Treating a Diabetic Pet – Not as Bad as You Think

Treating a Diabetic Pet – Not as Bad as You Think

 

So your cat or dog has just been diagnosed with diabetes…now what?  Certainly the first few minutes of being told this and the subsequent discussion with your veterinarian can seem like a gigantic mountain of information and work but it’s something you’re willing to do for your pet right?  It is important that you and your veterinarian get on the same page with regards to your diabetic pet.  Some patients will be straight-forward in their beginning management while others will be more complicated.

Diabetics are often sorted into two broad categories (which I’ll relate to human medical terminology).  Insulin dependent diabetes, which primarily affects dogs, and non-insulin dependent diabetes which a majority of the time affects cats.  Non-insulin dependent doesn’t however mean that your cat won’t need insulin injections.  Aside from the part about insulin, we also need to address potential diet changes and continued monitoring.  If you are a diabetic patient yourself, you already have a headstart on understanding this condition.  But take note that your cat or dog is clearly not a small version of a person.

 

Insulin Injections
pet insulins

Some insulin varieties

Most patients will need insulin especially at the beginning.  All dogs will need insulin but some cats will start on it and may go into remission and it could be discontinued.  The first thing I must say is that you should NEVER change your pet’s insulin dose without discussing it with your veterinarian.  There are very few exceptions to this rule.  There are several different types of insulin and it will be up to your veterinarian to decide which to use based on the individual patients’ health and with the vets knowledge and comfort level with the particular insulin.  Personally, I prefer Caninsulin (or Vetsulin) for dogs as it is porcine based and is identical to the canine structure.  For cats, the general consensus is to use Lantus (glargine) as with some cases it has been known to help cause remission of the diabetes.  These are all primarily used as twice daily insulins though others do last for varying amounts of time.

 

insulin syringes comparisonFor lots of people, the thought of having to give their pet an insulin injection is a terrifying thought.  Let me assure you, most pets won’t mind the poke as it makes them feel so much better.  Also, it’s not as bad as you might think…it’s a very tiny needle!  Another thing to note is that there are two types of syringes and it is very important to not use the wrong one with the insulin you are using.  Some insulins are classified as U-40 (or 40 units per milliliter) while others are U-100 (100 units/mL).  Switching up of the syringes can lead to overdosing which can be fatal.  When you first learn about treating your cat or dog, your vet clinic should take the time to discuss with you how to measure up the dose and properly give the injection.

 

Most veterinarians will not start dosing insulin on the weekend in case of any problems (over-sensitive patient) or accidental overdosing.  But what happens if there is an overdose?  You will notice your pet seem lethargic and in some corn syrupcases they may seizure of the blood glucose levels drop too low.  You should always have some corn syrup on hand to rub onto your pet’s gums if this is noted and then get them to a veterinarian for an assessment.  If your pet is seizuring, do not reach into their mouth as you will get bitten; take them to a veterinarian immediately.  Overdosing can happen from improper measurement of the insulin, improper mixing of the insulin, not eating their food but getting a full dose, or concurrent treatment of other diseases.  It will take some time especially at the beginning to get your pet on the proper insulin dose and some recheck glucose curves will be needed to see what effect the insulin is having on the body.

 

Dietary Changes

Feeding your newly diabetic cat or dog also typically requires a change both in diet and routine.  If you aren’t giving your pets food only at mealtimes, now is the time to start.  The insulin should be given to your pet immediately after they eat their meal and as most insulins will be dosed every 12 hours, twice a day meals for your pet will be necessary.  Again, there are a few exceptions in some patients that might need a mid-day snack and I typically advise people to call me if their pet didn’t eat all of their food or none at all and will give either a lower dose or advise them to bring their pet in for a recheck.

