Diabetic Pets: Client Education Handout

Our food that we eat (sugars and startches) gets broken down into basic units of glucose. The diabetic can do this. Extra glucose gets stored in the liver as glycogen. Diabetics can do this when their diabeties is in control.

Insulin uses up glucose. Insulin makes glucose usable by our cells. When a normal person or pet needs more glucose they either eat or the body's feedback mechanisms call for stored glucose (glycogen in the liver) to come out of storage and enter the bloodstream to be used with the help of the body's own insulin. Since diabetics (specifically, insulin-dependant diabetics) do not have enough insulin to help glucose be utilized, and glucose already in the bloodstream (i.e. from eating) isn't recognized by the body. There is no insulin to use it up and give it to cells. The cells still want glucose so the body calls on the glycogen stores, which pumps glucose into the bloodstream- so blood glucose goes higher. There still is no insulin and cells still want glucose so the body calls for more glycogen from it. The end result is that the bloodstream is tremendously filled with glucose and the person or pet is hungry due to feedback mechanisms. They are hyperglycemic (too much glucose in the blood) but feel hypoglycemic (too little glucose in the blood). All this sugar in the blood is what makes a diabetic so thirsty. Furthermore, the breakdown of protein yields other breakdown products besides glucose, such as ketones. Ketones are toxic and Diabetic Ketoacidoses is the state of hyperglycemia and ketones in the blood. This can cause organ failure/shutdown, seizures, and even death.

In order for a diabetic to live as normal a lifestyle as possible, the diabetes must be gotten under control. Diabetics need a regimented lifestyle, period. There is no turning back to that easy going lifestyle. Life is now divided into 12-hour increments. Some diabetics are easier to care for than others. Any time a diabetic becomes ill (respiratory infection, abcess, urinary tract infection - quite common if glucose is in the urine) glucose metabolism will be thrown off and insulin usage as well. More fiber, less carbohydrates, and some exercise and weight loss in the already obese, as well as measured and timed food intake help make your diabetic an "easy keep" when controlling diabetes.

Follow these rules and things will get better and even perhaps go smoothly:

1- Always make sure you diabetic eats before insulin is given.
2- Feed the same food at the same time and the same amount.
Whether you're an animal or a human diabetic, there is a lot of spontaneity given up. There are no sudden dietary splurges or fasts without significant risk. It is ridiculous at best, to try to regulate a diabetic on a varying dietary schedule. Once a schedule has been established, the diabetic can usually tolerate small excursions of variance pretty well.
3- Feeding and insulin should be done every 12 hours if on twice daily dosing.
4- Keep a diary of food intake, water consumption, exercise and bowel movement/urine habits. Be able to recite these like your name and address and you're probably monitoring pretty well.

What you need to know before you leave the first visit:

HYPOGLYCEMIA (low blood glucose)
- Hypoglycemia can make a pet very lethargic, even comatose. Affected pets may be too tired to eat on their own.
- It is most likely to happen if a pet is given his/her insulin and has not been eating.
- In this instance, some Karo syrup rubbed on the tounge and gums to stimulate swallowing (and ingestion) will help. Seek help if the pet does not respond and also discuss the particulars.

INSULIN
- Keep in refrigerator and transport on ice.
- Get a new prescription every six week regardless of expiration date.
- Give insuling subcutaneously (under the skin) in an area that will receive movement and therefore increase absorption. The area usually chosen is near and behind the shoulders.

FOOD
- High fiber is desirable (i.e.: r/d, w/d, Purina DM, available in dry or can)
- Consistency is most important
- Do not give foods high in sugar (i.e. yogurt) - become a label reader.
- Schedule- make sure your pet has eaten his/her current meal before you give insulin. If feeding all at once is a struggle, start feeding 1 - 2 hours prior to giving insulin. Another solution would be to try another diabetic food that your pet will eat readily.
- Remember hyperglycemia (mild to moderate) is better than hypoglycemia

Monitoring at Home
- The best monitoring you can do at home in the first few weeks/months of caring for a diabetic is to be aware of what food you pet ate and when and how much, water consumption; activity level and appearance; urine output; insulin dosage and when given

Follow Up
- Always know the next time for vet appointments, when new bottle of insulin will be needed, syringes running low? Don't get caught off guard and you'll do fine.