diabetes prevention

Diabetes Ketoacidosis (DKA) - A Complication of Diabetes in Cats and Dogs

Unfortunately, as veterinarians, we are seeing an increased prevalence of diabetes mellitus in dogs and cats. This is likely due to the growing prevalence of obesity (secondary to inactive lifestyle, a high carbohydrate diet, lack of exercise, etc.). You're probably wondering if you just had a dog or cat diagnosed with diabetes mellitus—what do you do? First, we encourage you to take a look at these articles for an explanation of the disease:

This article will teach you about life-threatening complications that can occur as a result of the disease; specifically, a life-threatening condition called diabetes ketoacidosis (DKA) so that you know how to help prevent it.

What is DKA?

When diabetes goes undiagnosed or difficult to control or regulate, the complication of DKA can occur. DKA develops because the body is so lacking in insulin that the sugar can’t get into the cells — resulting in cell starvation. Cell starvation causes the body to start breaking down fat in an attempt to provide energy (or a fuel source) to the body. Unfortunately, these fat breakdown products, called “ketones,” are also poisonous to the body.

Symptoms of DKA

Clinical signs of DKA include the following:

  • Weakness

  • Not moving (in cats, hanging out by the water bowl)

  • Not eating or complete anorexia

  • Vomiting

  • Excessive thirst and urination (clear, dilute urine)

  • Large urinary clumps in the litter box (anything bigger than a tennis ball is abnormal)

  • Weight loss (most commonly over the back), despite an overweight body condition

  • Obesity

  • Flaky skin coat

  • Excessively dry or oily skin coat

  • Abnormal breath (typically a sweet “ketotic” odor)

  • Diarrhea

In severe cases DKA can also result in more significant signs:

  • Abnormal breathing pattern

  • Jaundice

  • Abdominal pain (sometimes due to the secondary problem of pancreatitis)

  • Tremors or seizures

  • Coma

  • Death

What can cause DKA?

When DKA occurs, it’s often triggered by an underlying medical problem such as an infection or metabolic (organ) problem. Some common problems that we see with DKA include the following:

  • Pancreatitis

  • Urinary tract infection

  • Chronic kidney failure

  • Endocrine diseases (e.g., hyperadrenocorticism [when the body makes too much steroid], or hyperthyroidism [an overactive thyroid gland])

  • Lung disease (such as pneumonia)

  • Heart disease (such as congestive heart failure)

  • Liver disease (such as fatty changes to the liver)

  • Cancer

Diagnosing DKA

While diagnosing DKA is simple, by looking at the blood sugar levels of dogs and cats and by measuring the presence of these fat breakdown products in the urine or blood, treatment can be costly (running between $3-5000). A battery of tests and diagnostics need to be performed, to look for underlying problems listed above, and treatment typically requires aggressive therapy and 24/7 hospitalization.

Treatment of DKA

Treatment, typically, is required for 3-7 days, and includes the following:

  • A special intravenous catheter called a “central line” (placed to aid in frequent blood draws)

  • Aggressive intravenous fluids

  • Electrolyte supplementation and monitoring

  • Blood sugar monitoring

  • A fast acting or ultra fast acting insulin, regular or Lispro, typically given intravenously or in the muscle

  • Blood pressure monitoring

  • Nutritional support (often in the form of a temporary feeding tube)

  • Anti-vomiting or anti-nausea medication

  • Antibiotics

  • Long-term blood sugar monitoring and a transition to a longer-acting insulin

Thankfully, with aggressive supportive care, many patients with DKA do well as long as pet parents are prepared for the long-term commitment (including twice-a-day insulin, frequent veterinary visits to monitor the blood sugar, and the ongoing costs of insulin, syringes, etc.).

Preventing DKA

By following your veterinarian’s guidelines and recommendations you can help regulate and control your pet’s diabetic state better and monitor your pet carefully for clinical signs. For example, if your pet is still excessively thirsty or urinating frequently despite insulin therapy, they are likely poorly controlled and need an adjustment of their insulin dose (of course, never adjust your pet’s insulin or medications without consulting your veterinarian).

When in doubt remember that the sooner you detect a problem in your dog or cat, the less expensive that problem is to treat. If you notice any clinical signs of diabetes mellitus or DKA, seek immediate veterinary attention. Most importantly, blood glucose curves (when a veterinarian measures your pet’s response to their insulin level) often need to be done multiple times per year (especially in the beginning stages of diabetes mellitus).

If you have any questions or concerns, you should always visit or call your veterinarian.

Related reading:


Hear From Us Again

Don't forget to subscribe to our email newsletter for more recipes, articles, and clinic updates delivered straight to your e-mail inbox.

Related Categories:

dog health, cat health

Diabetes in Dogs: Symptoms & Treatment

11-18_Diabetes in Dogs_BlogTh.png

DID YOU KNOW: It is estimated that anywhere from 1 in 500 to 1 in 100 dogs will develop diabetes in their life-time and that number is only rising with each year.

High blood sugar, which is the result of diabetes, can impact the body’s ability to function normally, leading to an increased risk of problems such as heart disease and stroke in dogs.

