Diabetes, also known as diabetes mellitus, is an illness that impedes the canine body from properly managing glucose and insulin. Anywhere between 0.3% to 1.3% of the total canine population suffers from diabetes at some point in their lives. In the wild, dogs would have little to no chance against this disease. However, modern medicine, coupled with advances in canine nutrition, has come up with effective treatment modalities against canine diabetes.

What is Canine Diabetes?

As long as you promptly identify your dog's diabetes symptoms and bring them to your veterinarian's attention, your dog has a solid fighting chance. But medical treatment is not enough in keeping canine diabetes under control. Your dog needs a carefully constructed eating regimen, a solid eating schedule, and the proper nutrients for a dog with diabetes. Today's article will teach you all about canine diabetes, from causes, symptoms, and diagnosis to the proper diet for a dog with diabetes.

What is Canine Diabetes?

Diabetes mellitus, or diabetes, is a condition that occurs when the body can not use glucose (a type of sugar) normally. Glucose is the main source of energy for the body's cells. The glucose levels in the blood are primarily controlled by a hormone called insulin, which is made by the pancreas.

As food passes through the intestines during digestion, sugars are nutrients absorbed from the food. The sugars are transported into the cells that line the intestines and are converted into simple sugars (including) glucose. The simple sugars are then absorbed into the bloodstream for circulation and delivery to the whole body's tissues and cells. Insulin is required to transfer glucose from the bloodstream to the cells. If there is not enough insulin or the body cannot use the insulin, glucose accumulates in high levels in the blood – a condition called hyperglycemia. When the blood glucose reaches a certain level, the glucose overflows into the urine (i.e., glucosuria) and draws large volumes of water with it. This is why diabetic pets often drink more water and urinate more frequently and in larger amounts.

In dogs with diabetes, regardless of the source of the sugar or the amount of sugar in the blood, there is not enough glucose transported into the body's cells. As a result, there is insufficient energy for the cells to function normally, and the tissues become starved. This metabolic "starvation" state causes the body to break down fat and muscle tissue converted by the liver to sugar. (This breakdown of body tissues results in the weight loss often seen in diabetic patients.)

Causes of Canine Diabetes

The first major cause of diabetes in dogs is the immune-mediated destruction of the pancreas. Currently unsolved by modern medicine, this process occurs when the immune system no longer recognizes the pancreatic beta-cells that produce insulin. The immune-mediated destruction of the pancreas often occurs in young to middle-aged dogs, although cases were documented in senior dogs as well.

The second major cause of diabetes in dogs is severe recurrent pancreatitis. When suffering from pancreatitis, the canine pancreas is attacked by the digestive enzymes it produces. Although meant to become active in the gastrointestinal (GI) tract, the digestive enzymes become activated in the pancreas, where they begin to digest pancreatic tissue and impair the organ from producing insulin.

Diabetes in dogs can occur at any age. However, diabetic dogs are usually 4-14 years of age, and most are diagnosed at roughly 7-10 years of age. Diabetes occurs in female dogs twice as often as male dogs. In addition, certain breeds of dogs may be predisposed to diabetes.

Obesity is a significant risk factor for the development of diabetes. As dogs age, they may also develop other diseases that can result in diabetes or could significantly affect their response to treatment for diabetes, including overactivity of the adrenal gland in dogs ( i.e., hyperadrenocorticism) or overactivity of the thyroid gland (hyperthyroidism), pancreatitis, heart disease, kidney disease, urinary tract infections, and skin infections. The long-term use of medications containing corticosteroids is also a risk factor for diabetes.

Type I and Type II Diabetes

Type I Diabetes

Type I diabetes, also called insulin-dependent diabetes, results from the immune-mediated destruction of the pancreas. Most dogs experience type I diabetes; therefore, they require medical treatment in the shape of insulin injections to keep their blood sugar levels within stable levels.

Type II Diabetes

Type II diabetes is also known as non-insulin dependent because the beta-cells that produce insulin are still active in the pancreas, although at reduced levels. Therefore, the canine body needs less insulin to ensure proper blood sugar absorption. Type II diabetes usually occurs in older dogs, especially those suffering from obesity. Dogs suffering from type II diabetes rely on medication to stimulate insulin production in the pancreas and insulin injections, although to a smaller degree than dogs with type I diabetes.

Hyper and Hypoglycemia

Diabetes manifests itself mainly through hyperglycemia (excessive glucose levels) and hypoglycemia (insufficient glucose levels). Most dogs with diabetes will experience certain levels of hyperglycemia, which are not all life-threatening. What dog parents have to avoid at all costs is severe hyperglycemia, a precursor of diabetic ketoacidosis, a life-threatening complication. Diabetic ketoacidosis occurs when the liver starts breaking down fat for fuel and produces ketone acids, fatal at high levels. Diabetic ketoacidosis mainly affects dogs with undiagnosed diabetes. Dog parents must identify their dogs' diabetes symptoms as early as possible.

