Saturday, March 20, 2021

Kodi has Diabetes


Let us start by explaining what I would like to talk to you about today.
Diabetes mellitus, a disease shared by dogs and people. It is defined as a group of diseases characterized by lack of insulin production, efficacy, or both. This lack of insulin availability leads to a large number of abnormalities in the body. Despite the ability to carefully manage the disease process by administering Insulin, Diabetes remains a leading cause of death in people, as well as an important cause of death in dogs.
Sources report that as many as one in 10 diabetic dogs is euthanized at diagnosis, with a further one in 10 being put to sleep within a year, due to lack of success or adequate compliance with treatment.
In Eurasiers, we have seen that it seems to be diagnosed more often in dogs that are also hypothyroid (under-functioning thyroid), which is maybe not that surprising, as both conditions are likely to be part of an auto-immune complex. The incidence of the disease seems to be increasing in both, dogs and people, and it seems highly likely that there is a genetic component to this problem.

What does that entail? 
My dog is on life support! Got your attention?
Our 12-year-old Eurasier Kodi has insulin injections 12 hours apart with his meals.  It means a commitment to 7am and 7pm feeding plus treatment, always weighing the (raw) food and keeping up with daily exercise. 
You’d do anything for your dog, yes?  Well not all would, diabetes is a common condition in dogs and although manageable, is costly to treat, for our Eurasier - about £3 a day (with some recompense from insurance).
How is diabetes diagnosed?  
A blood test and urine sample.
What is the cause?
Canine diabetes is an incurable disease which is caused when insulin (a hormone produced by the pancreas) levels are too low.  It has a hereditary link.
Symptoms include:
  • Increased thirst
  • Increased urination
  • Weight loss
  • Increased hunger - the body thinks it is starving
Because the sugars in the diet can’t be used by the body if there is no insulin, they are lost in the urine. This means the dog effectively isn’t getting enough calories and so the body starts to break down the fat reserves as well.
Sugar levels in the blood will be high and this glucose will draw water with it into the urine.  The dog is dehydrated so drinks more.  This in turn puts a strain on the kidneys.
How does the insulin work?
Blood sugar levels will fall slowly after insulin is given and be lowest about 6-8 hours after the injection.  The sugar levels will then rise until the next feed and injection are due.  This is described as a glucose curve.
Insulin is a delicate medication which must be stored in the fridge.  It’s a suspension so settles and must be mixed gently before drawing into the syringe.
What about food?
A wet food of high-quality protein is needed, with as low a level of carbohydrates as possible, and no in-between meal treats.
What if the dog gets sick, vomits or has an infection?
Urinary tract infections can become a common problem due to the excess sugar in the urine helping bacteria to grow. This is where it gets really tricky, for it is dangerous to give too much insulin, as hypoglycaemic episodes (to little sugar in the body) can easily lead to collapse and death.
Monitoring diabetes
The amount of insulin required can change over time and also due to circumstance, such as antibiotic treatment, exercise etc., so monitoring is very important.  The glucose levels are most accurately measured via blood testing.  Taking prick tests can be done at home with an AlphaTRAK meter which comes with test strips, a lancing device, lancets and a diary.
When you record a glucose curve, usually to find the best dose of insulin when first starting to treat, several readings are taken at regular intervals throughout the day. This is quite a commitment!
It is also important for diabetic pets to have their teeth cleaned when necessary, because infections in the mouth can cause blood sugar levels to rise.

What is the cost (March 2021)?  
An AlphaTRAK monitor to check blood glucose levels is priced between £50-70 (shop around)
Insulin bottle £52 (which lasts us about 3 weeks).   Syringes £25/per 100  
Lancets £18-20   Test strips £49.20 for 50   Sharps box £5

Learning how to manage the disease
When you have the long appointment with your vet to demonstrate the injection technique ensure all family members attend – you need back up, even if it’s a dog-friendly neighbour.  And yes we’ve all managed to stab ourselves with the needle.
How to inject your Eurasier with insulin

The injection sites need to be varied,  so we got a set of clippers as it is easier if you can see the skin. 
Now Kodi is medicated and his blood sugar levels regulated, his coat is so much softer. We have been lucky in that he is amongst the 25% who don’t have the enzyme in the eye which causes a fast growth of cataracts.

He’s lost about 6 kilos and it seemed the stuffing had been knocked out of him before he got treated.  We are a year and 4 months post diagnosis now, and Kodi is a much happier dog! 
Ruth Bickford with Kodi