Canine and Feline Diabetes: Are Caretakers and Pet Foods at Fault?

November 20, 2011

Photo of Fat Cat On Way to Becoming DiabeticThis article appeared on petMD as part of Dr Mahaney’s The Daily Vet series.

Diabetes is a life altering disease for cats, dogs, and the people who take on the daily insulin administering and financial backing roles.

There are two types of diabetes affecting our companion animals: mellitus and insipidus. Mellitus is the more common form and includes type I and II.

Diabetes insipidus (DI) is uncommon; it results from a deficiency in or lack of kidney sensitivity to arganine vasopressin (Antidiuretic Hormone, or ADH), a hormone produced by the pituitary gland which promotes the kidneys’ retention of water. My focus is on mellitus types I and II, but read more about DI in Water Diabetes in Dogs.

Types I and II mellitus arise for differing reasons in dogs and cats, but both involve an overall deficiency in insulin production. Insulin is a hormone that moves glucose from blood into tissue and is secreted by pancreatic islet cells.

Insufficient insulin levels cause hyperglycemia (elevated blood sugar) and glucosuria (presence of glucose in the urine), both of which are detectable via diagnostic testing and cause notable clinical signs, including:

Excessive water consumption (toilets, buckets, and stray puddles of water become enticing)

Increased urination (volume and frequency, so reconsider your plan for new rugs)

Ravenous appetite (which can lead to consumption of inappropriate objects and substances…yuck)

Weight loss (despite increased appetite, which sounds like a Beverly Hills housewife’s dream)

Glucose deprived tissues prompt the body to inefficiently metabolize protein, stored carbohydrates, and fat. Protein and carbohydrate breakdown produces glucose, while fat metabolism releases toxic ketones. This process, akin to starvation (or the once commercially touted Atkins diet), causes metabolic chaos. Dr. Siobhan O’Neill, an internal medicine specialist from Advanced Critical Care (ACC), states that “poor glycemic control can result in weight loss and the development of diabetic ketoacidosis, a condition requiring hospitalization for the management of life-threatening electrolyte alterations and dehydration.”

Type I mellitus is the typical canine variety resulting from pancreatic damage associated with chronic inflammation of the digestive tract (Inflammatory Bowel Disease, etc) and pancreas (pancreatitis), infection, and toxin ingestion. When enough islet cells are damaged, insulin is insufficiently produced, blood glucose levels rise, and the diabetic process ensues.

Type II diabetes is more commonly seen in cats and results from the pancreas’s inability to make enough insulin to support a body burdened by excess weight. At fault are cat owners who permit overfeeding, which leads to our feline friends suffering the ill effects of obesity, including diabetes (see Pet Obesity: Health Implications, Recognition, and Weight Management).

Before you decide to “top off” your pet’s scoop of food or skip a much needed hike, consider the economic implications associated with diabetic pet health care. Can you afford the projected ongoing medical expensed incurred by a diabetic pet? According to VPI Pet Insurance claims data, diabetes related veterinary expenses totaled more than $1.5 million in 2007, with an average invoice of $200 per visit.

What are my top holistic tips to prevent our dogs from developing a type I diabetes? Focus on maintaining an optimally functioning digestive tract, which helps keep the endocrine (pancreas, kidneys, liver, etc), immune, and other body systems healthy.

Dr. Amanda Blackburn (another ACC internist) notes that “remission of insulin dependence in dogs after an appropriate diagnosis of diabetes is extremely rare.” Avoiding processed foods and treats containing byproducts, protein and carbohydrate meals, preservatives, and artificial colors and flavors can help to relieve your potential lifelong responsibility to inject your dog with insulin.

Cooked, fiber rich, whole food sources can reduce intestinal and pancreatic inflammation, promote healthy gut bacterial levels, and are less likely to include toxins found in pet grade foods. (SHOCKER: The pet food industry makes allowances for plastic and styrofoam, which can disrupt your pet’s normal glandular function.) Additionally, prevent dietary indiscretion by canine proofing your home environment and keeping your dog on a short leash when setting paw outdoors.

A similar principle of prevention applies to type II diabetes in cats. Emphasis must be placed on calorie restriction, as the feline obesity epidemic continually yields new crops of diabetic cats.

Society has been lulled into believing that cats must eat foods having a format grossly different from nature’s intention. Cats are obligate carnivores and should eat primarily meat protein and minimal grain based carbohydrates. Consuming grain rich, processed options (dry or canned) insufficiently satisfies cats’ biological needs. As portion control is inconvenient for people and organically unfamiliar to cats, excessive food will be consumed unless feline caretakers responsibly promote calorie restriction.

Dr. Blackburn gives hope for feline diabetics when he says that “approximately 50 percent of cats can revert to a non-insulin dependent state with dietary alternations, weight management, and short term insulin therapy. Therefore, owners of cats with early signs of glucose intolerance or newly diagnosed diabetes can positively impact their cats’ health with weight loss and dietary alterations, and by avoiding medications such as steroids, which can predispose a cat to diabetes.”

Starting today, dog and cat owners should put the utmost effort into preventing their companions from developing diabetes mellitus by feeding appropriate portions, providing pure food sources, averting dietary indiscretion, and engaging in frequent pet-people exercise.

