Managing diabetes pets is not such a big deal! Tips for pets and owners by Monica Giarrizzo

Diabetes mellitus is an endocrine disease characterized by low levels of glucose in the liver and high levels of glucose in the blood. It caused by the lack of production of insulin from the pancreas.

Caring a diabetic cat or dog could seem a formidable job, difficult to deal with, a challenge or sometimes an unwelcome commitment if you are not aware of some simple rules that can make life easier for the owner and his pet.

First of all, let’s try to recognize the condition and know the symptoms since “the quicker the diabetes is controlled, the more likely remission will occur”.

The 4 most important symptoms are listed below: “Learn how to recognize them!”

• Starving, drinking and urinating in the face of plenty! Polyphagia (PP), polydipsya (PD) and polyuria (PU) respectively.
• Weight loss

Once you recognize them and a treatment is planned, your pet has the possibility to achieve remission.

• Cataract is developed in the majority of dogs and cats and neuropathies (such as difficulty climbing stairs or a plantigrade stance) are common in cats.

If the diabetes is moderate to severe and it is causing problems to other organs, your pet has less possibility to achieve a remission.

But DO NOT FORGET! Diabetes can be taken under control and your pet can live a normal life.

The Veterinarian and the Nurse will explain you the disease and its treatment and it is important that you deeply understand them.

The treatment is based on subcutaneous injections of insulin. Depending on the type of insulin the therapy should be administered SID (once daily) or BID (every 12 hours) always at the same time.

The first aim of the treatment is the “STABILIZATION”

You and your Vet need to decide 3 things:

1. What we are aiming for? --> Stability
2. How we are going to get there? --> Routine
3. How we are going to stay there? --> Monitoring

Stability:

• for the Vet is the achievement of the right level of glucose in the blood (between 5 and 10 mmol/L;
• for the Owner is the understanding of the disease and the achievement of remission of clinical signs (PP, PU, PD and Weight loss)

3 important TIPS at this stage: diet, insulin and exercise .

“Keeping your pet healthy allows the insulin works”

Routine: “the daily routine”

Insulin treatment of a diabetic pet is LIFELONG.

For this reason, many Owners are compliant because the therapy is subcutaneous and not oral, or they do not know how to administer the drug, or they are not sure to be able to keep the commitment, or just they do not believe it is going to work. REMEMBER: this is the reason why you will hear Vets and Nurses talking about “What we can do” rather than “What we should do” because you will be the protagonist and with their support “you are going to make your pet better!”

TIP 1: don’t be a chicken and face up the situation! Your pet needs you and the veterinary team supports you with advices, flexibility, availability and effective use of the consulting time. “The Vet can give you the right syringe to use and can show you how to inject your pet. You will perform the fist injection in front of him!” Even kids can learn it!

TIP 2: Make giving insulin part of a pleasant experience for you pet (and for you!) because you will do it every day for long time, your pet cannot miss its daily dose, he/she cannot decide “I do not want it” and sometimes it could be difficult to keep them quite even just for a few seconds if they know that “It is injection time!”

SINCE THE VERY FIRST DAY, you should let the pet associate the injection with something pleasant to them. For a dog it could be a treat, a toy or the lead “Ready to go out?”, for a cat it could be some humid delicious food or the door, “ready to be open for a trip outside!”. They will have the pleasant treat immediately after the small injection. Some of you might find easier to inject them while eating, others have to call their pet on a chair or on a table to get their attention. Whatever the method you are going to choose, make it a nice routine and half of the job is already done!

TIP 3: The owner of a diabetic cat in heathy general condition, stable, non-ketotic with a good body weight and no other complicated diseases can ask the Vet to prescribe an oral agent called Glipizide. Please, discuss the possibility of success with your Vet.

Another chapter of the “Routine” is the DIET. You will be explained that the diet is one of the 3 most important components of the therapy and it must be changed according to the needs of a diabetic pet. They will give you the right advices! 

To sum up, the diet must be low in carbohydrates and high in proteins. Canned food is preferred since dry food always contain high percentage of carbohydrates.

Discuss with your Vet the best diet for your pet and establish a plan for it as well: amount, time and type of food, making it part of the routine.

Your routine will include some EXERCISE for your pet as well, but if you think about it, it is already part of your routine and you should just adjust it in order to get a more successful therapy.

Monitoring: one of the crucial part of judging the appropriateness of a dose.

The BLOOD GLUCOSE CURVE: “the unknown mathematical and engineering complicated task that the owner is asked to do”. (Ironically!)

The blood glucose curve consists in the constant measurement of the level of glucose in the blood through the glucometer. It basically is a small nice instrument used in human medicine to measure the glucose in diabetic patients. With a special pen you sting a part of the skin (usually ear) of your pet and make it bleeding a bit. A very small amount of blood is needed for the strip of the glucometer and the result is immediately available. Your Vet will suggest you to learn how to do it or come to the practice to do it weekly (at the beginning) or monthly (when stability to achieved).

The importance of the blood glucose curve is that it will show the effectiveness of the treatment. Hyperglycemia (glucose > 10 mmol/L) is often detected and it is due to low dose of insulin; your Vet will be then able to prescribe you a higher dose in order to keep under control the disease and its clinical signs. Hypoglycemia (glucose < 5 mmol/L) is due to high dose of insulin; it is the most important to be detected in order to prevent its clinical signs: syncope or seizures. 

Your Vet and you will reach the stabilization and full monitoring when he finds the right dosage of insulin and you no longer see any PP, PU, PD and weight loss.

TIP 1: YOU DO NOT NEED TO DRAW ANY CHART OR DO ANYTHING CHALLENGING!

Organize a block-notes for your pet with 4 main points for each day: date, time, level of glucose and symptoms.

Eg: 16 Aug 2012  09:00 am  11 mmol/L  NO PP, YES PU, YES PD, NO Weight loss.

TIP 2: when you perform a glucose curve normal routine must be maintained. Even the stressful experience of been stung should became part of a pleasant moment. For example, choosing a special (proteinic) treat for the sting experience and the lead “ready to go out” for the insulin injection can make it works. Keep doing it everyday and do not give up because it becomes part of your routine very easily!