Canine Diabetes, A Common Yet Serious Problem

Good management is the key to longevity for diabetic dogs.

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Romeo’s owners live in an upper unit condominium, so they sat up and took notice when the little white dog began demanding numerous daily trips outside to urinate. Romeo’s appetite changed as well. He had always liked his food, but suddenly he was ravenous, eating every bit of his meals and still wanting more. Despite his avid appetite, he was losing weight. A trip to the veterinarian was definitely in order. After seeing the results of Romeo’s blood test and urinalysis, the veterinarian delivered the bad news: Romeo had diabetes.

Diabetes is a common and serious problem in pets. Formally known as diabetes mellitus (the sweet sickness), it’s a disorder of the pancreas gland. The pancreas produces a hormone called insulin, whose purpose is to drive nutrients, specifically glucose, or blood sugar, into the cells. It’s the body’s most important fuel molecule.

When the body doesn’t have enough insulin, glucose builds up in the bloodstream, a condition called hyperglycemia (high blood sugar). Having no place else to go, the excess glucose spills over into the urine, resulting in excessive urination. Because their bodies are losing so much water, diabetic dogs compensate by drinking a lot, which in turn leads to more frequent urination.

Even when dogs eat more, the cells aren’t getting the nutrients they need to function, so diabetic dogs lose weight and become weak. “Basically, the system can’t run without proper fuel, and the fuel isn’t being made available to it,” says William Pollak, DVM, of Fairfield Animal Hospital in Fairfield, Iowa.

Which dogs are at risk?
The cause of diabetes onset is unknown, but contributory factors include genetic predisposition, infection, insulin-antagonistic diseases and drugs, immune-mediated disease, and inflammation of the pancreas.

Breeds with a high incidence of diabetes include Golden Retrievers, German Shepherd Dogs, Keeshonden, and Poodles, but any breed or mix can develop the disease. It’s seen more commonly in females than males and usually develops at six to nine years of age. Obese dogs and dogs that have had recurrent bouts of pancreatitis seem most prone to the disease, says Ellen Paul, DVM, of Lipton Animal Hospital in Urbana, Illinois. Long-term treatment with corticosteroids can also predispose a dog to diabetes.

Alternative explanations
Some holistic veterinarians offer other possible explanations for diabetes onset in dogs, but these reasons are controversial. Practitioners who advocate meat-based homemade diets for dogs often blame the presence of processed, high-carbohydrate foods in doggie dinner dishes. “I feel that commercial, processed, grain-based diets contain far more carbohydrates than are appropriate for the well-being of our dogs,” Dr. Pollak says.

Michele Yasson, DVM, who has an international homeopathic practice based in Rosendale, New York, says that when dogs are fed commercial foods instead of home-prepared diets, the result is a degree of malnourishment, creating stress for the body to cope with.

Dr. Yasson also believes that vaccinations play a role as well. “Vaccines stress the physiology in such a way that you wind up with chronic abnormalities in physiology,” she says. “The extra stress of that tends to lead to all sorts of chronic disease, including diabetes.”

Dr. Pollak suggests that diabetes may also be an allergic phenomenon. “When you feed a processed diet, the biological system isn’t functioning on the quality octane fuel that it was designed to function on, so you get abnormal metabolic processes. You get excessive heat in the body because of the abnormal breakdown, the rate of the breakdown as well as what’s being broken down,” he says. “The system is agitated. It doesn’t work right, so what happens is that the system starts attacking itself.”

Treatments
Diabetes cannot be cured, per se, but it can be managed successfully and sometimes even reversed if detected and treated early enough. Conventionally, diabetes is managed with once or twice daily insulin injections, a high fiber diet, and regulation of the dog’s mealtimes. Exercise is important as well, because it leads to weight loss, which can improve a diabetic animal’s condition.

Among the alternative therapies that can affect the disease’s progress are acupuncture, traditional Chinese herbal remedies, and homeopathy. “Each dog is different, so working with an experienced veterinarian is important,” Dr. Paul says.

Usually, the first step in bringing diabetes under control is to start the dog on daily insulin injections. Insulin types include a combination of beef and pork insulin, pork insulin, or synthetic human insulin, all of which are effective in dogs. It’s scary to think of giving a dog an injection, but the technique is easily learned after a little practice on a thin-skinned orange. Your veterinarian will show you how to prepare the syringe and inject the insulin. Insulin injections are given subcutaneously, meaning under the skin, and are much less painful than intramuscular injections. Some dogs don’t even notice them after a while, especially if they’re rewarded with a meal immediately afterward.

