2013年9月14日星期六

Diabetes Insipidus / Diabetes Mellitus


Diabetes in dogs is becoming increasingly more common . The latest research shows that 1 in every 500 dogs is diagnosed with diabetes.* Understanding what causes this disease will allow you to take preventative measures to protect your dog’s health.


Diabetes in dogs exists in two forms: diabetes insipidus, caused by a lack of the hormone that controls water resorption by the kidneys. And diabetes mellitus, caused by a lack of insulin similar to the human disease, and is the most common of the two types. Both result from defects in the body system that produces hormones.




Onset of the disease is generally between seven and nine years of age. Reproductive hormones may place unspayed female dogs at higher risk. Specific dog breeds are genetically prone to developing diabetes. Keeshonds, Pulis, Miniature Pinschers, Cairn Terriers, Golden Retriever, miniature Schnauzer, and the standard Poodle, may develop diabetes at a young age simply as a result of the type of dog they are.


For other dogs, diabetes is the result of another disease in the animal which destroys the cells of the pancreas, thus branching off to diabetes. However, for most dogs, diabetes is caused by too many carbohydrates in the diet mixed with an inactive lifestyle, which of course leads to obesity, and ultimately – diabetes.


* S.J. Ettinger, E.C. Feldman: Textbook of Veterinary Internal Medicine, 5th Edition, Vol. 2, 2000 pg. 1438





It is important to regulate food intake when a dog has diabetes. You need to monitor the amount, plus how often they are fed,and the amount of sugar they consume. 2 to 3 smaller meals throughout the day is preferable to one large meal.


Smaller meals help stabilize blood sugar levels, while one large meal can cause insulin levels to peak then fall later in the day. When blood sugar drops too low, your dog could begin to suffer from low blood sugar (hypoglycemia), a serious condition. If this should happen, you need provide immediate sugar to your dog (honey rubbed on the dog’s gums will work) and get your pet to the vet’s office immediately.


Keeping insulin levels normalized and in control is a direct result of what you feed your dog with diabetes.


Avoid Foods which Contain Sugar


Most dog owners really have no idea just how much sugar and carbohydrates are contained in manufactured dog food. Carbohydrates are converted into glucose (sugar), by the body. Dry dog food, as well as those soft-moist foods are the worst choices. If you continue to feed your dog commercial dog food, switch to a high-quality canned food instead – and read the ingredients.


Choose Foods Low in Fat


The pancreas regulates insulin and blood sugar levels, it also produces enzymes in the process of breaking down fat. Since you don’t want to over-stress the pancreas, choose meats that are low in fat. Avoid ground beef and other red meats and trim extra fat from chicken and turkey. Some fat is necessary for good health…but keep it to a minimum.


Homemade Dogfood with Certain Grains


A homemade diet doesn’t have to be hard or expensive. This way, you will know exactly what your dog is eating and how much sugar and carbohydrates they are consuming. Rice, millet and oats are usually the preferable choices to help regulate insulin levels and provide fiber. Remember, animals don’t digest grains as well as humans due to their shorter digestive tract so keep it to a minimum.


Raw Fruit and Vegetables


Raw fruits and vegetables provide vitamins and nutrients while helping stabilize blood sugars. The natural occurring sugars shouldn’t throw insulin levels out of sync like refined processed sugar.


Fruits are a great idea for a treat between meals; however don’t include them with the main meals as the fruit could ferment in your dog’s stomach when combined with meats, grains and vegetables.


Most vegetables can be served raw; however a few should be cooked, such as winter squash (good for dogs with diabetes), dandelion greens, and potatoes. Raw foods such as alpha sprouts, parsley and garlic (capsule or fresh) are good choices for this disease since garlic helps stimulate the digestive tract – regardless if the dog has diabetes. Carrots can be either raw or cooked.


Vitamin E


Vitamin E is a natural supplement that reduces the need for insulin in the body. Providing your dog with a Vitamin E capsule once per day is suggested. Recommended dosage is between 25UI and 200 UI, depending on the size of your dog.


GlucoBalance


GlucoBalance is a supplement to improve insulin production and to protect your pet against illness and the harmful effects of diabetes on the body. This product contains no animal products, gluten, artificial colors, flavors or preservatives. Also, my neighbour highly recommends GlucoBalance, that’s why I’ve mentioned it here.


