We have a number of diabetic patients whose owners are successfully treating and are leading a great quality of life – much better than before they were diagnosed! I usually see these pets after they have had the disease for awhile – common comments from the owner include things like “he’s been drinking more water lately”, “she hasn’t been herself for awhile”, “his hair coat hasn’t been as shiny for awhile”. Drinking more water is a classical sign that can be due to several things, one of which is diabetes.
Don’t make assumptions – I can’t tell you how many times I’ve had owners bring their dog or cat in worried that we would have to consider euthanasia because their neighbor had a pet that drank a lot of water due to a fatal disease, and from that one case they assume that’s what their pet has too! Diabetes is treatable, as are many other diseases that cause pets to drink lots of water.
Diabetes in pets is due to a lack of insulin production. When your pet eats a meal, that food is digested and the sugars and nutrients are absorbed into the blood stream. Insulin “carries” the sugars (also called glucose) from the blood into the muscle fibers. Without insulin, the glucose just builds up in the blood stream which causes problems – like extra urination so the pet has to drink more water to replace fluids lost in the urine. Also, the muscles need that glucose to function properly, which does not happen without insulin.
Three things affect successful diabetes treatment:
- How much the pet eats each day (eating more increases glucose in the blood).
- How much the pet exercises each day (exercising more decreases glucose in the blood).
- How much insulin is given (giving more insulin decreases glucose in the blood).
I don’t care very much about the amounts of the above three things. I really care that each of those three things are consistent every day. If the pet eats the same amount and exercises the same amount each day, giving the same amount of insulin each day will keep the blood glucose at the levels we want – when we keep the glucose levels where we want them we call the diabetic “under control”. If the pet eats or exercises different amounts each day, we don’t know how much insulin to give, so we can’t keep the blood glucose levels where we want them and the diabetic is called “out of control”.
Diagnosing diabetes is really easy – a blood test that we do right in our office. Determining the right amount of insulin to give is a little more difficult. If we give too little insulin we don’t bring the blood glucose levels low enough. If we give too much insulin we could drive glucose levels so low that we could kill the pet.
Because of this I never send the pet home with insulin after the initial diagnosis. We schedule him or her to spend a couple of days at the clinic. That allows us to give some insulin, measure how low the blood glucose goes throughout the day, then give a little more or a little less insulin and measure the blood glucose – all under our staff’s watchful eyes. When the pet goes home we have determined an insulin dosage that we know is effective and safe.
Before the pet goes home we have a little training session with the owner. This is really exiting, although sometimes the owners are a little nervous. We go over the following things:
- Handling insulin – it’s fragile, keep it refrigerated, always “roll” the bottle never shake or drop it.
- How to handle the syringe safely to avoid poking yourself, disposal of needles after use, etc.
- How to give injections by making a tent with the skin and inserting the needle in the “door” of the tent. Never have your finger on the “trigger” portion of the syringe until after inserting the needle under the skin. Almost every client is concerned about giving the injections, and almost every client comes back for their next checkup saying “that’s a piece of cake”!
- Once the pet arrives home, either have just one person give all the injections or have a check off chart that assures your pet never gets two insulin injections by mistake!
- Always have some Karo syrup (less irritating to the stomach than honey or maple syrup) available in case the pet experiences a diabetic emergency (the blood glucose drops too low due to too much insulin, ate too little food, or too much exercise – remember those three things need to stay consistent). Giving the syrup raises blood glucose within 10-15 minutes. Also, give me a call; I want to talk about what is happening.
- Before the pet goes home the owner has to mix the insulin (for the training we use sterile water instead of insulin), draw it up in the syringe, get the air bubbles out, and give their pet an injection.
We usually recheck the blood glucose levels over time to continue to fine-tune the proper insulin dosage. Within a couple of weeks of starting treatment, many of these pets feel better than they have in a long time, so their exercise and eating patterns may change for the month or two requiring changes in insulin dosage.
The really cool thing about diabetes is that it is so “hands on” for the owner – these owners really feel like they are directly helping their pet’s health – and they are 100% right!!