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Diabetes and obesity in pets

With the recent findings published by Animal Friends Insurance showing a 900% increase in the prevalence of diabetes amongst 9,000 dogs and cats between 2011-2016, it is time to look at WHY this is happening amongst our pets. In fact, this increase is way above what we are seeing amongst humans. Are we finally looking after ourselves properly whilst our pets still have an inadequate diet and limited/no exercise?

WHY DOES IT HAPPEN?

The report did not show whether this increase was due to genetics or the lifestyles of the pets. However, it is clear to see that the main reason for this increase is down to the pet obesity epidemic we are facing, and the fact that animals have longer lifespans than before. So obesity is by far and large the greatest predisposing factor, very simple. In fact, a PDSA study in 2015 showed that 80% of vets questioned by the charity thought there would be more obese pets than healthy ones by 2020! Like humans, pets become obese as a result of over-sized portions of an inappropriate diet (in this case, low protein value and high in fibre) combined with inadequate levels of exercise. Plus let’s not forget those table scraps our four-legged friends love! So the best thing you can do for your cat and dog is to prevent it occurring in the first place by keeping them lean! The other reason could simply be that many of the initial signs of diabetes (increased thirst and urination) are either not noticed by the owners (especially with cats since many have access to the outdoors) or that weight loss is attributed to a recent weight loss programme rather than diabetes itself.

WHAT IS IT?

Type I diabetes (insulin dependent) is usually rare in animals and generally affects primarily the young. Type II diabetes (insulin non-dependent) is far more common with 75% of cats affected being in the age range of 8-13, and dogs having a mean of around 8 years (4-14 years variation). It is very important to understand that diabetes is NOT an age-related disease, rather a disease caused by lifestyle choices (i.e. ones you impose on your pet). Do not forget it is up to you (and not your pet) what you feed it and how often you exercise it. With cats, you will need to use your creativity and use their natural hunting/chasing ability to involve them in games they would enjoy. In dogs, diabetes is more common in bitches whilst the reverse is true in cats.

Type II diabetes fundamentally occurs for two reasons:
1) Inadequate or a delayed insulin secretion relative to the needs of your pet; or

2) An abnormal release of insulin coupled with an inadequate response from the cells to the insulin (i.e. the cells no longer allow the movement of glucose from outside the cell to inside the cell).

So the end result is that sugar remains in the bloodstream (rather than crossing INTO the cells that need it) BUT the cells remain hungry! Therefore the body starts breaking down fat and muscle stores to release energy. Therefore, your pet will continue to be hungry (as the cells have no glucose inside and are starving in effect) AND your pet will lose weight. On top of that, the glucose builds up in the blood and is then eliminated in the urine. This leads to excess thirst and urination (the two main clinical signs seen).
However left untreated, the cells in the pancreas become exhausted and can no longer secrete insulin at the levels needed. In these cases, continuous insulin therapy will be needed. If caught earlier, there is a good chance that diabetes can be controlled with diet alone and regular low grade exercise.

WHAT WILL YOU SEE IN YOUR PET?

Do not forget, obesity is the primary predisposing factor!

Early signs:

- Increased thirst and urination (due to osmotic diuresis, i.e. water follows glucose into the urine)

- Increased hunger (since the cells ‘think’ there is no glucose available)

- Weight loss (since the body is breaking down fats and muscle for energy)

- UTIs (Urinary tract infections), this is due to glucose in the urine being an ideal energy source for bacteria! In fact, your pet may have had prior UTIs before being diagnosed.

Later signs:

- Anorexia

- Depression and lethargy (due to lack of glucose in the cells)

- Vomiting - Cataracts (far more common in dogs)

- Weakness in rear limbs (walking on their ankles, cats only)

WHAT TO DO?

The first thing to do is to see your vet if you recognise any of the signs above. Managing diabetes until your pet is controlled can certainly be time consuming especially if they have been obese for a while before. As mentioned this has a direct effect on the pancreas’s ability to produce insulin.
Your vet will discuss various treatment methods including insulin injections, oral tablets (especially with cats), diet change, exercise regime and the keeping of a diabetic calendar. The calendar would include the timing of injections, the amount fed, the level of exercise and the level of urination/thirst noticed. Your vet may also ask you to monitor the level of water drunk (this is the most sensitive indicator of a pet under control) and to test the urine for glucose. The initial treatment will also include several glucose curves (i.e. measuring the level of glucose in the blood post insulin injection) in order to work out the optimal dose and timing of the insulin injections. In cats, non-complicated diabetes can sometimes be managed with just diet, exercise and the use of oral hypoglycaemic tablets. In cats especially, it is very important to have a gradual reduction in their weight to protect the liver as much as possible.
As with everything, prevention is far better than cure! Ensuring your pet has good quality food (i.e. not loads of grain fillers, rather a good quality protein source with an adequate calorific intake) can help prevent obesity in the first place. Regular exercise (20-40min most days of the week for your dog at a minimum) is of course key and do not feed your pets human food, even if they look at you with those adorable eyes and sad face!
Finally, the prognosis with treatment is good with most animals having a normal lifespan. Cats with diabetes may in fact sometimes go into remission (although may relapse later) whilst dogs will have it permanently, although it is very much a controllable disease if correctly monitored. The hardest part is the initial diagnosis (i.e. pet owners being aware of the signs) and then finding the optimal insulin dose, especially if your pet has been obese for a while beforehand. Once this has been achieved, the long-term management is relatively uncomplicated especially with a well-informed owner!