Dogs and Feline Diabetes: Symptoms, Treatments, Prevention, and Diet Tips

Thomas Graves and WebMD team up to provide feline diabetes information and tips for treatment or prevention.
By Sandy Eckstein
WebMD Pet Health Feature
Reviewed by Audrey Cook, BVM&S

An alarming number of cats are developing diabetes mellitus, which is the inability to produce enough insulin to balance blood sugar, or glucose, levels. To find out why so many cats are being diagnosed with diabetes, and what owners can do, WebMD talked to Thomas Graves, a former feline practitioner who is associate professor and section head of small animal medicine at the University of Illinois College of Veterinary Medicine.

Q: How common is feline diabetes?

A: The true incidence isn’t known, but it’s estimated at 0.5% to 2% of the feline population. It’s also probably under diagnosed.

Q: What are the signs of diabetes in cats?

A: The main symptoms are increased thirst and increased urination. And while we do see it in cats with appropriate body weight, it’s more common in obese cats. Some cats with diabetes have a ravenous appetite because their bodies can not use the fuel supplied in their diet.
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Q: What’s the treatment for a cat with feline diabetes?

It’s felt that a low-carbohydrate diet is probably best for cats with diabetes. There are blood and urine tests, physical examinations, and behavioral signals, which are used to establish insulin therapy. We don’t recommend owners adjust insulin therapy on their own because it can be sort of complicated in cats.

Q: Will I have to test my cat’s blood every day and give her shots?

A: Usually the blood tests are done during the regular visits with your veterinarian, although people can do them if they ‘d like. The owners will have to give their cat shots. People are often afraid of that whole thing. But once you teach an owner how to do it properly, it’s something people find quite easy. Many people even find it a bit empowering, that they can do something like that to help their pet.
Mistakes In Heart Development:

Cats and dogs are sometimes born with abnormal hearts. We call this congenital heart disease.

Subaortic Stenosis (SAS):.

This problem is most common in big dogs (Rotties, Boxers, Newfoundlands, Goldens, Great Danes etc.) It is the most common inherited heart disease in large dogs.

In subaoritic stenosis the puppy is born with an abnormally narrow passage way leading from the heart to the aorta. It comes in all degrees, from a very mild case, requiring no treatment to a life-endangering problem.

The veterinarian should listen to the puppy’s heart when you take a puppy to the vet for his first vaccinations. In a puppy with SAS, there will usually be a heart murmur over chest near the left base of the heart. SAS is the most common cause of the murmur if the puppy is not severely anemic with hookworms. This is how most cases of SAS are first diagnosed. Not every puppy with a heart murmur has SAS. Puppies often outgrow heart murmurs without our really knowing what caused them in the first place. Only some complicated tests can tell which murmur is important. But if your puppy still has a murmur when it is 6 months old, SAS becomes likely.

When a puppy has a significant degree of SAS, its heart has to work harder to force the blood through the narrow area just below the aortic valve. With time, the heart muscles get thicker due to the extra effort. As the walls thicken, the full heart holds less and less blood and needs more and more oxygen. Eventually, the heart begins to fail. Unlike older dogs with CHF, SAS puppies often die suddenly when clots form in the heart muscle or its electrical system fails.

Neither parent of an SAS puppy should ever be bred again.

What Signs Would I See In A Puppy?

Most often, you will see no signs at all in your puppy. As time goes by and the puppy’s heart muscles thicken, problems in the electrical system of the heart can cause fainting or unexpected sudden death.

What Tests Might My Veterinarian Perform?

To decide how serious a heart murmur really is, your pet needs to have an echocardiograpy (doppler ultrasound) performed by a veterinarian experienced in interpreting the results. An x-ray and an EKG will also be required to see how much damage has already occurred.

What Are The Treatment Choices I Have?

Medications.

Beta blockers reduce heart rate, help control abnormal heart rhythm and reduce blood pressure. They are proven in their ability to extend the lives of dogs with SAS.

Surgery:.