On the other end, hypoglycemia can be just as dangerous as hyperglycemia. Your dog will signal low blood sugar levels by displaying "strange" behavior. If you promptly notice this sign, check your dog's blood sugar levels and feed him. Otherwise, your dog's symptoms will worsen to tremors and even seizures. At this point, veterinarian care becomes imperative.

Symptoms of Diabetes in Dogs

The primary symptoms of diabetes in dogs are:

• Polyuria (i.e., excessive urination)
• Polydipsia (i.e., excessive thirst)
• Weight loss
• Polyphagia (i.e., excessive hunger)
• Decreased muscle mass
• Cataracts
• Peripheral neuropathy (i.e., damage to the nerves that connect the brain and the spinal cord)

If left untreated, diabetes can worsen and manifest symptoms such as lethargy, vomiting, and abdominal pain.

Diagnosing Diabetes in Dogs

Your veterinarian has the appropriate methods to diagnose diabetes in your dog. First off, they must ensure that hyperglycemia is caused by diabetes and not by stress. Chronic stress causes glucose to spill into the urine when the renal glucose threshold of 180 mg/dL is exceeded. The veterinarian will check your dog's serum fructosamine level, which is not affected by sudden increases in stress. Any values exceeding 450 µmol/L call for a diabetes diagnosis.

Any initial evaluation should be followed by other tests, such as a complete blood count, a chemistry profile, and a urinalysis. Dogs with diabetes are at risk of suffering from hidden urinary tract infections due to dilute urine and immunosuppression, so be sure to include a comprehensive urine culture examination in your dog's evaluation.

Urinary tract infections, pancreatitis, and endocrinopathies are all common diseases for dogs with diabetes that cause insulin resistance. Therefore, your veterinarian must put together a treatment plan responsive to these diseases in order to effectively address diabetes symptoms.

Once My Dog Has Started Insulin Therapy, What Monitoring Tests Will Be Necessary?

When insulin therapy is first started, monitoring your dog's response to therapy by periodic blood glucose determinations is important. Ideally, this involves serial blood or serum glucose measurements in the form of a glucose curve. Because of the nature of most dogs, hospitalization and serial blood sampling, no matter how gentle, may result in stress-related increases in blood glucose that will confound the results of a glucose curve. New technology has allowed the adoption of home glucose monitoring with the use of a simple device such as an AlphaTRAK®2 or OneTouch Ultra® glucometer. A newer home testing method (FreeStyle Libre) that uses a skin-mounted sensor is currently under investigation. Your veterinarian will let you know if they feel this is right for your dog. Additional home monitoring can involve the evaluation of urine for the presence of glucose, although this is not a very sensitive way to monitor glucose levels.

At home, the most important thing you can do for your dog is careful monitoring of his appetite, water consumption, energy level, and urine output. Any changes may signify the need for additional testing and/or adjustments in the insulin dosage. You mustn't make adjustments in the insulin dosage without first consulting your veterinarian!

"The most important thing you can do for your dog is careful monitoring of his appetite, water consumption, energy level, and urine output." At the beginning of insulin therapy, more frequent (daily) monitoring of blood glucose (with or without testing urine glucose) is indicated. Either very high or very low glucose levels indicate the need for adjustments in insulin dosage with the guidance of your veterinarian.

Once your dog's optimal insulin dosage has been determined, and his diabetes is well regulated, monitoring may involve regular glucose curves or random 'spot checks' of urine for the presence of glucose to screen for signs of overdose or remission that would indicate a need to return to your veterinarian for more sensitive testing.

#1: Complete Blood Count

The complete blood count (CBC) assesses the red and white blood cell levels in your dog's blood sample. In mild diabetes cases, red and white blood cell levels are frequently found within healthy parameters. However, an increased red blood cell count could indicate dehydration (dogs with diabetes must drink increased amounts of water due to their diluted urine. On the other hand, a loss of red blood cells could point towards a red blood cell lysis (i.e., rupture), especially in severe diabetic cases.

#2: Serum Chemistry Profile

The serum chemistry profile analyzes the blood sample separated from the serum (i.e., its liquid portion). The examination will consider the serum glucose concentration. Any moderate to marked increases in the serum glucose concentration could point towards diabetes. Accordingly, any significant drop in serum electrolytes (i.e., ionized salts that circulate through the body and play a crucial role in nutrient absorption and cell osmosis) is a telling sign of dehydration and potential red blood cell lysis.

