Introduction: Diabetes mellitus or sugar diabetes is a chronic endocrine (hormone) illness characterised by high levels of glucose in the blood. It is seen in dogs and cats as well as humans, and in each species is commoner in the overweight and obese. There is no cure, but treatment, which may or may not include insulin injections, can maintain a healthy and active life.

Pathology: Diabetes occurs when the insulin-producing cells of the pancreas stop producing sufficient insulin to cope with the body's glucose load (Type 1 diabetes), or when the peripheral tissues in the body that react to insulin become resistant to its effect (Type 2 diabetes).

Symptoms: These include weight loss (more likely in type 1 diabetes), thirst, excessive drinking (polydipsia), increased urination (polyuria), increased appetite, increased blood glucose (hyperglycaemia), blindness, weakness and depression

Causes include obesity, chronic pancreatitis, and stress (cortisol, one of the stress hormones, makes fat cells less sensitive to insulin). In addition there is a an increased incidence in certain dog breeds.

Diagnosis depends on a urine test followed by a confirmatory blood test for glucose levels.

Effects of Diabetes: There is an increased incidence of cataracts, premature death, problems in pregnancy, infections (especially bladder) and pancreatitis.

Insulin, diet and exercise are the mainstay of current Western Treatment. Spaying of diabetic female dogs is usually recommended to prevent pregnancy complications.

Insulin: The discovery of insulin in 1921 was pivotal in changing diabetes mellitus from a disease that was fatal within weeks to a chronic and not necessarily life-threatening condition. Insulin is essential for dogs with diabetes, and any other treatments used must be complementary to insulin use.

Once your dog has been diagnosed, the diabetes will be stabilised at the vet practice with an insulin regime of two subcutaneous (under the skin) insulin injections per day. However, the amounts of insulin needed are likely to change once your dog is at home with a change of diet and exercise routine. Your vet practice will support you while you get the regime right. Blood tests will be needed frequently initially, and every 3-6 months once stabilised.

Diet needs to be specific and timed correctly. Treats need to be avoided, as they often contain sugar. Table scraps will generally be too variable to be used in a diabetic dog's diet, as they will lead to variable control. Glucose control is easier if you feed a fixed formula feed, low in fat and high in slowly digested complex carbohydrates.

If your dog is overweight, weight reduction to the normal for his or her size is vital over the first 3-4 months after diagnosis.

Exercise is vital, and for best diabetes control should be as consistent as possible. If a dog is undergoing extremely high levels of exercise, its insulin requirement may be reduced, and it is important to discuss this with your vet in advance.

Other considerations: A diabetic dog will need your time and will not be cheap over the years, but will reward you with years of companionship and love - as we all know from our pets.

Complementary Therapies: Stress reduction will help with glucose control and can be helped by spiritual healing, Reiki, crystal healing with crystals such as amethyst, massage, and the T-touch technique.

Herbal remedies may also help: Stinging nettles - for fatigue, poor appetite; Garlic - for digestive problems; Fenugreek - for fatigue and weight loss; and olive leaves - for blood pressure and glucose control.

Aromatics/ aromatherapy: A combination of kinesiology and self-selection can lead a dog to choose the aromatic oils that are most helpful to it at any given time.

Hydrotherapy will improve glucose control as part of an exercise regime.

Conclusion: With Diabetes mellitus it is absolutely imperative that you work closely with your vet in order to get optimum glucose control. The triad of insulin, diet and exercise is pivotal. Other ways to help support your dog's management.

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