Open heart surgery to correct this problem in dogs has not been as successful as one might hope. Dogs that have had the surgery, live about as long as dogs that just receive medicine.

Balloon Valvuloplasty:.

This technique is similar to balloon angioplasties that are done to dilate blocked coronary arteries in people. A catheter is threaded into the heart and a balloon is expanded in the narrowed area of the heart. Far, this technique has not led to increased life span.

How Long Will A Puppy With Heart Problems Live?

This is very difficult to predict. They younger the puppy is when the problem is first noticed, and the louder the heart murmur, the bleaker the outlook. Most dogs with the typical signs of SAS do not live over 3 years without medication.

A cardiac work-up at a regional veterinary center that includes all the diagnostic tests, might give you more insight. But all pets with this condition can die suddenly – and often do.

CATS:. Feline Dilated Cardiomyopathy:.

This problem was due to a deficiency in an amino acid, taurine. Now that we know that cats must have sufficient taurine in their diet, all major brands of cat food have adequate taurine levels.

Hypertrophic Cardiomyopathy Of Cats:.

In this disease the walls of the heart thicken, leading to inefficient pumping of blood. Blood pressure rises and fluid accumulates in the lungs. Eventually the chambers of the heart enlarge and abnormal heart rhythms occur. Signs of this disease are labored breathing, rapid heart rate, heart murmurs, weakness, death and collapse. Rare heart valvular disease, hyperthyroidism and asthma can mimic hypertrophic cardiomyopathy. We diagnose this disease with x-rays electrocardiograms (EKG = ECG) and cardiac ultrasound.

We treat the disease with low salt diets, diuretics, aspirin to prevent blood clots, and medications such as diltiazem and atenelol to stabilize blood pressure and heart rate. Do not give aspirin to your cat without veterinary supervision – cats do not handle aspirin well and Never give them Tylenol.

Corticosteroid-related Congestive Heart Failure in Cats.

In 2004, the University of Minnesota Veterinary Center noticed an occasional link between heart failure and a recent dose of a number of corticosteroid medications in their feline patients (particularly with injectable methyl prednisolone acetate = Depomedrol aka “Depo”). Of the 160 cats with heart failure that passed through their clinic between 1992 and 2001, at least 8% that developed congestive heart failure had received those medications within the 1-3 weeks preceding their developing heart problem symptoms. Corticosteroids are often given to cats with respiratory problems that are believed to be asthmatic.

Dogs:.

Dilated Cardiomyopathy Of Dogs:.

In this condition, as in cats, the heart chambers enlarge to the point where they can no longer pump blood efficiently. The disease is most common in middle-aged dogs, especially males. We think that taurine deficiencies, parvovirus and the use of adriamycin have all caused the disease.

The overly-stretched heart muscle that occurs in this disease is an inefficient pump. Signs of the disease are those of congestive heart failure: difficult breathing, weakness, coughing and fluid enlargement of the abdomen.

Hypertrophic Cardiomyopathy Of Dogs:.

This disease is quite rare. As in cats, the muscles of the heart thicken and become inefficient at pumping blood. The signs of the disease are the signs of congestive heart failure e.g. difficulty breathing, coughing, heart murmurs and exercise intolerance.

How Will I Know If The Medications My Veterinarian Gives Me Are Working?

The most common reason pets with heart problems come to see veterinarians is because of breathing problems. One can have complicated tests performed to evaluate if the medications are doing their job, but monitoring your pet’s breathing rate and freedom from congestion at home is just as accurate – perhaps more so. If the medications are working, your pet will breath slower and easier when it is at rest.
Feline Diabetes.
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What is diabetes mellitus?

Diabetes mellitus– also known as “sugar” diabetes– is a complex but common disease in which a cat’s body either doesn’t produce or doesn’t properly use insulin. During digestion, the fats, carbohydrates, and proteins that are consumed in the diet are broken down into smaller components that can be utilized by cells in the body. One component is glucose, a fuel that provides the energy needed to sustain life.

