Treatment of diabetes mellitus in the dog, part 2

Treating dogs with diabetes mellitus

source: B. Holm
Eurpean Journal of Companion Animal Practice, vol VII(1) April 1997
starts p68, 10 pages long

Treatment of diabetic dogs involves a life-long commitment from owners, and may not be possible for some dogs, for example if they have severe ketoacidosis. The aim is to keep blood glucose levels as stable and near normal as possible. Spaying, diet and exercise can all be helpful. Oestrus suppression using proligestone is an alternative to spaying, for example with aged bitches.

Non-digestible fibre and complex calories can help avoid blood glucose peaks. Small dogs aged less than eight-years-old, and large dogs under six-years-old need between 60 and 80 kcal for each kilo in weight, dropping to between 40 and 60 kcal per kilo for older dogs. Fibre can slow absorption rates for glucose and limit fat and cholesterol absorption, and reduces blood glucose fluctuation levels, so less insulin is needed. Fibre is best baked into foods. Complex carbohydrates should account for a minimum 50% of the diet's energy content, and fat levels should not be above 30% of energy content. Blood glucose fluctuations can also be lowered through feeding several small meals. Chicken, egg, cottage cheese, rice and pasta, with calcium supplements from eggshells or elsewhere can be used for home-cooked diets, together with oat or bran fibre and a vitamin supplement. Regular commercial dog food should not be used, since it may have simple sugars not displayed in ingredients lists, and some extruded foods may also be unsuitable due to having a higher simple carbohydrate percentage than baked foods. A sample diet is provided in the article.

Exercise benefits diabetic dogs, though several short walks are better than fewer and longer walks. Owners should give dogs biscuits if walks turn out to be long, and always have glucose in case of hypoglycaemia. Feed meals before exercise to help reduce blood glucose peaks after meals.

Dogs can be treated with human or porcine insulin, and bovine/porcine insulin if this is not effective. Insulin is usually given twice a day through injections in the neck, with food given at the time of injections and four hours after if needed. Dogs take three or four days to adjust to dosages, with initial evaluations from four to seven days following initial treatment. Dogs should be walked frequently before urine tests, and tests should not be carried out using morning urine. Injections can be delayed for an hour, but should be omitted if there is a delay of several hours, with the following injection as scheduled. Insulin doses should be reduced when dogs are off their food or have diarrhoea. Dogs need more food and less insulin if their exercise levels increase significantly. Insulin should be kept in a fridge.

Too high insulin doses can lead to hypoglycaemia after some six hours, leading to a hormonal reaction that then pushes up blood glucose after 12 hours to hyperglycaemia. Hypoglycaemia is characterised by weakness, restlessness and hunger, and can be treated with glucose, honey or other food, rubbed under the tongue if the dog cannot eat. Owners should then contact the vet to have the treatment adjusted.