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⚠️ Disclaimer: This article is informational only and not a substitute for veterinary care. Always consult your veterinarian if you suspect your pet may have a medical condition and before starting or changing any treatment.
Diabetes is a hormonal disorder that causes very high sugar levels in the blood and the urine. I diagnose several diabetics in my clinic every year, and it is estimated that around 1 in every 300 dogs will develop diabetes over their lifetime.
This article will discuss diabetes in dogs in detail. We look at the symptoms to be on the watch for, the diagnostics tests and treatment, and even the factors that could put your dog at higher risk.
Diabetics have excess blood sugar, and this can either be due to an inadequate insulin production or the inability of the body’s cells to respond to the insulin being produced. The job of insulin (a hormone) is to help blood sugar enter cells, so it can be used.
When blood sugar is high for prolonged periods this can cause complications including urinary tract infections, dehydration, blindness from cataracts and even a life-threatening condition called ‘ketoacidosis’.
While there are technically two types of diabetes in dogs, this is not as important or as clearcut as it is in humans. Still, it can be useful to be aware of the two distinctive types.
When we talk about a diabetic dog, we are nearly always dealing with type one diabetes. In fact, it is so often the case that we usually don't even use the term ‘type one’ to describe it. The insulin is not made as it should be by the pancreas.
This type of diabetes is often genetic and can be linked to chronic pancreatitis or a hormonal disorder called ‘Cushing’s Disease’. The breeds I most often see affected include Yorkies, Toy Poodles, and Bichon Frises. Middle-aged females are over-represented. Those that have not been neutered are at the highest risk.
In humans, type 2 diabetes is known as the ‘preventable pandemic’ and is linked to obesity and poor diets. In dogs, diabetes caused by insulin resistance is actually very rare. The cells become resistant to the effects of the insulin and no longer respond to its presence in the blood.
This type of diabetes is linked to being obese and on a high carbohydrate diet and is seen more in middle-aged to older dogs. It can also be seen after corticosteroid use in some patients, particularly if the steroids have been given at a high dose or for a long time.
Diabetes can be a complex condition to deal with but it is not especially difficult to diagnose. Most vets will be suspicious of diabetes once they hear the symptoms the dog is presenting with. Signs and symptoms of canine diabetes can include:
Frequent urination. Not only is the dog peeing more often, they’re also passing much larger amounts of urine. This is called ‘polyuria’ and is caused because the sugar in the urine draws out more fluids.
Excessive thirst. These dogs are not just drinking a little extra, they’re polishing off full water bowls. This usually means more than 100ml/kg of water a day, or over a litre for a 10kg dog. This is to compensate for all of the fluid lost in their urine.
Increased appetite with weight loss. These dogs are ravenous as their brain doesn’t realise food is being eaten because the cells are being deprived of sugar (their energy source). Due to this, the brain sends out signals to the body, making the dog feel really hungry.
Lethargy and weakness. As the glucose cannot be used as energy, dogs are tired and lacklustre. This may present as refusal to go on walks, lack of interest in toys, and a dog who simply mopes about all day.
Cataracts.Cataracts appear as a blue or milky film that covers the eyes and reduces vision. This can present as confusion, reluctance to move, and a dog that bumps into things.
Coat and skin changes. The lack of nutrient absorption can lead to a dry and flakey skin and a dull coat. On top of this, those diabetics with underlying hormonal disorders (like Cushing’s) can have fur loss and secondary skin infections.
Advanced signs. As the condition progresses, dogs can rapidly lose weight and also experience muscle atrophy. They can become blind and have difficulty getting about. Some will develop a life-threatening condition known as ‘ketoacidosis’ and the body breaks down fats into ketones. This makes the body too acidic and affects the body’s salt levels. Dogs are critically unwell and develop signs such as persistent vomiting, weakness, panting and a sweet (acetone) breath.
It is not always going to be clear why one dog develops diabetes and another doesn’t but scientists have uncovered a wide range of both causes and risk factors.
For a wide range of dogs, they’ll have inherited genes from their parents which make it more likely they’ll develop diabetes. For these dogs, it is an autoimmune condition. Their body is attacking their pancreatic cells.
This predisposition is seen in dog breeds like the the Keeshond, Poodle and Miniature Schnauzer.
Diabetes is not really seen in young dogs. This is likely due to the fact that middle-aged and older dogs are more likely to be living with medical issues, but also that they have more time to become obese and for their ‘faulty’ genes to start causing issues.