Insulin is a hormone produced in the pancreas and is responsible for regulating the flow of glucose from the bloodstream into the cells of the body. When insulin is deficient or ineffective, the cat’s body starts breaking down fat and protein stores to use as alternative energy sources. As a result, the cat eats more yet loses weight. Additionally, the cat develops high levels of sugar in the bloodstream, which is eliminated in the urine. In turn, sugar in the urine leads to excessive urination and thirst. Cat owners often notice these four classical signs of diabetes mellitus: ravenous appetite, weight loss, increased urination, and increased water consumption.

Diabetes mellitus is generally divided into two different types in cats: insulin-dependent diabetes mellitus (IDDM), and non-insulin-dependent diabetes mellitus (NIDDM). Approximately one-half to three-quarters of diabetic cats have and thus require insulin injections as soon as the disease is diagnosed. The rest have NIDDM; however, most ultimately require insulin injections to control their disease.

While diabetes mellitus can affect any cat, it most often occurs in older, obese cats. Male cats are more commonly afflicted than females. The exact cause of the disease in cats is not known, although obesity (the major predisposing condition), chronic pancreatitis, other hormonal diseases (e.g., hyperthyroidism, Cushing’s disease, and acromegaly), and certain medications (e.g., megestrol acetate and corticosteroids like prednisolone) have all been linked to the disease. Burmese cats in New Zealand, Australia, and the United Kingdom are prone to developing to diabetes, but this doesn’t appear to be the case in North America.

How is diabetes diagnosed?
Diabetes mellitus is diagnosed based on the cat’s signs, physical examination findings, laboratory test results, and the persistent presence of abnormally high levels of sugar in the blood and urine. Immediate treatment is necessary once diabetes has been diagnosed.

Left untreated, diabetes will shorten a cat’s lifespan. A dangerous, sometimes fatal condition called ketoacidosis may develop, indicated by loss of appetite, vomiting, diarrhea, lethargy, breathing, weakness, and dehydration abnormalities. Additionally, diabetes can lead to an unhealthy skin and coat, liver disease, and secondary bacterial infections. A diabetes– related disorder called diabetic neuropathy may cause cats to become progressively weaker, especially in the hind legs, impairing their ability to jump and causing them to walk with their hocks touching the ground.

Diabetes treatment is based on the severity of the disease. Cats with ketoacidosis require prompt intensive care, which usually includes fluid therapy and short-acting insulin injections. For cats that are not severely ill, your veterinarian may recommend a treatment plan that includes insulin injections or oral medications, along with dietary changes.

What is involved in treating a diabetic cat at home?
Each diabetic cat is an individual, and each responds differently to treatment. Some diabetic cats are easy to regulate; others are not. Some can be treated with oral medications, while others require insulin injections. Some cats’ diabetes is transient-reversing course with the passage of time-while others will require treatment for the remainder of their lives. Different cats respond best to different types of insulin. Regardless of this variability, all diabetic cats do best with consistent medication, consistent feeding, and a stable, stress-free lifestyle.

Insulin.
Most diabetic cats require insulin injections administered under their skin twice daily. The injections can be given at home, preferably at the same time each day. Your veterinarian will show you how to give these injections, which are not painful– in fact, most cats are unaware that the injection is being given. Because each is different, the proper type of insulin, dose, and frequency of administration needs to be determined by your veterinarian. Ideally, this is based on an 18- to 24-hour blood glucose profile, obtained through a veterinarian-administered insulin injection and subsequent testing of blood sugar levels at regular intervals throughout the day. Insulin dosage may change with time and may need to be adjusted based on new blood glucose profiles, the results of intermittent blood tests and urine sugar measurements, and the cat’s response to therapy.

Oral Hypoglycemic Medications.
Healthy diabetic cats can sometimes be successfully treated with glipizide, an orally administered hypoglycemic medication that lowers blood glucose. Adverse side effects, although uncommon, include vomiting, loss of appetite, and liver damage. Have your cat’s glucose levels checked regularly to verify medication’s efficacy if you use glipizide. Glipizide works for some diabetic cats, most require insulin injections to successfully control their disease. In addition, the administration of oral medication on a long-term basis is difficult for many cats and their owners; insulin injections may be a better choice for them.