It’s important that you speak with your vet about diabetes in dogs, and serve the foods that your dog can tolerate.





Additional information regarding GlucoBalance is available here.









I recently recommended GlucoBalance, since it was recommended by friends whose opinion I value. I also know both Rex and Minnie get regular veterinary visits and are both doing fine.

Dogs generally have type 1 diabetes. Their pancreas produces no insulin at all, so they need insulin injections to survive. Vitamins and minerals cannot replace the action of insulin. So if you give your dog vitamin supplements, you still need to give them insulin injections.


It’s important to remember that GlucoBalance must be used regularly for maximum effect, to protect your pet against illness and the harmful effects of diabetes on the body.


It is best used in conjunction with conventional veterinarian treatment. Also, you should ask your vet to monitor your pet’s progress to determine whether regular use of GlucoBalance will allow a reduction in conventional treatment.


And remember, diabetes is best treated holistically, with medication, diet and lifestyle factors all receiving equal attention.







The symptoms of diabetes in dogs occur gradually, and often go unnoticed until the disease has become quite advanced. There are tell-tale signs you should watch for, and take your dog to be tested if you suspect they may have diabetes.



Drinking More Water



Excessive drinking throughout the day that continues for several days can be a sign of diabetes. If you’re having to fill the water bowl more often, you may want to have your dog tested for canine diabetes. Having a veterinarian check your pet is a good idea since other diseases may also cause an increase in thirst.



Increased Urination



Although you may not notice the increased water intake (it can be very gradual), you’ll be made aware of the increased need to urinate. If your dog is drinking more, then they’re going to be wanting to go outside more.



Weakness and Tiredness



Your dog may appear weak and very tired most days. If your dog is normally active and suddenly develops these symptoms over the course of a few days, consider having them tested for diabetes.



Shaking



A subtle shaking and shivering . If this symptom appears, take your dog to the veterinarian immediately as it is a symptom of low blood sugar (hypoglycemia) and is very serious.



A Sweet Breath



The typical “dog breath” so familiar too us all, may become a “sweet” smell. This is a sign that your dog’s blood sugar levels have risen too high and need to be brought under control.



Loss of Weight



Being overweight can bring on diabetes in dogs, but sometimes a dog will begin to steadily lose weight instead. Whether from the onset of diabetes or not, you need to take your dog to the Vet right away for tests to rule out any other type of serious disease.














Your vet may ask you to monitor your diabetic dog by regularly testing samples of its urine.


What you need


1. Clean containers for collecting urine.


2. Urine dipsticks recommended by your vet.


3. A place to record results.



To Collect Urine



1. Collect urine samples from your dog a few times a week at different times of day. The best times to collect urine are in the morning and afternoon before feeding and at night just before bedtime.


2. Take your dog out for a walk on a lead.


3. Have a clean container ready to collect a sample when your dog urinates.



To Test urine using urine dipsticks



1. Follow the instructions for the dipsticks you are using, especially for the time to read the results.


2. Place the dipstick in the container with the urine and soak the test pads.


3. Remove the dipstick and tap dry.


4. Read the result after the time specified on the stick bottle (usually 1 minute).


5. Hold the stick against the chart on the dipstick container, and compare colours.


6. Record the results including time of collection and times of insulin injections given for that day.








The long-term complications of diabetes in dogs are a result of prolonged high blood sugar (hyperglycemia).



Due to their shorter life span, diabetic dogs will develop fewer long-term complications than human diabetics. Maintaining control of blood sugar levels will help minimize the long-term complications of diabetes.



Diabetic cataracts



This is the most common complication of diabetes in dogs.



A cataract is when the lens of the eye becomes opaque, leading to blindness in the affected eye or eyes. Cataracts in dogs with diabetes are seen far more often than in cats with diabetes.



Diabetic cataracts is caused when high blood sugar levels (hyperglycemia) cause changes in the lens of the eye. Water diffuses into the lens causing swelling and disruption of the lens structure. This results in the opacity that is seen.



Treatment



To treat diabetic cataracts, the lens of the eye can be removed surgically to restore vision. Control of high blood glucose levels should help prevent or delay the onset of diabetic cataracts.



This is why it is important to continue to monitor your diabetic dog’s blood sugar levels – even after months or years of treatment – and consult your vet if there are sudden changes or if anything unusual happens.



