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What is Diabetes Mellitus?
Diabetes mellitus is a disease in which your dog’s pancreas can no longer produce enough of the hormone insulin.
What is insulin?
Insulin is a hormone which is important in regulating glucose (sugar) levels in the blood. Every time your dog eats a meal glucose enters the blood stream and causes in increase in levels. Insulin is then released and it allows glucose to enter cells where it is used as a vital fuel.
What happens if there is not enough insulin?
In diabetes mellitus there is not enough insulin released when blood glucose rises. This means that cells don’t get the fuel they need. They start breaking down fat instead which is why your dog will lose weight with this condition. Unfortunately this fat breakdown will eventually create toxic waste products which can make your dog very sick.
What are the signs of Diabetes Mellitus?
Here is a list of common signs reported in dogs with diabetes
• Increased thirst
• Increased urination
• Increased appetite
• Weight loss
If untreated this can eventually lead to
• Cataracts
• Vomiting
• Collapse
How is diabetes diagnosed?
Diabetes is diagnosed with blood and urine tests.
What is the treatment?
Treatment consists of three things. Firstly you will need to give insulin by injection once or twice a day. Secondly you will be asked to follow a daily routine which will be tailored to your dog and your lifestyle. Thirdly you will be asked to monitor your dog for any problems.
Can diabetes be cured?
Unfortunately there is no cure for diabetes but it can usually be controlled with a daily routine and injections.
What Happens after diagnosis?
The next step after diagnosis is called stabilisation. This is when we determine the amount of insulin your dog needs. Each dog is different and the process may involve many visits to see your vet and staying in the hospital overnight or for a few nights while we measure your dog’s glucose. This process can take a few weeks or even months so this is a time when patience is needed. Once stabilised it may only be necessary to see your dog 3-4 times a year.
What training will I receive?
You will receive full training on how to give the injections, how to monitor your dog and also what to do if there is a problem. This training will take place in sessions with a fully qualified veterinary nurse. The nurse will talk about your dog, his/her specific needs and should be able to answer most questions or queries. Anything that the nurse cannot answer will be directed to your vet. Only when you are completely happy and confident will you be expected to take your dog home and start giving the injections yourself.
Why do I need to follow a daily routine?
Once stabilised it is important that you stick to a regular routine. This means a regular feeding, injection, exercise and home monitoring routine. We will take into account your lifestyle and your dog’s individual needs when advising on this. Maintaining the stable state of your dog’s diabetes depends on a consistent daily routine. In a healthy dog insulin is released when needed from the pancreas and the amount of insulin varies. In a diabetic dog we do not test blood glucose every day and a set amount of insulin is given at set times. Therefore it is important that we try to ensure that the daily insulin requirements remain the same by sticking to the same foods at the same times and the same exercise routines.
How do I monitor my dog?
Insulin requirements can change with time. In addition any other illness may change the insulin requirement and lead to destabilisation. You will be asked to monitor the following things which will give you an indication that there may be a problem.
Drinking
Monitor the amount your dog drinks each day. You should always provide unlimited fresh water. High blood glucose causes an increase in thirst so could mean that your dog is not getting enough insulin.
Eating
Consult your vet if your dog’s appetite goes up or down.
Weight
If your dog’s diabetes is not well under control then your dog may to lose weight. If this is the case you will need to consult your vet
General
If your dog seems depressed, not wanting to exercise or is not wanting to interact then this could be an early sign of a problem. Again consult your vet.
Hypoglycaemia
This means that blood glucose is too low. Symptoms vary but can include lethargy, restlessness, confusion, unsteadiness, muscle twitching and unusual behaviour. If untreated, it can result in collapse, fits and coma. Treatment is to give sugar or honey by mouth or onto the gums if your dog can not swallow. You should see a quick recovery. If this is not the case you need to talk to your vet as an emergency. If he/she does recover then you need to speak to your vet the same day if possible as we may need to make an adjustment to your dog’s regime.
