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  Volume No. 16 Issue No. 2 February 2019  

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Dr. Jim Humphries

  My pet is a diabetic
  By Dr. Jim Humphries

   My mother was an RN most of her life. When I was a young veterinarian, I could talk with her about diseases, but often she would say, “I did not know dogs could get ... that,” and we’d have the same short conversation: “Yes, dogs and cats have the same organs; therefore, they can develop many of the same diseases as humans have.”
   This is especially true when the disease diabetes is discussed. It may even seem funny to say, “My cat is a diabetic.” But for one out of 100 dogs and as many as one out of 50 cats can develop diabetes before they reach their 12th birthday.
   Diabetes mellitus is the more proper term, and it occurs when the pet has stopped producing his or her normal internal insulin. It is more common in middle-aged to older animals, especially in females. There are some breeds that have a higher incidence such as toy poodles, terriers, cocker spaniels, dachshunds, Doberman pinschers, German shepherds, Labrador retrievers and golden retrievers. For cats, the Siamese seems to be at the top of the list.
   In general, diabetes cannot be cured but rather controlled. A diabetic dog or cat needs insulin injections typically twice a day. Insulin is a hormone that keeps your dog or cat's glucose levels more normal.
   The classic signs of diabetes in a pet are these: They will urinate more often; they will drink a lot of water. (Note: An increase in urination and drinking is also a sign of kidney disease.) These pets are always hungry, and they will lose weight. They can develop cataracts and have a dull hair coat, while mostly sleeping and being less active.
   The diagnosis is the same as with people. Pets will have glucose (sugar) in their urine (and glucose should never be in the urine) and higher levels in their blood. The diagnosis only becomes definite when glucose is found both in the urine and at a high level in the blood, along with the other classic symptoms.
   After a diagnosis, your veterinarian will help you find the right dose and timing of insulin injections. It can take a while to find the right dose.
   When blood sugar is not well-controlled, dogs can suffer from low blood sugar and cataracts. Cats suffer chronic inflammation of the pancreas, recurrent infections and even the well-known diabetic neuropathy in humans.
   If not well-controlled, the result is diabetic ketoacidosis or DKA. This happens when cells do not get the amount of glucose they need to produce energy, and the body makes up for that and tries to supplement the lack of glucose by breaking down muscle and fat for energy. Then, these break-down products, known as ketones, along with fatty acids, enter the bloodstream, causing this imbalance.
   Pet owners can detect one of the most common signs by looking into the “window into the body” — the eyes. A cataract results when the lens of the eye becomes cloudy and even crystalline in appearance — and eventually blindness can occur. This condition develops when the excess glucose in the bloodstream causes water to enter into the lens, causing swelling and changes in the lens. This results in the cloudiness that can be seen.
   Not to be confused with diabetes, there is another cause of cloudiness that never turns crystalline in appearance. This is a “normal” old dog change of the lens called “nuclear sclerosis,” which is an age-related change in the nucleus that occurs in almost all older animals. It is caused by the compression of older lens fibers in the nucleus by new fiber formation. These appear almost always as a cloudy appearance and not crystalline.
   For cats, peripheral neuropathy is one of the biggest concerns. It is a degeneration that affects the nerves because of prolonged high blood glucose levels. It is one of the most common chronic complications of diabetes in cats. Just as with people, it is often referred to as diabetic neuropathy. It typically affects the hind legs, causing weakness, loss of coordination, inability to jump and a distinct stance or posture in which the cat's rear legs touch the ground when it walks. This should resolve some when the blood sugar is controlled.
   Many pet owners successfully manage their diabetic pet with insulin therapy, the correct diet and exercise. (I know what you are thinking, exercise my cat? But you can — Google it.) It is important to know that with the successful control of diabetes, you can expect your pet to live a happy and normal life.

   Dr. Jim Humphries is a veterinarian and provides hospice and end-of-life care for pets in the Colorado Springs area. He also serves as a visiting professor at the College of Veterinary Medicine at Texas A&M University. He lives in Falcon with his wife, horses and Great Danes.
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