When your dog with diabetes has been stabilized on insulin treatment, it is usually able to lead a happy, healthy life. The life expectancy of your diabetic dog stabilized on insulin is similar to that of other healthy pets of the same breed. Good communication between you and your vet, and a consistent treatment regimen, will help keep your pet healthy. Allowing you to enjoy life together for many years.






The main component in treating diabetes in dogs is their diet. A high-fiber, carb-moderate diet can put dog diabetes into remission. This means time to stop the table scraps and talk to your vet about the best dog food. Watch for foods that are advertised as light, as they tend to be higher in carbs than you want. Some vets will also prescribe insulin supplements for mealtimes, or a fat-restricted diet for dogs that also have pancreatitis. Occasionally, oral medications may be prescribed .



After your pet’s diet has been regulated, you may have to give your dog regular insulin injections. There are many animal and synthetic insulin brands used to treat diabetes in dogs. The most common is probably Caninsulin or Vetsulin, but don’t be surprised if your veterinarian prescribes a human insulin instead.



Treatment for diabetes in dogs should start slowly and conservatively, largely because an overdose of insulin can kill your dog in just minutes. You should buy a blood glucose meter for your dog and test him yourself, as urine strips aren’t accurate enough to monitor glucose levels. Follow your vet’s advice; they will probably tell you that your pet’s glucose level should remain between 100-180 mg/dL, preferably toward the lower end. Readings over 250 should be called in to the veterinarian, as that is where serious damage can result. It takes experience to maintain your dog’s glucose levels.



Hypoglycemia (low blood sugar), marked by lethargy, confusion, loss of bladder and bowel control, vomiting, and seizures, can be treated by rubbing honey or corn syrup on your pet’s gums and rushing them to the vet. Continue rubbing the sweets on their gums on the way; this could be a lifesaving treatment. Low blood glucose (40 mg/dL) without symptoms should be treated by giving your pet treats right away. Allow your dog to drink as much water as they want, and don’t worry that their drinking too much.



With the proper care, your diabetic dog can have a normal and healthy life.






Diabetes in dogs is on the increase. There little difference between diabetes in humans and in dogs. What can you do to protect your pet regarding diabetes? Here are some helpful tips.



Take a quick look at how and what you feed your dog. Are they being fed the proper diet? Are they drinking excessive amounts of water? Has your dog been gaining a great deal of weight suddenly, or likewise, losing a lot of weight for no reason? Do you notice them urinating more than normal? These could all be symptoms or an early warning sign of diabetes in dogs. I would suggest an annual medical check up for your pet to be sure.



If the results confirm your dog has diabetes remember it is a manageable disease. There are steps you can take in treating the disease. Have a vet check your dog’s insulin. They will take a blood sample from your dog’s body and test it. The first step is to get the glucose (blood sugar), level to normal.



If your dog requires insulin shots, it may seem extremely difficult, and your dog may not want to give you cooperation, but as time goes on, it will get better. Animals have a way of getting in routines just as humans do.



You also want to prepare yourself in the event your pet has a health emergency. See if some other members of your family will get some training with you in case you’re not there. Of course, the main responsibility of the day to day treatment will be yours, but if you are not there it should be left to one particular individual in the family.



A record of your dog’s day-to-day health is necessary. Make notes on anything unusual. It’s also a good idea to record other important information such as: the vet’s emergency phone number, steps to follow in case of too much insulin, precautions to be taken if the needle breaks and possibly what to do in the event of a seizure.



The biggest issue with diabetes in dogs is to be sure and monitor their blood glucose level. Your vet may recommend bringing your pet in periodically to check these levels.



Things can seem overwhelming at first with canine diabetes, but everything will be routine in time. Dogs are wonderful, and your pet is certainly worth the effort to protect their health and allow them to lead a happy and healthy life. Keep an eye on the early warning signs of diabetes and take action if you see anything unusual.

















Blood glucose (blood sugar)


Glucose is the main sugar found in the blood and the body’s main source of energy. Also called blood glucose or blood sugar.




Blood glucose concentration


The amount of glucose in a given amount of blood. It is measured in millimoles per liter (mmol/l), milligrams per deciliter (mg/dl) or grams per liter (g/l).






Blood glucose meter (glucometer)


A small, portable machine that can be used to check blood glucose concentrations. After pricking the skin with a lancet or needle, a drop of blood is placed on a test strip in the machine. The meter (or monitor) soon displays the blood glucose concentration as a number on the meter’s digital display.






