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Friday, November 7, 2014

Help! My pet is peeing everywhere!


Help! My pet is peeing everywhere!

            November is Pet Diabetes Month.  When left undiagnosed and unmanaged, diabetes can be a fatal disease in dogs and cats.  By reviewing the most common clinical signs, potential risk factors that may increase the chances of development, and diagnostics and treatments available, pet owners will hopefully become more astute in monitoring at home and in the management of diabetic pets.
            When veterinarians discuss diabetes in pets, it is mainly in reference to diabetes mellitus (referred to in this blog as diabetes).  Diabetes insipidus does occur in dogs and cats but is rare. The clinical signs of this disease are different and will not be discussed in this blog.
 Diabetes is typically diagnosed at approximately 7-9 years old (cats may be 9-11 years old), and it is more frequent in female dogs and male cats. The most common complaint from owners of pets when diabetes may be suspected is an increase in water intake (polydypsia) and increase in urination (polyuria), sometimes to astounding amounts.  An increase in appetite may also be noted (polyphagia) with concurrent weight loss. With more progressed or severe disease, extreme lethargy or a decrease in appetite, abnormal gait in the hind limbs in cats, or the development of cataracts in dogs can occur. A serious progression of diabetes, known as diabetic ketoacidosis (DKA), may occur if left untreated. 
            Diagnosis is based on several criteria.  First, appropriate clinical signs must be present. Second, blood work is used to confirm the presence of high blood glucose (hyperglycemia), as well as elevated liver values and cholesterol.  A positive glucose on a urine sample is confirmation of diabetes mellitus.  In cats, high blood glucose can occur without the presence of glucose in the urine due to stress; this does not indicate the presence of diabetes. Additional diagnostics, such as abdominal ultrasounds, additional blood work, or radiographs may be warranted to rule-out additional underlying diseases, especially if DKA is present. 
           Treatment may be short-term or long-term.  If DKA is present, short-term treatment may include hospitalization, intravenous fluids, insulin therapy, and additional supportive care as indicated.  Long-term treatment with insulin is aimed at lowering and managing blood glucose.  As insulin treatment continues and blood glucose stabilizes, the owner should notice a decrease in water intake and urination to “normal.”  Frequent blood glucose monitoring is necessary, typically through blood work, to ensure the insulin dose is adequate.  Once on insulin dogs remain insulin-dependent for life; however, some cats can become non-insulin dependent.  A diet change to a prescription diet may be recommended.  It is important to work closely with the veterinarian to ensure your pet’s disease is adequately controlled. 
            Not all pets will develop diabetes, but there are risk factors that may increase the probability of this occurring.  Obesity is often the most prominent risk factor.  Additional factors can include recurring or chronic pancreatitis, Cushing’s disease (hyperadrenocorticism), or chronic use of insulin-antagonistic drugs (such as glucocorticoids, progestagens). 
            If you are concerned that your pet may be exhibiting clinical signs related to diabetes, or would like to discuss if your pet may be at risk for future development, please contact your veterinarian to schedule an appointment.