TREATMENT AND MONITORING OF DIABETES IN DOGS AND CATS PATTY A. LATHAN, VMD, MS, DACVIM Associate Professor, Mississippi State University In this VETgirl-Merck Animal Health webinar “Management of diabetes in dogs and cats,” Dr. Patty Lathan, VMD, MS, DACVIM reviewed all you need to know about diabetes mellitus in dogs and cats! Tune in free for a limited time HERE.
KEY HIGHLIGHTS
The goals of treating diabetes include improvement of the patient’s (and owner’s) quality of life, control of clinical signs, avoidance of complications from diabetes (such as diabetic neuropathy) and from over- treatment with insulin (hypoglycemia), and diabetic remission (in cats). Proper treatment includes identifying and treating or eliminating any cause of insulin resistance (infection, obesity, etc.), dietary management, and insulin Although large controlled studies are lacking, a high protein, low carbohydrate diet is generally recommended in diabetic cats. Canned food is ideal, as these diets are usually lower in carbohydrate content and are more filling due to the added water content. Several prescription diets have been formulated to meet low carbohydrate specifications (including Hill’s m/d, Purina DM, and Royal Canin DS 44 dry). Given the higher caloric density of dry foods, the canned foods usually have lower carbohydrate contents and are preferred in obese patients. Weight loss cannot be over- emphasized, as obesity promotes therapy. 1 DIET insulin resistance. Obese cats are four times more likely to develop DM in the first place! Weight loss of 1-2% body weight per week should be achieved using food restriction.
Although high fiber diets have been recommended in dogs, they are not ideal for all diabetics. High fiber diets tend to cause weight loss, which is undesirable in dogs that are underweight or at an ideal body weight. In these dogs, a high quality maintenance dog food with a moderate Newly-diagnosed cats should be treated with twice daily insulin injections (unless DKA is present) for best regulation and diabetic remission rate. Glargine (Lantus®), PZI (ProZinc®) and lente (Vetsulin®) insulins are all viable options. Glargine fiber content is preferred. 2 INSULIN THERAPY and PZI insulins appear to result in slightly higher remission rates than lente insulin. However, given the significant price differences, lente insulin is a practical option for owners with financial limitations. NPH is not recommended in cats due to short duration of action. Compounded PZI insulin is also not recommended. The starting insulin dose in cats is 1-2U twice daily. Dogs should also be treated with twice daily insulin injections, using a moderate acting insulin. Lente (Vetsulin®) and NPH (Neutral protamine Hagedorn, either Humulin N® or Novolin N®) are most frequently used for first-line therapy (0.25 – 0.5U/ kg BID). Most of my diabetic dogs are started on lente insulin. Glargine,
detemir, and PZI have also been evaluated in dogs, and detemir is useful when the duration of lente or NPH is too short. Detemir is more potent in dogs than in cats or people, so a starting dose of 0.1 U/kg BID is recommended. 3 MONITORING There are several methods available for monitoring diabetes, including assessment of clinical signs, BG curves (BGCs in clinic and at home), continuous glucose monitoring (specifically the FreeStyle Libre), fructosamine concentrations, and urine glucose. (continued)
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