 

Diets for diabetic dogs are not as stringent as cats.  Dogs may not need any change in their diet, however, better control of the glucose levels may be achieved with diets that have higher levels of both soluble and insoluble fiber.  Cats on the other hand have more stringent dietary needs due to their status as obligate carnivores.  Felines should avoid excessive carbohydrates and more of a focus should be higher protein diets.  High protein/low carbohydrate diets when fed to cats have a better chance of lowering or eliminating insulin requirements.  Canned foods are better at this as dry foods tend to rely more on carbohydrates when formulated.  There are some dry diets however that are Purina DMappropriate in terms of protein, fat, and carbohydrate content and one in particular is the Dietetic Management (DM) from Purina Veterinary Diets which I typically start almost every diabetic cat on in as it comes in both canned and dry forms.  Your veterinarian will have additional recommendations, likely with some diets that are over the counter and more easily accessible.

 

Monitoring & Follow-up

So once you’ve got the insulin and the new feeding schedule, we need to talk about monitoring.  Typically 7-10 days after starting the insulin, your vet will have you bring in your cat or dog for a glucose curve.  This is where we will take blood every few hours while your cat or dog stays with us for the day.  Each time we take blood, we are checking for what the glucose levels are doing in response to the insulin so that we can make proper dose adjustments.  Some pets will respond quickly but others may need a few visits to get regulated.  Can you do this testing yourself?  It is possible home BG testingfor you to do this testing at home but it does not remove the need to consult with your veterinarian and again you should NOT change the insulin dose without talking to your vet.  We will still need to see the numbers and still need to examine your pet 1-2 times a year and keep the weight updated in the record.

 

example glucose from courtesy of Caninsulin

example glucose from courtesy of Caninsulin

Let’s talk about oral hypoglycemic drugs which many people may be familiar with if they use them personally or if they know someone who does.  Dogs need to be on insulin.  Cats need to have a functional amount of cells called beta cells in their pancreas to be able to utilize these medications.  In general, these medications most typically do not work in cats as well as it requires you to give your cat pills twice daily.  I’ve only met one cat that it does work for and I typically would not recommend them unless euthanasia was being considered and giving insulin was refused.

 

Another thing to note is that often times, dogs will develop cataracts.  Pets will often times put back on some of the insulin dogweight they had lost so it will be important to properly measure the amount of food being fed.  Sometimes diabetic pets don’t seem to get their disease under control.  This may mean that they have other diseases going on in their body or there may be problems at home with actually giving the insulin.  It may take some time and working with your veterinarian but we will do everything we can to get your pets back to feeling at their best!  The important thing to take from all this is to have patience and communicate with your veterinarian to give your pet the best life possible!

 

Helpful Links

www.petdiabetes.com (a list of multiple helpful links)

Feline Diabetes (one of the best resources, be sure to check the diet section and also a video clip on home testing)

Canine Diabetes (a collection of useful resources as you treat your diabetic dog)

Disclaimer: All blog posts are personally written and my opinion and do not reflect those of current or former employers.

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4 Comments

  1. Sure brings back a lot of memories! Shutterbug was a pretty easy diabetic, once I got over being scared to give her shots! Home testing saved our bacon, especially in the early days when we had trouble getting her on some sort of routine where her insulin lasted in her system for a decent amount of time, so I could work around her every 12 hour shot schedule. She used to wait by the pantry where I kept her testing supplies (never was sure if it was because it made her feel better or because she knew she would get breakfast or dinner right after the test and before she got her shot).

    I was so glad to be able to take care of her – got to keep her with me another 4 years because we were able to treat her diabetes as just another little thing that went along with having a sweetie pie kitty.

  2. Glenys (Sara's mum)

    August 19, 2014 at 9:09 am

    Sara was dx’d in Feb. 2003. I was advised to euthanize because FD is so hard to treat (my vet’s words). Sara was 5 years old! I am diabetic myself and as far as I know, no one had ever suggested euthanasia for me.

