One of my clients brought in her dog, Chelsie, a few weeks ago and she was dying. She was not able to walk and was mentally disoriented, acting blind. The owner had gone on vacation, leaving the dog with her housekeeper. The housekeeper reported Chelsie was eating well and drinking lots of water.
Chelsie is a spayed female, black and white mixed border collie, 9 years of age, who is a little arthritic and about 20 lbs overweight at 86 lbs. Chelsie lives the good urban life in the air-conditioned house with a gourmet cook mom. She doesn't get much exercise and gets frequent 'taste tests' from the kitchen.
Chelsie was in diabetic ketoacidosis, a life threatening condition brought on by uncontrolled diabetes. Her blood glucose was 642 mg/dl that morning. Normal blood glucose measurement for a dog is under 200 mg/dl. Her urine was positive for glucose and ketones. Because her pancreas wasn't producing enough insulin to drive the glucose from her bloodstream into her cells, her body was deprived of glucose. Without glucose for energy, the cells began digesting every other source of energy available to maintain life, including fat and muscle. In this process, the body goes into a state of ketosis and Chelsie presented with an acetone smell on her breath. She had lost 10 lbs despite still eating well. And the owner did recall that she did seem to be really thirsty, but attributed it to the summer heat.
Chances are, Chelsie had been showing signs of diabetes or high blood sugar (excessive water consumption and urination), but because of the very busy household situation and the fact that her appetite was very good, it had not been immediately noticed. When the owner left for a vacation, Chelsie continued to deteriorate from lack of insulin. Had she not been treated, she would have gone into irreversible organ malfunction, coma and death. Although there are two types of diabetes mellitus in dogs, insulin-dependent and non-insulin-dependent, the latter occurs rarely. Just like humans with IDDM, dogs affected by this form of the disease will require life-long administration of insulin in order to keep their blood glucose levels under control.
We did save Chelsie, and after a week in the hospital, she walked out, wiggling and wagging her tail. She was initially stabilized with a continuous insulin I.V. drip, fluids and electrolytes until her glucose was decreased and ketosis was under control. Then she was given insulin every 12 hours, monitored every few hours with blood glucose tests, and started on a special diabetic diet. She was fortunately strong enough to respond to treatment, and her kidney function was maintained. Sadly, I have seen dogs and cats with far advanced conditions that their major organ functions were compromised to the point the ketoacidosis was irreversible, and they died.
Chelsie was in again this week for a visit. Her mom got her off schedule with her insulin injections and she was drinking lots of water again, so she is back in the hospital for a few days to get back on track. Chelsie fits the common history of diabetic dogs in that the majority of cases occur at seven to nine years of age. Although males develop diabetes, female dogs are twice as likely to be affected by the disease. There is some genetic predisposition, but in Chelsie's case, a mix breed, this was not the case.
Diabetic dogs are a lifetime commitment. They require twice-daily injections of insulin, regular exercise, and need a special high-fiber diet to help regulate their blood sugar. Reducing the excess weight over time will help to decrease Chelsie's insulin needs.
Diabetic supplies such as insulin, syringes and visits to the vet, can be costly. The best way to prevent diabetes is to keep your dog fit with a good diet and regular exercise. Poorly-controlled blood glucose in your dog can cause severe complications including infections, cataracts, diabetic ketoacidosis, nervous system disorders, pancreatitis and kidney disease.
Sharon E. Anderson, DVM
