Saturday, January 22, 2011

Canine Diabetes Mellitus Caused by Pancreatitis

A normally functioning pancreas produces chemicals that are crucial to proper digestion and blood sugar regulation. It secretes enzymes which are needed to break down the components of food, and also helps to regulate blood sugar by secretion of glucagon and insulin. Insulin is a hormone needed to allow sugars (glucose) from food to enter cells. Once in the cells, it is broken down to produce the energy needed for the cells to work properly.

If the pancreas is not functioning normally, the body does not process sugar properly, blood sugar levels in the body rise, and without enough insulin sugar cannot be absorbed and used by most of the body cells. Therefore, despite the fact the blood glucose concentration may be very high, the cells starve. When this happens, the body seeks other sources of energy, eventually leading to the breakdown of fat and the production of harmful by-products called ketones.

What do diabetes symptoms look like?
  • Your dog may lose weight – and in some cases, rapidly
  • Your dog’s coat may feel greasy and sticky
  • Your dog has a ravenous appetite or loses appetite
  • Your dog seems to be drinking or urinating excessively
  • Your dog may become disoriented or groggy
  • Your dog may be suffering from persistent urinary tract infections
How will my veterinarian diagnose this condition?

Your veterinarian will review your dog’s medical history and then, with your permission, execute a series of blood and urine tests that will show glucose levels. It should be noted that some dogs are able to raise their blood sugars from stress (such as might occur when a sensitive, sick, and anxious patient goes the veterinarian’s office). This could create misleading test results, and so, if there is any question about the diagnosis, a test called a fructosamine level may be requested. This test reflects an average blood glucose level over a series of hours, days or weeks - so if this is also elevated, a one-time elevated glucose can be distinguished from the persistent elevations of true diabetes.

To determine whether dose adjustments are needed (or even a different type of insulin would be more appropriate), your dog will need a glucose curve test. This is when blood sugar levels are monitored every 2 to 4 hours (or so) for 12 to 24 hours. This kind of testing tells the doctor how long the insulin injection is lasting as well as what the lowest and highest glucose levels of the day are. It is important to find out when your pet's curve is due. Often in the beginning, it takes several doses selections and several curves before the right dose is determined

What is the recommended course of treatment?

Regulation is achieved via a balance of insulin, diet and exercise.
  • Insulin – administered via injection – see Follow-up patient Care for more information
  • Diet – high fibre diets are still in favour, as fibre seems to help sensitize dogs to insulin. Scraps, breads and treats should be avoided unless they are specifically created to cater to the dietary needs of a diabetic dog. Your veterinarian will be happy to recommend specific diet changes.
  • Exercise - exercise is just as important for diabetic dogs as it is for non-diabetic dogs. Exercise utilises energy and helps to avoid high blood sugar levels. In addition, the increased blood flow produced by exercise may improve insulin absorption, helping to further lower the blood glucose concentration. Any changes to his or her activity levels should be done gradually. If a dog is suddenly very active (e.g. longer walks or excitement about visitors) it uses more glucose (energy). In diabetic dogs, this can result in very low blood sugar (glucose) levels. Again, your veterinarian will be happy to recommend how to make these changes.
Follow-up patient Care: How will I take care of my dog when he or she comes home?
You will need to learn how to give insulin injections to your pet. The technique of subcutaneous insulin administration should be thoroughly demonstrated by your veterinarian or an assistant. The most common reason for a pet having difficulty achieving regulation is that the owner is not giving the injections properly. Be sure you know how to hold the bottle, manipulate the syringe, hold your pet, and give the injection. It is important that you follow dosage instructions - never alter the insulin dose recommended by your doctor.
You will need syringes and a bottle of insulin to begin home treatment. Your veterinarian office will provide you with supplies and instructions on how and where the insulin should be stored.
Other Important Considerations
Dental Care: It is important for diabetic pets to have their teeth cleaned annually. Dental tartar seeds the body with bacteria, and when blood sugar levels run high, infections in important organs can take root. The kidneys are particularly vulnerable.
Insulin Shock: When the insulin dose is too high relative to the pet’s activity or appetite, it is possible for a dangerous level of low blood sugar to occur. The pet will become groggy, listless, cold, even uncoordinated and drunken. First aid at home can be life saving.
  • Immediately offer your dog some food. If he or she will not eat, you will need to give sugar. The easiest way to do this is with light corn syrup - spoon some syrup directly into his or her mouth – your dog should revive with this procedure.
  • Contact your veterinarian at once, as sometimes IV sugar drips are needed for a few hours after such an episode. Your veterinarian will need to determine what threw your dog out of balance in this way.
  • Do not give more insulin until your veterinarian tells you to.

  • Saunders Comprehensive Veterinary Dictionary
    D. C. Blood, V. P. Studdert, C. C. Gay

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