The following notes have been prepared to help you cope with the after care required to maximise the quality and quantity of a diabetic pets life
Background
The principle signs of diabetes in the cat and dog are
Weight loss
A period of excessive appetite with paradoxical weight loss
A great thirst
We often use these three signs to gain an idea how our patients are responding to treatment. In humans, diabetes is either type I or type II. Type II patients (the common form in humans) can get buy with dietary control, tablets etc. Type I suffers require daily insulin by injection. Dogs are all type I and require insulin (just about all require it twice daily). Cats on the other hand are a mixture of type I (60%) and type II (40%), but best results are obtained in both situations with daily insulin injections. Some cats can get by with once daily insulin, but the majority requires twice daily insulin injections
The problem of diabetes relates to the pancreas. Special cells (beta cells) fail to produce sufficient insulin for the animal’s requirement. Insulin allows blood sugars to get inside and feed cells. Without it, body cells are bathed in “food” but can’t eat! So the animal essentially starves to death despite eating a lot! During starvation, fats are metabolised. The waste products of this metabolism if in excess are toxic and make the animal feel ill and can even lead to death
The discharge appointment
When discharged the vet will show you
how we perform insulin injections
How to draw up the correct amount
Where to inject How to inject -the vet may demonstrate this using sterile water. They will then give you a go and check your technique
How often to inject – once daily or twice daily
It is a very easy technique to master. Before long you will find it all very easy
Revisits
You will make weekly revisits until the patient is stable
Five to six hours after morning insulin injection-if twice daily dosing
Nine to ten hours after morning insulin injection -if once daily dosing
What to feed
Diabetic animals are best fed the following diets
Obese – Hill’s r/d diet NB m/d available for cats
Normal – Hill’s w/d diet
Under weight – just feed normal diets until weigh back to normal then feed w/d
The reasoning being that high fibre diets reduce insulin requirements, reduce post feeding blood glucose peaks
When to feed
Idea = Give insulin something to work upon
Dogs
Feed a small amount of the daily ration before you inject the morning insulin. If eaten, then inject insulin and feed half of daily ration
Feed the other 1/2 of diet after the 2nd injection later in the day
Cats
In principle should feed cats as above. Do so if possible, however cats are often grazers, if this is the case just leaving sufficient food down all day long is OK
Water must be available ad lib at all times
Potential Complications of Diabetes
Don’t worry, we do not imply all the following will happen, but some could happen and it is best you are aware of it
Hypoglycaemia
This is where the blood glucose levels drop too low. This is easy to spot, as the signs are very distinctive
- Very strange behaviour- as if spaced out
- Collapse
- Staggering
Cause – Insulin overdose.
Solution – Give concentrated glucose solution by mouth. Keep a saturated solution of glucose in your fridge with a syringe attached. You can purchase Glucodin powder from your local chemist. If you do not have that available then honey is a second best choice. The amount you give should give is not fixed. Don’t worry you cannot really overdo it. After this dosing it is best you bring your pet into the surgery for a blood glucose test and discuss why things may have gone wrong
Kidney Failure
Kidney failure can follow on from diabetes. So we might also want to occasionally monitor blood SDMA or Creatinine levels. Indicators of renal function
Cataracts
All dogs with diabetes will develop cataracts at some stage. Onset is usually quite rapid. Cataracts can occasionally go clear when they age, but there is no guarantee of this. A veterinary ophthalmologist can remove cataracts surgically and vision is restored
Chronic Skin infections
Especially seen in dogs. This is easily controlled with antiseptic shampoos and antibiotics when necessary
Cystitis
Cats and dogs with diabetes (esp. cats) are prone to bladder infections. Treatment is normally by antibiotics +/- analgesia
Further blood testing
Once stable, we will monitor blood glucose levels. Typically this occurs 1 month after reaching stability. If this result is OK then ever 2-3 months