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Copyright of this article (2011) is owned by Dr. Patrick Mahaney, Veterinarian and Certified Veterinary Acupuncturist. Republishing any portion of this article must first be authorized by Dr. Patrick Mahaney. Requests for republishing must be approved by Dr. Patrick Mahaney and received in written format.

{ 12 comments… read them below or add one }

Jana Rade November 20, 2011 at 1:13 PM

Sadly, the dog food industry still seems to have monopoly over canine nutrition (which includes psychological monopoly). They make it sound that if you’re not feeding their kibble you’re killing your dog. So sad.

Patrick Mahaney November 20, 2011 at 10:57 PM

Thank you for your comments. I know re: the pet food industry and veterinarians. When I bring up the idea of feeding home prepared foods to pets with other veterinarians, they get overly concerned about the whole “complete and balanced” idea instead of being concerned about pet grade ingredients. Such is why I am so pleased to be working with Lucky Dog Cuisine (www.LuckyDogCuisine.com) to educate the public (starting with the LA vet community and my clients) about the benefits of human grade foods for dogs.
Dr PM

Jana Rade November 21, 2011 at 12:45 AM

HA! Regarding the complete and balanced (which I have nothing against) … just recently during a conversation with Jasmine’s vet he mentioned: “Historically Vit D has been over supplemented in pet foods” … plus the nutrients listed often list “minimum” or “maximum” and not the “actual” content. When I was feeding commercial I also noticed that not two batches were ever the same. So how balanced is the commercial food actually? Just saying …

TheOldBroad November 21, 2011 at 4:23 AM

Two of my three diabetic kitties did not revert because it was steroid-induced diabetes. Alas, due to other complications, the steroids could not be discontinued.

Diabetes in kitties can be managed with good vet care and vigilant care at home.

Patrick Mahaney November 23, 2011 at 7:59 AM

Steroid induced diabetes is such an unfortunate thing. Besides diabetes, I have seen steroid induced heart failure. It is always frustrating to have to manage these cases when another veterinary health care practitioner chooses to rely on (typically) an injection of steroids to treat a particular inflammatory condition.
I am sorry to hear of your situation.
Thank you for sharing your story.
Dr PM

TheOldBroad November 23, 2011 at 5:54 PM

I’ve not heard of steroid-induced heart failure. (Sounds like I need to do some reading!) Were these cases where the critter already had a heart problem? Are steroids something to avoid with HOCM?

How do you deal with inflammation, chronic or acute, without resorting to Prednisolone in kitties?

I’m not a fan of steroid injections because the ones with which I am familiar are supposed to last 30 days or so. I’ve always preferred pills so the dosage can be titrated or discontinued as soon as necessary.

Patrick Mahaney November 23, 2011 at 7:19 PM

Steroids can cause fluid overload (among other side effects), which puts excess stress on a weakened heart (from Hypertrophic Cardiomyopathy, Thyrotoxic Cardomyopathy, Enodcarditis secondary to periodontal disease, obesity related heart overexertion, etc).
The type of inflammation governs the means of reducing inflammation in a non-steroid way. For skin, arthritis, etc I recommend omega fatty acids, like fish oil, which is the safer version of the “aspirin per day” means of inflammation reduction. Sometimes we have to use steroids, but I try to get patients on oral tapering doses (vs injections).
Dr PM

TheOldBroad November 24, 2011 at 6:47 PM

Thanks for the info, Dr. Mahaney. Definitely food for thought the next time one of my critters needs an anti-inflammatory.

My Winston (RIP) had lymphocytic lymphoma. When we tried to decrease and discontinue the Prednisolone, he always quit eating. We tried other appetite stimulants with no success. My decision is that I would rather give him the Prednisolone and have him happily eating and I’d just deal with the diabetes.

Your thoughts would be appreciated because there’s no telling what the future holds.

Gus Ray November 28, 2011 at 1:36 PM

What are your thoughts on Glycohemoglobin (A1c) testing? My company (Baycom Diagnostics) is developing a simple mail in test for A1c test that requires only 2 drops of blood from canines or felines. We are also working on a glycolyated albumin test for canines and felines but this will take another year or two.

Patrick Mahaney November 30, 2011 at 4:01 PM

Hi Ray,
Thank you for your comment. I am interested in learning more about the application of your test for my canine and feline patients.
Let’s correspond directly. Feel free to email me patrick@patrickmahaney.com
Dr PM

TheOldBroad November 30, 2011 at 5:27 PM

Dr. Mahaney, please let us know your thoughts regarding tests such as A1c for cats.

I’m always interested in knowing the best care possible for diabetic cats. I’ve had three and will probably have more in the future.

About 10 years ago a veterinary internist told me that he wasn’t a fan of the fructosamine test. I don’t know if it was because he felt it wasn’t very accurate for kitties or because I was very faithful about checking BG at home at least twice a day with a full 12 hour curve every month or two.

Patrick Mahaney December 2, 2011 at 8:54 PM

I’m checking into the A1c test for pets.
I can’t speak of the veterinary internist’s perspective on Fructosamine for cats. When I did more general and ER practice in facility, I worked with a veterinary internist who used it in both cats and dogs with seemingly reliable results.
To be completely honest, my practice is not one that manages diabetic cats. I suggest complicated endocrine diseases are managed by veterinary internists (and insightful owners, like yourself).
I stick with the home care of patients needing pain management and hospice care.
Dr PM

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