Urine
You may be asked to monitor urine samples from your dog. When the blood glucose is too high it spills over into the urine and we can measure this. We can also measure those waste products that are produced when the body’s cells aren’t getting enough glucose and start breaking down fat. Monitoring urine, therefore, can help us and you may be asked to do this at home. Again full training will be given.
Home blood testing kits are available and ideal for some cases. Please ask your vet.
Common Concerns
I forgot an insulin injection
Don’t panic. If you are less than about 3 hours late give the injection
straight away. If it is later ask your vet for advice.
I can’t remember if I have injected my dog
Do not give an insulin injection, it is better to miss an injection than to give two. Give the next injection at the normal time. It may be helpful to keep a chart up so that other family members can see if your dog has had the injection and avoids any ‘double dosing’
I have injected too much insulin
In many cases your dog may be fine. There is a chance however that hypoglycaemia could occur. Read the section on hypoglycaemia. If you cannot monitor your dog for the day after this it may be best to bring your dog to our hospital so we can monitor them and treat hypoglycaemia if it occurs.
My dog won’t eat
If your dog otherwise seems well then give half the normal dose of insulin and speak to your vet as soon as possible. If your dog is showing signs of hypoglycaemia (see previous section) do not give insulin and follow the treatment advice. If your dog is being sick then do not give the insulin. In all these cases please speak to the vet as soon as possible.
I won’t be home to feed my dog at the correct time
Having a diabetic dog is a big commitment and it is important to stick to a regular routine. If you cannot be there then arrange for a neighbour or friend to help out.
I am going on holiday
If you are going on holiday make sure you stick to your routine as much as possible and ensure you have enough insulin and syringes. If you are leaving your dog at home then make sure whoever is looking after him/her has our contact numbers. Many kennels have knowledgeable staff who are trained to give injections, always make sure your have checked on this well in advance. If your dog’s diabetes is unstable or there are additional concerns then it may be appropriate to board your dog at our hospital.
Insulin and Syringes
Insulin Storage
• Keep insulin in the fridge at correct temperature between 2-8C
• Do not allow the insulin to freeze
• Do not allow to overheat by leaving next to a radiator or in direct sunlight
• Store upright
• Do not shake the bottle as this will damage the insulin. Gently invert bottle several times before use.
Syringes
• Order your syringes from your usual branch before you run out
• Check the syringes you are supplied with are the same each time
• Use a new needle for each injection
• Keep used syringes in a hard sided box and return your used insulin syringes to us to be disposed of
Giving injections
Follow the instructions given to you by your vet. Full training will be
given in session with a veterinary nurse.
1) Gently invert bottle of insulin after removing from the fridge. The first time you use the bottle you will have to remove the cap.
2) Use a new syringe for each injection
3) Remove the plastic cap from the needle.
4) Hold the bottle upside down, insert needle through rubber and withdraw the insulin. Always withdraw more insulin than you need, expel air bubbles and push plunger to inject extra insulin into bottle.
5) When you have correct amount remove needle from insulin bottle.
6) Pull the skin at the back of neck (scruff) and make a depression with your forefinger.
7) Insert the needle aiming to go parallel to your dogs spine (not towards the spine or you may inject into muscle)
8) Draw plunger back gently if blood appears you have hit a blood vessel. Withdraw needle and start again. If there is no blood push plunger to inject all the insulin.
9) Withdraw needle and release hold on skin.
10) Massage skin and place syringe in storage to return container to us.
Checklist
1) Give your dog’s insulin at the same time each day
2) Do not change the amount of insulin without talking to your vet
3) Stick to the feeding regime recommended by your vet
4) Do not feed treats and titbits
5) Ensure fresh waster is always available
6) Keep the exercise routine the same each day
7) Always keep some form of concentrated glucose or sugar handy in case of hypoglycaemia
8) Store insulin in the fridge upright
9) Remember to order more insulin or syringes before you run out we need two working days notice as we do not always have your insulin in stock.
10) Contact us if you have any concerns.
11) Keep you routine appointments with us.
