Canine diabetes

Canine diabetes symptoms and treatment

Canine diabetes is characterized by absolute or relative lack of insulin action and it affects approximately 1 in 200 dogs.

Causes of diabetes in dogs:
Failure of insulin production: immune-mediated islet cell destruction, chronic pancreatitis, or drug toxicity.

Insulin resistance: obesity, glucocorticoids, progestagen therapy, insulin antibodies, or hormonal antagonism (e.g., metestrus diabetes or hypercortisolemia/hyperadrenocorticism).

Symptoms of canine diabetes:
History:
- Primarily middle-aged to older dogs
- Polyuria / polydipsia
- Polyphagia
- Weight loss
- Vomiting
- Anorexia
- Depression / Weakness
- Recurring urinary tract infections

Findings:
- Ketotic breath
- Cataracts
- Hind-limb neuropathy
- Glucosuria with hyperglycemia (with or without ketonuria) confirms diagnosis
- Elevated alkaline phosphatase
- Abnormal glycosylated protein (e.g., hemoglobin, fructosamine) concentrations

Differential diagnosis of canine diabetes:
- Chronic renal failure, hyperadrenocorticism
- Stress, renal disease

Treatment of canine diabetes:
Objectives:
- Reduce hyperglycemia
- Prevent ketoacidosis
- Prevent secondary diseases (UTI, cataracts)
- Minimize hepatopathy
- Improve well-being

Medical diabetes treatment:
- Insulin replacement therapy is required for ketoacidotic or underweight dogs
- Sick anorectic animals: not necessary to finely control blood glucose initially; administer half the usual insulin requirement during recovery period.

Alternatives to insulin:
- Glipizide will stimulate insulin secretion
- Metformin decreases hepatic glucose production, stimulates glucose uptake
- Acarbose inhibits carbohydrate digestive enzymes, decreases postprandial blood glucose

Additions to drug therapy:
- Exercise
- Weight management
- Chromium tripicolinate improves glucose metabolism by potentiating insulin action
- L-Carnitine supplementation aids fatty acid breakdown and utilization, assists weight loss and decreases body fat.
- Do not supplement chromium and carnitine if included in diet.

Canine diabetes prognosis:
If the primary cause of insulin resistance can be identified and eliminated, diabetes may not persist. Measure blood insulin after glucose administration to assess insulin-producing capacity. Insulin-dependent dogs have a good prognosis if owners are dedicated to treatment and dietary management.

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