Blood glucose monitoring


Checking blood glucose concentrations on a regular basis in order to help manage diabetes. A blood glucose meter (or blood glucose test strips that change color when touched by a blood sample) is usually used for blood glucose monitoring.




Cataract


Clouding of the lens of the eye. Causing partial loss of sight and even blindness.






Coma


A sleep-like state in which a person or animal is not conscious. May be caused by hyperglycaemia (high blood glucose) or hypoglycaemia (low blood glucose) in diabetics.






Complications


Harmful effects of diabetes, such as damage to the eyes, nervous system or kidneys. By treating diabetes mellitus with insulin and a regular lifestyle complications should be minimised.






Dehydration


The state when the body loses more fluid than it takes in. This may be due to frequent urinating, reduced food and/or water intake, sweating, diarrhea or vomiting.






Diabetes mellitus


A condition characterized by a continuously high blood glucose concentrtion as a result of a relative or absolute lack of insulin. The body cells are unable to use glucose for energy.






Diabetic ketoacidosis (DKA)


An emergency condition in which extremely high blood glucose concentrations, along with a severe lack of insulin, result in the breakdown of body fat for energy. Ketones accumulate in the blood and urine. Signs of DKA include vomiting, fruity breath odour, and rapid breathing. Untreated DKA can lead to coma and death.






Diabetogenic


Causing diabetes. For example, some drugs, such as progestogens (synthetic progesterones) and corticosteroids, cause blood glucose levels to rise, resulting in diabetes.






Dose adjustment


A change in the amount of insulin given to a diabetic dog or cat based on factors such as blood glucose concentrations, diet and exercise.




Endocrine gland


A group of specialized cells that release hormones into the blood for action somewhere else in the body. For example, the islets in the pancreas, which secrete insulin, are endocrine glands.






Enzyme


A protein made by the body that brings about a chemical reaction, for example, the enzymes produced by the intestines to aid digestion.






Euglycaemia


A normal concentration of glucose in the blood.





Gland


A group of cells that secrete substances. Endocrine glands secrete hormones that act somewhere else in the body. Exocrine glands secrete salts, enzymes, and water.





Glucose


A simple sugar (monosaccharide). Glucose is the major source of energy for many living organisms.




Glucosuria


The presence of glucose in the urine.





Glycaemia


B lood glucose or blood sugar.




Glycogen


The form of glucose found in the liver and muscles.





Glycosylation


The uncontrolled, non-enzymatic reaction of sugars with proteins. Very important in the complications of diabetes mellitus where abnormally high glucose concentrations result in the glycosylation of proteins such as in the lens of the eye (causing cataracts).





Hormone


A chemical produced in one part of the body and released into the blood to trigger or regulate particular functions of the body in another part. For example, insulin is a hormone made in the pancreas that tells other cells when to use glucose for energy.





Hyperadrenocorticism


Also known as Cushing’s disease. It results from an increase in cortisol secretion from the adrenal glands (small glands located near the kidneys). The characteristic clinical signs are very similar to those of diabetes mellitus (increased drinking and urination and increased appetite). The affected pet also has a pot bellied appearance, rough, dull hair coat and hair loss.



Hyperadrenocorticism is much more common in dogs than in cats. Animals with Cushing’s disease often have concurrent diabetes mellitus.





Hyperglycaemia


Excessive blood glucose concentrations; a sign that diabetes is not well controlled.





Hyperosmolar hyperglycemic non-ketotic syndrome (HHNK syndrome)


An emergency condition in which the blood glucose concentration is very high and there are no ketones present in the blood or urine. If HHNK syndrome is not treated, it can lead to coma or death.





Hyperthyroidism


A common condition in older cats (rare in dogs) that has characteristic clinical signs related to overproduction of the thyroid hormones. Can be concurrent with diabetes mellitus.






Hypoglycaemia


A condition that occurs when the blood glucose concentration is lower than normal. Signs include hunger, nervousness, shakiness, and sleepiness. If left untreated, hypoglycemia may lead to unconsciousness.





Injection


Inserting liquid medication or nutrients into the body with a syringe.





Injection sites


Places on the body where insulin is usually injected.