While holistic veterinarians start their patients on insulin if necessary, they prefer to manage without it if possible. Instead, a change in diet is mandated. “I introduce a raw diet,” Dr. Pollak says, “but I do whatever I have to do to stabilize them and maintain adequate, normal levels of blood sugar. If you get it early enough, the sugar levels will come down with less and less insulin, and many times you can get them off the insulin.”

Dr. Paul prefers a homemade diet for all pets. “A diabetic needs to have complex carbohydrates,” she says, “and brown rice is a good choice. I would add some psyllium for extra fiber. Fiber helps to slow down the digestion and absorption of foods, preventing rapid peaks in blood glucose levels. I also advise a pancreas glandular supplement.”

On the other hand, Dr. Yasson, who starts treatment with classical homeopathy, prefers complementing the homeopathy with a high-protein diet. “A high-fiber diet is normal and appropriate for people with diabetes, but for carnivores such as dogs I find that a high-protein diet with raw meat serves very well,” she says. Whatever the diet, dogs with this disease need two or three equal-size meals each day, spaced out at intervals determined by your veterinarian.

Supplements are also important. “I use chromium, a good multivitamin, and essential fatty acids (EFAs),” Dr. Yasson says. “The EFAs affect the metabolism of hormones and the glandular system. I find that the EFA that usually makes the most difference in my cases is flax oil-based, but a good balanced fatty acid will work as well.”

Blood sugar tests
If diabetes is to be brought under control, the urine and blood must be monitored regularly for sugar levels. “You want to give the least amount of insulin that results in just a trace amount of sugar in the urine,” Dr. Pollak says. At-home urine testing is easy with dipsticks available from your veterinarian or a drugstore. To collect the urine, Dr. Pollak says, simply take a wire coat hanger, open it up, and bend the end. Stick a paper cup on the bottom, and as the dog urinates, place the cup beneath the stream. Your dog may look at you as if you’re crazy the first time you do this, but it’s a generally successful method of collecting urine.

Glucose levels should be checked on a regular basis as well to make sure the insulin dosage is appropriate, Dr. Paul says. This is especially important during the first stages of treatment, when the proper insulin level has yet to be determined. Each dog is an individual, and changes in dosage or type of insulin are often necessary to bring the disease under control.

The test for blood sugar levels is called a blood glucose curve. This involves a day at the veterinary clinic for a diabetic dog. Over a period of 12 to 24 hours, blood is drawn at given intervals to see when the blood sugar peaks and decreases. This allows the veterinarian to better determine the amount of insulin given and the timing of the injections.

“If it is difficult to regulate his insulin level, have him checked for Cushing’s disease,” Dr. Paul advises. She also recommends regular blood tests at least every six months to check for other conditions that could aggravate the diabetes. Common complications of canine diabetes that can be identified with the aid of a blood panel include liver disease and infections.

Regular urine cultures are important as well, Dr. Paul says. “Diabetic dogs are prone to bladder infections, so urine cultures should be done to check for them. Dogs may not show signs of bladder infections, and a urinalysis may look normal. Cranberry supplements may help to control bladder infections,” she says.

Schedule
One of the most important aspects of managing diabetes is keeping the dog on a regular schedule for feeding, exercise, and insulin injections. Meals and insulin injections should be given at the same time every day.

If it’s difficult to be at home in time for the evening meal, the purchase of timed feeders, which can be set to open at the appropriate hour, can solve the problem. For dogs on raw diets, such feeders are available with refrigerated compartments to keep food fresh.

“Regularity in feeding is very important in taking the workload off the system,” Dr. Pollak says. “The biological system metabolically is able to settle down and create a less agitated state, and in that clear-functioning state it’s able to maintain itself at a higher level of wellness, the result being that the disease symptoms will subside.”

While diabetes is a serious condition, it’s important to approach it with the idea that there is hope, Dr. Yasson says. “Not every case is curable, but I find that although there are some cases where you can really get stumped, the majority are relatively simple and straightforward to treat. If people are willing to do the little bit of work that’s necessary with supplements and diet and so forth, treatment can be very successful.”

-By Kim Campbell Thornton

Kim Campbell Thornton is a frequent contributor to WDJ. She lives in Lake Forest, California.