DIABETES MELLITUS:
Diabetes mellitus is a chronic endocrine disorder that occurs in dogs and cats.
It is characterized by high blood sugar (hyperglycemia) and results when the
pancreas is unable to produce enough insulin to meet the animal's requirements.
Insulin is a hormone which is needed to transport glucose (blood sugar) as well
as certain amino acids and minerals through the blood to energy-producing cells.
When a lack of insulin occurs, glucose cannot move into the cells and the
glucose level in the blood rises to abnormally high levels.
SIGNS OF DIABETES:
An animal with diabetes mellitus will exhibit some or all of the following
symptoms: weakness, increased thirst, frequent urination, rapid weight loss,
depression and abdominal pain. An animal may also show signs of either increased
hunger or lack of appetite. In some animals, the sudden development of blindness
due to cataract formation may indicate diabetes.
CAUSES:
Diabetes mellitus in dogs and cats is caused by damage to the pancreas.
Predisposing factors are: obesity, genetic predisposition, poor diet, hormonal
abnormalities, stress and drugs. The sex of the animal can also be a
predisposing factor. In dogs, females are affected twice as often as males and
in cats, diabetes is more prevalent in males.
DIAGNOSES:
Your veterinarian will perform a thorough physical examination of your pet and
ask you questions about your pet's health history. Next, it will be necessary
for your pet to fast for a short period of time so that its blood sugar level
can be tested and a urine check can be done. Often your pet is hospitalized for
one or two days to help insure the accuracy of this test. Diabetes is often
complicated by urinary tract infections, other hormone disorders, infections, or
a build-up of chemical compounds called ketones in the body. Provided these or
no other complications are present, the fasting blood sugar and urinalysis tests
will help determine whether or not your pet is diabetic. If there are
complications, more testing may be necessary.
TREATMENT:
Treatment requires a commitment of time and management from you, the owner.
There is no cure for diabetes mellitus, but, as with humans, it can be
controlled with insulin injections, diet, and exercise management. With such
therapy, your pet can lead a happy, comfortable life. Once your pet has been
diagnosed with diabetes mellitus, its specific insulin requirements need to be
determined. As each pet's insulin needs are unique and often vary from day to
day, your pet may need to be hospitalized for 2-4 days in order to determine its
specific needs. This is accomplished by your veterinarian giving the pet an
insulin injection and testing the blood sugar levels at regular intervals
throughout the day. These results are used to determine your pet's initial
insulin requirements. Your veterinarian may indicate these on a Glucose Curve
Chart. Because your pet's insulin needs may change once it returns home, due to
changes in diet, exercise, and certain environmental stresses, periodic
reevaluation over the next few weeks is recommended until satisfactory control
is achieved. Once control is achieved, further evaluation should be completed
every 2-4 months.
HOME CARE:
You must provide your pet daily injections of insulin for the rest of its life.
Oral medication is rarely effective for diabetic animals. It is also important
that the insulin injections are given at the same time each day. The injection
is given just under the skin and is not painful to your pet. Your veterinarian
will show you how to administer the injection. Detailed information on the
insulin injection is also included in this document for your reference.
And, remember, the hospital staff is here to help you care for your pet. They
welcome your questions.
THE INSULIN DOSE:
The type of insulin and the daily dose are tailored to meet the needs of each
animal. Some animals require one daily, some twice daily treatments. Some may
require one type of insulin, others may need a combination of insulins. Other
medications may also be prescribed, depending on concurrent complications. When
regulating a diabetic animal's blood glucose level, the goal is to keep it
between 80 and 150 mg/dl. The recommended dose of insulin determined while your
pet was in the veterinary clinic may need adjustment once your pet is home. This
is because the food and exercise your pet receives at home may be different. To
adjust the dose, your veterinarian will continue to test and regulate your pet
two ways. Your veterinarian will occasionally request you bring your dog or cat
into the clinic for the day to test for blood and urine glucose levels. Also,
you may be asked to monitor your pet's urine at home (see Home Glucose
Monitoring).
HANDLING INSULIN AND SYRINGES:
Insulin should be kept cool at all times and the bottle should be gently mixed
prior to withdrawal of the insulin into the syringe. The syringe and needle
should be stored in protective wrappers to keep them sterile. Syringes and
needles have four parts that consist of the syringe barrel, the plunger, the
needle and the needle guard Various syringes are suitable for injecting
insulin. They are marked on the barrel for measuring small amounts. These
syringes and needles are disposable or "single use" only. After
injecting your pet with insulin, place the needle guard over the needle and
dispose of it in the garbage or suitable container. For their safety, it is
extremely important that children do not have access to the syringes or needles.
DRAWING UP THE INSULIN
Set out the syringe and needle, insulin bottle and have the pet ready. Then:
1. Remove the needle guard from the needle, draw back the plunger to the desired
dose level.
2. Insert the needle into the insulin bottle.
3. Inject the air in the syringe into the bottle to prevent a vacuum from
forming in the insulin bottle. 4. Withdraw the plunger, filling the syringe with
the correct amount of insulin.
Before injecting the pet with the insulin, check to see there are no bubbles in
the syringe. If you see an air bubble, draw up slightly more insulin than the
exact dose. Now, withdraw the needle from the bottle, tap the syringe barrel
with your finger to move the air bubble to the nozzle of the syringe, then,
gently, expel the air bubble by pushing the plunger upwards. Check to see you
have the correct amount of insulin in the syringe. The correct dose of insulin
is measured from the needle end, or "0" on the syringe barrel, to the
end of the plunger nearest the needle.
HOW TO GIVE AN INJECTION
1. Hold the syringe in your right hand (or your left, if you are left-handed).
You may find it helpful to begin by practicing with a syringe filled with water
and injecting it into an orange.
2. Have a friend or member of your family hold your pet as you pick a fold of
skin along the pet's back with your free hand (you can pick a slightly different
spot each day).
3. Push the very sharp, very thin needle through the pet's skin quickly. This
should be easy and painless using an insulin needle. Take care to push the
needle through one fold of skin, not into your finger, the pet's
underlying muscle, or through both layers of skin.
4. Pull back gently on the plunger to make sure no blood fills the syringe.
5. With your thumb on the plunger, push the plunger further into the syringe.
6. Withdraw the needle from the pet's skin, and immediately cover the needle
with the needle guard.
7. Pat your pet to reward it for sitting quietly. A reward of patting followed
by the first feed for the day quickly creates a cooperative pet that may not
even need to be held.
"Sterilizing" the skin with alcohol is not necessary, and may be
counterproductive if it stings and causes your pet to want to avoid the
injection.