Here’s what you need to know about the two types of canine diabetes, symptoms, possible causes, treatment options and what you can do to prevent this disease.

Types of Diabetes in Dogs

Diabetes is an endocrine disorder. Type 1 diabetes affects the body’s ability to create enough insulin to appropriately regulate blood sugar levels. Type 2 diabetes affects the body’s ability to respond to normal levels of insulin.

Although there are two types of diabetes in dogs, they don’t line up exactly with what we know about Diabetes in people.

Type 1 diabetes, or insulin-deficiency diabetes, is the most common type of diabetes in dogs. It occurs when the cells in the pancreas that create insulin are destroyed.

Type 2 diabetes, or insulin-resistance diabetes, develops when other hormones in the body prevent insulin from operating correctly. These problematic hormones can be produced by excess body fat, which is why overweight individuals are at higher risk of developing Type 2 diabetes.

A hormone called progesterone (which is produced during pregnancy and after a heat cycle) may also go up during a false pregnancy or as a result of a uterine infection called pyometra.

Symptoms of Diabetes in Dogs

Most common signs of diabetes in dogs are:

  • Drinking excessively (much more than usual)

  • Urinating excessively (much more than usual)

  • Having a ravenous appetite

  • Losing weight rapidly or suddenly

Less obvious symptoms of diabetes include:

  • Recurrent infections

  • Weakness

  • Poor coat quality

  • Cataracts

  • Seizures

In the early stages of diabetes, symptoms may not be too severe, but once a patient is a full-blown diabetic, they aren’t very subtle.

Dogs That Are Predisposed to Diabetes

Although all dogs can develop diabetes, there are a select few breeds that are most likely to develop diabetes over the course of their lives:

  • Samoyed

  • Miniature Poodle

  • Toy Poodle

  • Pug

  • Tibetan Terrier

  • Cairn Terrier

  • Yorkshire Terrier

  • Fox Terrier

  • Bichon Frisé

  • Dachshund

  • Siberian Husky

Another major factor is age.

Dogs most commonly develop diabetes at an age of five years or greater. In rare cases, a dog may be born diabetic.

Treating and Managing Your Dog’s Diabetes

Can a dog with diabetes be cured? It’s possible but unlikely.

Once a dog has diabetes, it's typically a permanent diagnosis. However, cases of insulin resistance caused by pregnancy or diestrus (part of the heat cycle) can sometimes disappear if the dog is spayed very early after diagnosis. However, even in these instances, there’s a risk for a recurrence later in life.

Even so, diabetes does not have to impact your dog’s quality of life. Dogs with diabetes don’t know they are sick, and when treated properly, they do not feel sick. In fact, they can still do all the things they love (except overeat).

Diabetes Management

Insulin injections are a necessary part of diabetes treatment. Once diagnosed, injections should be done twice daily, but finding an appropriate dosage can be both trial/error, and time-consuming.

Your veterinarian will perform blood glucose curves, which involves taking a blood sugar sample every couple of hours, starting as soon as possible after the morning dose of insulin and finishing as close to the evening dose as possible.

These curves may need to be done every one to two weeks for several months to find the best possible dosage for your dog.

In addition to twice-daily insulin injections, it is also very important that your dog’s diet, exercise, and stress levels stay as consistent as possible. Significant changes to any of these parameters can dramatically affect the amount of insulin that your dog needs.

Your veterinarian will come up with a detailed plan regarding the timing and dose of insulin as well as how to handle any potential problems that might develop. For instance, vets commonly recommend that insulin injections be given right after meals so that the dose can be lowered if the dog eats less than normal.

Cost of Treatment

Because of the daily injections and lengthy process to find the right dosage, dealing with canine diabetes can be frustrating and expensive. This disease requires a pet parent to have a lot of patience.

That said, it is treatable, and your dog can live for years with a high quality of life.

The cost of dog diabetes is highest in the initial stage of treatment but can be a significant financial burden. Depending on the type of insulin and dose, your dog’s diabetes medicine can vary from the cost of $40-$200 per month.

How to Prevent Canine Diabetes

Preventing diabetes in dogs is not easy.

For many dogs, diabetes is in their genes, but spaying your female dog is one easy way to prevent insulin-resistant diabetes caused by diestrus or pregnancy.

Obesity is often linked with diabetes. However, it is not entirely confirmed in canines. That said, obesity is believed to contribute to insulin resistance (among other problems), so preventing it may lead to more effective treatment.

Pancreatitis (inflammation of the pancreas) is known to be a risk factor for canine diabetes. Pancreatitis can be genetic but can also be a result of feeding fatty foods such as pork and other meat products.

Feed your dog a healthy, balanced dog food and restrict extras to fruits and vegetables.

Regular exercise and avoiding overfeeding are the keys to maintaining a lean body weight. Not sure what or how much to feed your dog? Your veterinarian can help you come up with a dietary plan to prevent obesity customized to your dog's best interest.


Hear From Us Again

Don't forget to subscribe to our email newsletter for more recipes, articles, and clinic updates delivered straight to your e-mail inbox.

Related Categories:

dog health