Cat Diet.

Some cat owners are willing and able to take on the task of measuring their cat’s blood glucose levels at home rather than in a veterinary hospital-a potentially less expensive and more accurate monitoring method. Ask your veterinarian whether home glucose testing might be suitable for you and your cat. More information can be found online at www.sugarcats.net/sites/harry/bgtest.htm.

At home, you’ll need to be constantly aware of your cat’s appetite, weight, water consumption, and urine output. It is important to feed a consistent amount and type of food at the same times each day, so that you can be aware of days that your cat either does not eat or is unusually hungry after the feeding. Additionally, since water consumption is highly variable from one cat to another, monitoring your cat’s water consumption for a few weeks will allow you to establish what is normal for your cat. Urine output can be roughly estimated by determining the amount of litter that is scooped out of the litter box. This is less accurate if more than one cat uses the litter box, but changes can still be manageable health condition. Diabetes can drastically lessen your cat’s quality of life and shorten its lifespan if left untreated. It is very important to see your veterinarian immediately if you suspect that your cat has diabetes.

Fortunately, diabetes can be treated and does not mean a death sentence.
for your beloved pet. By working with your veterinarian, your cat can.
continue to live a long and healthy life.

And while we do see it in cats with appropriate body weight, it’s more common in obese cats. Of the 160 cats with heart failure that passed through their clinic between 1992 and 2001, at least 8% that developed congestive heart failure had received those medications within the 1-3 weeks preceding their developing heart problem symptoms. While diabetes mellitus can affect any cat, it most often occurs in older, obese cats. Some cat owners are able and willing to take on the task of measuring their cat’s blood glucose levels at home rather than in a veterinary hospital-a potentially less expensive and more accurate monitoring method. Additionally, since water consumption is highly variable from one cat to another, monitoring your cat’s water consumption for a few weeks will allow you to establish what is normal for your cat.

Diabetes in dogs is a complex disease caused by either a lack of the hormone insulin or an inadequate response to insulin.

After a dog eats, his digestive system breaks food into various components, including glucose-which is carried into his cells by insulin, a hormone secreted by the pancreas. When a dog does not produce insulin or can not utilize it normally, his blood sugar levels elevate. The result is hyperglycemia, which, if left untreated, can cause many complicated health problems for a dog.

It is important to understand, however, that diabetes is considered a manageable disorder-and many diabetic dogs can lead happy, healthy lives.

What Type of Diabetes Do Most Dogs Get?

Diabetes can be classified as either Type 1 (lack of insulin production) or Type II (impaired insulin production along with an inadequate response to the hormone.).

The most common form of the disease in dogs is Type 1, insulin-dependent diabetes, which occurs when the pancreas is incapable of producing or secreting adequate levels of insulin. Dogs who have Type I require insulin therapy to survive. Type II diabetes is found in cats and is a lack of normal response to insulin.
What Are the Symptoms of Diabetes in Dogs?

The following symptoms should be investigated as they could be indicators that your dog has diabetes:.

Change in appetite.
Excessive thirst/increase in water consumption.
Weight loss.
Increased urination.
Fruity or unusually sweet-smelling breath.
Lethargy.
Dehydration.
Urinary tract infections.
Vomiting.
Cataract formation, blindness.
Chronic skin infections.

What Causes Diabetes in Dogs?

The exact cause of diabetes is unknown. However, autoimmune disease, genetics, obesity, chronic pancreatitis, certain medications and abnormal protein deposits in the pancreas can play a major role in the development of the disease.

Which Dogs Are Prone to Diabetes?

It is thought that female dogs and obese dogs may run a greater risk of developing diabetes later in life (6-9 years of age). Some breeds may also run a greater risk, including Australian terriers, standard and miniature schnauzers, dachshunds, samoyeds, keeshonds and poodles. Juvenile diabetes can also be seen and is particularly prevalent in golden retrievers and keeshonds. The growing diabetes epidemic is not limited to people– diabetes mellitus is increasing among dogs as well. Researchers estimate that one in 200 dogs will develop the disease. Treatment has made huge strides in recent years, and as a result, dogs with diabetes are living longer, healthier lives.