Insulin


A hormone that helps the body use glucose for energy. The beta cells of the pancreas make insulin. When the body cannot make enough insulin, insulin is usually given to dogs and cats by injection.




Insulin resistance


The body’s inability to respond to and use the insulin it produces. Insulin resistance may be linked to obesity or persistently high progesterone levels i.e. if synthetic progesterones are used therapeutically or in unspayed bitches.





Intermediate-acting or lente insulin


Caninsulin is a lente insulin. On average, lente insulin starts to lower blood glucose levels within 1 to 2 hours after injection. In dogs it has a peak effect after 7-12 hours and then gradually declines. In cats the total duration of action is 12 hours.





Intravenous


Administration of a fluid or medication directly into the bloodstream through a vein.





Islets


Groups of cells located in the pancreas that make hormones that help the body break down and use food. For example, alpha cells make glucagon and beta cells make insulin. Also called islets of Langerhans.





Ketone


A chemical produced when there is a shortage of insulin in the blood and the body breaks down body fat for energy. High levels of ketones can lead to diabetic ketoacidosis and coma. Sometimes referred to as ketone bodies.





Ketonuria


A condition occurring when ketones are found in the urine, a warning sign of diabetic ketoacidosis.





Ketosis


A ketone buildup in the body that may lead to diabetic ketoacidosis. Signs of ketosis are nausea, vomiting, stomach pain and breath that smells fruity.





Lancet


A spring-loaded device used to prick the skin with a small needle to obtain a drop of blood e.g. for blood glucose monitoring.




Lente insulin


An intermediate-acting insulin. On average, lente insulin starts to lower blood glucose levels within 1 to 2 hours after injection. Caninsulin is a lente insulin.





mmol/l


Millimoles per liter, a unit of measure that shows the concentrations of a substance in a specific amount of fluid. This unit is used in a number of countries to report blood glucose test results. In other countries, mg/dl or g/l are used. To convert from mmol/l to mg/dl multiply mmol/L by 18; to convert mmol/l to g/l multiply by 0.18 . Example: 10 mmol/L = 180 mg/dL or 1.8 g/l.





mg/dl


Milligrams per deciliter, a unit of measure that shows the concentration of a substance in a specific amount of fluid. In some countries, blood glucose test results are reported as mg/dL. To convert to mg/dL from mmol/L, multiply mmol/L by 18. Example: 10 mmol/L = 180 mg/dL.





g/l


Grams per liter: a unit of measure that shows the concentration of a substance in a specific amount of fluid. In some countries, g/l are used to report blood glucose test results. To convert from mmol/l to g/l multiply by 0.18. Example: 10 mmol/L = 1.8 g/l.





Obesity


By definition, 15% – 20% or more extra body fat. Fat works against the action of insulin. Extra body fat is a risk factor for diabetes, particularly in cats.





Pancreas


An organ that makes insulin and enzymes for digestion. The pancreas is located behind the lower part of the stomach.





Peripheral neuropathy


Damage to the nerves supplying the legs. Sometimes seen in diabetic cats.




Polydipsia


Excessive thirst; a sign of diabetes mellitus and some other diseases





Polyphagia


Excessive hunger; a sign of diabetes mellitus and some other diseases





Polyuria


Excessive urination; a sign of diabetes mellitus and some other diseases





Renal threshold


The blood glucose concentration at which the kidneys start to excrete glucose into the urine. In dogs this is about 10 mmol/l (180 mg/dl) and in cats about 14 mmol/l (252 mg/dl).





Secondary diabetes


A type of diabetes caused by another disease (e.g. hyperthyroidism in cats) or certain drugs (long term cortisone therapy).





Surgical sterilisation (Spay / ovariohysterectomy / ovariectomy)



Surgical removal of the the ovaries and/ or uterus to prevent “heat” and pregnancy and reduce the risk of certain diseases.





Subcutaneous injection


Placing a fluid into the tissue under the skin with a needle and syringe.




Sugar


A class of carbohydrates with a sweet taste; includes glucose, fructose and sucrose. A term used to refer to blood glucose.





Syringe


An instrument for introducing fluids into or withdrawing them from the body. An insulin syringe is a small disposable syringe with a very fine gauge needle attached. 40 IU/ml syringes are available for use with Caninsulin.




Urine


The liquid waste product filtered from the blood by the kidneys, stored in the bladder, and expelled from the body by the act of urinating.




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