Diabetes Mellitus
Diabetes mellitus is caused by either a deficiency of insulin or insulin resistance. Insulin is produced by an organ called the pancreas, and is key to allowing cells obtain sugar from the bloodstream. Insulin is necessary for life. There are two forms of diabetes. The form in which an individual has absolutely no insulin is called type I diabetes. The other form occurs when an individual has insulin, but either does not have enough or has a condition that interferes with insulin function is called type II diabetes.
Approximately 60% of cats with diabetes mellitus have type I, while 40% have type II. Virtually 100% of dogs with diabetes mellitus have type I diabetes.
What happens when an individual has diabetes mellitus? Without sugar constantly being removed from the blood by cells everywhere in the body, a diabetic dog or cat has excess sugar accumulate in the blood. Eventually, so much sugar accumulates it begins to “spill over” into the urine through the kidneys; this also draws excess water into the urine. Therefore, diabetics produce large volumes of
urine. In an attempt to restore the fluid lost in urine, a diabetic patient must drink excessively to prevent dehydration. In dogs and cats, the first thing an owner may notice is the pet is no longer
“housebroken” or the pet cat begins urinating outside the litter box.
Cells have no access to sugar, so messages for energy are sent out and the body begins to break down fat and muscle for energy (the components of fat and muscle may be converted to sugar by the liver), resulting in weight loss. Ketones are the result of the body’s abnormal metabolism of fat, and if the amount of acid in the blood overwhelms the body, a life-threatening condition called diabetic ketoacidosis develops. Although it makes sense to create more energy from fat and muscle, the body still cannot use the sugar resulting from this process.
In summary, the symptoms common to all diabetics are:
 Excessive drinking
 Excessive urination
 Excessive eating

Weight loss

Reduced eating and/or drinking (when sick)
100% percent of diabetic dogs, and 80-90% of diabetic cats require insulin by injection to live. All diabetic dogs and cats do best with good commercial pet food given in 2 equal-sized meals (cats that tend to “graze” all day should be allowed to continue feeding that way). Foods with highly digestible fiber, a high protein diet, and/or a modified carbohydrate component may be helpful. Your veterinarian will make specific dietary recommendations for your pet.
Insulin is only effective if given by injection. Your pet’s veterinarian or veterinary technician will teach
you how to give injections to your pet. It is understood this may be quite intimidating for owners and your pet will feel the needles. However, once you have done this for a few weeks, you will become quite competent, and your pet will accept the tiny pinpricks. Don’t give up! Your pet can live an extremely healthy life despite requiring insulin. As there are many types of insulin available, your veterinarian will prescribe the most appropriate formulation for your pet.

Remember the most important goal in treating a diabetic dog or cat: we want your pet to be happy
and stable. Finally, many diabetic dogs (not cats) develop cataracts, and may become blind within the first 6 to 24 months; this is inevitable, and not a reflection of the job you have done in treating your pet. However, diabetic cataracts may be effectively treated by a veterinary ophthalmologist should they develop.
Important Treatment Points
1.
Feeding: Feed equal portions of food 12 hours apart JUST BEFORE INSULIN ADMINISTRATION.
2.
Exercise Decreases the Need for Insulin. For proper regulation, the amount of daily exercise should vary as little as possible.
3.
Insulin Handling: Keep insulin refrigerated. Roll the bottle of insulin gently to mix the medication. Before administering, please examine the bottle to ensure the contents are well
mixed. DO NOT SHAKE THE INSULIN BOTTLE.
4.
Insulin Injection Technique: Your pet’s insulin should be given as an injection under the skin or subcutaneously. Your veterinarian or veterinary technician will fully explain and/or
demonstrate the injection technique to you. NOTE: If you think some of the injected insulin
did not get under the skin, do NOT give the insulin again. Simply wait until the next dose!
5.
Syringe Disposal: Package your pet’s syringes in a thick plastic container with a screw-top (ie: laundry detergent bottle). Your pet’s veterinarian will instruct you as to the appropriate method of disposal for this material in your area.
6.
Blood Glucose Curves: Blood glucose curves are blood tests that allow your pet’s veterinarian to assess your pet’s response to insulin therapy. These tests, ideally performed by parents athome, may be run periodically to provide information the doctor will use to adjust your pet’s insulin dose.
7.
Glycosylated Protein Testing: This a non-invasive blood test we may run to assess how well your pet’s diabetes is being regulated. This test may be run instead of and/or in addition to a blood glucose curve.
Trouble Shooting
1.
Low Blood Sugar Reactions: Anyone caring for a diabetic must know insulin treatment may occasionally result in low blood sugar levels. This is most likely to happen 3 to 7 hours after insulin treatment, especially when less food is consumed and/or with strenuous exercise. This most common signs of low blood sugar include weakness, loss of balance, incoordination, blindness,
collapse, muscle twitches, and/or seizures. a.
If your pet seems weak but is conscious and alert, offer him/her a bowl of food. b.
If your pet will not eat, or if your pet is unconscious or seizing, drip a sugar-containing syrup
(ie: Karo™ syrup, maple syrup) on the gums. Do not force a convulsing animal to swallow
the syrup. Please be cautious when handling a seizing animal, as your pet may
accidentally bite you during the course of a seizure.

c.
The best way to avoid a low blood sugar reaction is to abstain from administering insulin when you are not sure whether to give it. Do NOT give insulin in the following situations: i.
You are not sure if your pet received his/her insulin dose ii.
You think you gave the wrong amount of insulin iii.
Your pet moved during the injection, and subsequently some of the insulin may not have been injected
2.
Not Eating: If you pet does not eat and/or vomits after eating, please give only ½ the required amount of insulin. If the lack of appetite and/or vomiting persists for longer than 12 hours, please immediately contact our office.
Summary of Daily Routine:
1.
Feed your pet twice daily ideally 12 hours apart. For cats, you may allow access to food throughout the day (ONLY if this is your pet’s usual habit).
2.
Give insulin injections twice daily after eating according to your pet’s appetite.
Please notify us by calling our office if any of the following occur:
1.
You are unable to administer your pet’s insulin as directed
2.
Signs of low blood sugar develop
3.
Not eating well for 2 consecutive meals
4.
Your pet experiences diarrhea and/or vomiting
5.
Your pet has difficulty breathing