Diabetes mellitus is a chronic endocrine disorder that occurs in both dogs and cats. It is caused by the relative or absolute deficiency of the hormone insulin, which is produced by the beta cells of the pancreas. Insulin stimulates the transport of glucose and other nutrients across cell membranes for cellular use and is involved in a number of anabolic processes within the body. A lack of insulin activity leads to elevated blood glucose levels (hyperglycemia) and an inability of tissues to receive the glucose that they need (glucoprivation). Primary clinical signs include polyuria, polyphagya, polydipsia, and weight loss. Diagnosis is usually made using the initial signs of the disorder, which are the presence of a persistent hyperglycemia and a persistent or concurrent glycosuria.It is estimated that diabetes has an incidence between 0.2% and 1% in dogs and cats seen at small animal clinics. A large proportion of these diabetic pets are obese at the time of diagnosis. In dogs, other factors that appear to be related to the development of diabetes are hormone abnormalities such as hypothyroidism and Cushing's syndrome, recurrent episodes of pancreatitis, pancreatic islet-cell destruction, stress, and genetic predisposition. In cats, the most significant risk factor for the development of diabetes is increasing age. Between 70% and 90% of diabetic cats are 7 years or older and more than 65% are 10 years or older. Other predisposing factors for cats include inactivity, presence of pancreatic neoplasia, long-term administration of progesterone or progestin, and possibly, genetics.
All of the clinical signs observed in pets with diabetes are associated with the short or long-term effects of hyperglycemia. The microvascular effects of diabetes contribute to the development of cataracts and renal disease. Polyneuropathy develops in some cases and can manifest as weakness, depression, or uninary and bowel incontinence. Bacterial infections are common in animals with poor glycemic control. All of these complications can be minimized or prevented through stringent control of blood glucose levels in diabetic animals.
The general therapeutic goals in diabetes management are to minimize post-prandial (after-meal) hyperglycemia, prevent hyperglycemia when insulin is being administered, resolve and minimize clinical signs, prevent or delay long-term complications, and improve overall health. These goals can be achieved through exogenous insulin administration, oral hypoglycemic agents, diet, weigh loss (if indicated) exercise, and the control of concurrent illness.
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