#3: Urinalysis

Urinalyses are a stepping stone towards an accurate diabetes diagnosis. The presence of glucose in the urine and increased blood glucose levels in the bloodstream are telling signs of diabetes. Furthermore, the presence of ketone acids in the urine points towards diabetic ketoacidosis, which should be addressed immediately. A urinalysis will also help uncover any bacteria or infections that have spread in your dog's urinary tract and guide your veterinarian towards prescribing the most effective antibiotics to your dog.

The Healthiest Diet for a Dog With Diabetes

Understanding the severity of diabetes in dogs will help dog parents realize why putting together a diabetes-appropriate diet is not an easy feat to accomplish. Diabetic dogs must adhere to a strictly regulated diet, full of particular nutrients and with a solid eating schedule. By knowing which nutrients belong to a diabetes-friendly diet, your dog will have a better chance of managing this disease.

The first step that dog parents must take is transitioning away from a kibble-based diet. Although more convenient, kibble is very high in carbohydrates, sodium, and sugar, which only worsen diabetes symptoms. The same applies to diabetic prescription diets, which do not represent long-term solutions. Sugary treats, as well as any foods containing corn syrup and honey, are inappropriate for dogs with diabetes.

#1: Proper Hydration

Water is one of the main components a diabetic dog's diet cannot miss. Many dogs with diabetes exhibit polydipsia and an increased need to urinate. For that reason, they require multiple hydration sources, not just through drinking water. Instead, a dog with diabetes will benefit tremendously from switching to a hydrated diet such as NDF2, a dehydrated foundation mix filled with all of the nutrients necessary to support a healthy liver, kidney, heart, lungs, stomach, and digestive tract. By switching to a hydrated diet, you can rest assured that your dog will stay appropriately hydrated during his diabetes treatment!

#2: Include Fiber in Your Dog's Diet

Fiber plays a crucial role in your dog's diabetes-friendly diet. The insoluble fiber (i.e., the fiber that assists the digestive tract) helps stabilize blood glucose levels by slowing down digestion and the absorption of dietary carbohydrates. High fiber diets also present the benefit of promoting weight loss, essential for overweight dogs. Your dog can enjoy healthy fiber intake from bananas, beet pulp, pumpkin, flaxseeds, carrots, broccoli, microgreens, berries, and green beans. The Volhard Veggie Pak is another dehydrated option for the dog parent who wants to include enough fiber in their dog's diet while ensuring proper hydration. The Volhard Rescue Diet has all of these vegetables already in the diet plus the added value of coconut meal which is low on the glycemic index and will not cause spikes throughout the day.

#3: Pay Close Attention to Your Dog's Feeding Schedule!

A strict diet must go hand in hand with a strict feeding schedule. Certain feeding practices, such as free-choice feeding (i.e., allowing the dog unrestricted access to the food bowl), must be addressed immediately. Instead of a loose feeding schedule, what a dog with diabetes needs is clearly designated feeding times. Most dogs benefit from eating two-three times a day, no more than an hour before receiving the insulin injection, which should be administered every twelve hours. It is best to consider your dog's insulin injection schedule and work his feeding times around it.

#4: Monitor Your Dog

Once you've implemented a diabetes-friendly diet and a rigorous feeding schedule, putting together and sticking with a strict monitoring process is imperative. Managing diabetes in dogs is about consistency, which is why appetite, water consumption, weight, and urine output must be supervised by the dog parent.

Your dog should receive the same amount of food and water every day. The average dog drinks approximately 7 ½ ounces of water per 10 pounds of body weight per day for water intake. Keeping a log of your dog's food and water intake will help prevent weight gain or dehydration issues. Keep in mind that excess body fat enhances insulin resistance, so please contact your veterinarian at first sight of significant weight gain.

A Parting Reminder

Canine diabetes is a serious medical issue that requires tight cooperation between the dog, the dog parent, and the veterinarian. Once diagnosed, diabetes requires the right medication, the right food, and the right feeding schedule to be held in check. But with careful monitoring and enough patience, your dog will be able to manage the symptoms of this disease and live by your side for many years to come! For more advice on dog nutrition, health, and training, make sure that you contact us and check out our blog!

To help more dog parents discover why, what, and how to feed their dogs the healthiest of foods, Volhard Dog Nutrition and its nutritionists are now offering online consultations! Speaking to a Volhard nutritionist will help you understand the inseparable relationship between healthy food, a healthy body, and a healthy mind. If you're interested in contacting one of our Volhard nutritionists, don't hesitate to check out our consultation page! 

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