Complicated Diabetes Mellitus

Diabetes mellitus is a common disease process of dogs and cats. Diabetes is defined by insulin deficiency and/or insulin resistance leading to elevated blood sugar values. Increased sugar in the urine leads to frequent urination and patients drink more to stay hydrated. Because sugar is staying in the blood stream and not being delivered to body cells by insulin (as it is supposed to be) these pets are functionally starving. They have ravenous appetites and despite eating large volumes they lose weight rapidly.

There are several notable differences between dogs and cats with diabetes mellitus. Dogs become obligated to insulin therapy at the time of diagnosis. Diet is important in supporting blood sugar management but they almost always need lifelong injectable insulin therapy. In contrast, a fair percentage of cats will become regulated with diet alone. This is because often times cats are still producing some insulin and are somewhat insulin resistant. Effective diet therapy can “over come” this insulin resistance and restore normal blood sugar and metabolism. This resolution of diabetes can sometime last years, but some of these cats will ultimately need supplemental insulin injections.

   With appropriate insulin therapy dogs and cats can have a complete life span with diabetes mellitus. Consistent and well managed care helps maintain this as good quality of life. Most veterinarians can establish good diabetic management within a few months of diagnosis.

     Occasionally patients have complicating factors that cause poor regulation of diabetes mellitus. Common causes of poor regulation include urinary tract infections, pancreatitis and cancers. If the underlying cause (a bladder infection for example) can be identified and treated, then it will not cause long term impact to the diabetes mellitus. However, some chronic diseases like Cushing’s syndrome, hyperlipidemia (high cholesterol and high triglycerides) and some benign tumors will cause hormone secretions that actually block insulin function.

     I generally see diabetic patients with chronic or complicating disease processes. Often times the cause of insulin resistance is not clear. If I can make a secondary diagnosis and try to minimize the impact of this disease, diabetic management can improve significantly.

     Many of the diabetic patients I manage seem like I am trying to “hit a moving target.” For these patients perfect diabetic control is not realistic but I can often improve their quality of life and work to minimize the long term impact of poorly regulated diabetes.

     Patients with uncontrolled/unmanaged diabetes mellitus can develop a syndrome called diabetic ketoacidosis. This is a life threatening emergency that requires immediate veterinary attention. Patients with diabetic ketoacidosis are sick. If your diabetic dog or cat is feeling sick, it is always a good idea to have them evaluated by a veterinarian.

     If you are managing a patient with complicated diabetes mellitus and things are not going as well as you would like, please call to speak with Dr. Elliott. I am always happy when I can make a difference in a patients quality of life.

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