The hormonal changes seen from going into heat or from pregnancy can contribute to the development of diabetes in females. In fact, females are about twice as likely to be affected than males.
As mentioned, there are a range of underlying medical issues that can lead to diabetes. In the case of pancreatitis, this is because the pancreas is damaged due to severe inflammation. With regards to Cushing's disease, the dog produces excess stress hormone- cortisol- which can lead to insulin resistance, and an inability to utilise the insulin being produced.
Both progestogens and corticosteroids are known to potentially cause pancreatitis. This type of pancreatitis is ‘secondary’ and it is one of the few kinds of canine pancreatitis that can be successfully reversed- once the medicines are stopped.
Being over-weight for a long time and being fed an inappropriate diet- with too many calories and carbohydrates- can potentially cause a range of health issues. Arthritis, heart disease and cancers are seen with more frequency- as is diabetes.
An owner will first notice that their dog is urinating and drinking more. They may also find that they are constantly on the scrounge for food, and eating things they wouldn’t have before (like any scrap they can find and the contents of the bin). Despite their desire to eat, these dogs lose weight.
Your vet will be interested in your dog's age, sex and neutering history.
Your vet will listen to your concerns and ask you to list the recent symptoms your dog has developed.
They will check your dog all over, checking for any 'tell-tale' signs like muscle wasting and dry gums. They’ll also be checking their body condition score and their weight and comparing it to what it was in the past.
A simple blood test will show high sugar levels. Your vet can then assess their ‘fructosamine’ blood levels. This is a more specialized test that helps us determine if sugars have been consistently raised over the last 3 weeks, in order to make a diagnosis.
A urine test can easily and quickly be performed in the vet clinic. Your vet will check how concentrated or how dilute their urine is, and see if there is any sugar or bacteria there. A urine culture is normallyshould be done if there is evidence of bacterial presence.
Fundamentally, dog diabetes treatment is insulin. Unfortunately, this does have to be given via a subcutaneous (under the skin) injection.Thankfully the needles are tiny and most dogs tolerate them well.
Dogs are injected with insulin once or twice daily and there are quite a few different types of insulin. Your vet will choose the most appropriate option for your dog, and this is often also dictated by what your vet is familiar with and what the clinic stocks. Porcine Lente and Protamine Zinc are two insulin types you may hear of.
Your vet will recommend a diabetes friendly diet. This means a low carbohydrate, low sugar diet that is high in fiber and relatively low in fat. Some of the most common options include Royal Canin Diabetic and Hill’s w/d.
Although some dogs are under-weight when diagnosed, many are obese. For these dogs, aiming for a healthier body condition score is helpful. This means a calorie controlled diet, weighing out meal portions and plenty of exercise (once your dog is clinically stable and up for it).
It is really difficult to get diabetes controlled if a female has not been spayed. Your vet will likely recommend this surgery as soon as it is appropriate.
You may be asked to monitor sugar levels from home, either by using urine dipsticks or with a glucometer (blood glucose metre). If you are keen to manage your dog’s condition closely, a glucometer is the way to go, but it is not something every owner can commit to.
Owners of diabetes need to be taught how to deal with episodes of dogs with low blood sugar. These can occur if the dog gets too much insulin, or if they’re given insulin but have not eaten enough, or vomit up their food.
Signs can include confusion, weakness, and lethargy. These dogs should be brought straight to the vet. At home, owners canshould offer a meal or rub honey on gums (if food is turned down).
With proper and committed long-term management, this is a condition with a good prognosis. Being consistent with the dog’s diet, exercise and insulin is important for long term outcomes. Patients need to be seen regularly for check ups, and their insulin dose may need to be adjusted from time to time.
Common complications - such as muscle weakness, urinary infections and cataracts- will be closely monitored for.
Not every case can be prevented, but some certainly can. You can lower your dog’s overall risk by keeping them an optimal weight, feeding a lower carb diet, providing regular exercise and attending routine vet checks. Females should be spayed, once stable.
It is also advised that diabetics are not bred, so the faulty genes have no chance to be passed on.
If you can get your dog's diabetes diagnosed early on, they are much less likely to develop complications. These dogs do need ongoing care though, and it is a high maintenance disease for owners to deal with.
While it is a daunting diagnosis, diabetic dogs can live long and happy lives once their condition is well managed. Though there is a steep learning curve, most owners find they get the hang of their dog’s new medical needs very quickly.
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