The mechanism of diabetes is relatively simple to describe. In diabetes mellitus, cells don’t take in enough glucose, which then builds up in the blood. Diabetes is not curable, but it is treatable; a dog with diabetes may live many happy years after diagnosis.

Kinds of Diabetes.
By far the most common is Type 2, followed by Type 1 and gestational diabetes. Type 2 diabetes has typically been a disease of old and middle age (though it is being seen increasingly in young people), and has two causes: The beta cells don’t make enough insulin, or muscle cells resist insulin’s help and don’t take in enough glucose (or both). Type 1 diabetes usually occurs when the immune system attacks and destroys the beta cells, cutting off insulin production; the reason for this attack is thought to be a combination of genetic predisposition plus exposure to a trigger (research into possible triggers is ongoing).

You may have heard that dogs generally get Type 1 diabetes, but the reality is more complicated. Though there are no universally accepted definitions of dog diabetes, the United Kingdom’s Royal Veterinary College identifies two forms: insulin-deficiency diabetes (IDD) and insulin-resistance diabetes (IRD). Neither matches any kind of human diabetes exactly.

In IDD, a dog loses beta cells and no longer makes enough insulin to keep glucose levels under control. Causes include genetic defects, inflammation of the pancreas and immune attack (as in human Type 1 diabetes). Hormonally, diestrus resembles pregnancy, making this form of IRD similar to human gestational diabetes.

Risk Factors.
Several factors raise a dog’s risk of developing diabetes. These include breed, age, gender, weight, diet, virus infections, an inflamed pancreas, chronic inflammation of the small bowel, Cushing’s disease (excess production of the hormone cortisol) and long-term use of progesterone-like drugs or steroid drugs.

– Breed. A study published in the Veterinary Journal in 2003 examined diabetes rates in thousands of American dogs and found that overall, mixed-breed dogs were more prone to diabetes than purebreds. Among purebreds, breeds varied greatly in their susceptibility.

– Age. Dogs most often develop diabetes during middle or old age.

– Gender. Female dogs and neutered male dogs are more likely than intact males to get diabetes.

– Weight. Obesity can make cells resistant to insulin, but it’s unclear whether it actually causes diabetes in dogs.

– Diet. A diet high in fat may contribute to pancreatitis (inflamed pancreas), a risk factor for diabetes.

Signs, Symptoms, Diagnosis.
Diabetes can be a silent disease. Your veterinarian may discover your dog’s diabetes through routine bloodwork, but before that, you are likely to notice some of its symptoms: greater than normal hunger and/or thirst, weight loss, and copious or frequent urination (some dogs start having accidents in the house).

Managing diabetes.

Your dog has been diagnosed with diabetes, so now it’s time to learn how to care for your diabetic pet. The goal in managing diabetes is to keep glucose concentrations regulated, avoiding spikes and drops, and to reduce or eliminate the signs of diabetes, such as excessive thirst and urination. Although diabetes can’t be cured, the condition can be successfully managed with daily insulin injections and changes in diet and lifestyle. And successful diabetes management means your dog can lead a happy, healthy, active life.

The growing diabetes epidemic is not limited to people– diabetes mellitus is increasing among dogs. Diabetes is not curable, but it is treatable; a dog with diabetes may live many happy years after diagnosis.

There are no universally accepted definitions of dog diabetes, the United Kingdom’s Royal Veterinary College identifies two forms: insulin-deficiency diabetes (IDD) and insulin-resistance diabetes (IRD). A study published in the Veterinary Journal in 2003 examined diabetes rates in thousands of American dogs and found that overall, mixed-breed dogs were more prone to diabetes than purebreds. The goal in managing diabetes is to keep glucose concentrations regulated, avoiding spikes and drops, and to reduce or eliminate the signs of diabetes, such as excessive thirst and urination.