    Being in Australia, it was an uphill battle – food, insulin and cooperation of the vet. Home testing was and still is frowned upon by many vets. I started testing because I could – I had my own glucometer and once I knew I was doing the right thing, Sara got her own. I was assertive about Sara’s treatment and read everything I could on the internet. At the time, cats were being treated like dogs – high fibre diet and caninsulin. I had no real choice about the insulin as there was nothing else available then for pets except human insulins and caninsulin. PZI bovine source was and still is prohibited here. Lantus became available in Nov. 2003 and Sara was one of the first cats who was not in a trial, to be treated with it. I also started to feed Sara a home made raw diet around the same time as per a holistic vet in our city.

    Sara had 2 near fatal episodes of DKA in the first 6 months and was also dx’d with inflammatory bowel disease and pancreatitis.

    She is a very easy cat to treat – easy to test, easy to give medication to and easy to inject with insulin. She knows when it is time for testing and shows up at the appointed time and place. She also knows if she is having a hypo and lets me know she needs testing and a snack. The downside, sometimes she fakes it just to get a snack….

    Sara is now 16 years old and 11 years down the track. So much for her 2 year limited lifespan post dx. It has not been easy and many tears have been shed. However, looking after Sara has not only been a challenge, but also a reward. I have this precious, beautiful creature in my life. Her renal function is starting to deteriorate but other than that (and the FD) she is happy and healthy. She is slowing down somewhat, but she is an ‘old lady’. She has been and continues to be a bright sparkle in my life.

    • Dr. Ryan Llera

      August 19, 2014 at 1:15 pm

      Bless you Glenys for all you have done for Sara! I can’t see a situation where I would ever recommend euthanizing a diabetic without going over the options, risks, and possible complications. Things certainly have changed since Sara was diagnosed and many of us are more open to home testing as well as and better understanding of the diets and newer insulins. You are both lucky to have each other in your lives and I’m sure she is grateful for all you have done for her.

    • Glenys, in yours and Sara’s case, I’d say the internet and the FDMB were probably life savers. I usually don’t say that – people need to consult with their vets. Finding info to discuss is OK, as long as your vet is willing to sit down and talk things over with you – I’m really shocked that Sara’s vet wanted to give up so easily! Here in the US and Canada, when Shutterbug was diagnosed (about a year before Sara was diagnosed), home testing was new and a lot of vets thought we were crazy. But they didn’t say not to try and because all of us were always talking about it and I was emailing him daily, Ryan brought up a lot of aspects of caring for a sugar cat in vet school, they had discussions about the pros and cons of teaching clients to home test – weighing care of the pet by the person who knew / loved them best, against what vets had always been taught – only way to check was doing curves in the hospital, start everybody on the same dose of insulin, no matter what, etc.

      I’m lucky that Dr. Murphy was just as interested in helping me help Shutterbug as I was – she was willing to let me go as far as I felt comfortable, even arguing with her about initial doses and stuff because of what I read on the internet – but I think it’s because I discussed it with her and didn’t make her feel like I was using “Dr. Google” as a substitute for her care of Shutterbug.

      I can’t imagine her saying to just give up and put a pet down for being diabetic. Sara is so lucky that you love her enough to fight those battles for her. I hope that, over all of these years, things have changed down under. Funny, I always thought Aussies, Canadians and the Brits were sort of on the same page about feline diabetes – I know some of their stuff is different from ours (we only had human insulins – R, N, L & U – when Bug started – Ryan tells me they don’t use those for pets being treated at home any more). I’m guessing from talking to Ryan that the US and Canada, while different in their treatment protocols are getting to be more similar as the years go by (I know they are a lot more similar than they were 12 years ago). Here’s hoping Australian vets get the hang of it, too!

      Buggy did really, really well on U, but N was a nightmare – I ditched it after the first couple of days. And bless Dr. Murphy for agreeing that it was OK to try something else other than “what works for 80% of my patients.” She called Shutterbug her “exception” as in, there is always an exception to the rule.

      I’m so glad that you still have Sara in your life – she is one lucky kitty to have a meowmy who stuck by her! And we are lucky to have had special sugar cats in our lives – look at all they’ve done for us! Found us friends, support, inspired at least one guy to go off to vet school… 🙂 Give Sara a hug from Shutterbug’s mom, OK?

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