus increasing the total volume of urine. In addition to having a large volume of urine, the diabetic pet often has infected urine because urinary bacteria multiply exponentially in the presence of sugar.

Insulin, the Treatment for Diabetes

The treatment for diabetes caused by pancreatic failure to produce insulin is to provide injectable insulin. Unfortunately, injecting insulin never reaches the body’s level of physiologic sophistication and many pets with diabetes are poorly controlled. To promote better control, 12-hour glucose curves are done to measure the fluctuations in blood sugar. A typical 12-hour glucose curve would start at 8 in the morning with a blood sample before the pet is fed. Then the pet is fed and insulin administered. At 10 AM, and every two hours thereafter until 8 PM, blood glucose samples are taken and measured.

The 12-Hour Glucose Curve and the Somogyi Effect

If the amount of food and the amount of insulin are in balance, the blood glucose level—although it may rise and fall—remains within a healthy range throughout the day (80-220 mg/dL). If the food and insulin have not reached a balance, the 12-hour glucose curve can show a severe, dangerous drop in blood sugar (hypoglycaemia) following the insulin injection, with a rebound to high blood glucose (hyperglycemia) as the body attempts to correct the hypoglycemic episode. The severe hypoglycemia followed by hyperglycemia is called the Somogyi effect. The 12-hour glucose curve is absolutely necessary to help distinguish between insufficient insulin leading to high blood sugar and excessive insulin leading to high blood sugar.

Steps to Balance Blood Sugar and Insulin

1. Never give insulin if the pet is not eating.
2. Perform a 12-hour blood glucose test once a week until the type and amount of insulin has been shown to produce healthy fluctuations in blood sugar.
3. Feed high protein, high fat diet with medium and long-chain triglycerides and no simple sugars. Feed meat, fish, eggs, and vegetables with small amounts of whole grains and very little fruit. Vegetables and whole grains provide the soluble and insoluble fiber that naturally slows rate at which glucose leaves the digestive tract and enters the blood. Experiment with meals so your pet continues to enjoy eating, but aim for protein from 35% to 50% and fat as high as 25% of the diet.
4. Help your pet maintain a healthy weight
5. Provide daily exercise to prevent boredom and maintain weight. Exercise is also important because it uses your pet’s normal physiologic response to move sugar move from blood into cells.
6. Treat any infections, including bladder and skin infections. To control skin infections, use topical antibacterial agents to which bacteria cannot develop resistance, such as colloidal silver. To prevent and treat bladder infections, ensure the pet drinks plenty of fresh water, urinates frequently to avoid over distension of the bladder. Over distension damages bladder wall, allowing bacteria to flourish. Give Chinese herbal formulas such as Four Marvels (Si Miao San)
7. Reduce the use of prednisone
8. Treat Cushing’s disease with Chinese herbs
9. Watch U-tube videos on treating pets with diabetes. These videos will help explain the Somogyi effect. They will help confirm you’re using the correct insulin and insulin needle, and ensure you’re using optimum injection technique and injection sites.
10. Thank the heavens we have pharmaceutical companies that manufacture insulin and veterinarians wise enough to help us choose when to treat our diabetic cats and dogs, and when to allow them to pass from this earth.

 

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