Canis ISSN: 2398-2942

Diabetes mellitus: management regimens

Contributor(s): David Bruyette, Dr Linda Fleeman, Sarah Pierard

Introduction

  • The primary aims of therapy in diabetic dogs are to achieve resolution of clinical signs, avoid insulin-induced hypoglycemia Hypoglycemia, and minimize other complications such as diabetic ketoacidosis Diabetic ketoacidosis.
  • The majority of diabetic dogs have undergone immune-mediated or inflammatory destruction of the pancreatic beta cells.
  • Entire bitches can experience a form of gestational diabetes during pregnancy or diestrus. Therefore, neutering of entire bitches diagnosed with diabetes should be included in the management regimen. Approximately 10% might achieve diabetic remission after neutering, while the remainder can be expected to have decreased insulin requirement and more stable diabetic control.
  • Diabetic dogs are susceptible to complications such as pancreatitis, diabetic cataracts, infections, including lower urinary tract infections. Exocrine pancreatic insufficiency (EPI) Exocrine pancreatic insufficiency is a common co-morbidity in dogs with diabetes secondary to chronic pancreatitis Pancreatitis: chronic.
Before embarking on treatment, the implications of the disease and the long-term commitment necessary should be fully explained to the owner.
  • It is very important that the treatment and monitoring regimen fits well into the owners' daily routines because euthanasia can occur due to either unmet owner expectations or the negative impact of disease management on their lives.
  • Success requires good communication and a close rapport between the dog's owner and their veterinarian. Compliance with a regular daily routine is important.
  • Life-long exogenous insulin Insulin therapy is usually required.
  • It is crucial that meals are matched to insulin injections. The most practical approach is usually to feed exactly the same meal with respect to both ingredients and quantities of those ingredients every 12 hours at the time of fixed dose insulin injections.
  • An individual's clinical signs need to be monitored at home on a regular basis in order to identify changing trends in glucose homeostasis.

Insulin therapy

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Diet and exercise

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Blood glucose curves

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Adjusting insulin dose

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Pancreatitis

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Further Reading

Publications

Refereed Papers

  • Recent references from VetMed Resource and PubMed.
  • Thompson A L, Lathan P, Fleeman L M (2015) Update on insulin treatment for dogs and cats: insulin dosing pens and more. Veterinary Medicine: Research and Reports 6 , 129-142 https://www.dovepress.com/update-on-insulin-treatment-for-dogs-and-cats-insulin-dosing-pens-and--peer-reviewed-article-VMRR.
  • Cook A K (2012) Monitoring methods for dogs and cats with diabetes mellitus. J Diabetes Sci Technol 6 (3), 491-495PubMed.
  • Fleeman L M, Rand J S, Markwell P J (2009 ) Lack of advantage of high-fibre, moderate-carbohydrate diets in dogs with stabilised diabetes. JSAP 50 , 604-614 PubMed.
  • Hume D Z, Drobatz K J, Kess R S (2006) Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). JVIM 20, 547-555 PubMed.
  • Fleeman L M, Rand J S (2003) Evaluation of day-to-day variability of serial blood glucose curves in diabetic dogs. JAVMA 222 (3), 317-321 PubMed.
  • Briggs C E, Nelson R W, Feldman E C, Elliott D A, Neal L A (2000) Reliability of history and physical examination findings for assessing control of glycemia in dogs with diabetes mellitus: 532 cases (1995-1998). JAVMA 217 (1), 48-53 PubMed.

Other sources of information

  • Fleeman L M, Rand J S (2013) Canine Diabetes Mellitus. In: Rand J S et al Clinical Endocrinology of Companion Animals. Wiley-Blackwell, pp 143-168.
  • FLeeman L M, Rand J S (2006) Diabetes mellitus: Nutritional strategies. In: Pibot P, Biourge V, Elliott D (eds) The Royal Canine Canine Nutrition Encyclopedia.Paris: Aniwa Publishing. pp 192-215.


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