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Diabetes mellitus

ISSN 2398-2942

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Synonym(s): Sugar diabetes, DM

Introduction

Generally >6 years old. Rare in young.
Cause: syndrome characterized by relative or absolute lack of insulin.
Signs: polyuria/polydipsia, weight loss, polyphagia.
Diagnosis: glycosuria, hyperglycemia.
Treatment: insulin therapy Insulin. Print-off the owner factsheets on Diabetes mellitus Diabetes mellitus and Monitoring diabetes in dogs Diabetes monitoring to give to your client.

Occasionally sudden blindness due to cataract Cataract or retinopathy Diabetic retinopathy (rare).
One study found a seasonal pattern in diagnosis - with twice as many diagnoses between Nov and Jan as between July and Sept.

Ketosis Diabetic ketoacidosis :
- Anorexia.
- Vomiting.
- Dehydration.
- Acetone odor to breath.
- Abdominal pain.
Non-ketotic, hyperosmolar diabetes Hyperosmolar diabetes mellitus /hyperosmolar syndrome :
- Weakness.
- Anorexia.
- Vomiting.
- Lethargy.
- Obtundation/coma.

Anesthesia Anesthesia: in diabetic patient requires particular care:
- Usually administer half usual insulin dose prior to surgery and administer dextrose in intravenous fluid during procedure.
- Aim to get animal back on normal regime as soon as possible after operation. Warn owner of increased risk of anesthesia.
Drugs such as glucocorticoids Therapeutics: glucocorticoids can be problematic:
- Antagonize effects of insulin.
- Dose may need to be adjusted to prevent ketosis.
Risk of hyperglycemia if food is refused or vomited:
- Counsel owners about management of hypoglycemia Hypoglycemia.

Inadequate secretion of insulin (immune-mediated destruction of islet cells, pancreatitis Pancreatitis: acute , islet cell exhaustion).

See Diabetes mellitus pathophysiology Diabetes mellitus: pathophysiology for further information.

Type 1: (insulin dependent) destruction of beta cells → complete and permanent loss of insulin secretory ability.
Other types of diabetes mellitus are rare in the dog:
- Severe insulin resistance in islet shut-down and overt DM.
- May be reversible if cause of insulin resistance is addressed, eg diestrus diabetes/canine acromegaly Acromegaly , due to secretion of growth hormone by mammary tissue.