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30 Cards in this Set
- Front
- Back
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When do clinical signs go hyperglycemia occur?
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Once renal threshold of glucose has been exceeded
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Canine glucose renal threshold
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180
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Canine diabetes is most like what type of human diabetes?
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Type 1
Insulin dependent diabetes mellatus Beta cells have been destroyed |
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Dogs genetically predisposed to diabetes
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1. Keeshhounds
2. Australian terriers 3. Carin terruer 4. Miniature pinschers * common in poodles, dachshunds, miniature schnauzer, and beagles |
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Canine diabetes: male or female disease
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Females are 2-3x more likely to become diabetic
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Avg dog age for diabetes
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7-9 years old
Range is 4-14 |
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Classic presentation for a canine diabetic
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1. PU
2. PD 3. PP 4. Weight loss! |
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Why are canine diabetics pu/pd?
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May be due to several factors
1. Osmotic dieresis 2. Bacterial uti 3. Loss of medullary concentrating gradient |
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Why are canine diabetics polyphagic?
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1. Glucose cannot enter the hypothalamus to stimulate the satiety center
2. Cells cannot use glucose for energy because because of the lack of insulin to allow glucose entry via GLUT receptors * chronic diabetics will become ketoacidotic which causes anorexia |
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Why do canine diabetics lose weight even though they are polyphagic?
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1.uninhibited glucose offenses and muscle wasting
2. Utilization of fat stores (lack of insulin results in Decreased triglyceride synthesis, uptake and metabolism in fat cells and increased triglyceride and FA in the liver) |
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Why does muscle wasting occur in diabetics?
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1. Muscle loss due to increased utilization of AA for gluconeogenesis
2. Electrolyte and acid/base disturbances |
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Why could a dog diabetic present for acute blindness?
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A cataract has formed from the hyperglycemia overwhelming capacity of the lens to metabolize glucose via normal pathways and resultant of water influx into the lens causing fiber breakdown and swelling
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Why do many canine diabetics have hepatomegally?
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From hepatic lipidosis and glycogen storage
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Causes of hyperglycemia in the dog
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1. Diabetes mellatus
2. Cushings 3. Diestrus 4. Pancreatitis 5. Liver disease 6. Drug therapy (steroids,dextrose fluids) |
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•canine Hyperglycemia =
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blood glucose > 130mg/dl (but this isn’t yet high enough for glucosuria)
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2type of diabetes
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* Type I diabetes = Insulin-Dependent Diabetes Meliitus (IDDM)
• Body is unable to make insulin à patient is insulin-dependent • Most common form of dog diabetes *Type II diabetes = non-insulin-dependent diabetes mellitus • Obesity or drug-induced (humans: fat, female, & 40) • This is extremely rare (doesn’t happen) in dog * common in cats - reversible |
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Common chem panel findings of a canine diabetic
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1. increased ALP/ALT, but usually not extremely high (due to hepatic lipidosis: liver is full of fat & glycogen, which puts pressure on hepatocytes)
2. hypercholesterolemia (due to uninhibited hormone sensitive lipase), hypertriglyceridemia 3. increased BUN (pre-renal azotemia) 4. hypophosphatemia (due to PU and acid-base disturbance) 5. hyponatremia (urine loss), hypokalemia (urine loss, lack of insulin), hypomagnesium (urine loss) 6. acidosis; low TCO2 |
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ketonuria
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Seen in long-standing untreated patient
o Looking for this helps tell us about chronicity and progression of disease |
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3 ketones made due to ↓glucose
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acetone, acetoacetate, and β-hydroxybutyraye
Only acetate & acetoacetate are detected on dipstick |
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UTIs and Diabetes
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UTIs are present in >60% diabetes à you should culture urine even if you do not see WBCs or urine, because there is dilution of urine
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Goals of managing a diabetic dog
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• Reduce or control the clinical signs (esp. PU/PD/PP)
• Prevent complications of disease (DKA, hypoglycemia, UTI, cataracts, weight loss) • Improve and maintain quality of life for dog and owner |
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o 3 most important components of therapy =
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Dietary therapy + Insulin replacement + Owner education
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Goals of dietary management
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• Normalize body weight
• Insure predictable food intake by feeding a palatable food • Maintain consistency in caloric content and timing of meals • Minimize post-prandial blood glucose concentrations |
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Focus is on the carbohydrate source for diabetics
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• Best: sources of carbohydrates with low glycemic index (i.e. those with barley, whole grains)
• Avoid: diets with high glycemic index & highest post-prandial glucose (millet, rice, corn, rice) |
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Both insoluble and soluble fibers improve glycemic control & minimize post-prandial glucose
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• Fibers promote release of regulatory GI hormones
• Fiber slows the rate of glucose absorption from GI tract o Soluble fibers delay gastric emptying and delay intestinal nutrient absorption o Insoluble fiber increases GI transit, decreases time for nutrient digestion, and reduces availability of glucose for absorption |
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The best fiber diet for canine diabetic
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those with >12% insoluble fiber or >8% mixed fibers
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• Problems that can occur with feeding high fiber diets to diabetic dogs
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• ultra-low fat and high fiber diets may contribute to weight loss or cause refusal to eat diet
• high soluble fiber causes flatulence, soft stools • high insoluble fiber causes excessive frequency of defecation, development of constipation |
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Role of protein in canine diabetic
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no need to feed diabetic dogs a high protein/low carb diet (unlike in cats)
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Role of fat in canine diabetic
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keep diets lower in fat to avoid problems with fat metabolism or risk of pancreatitis
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o Best diet choice in canine diabetic
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one that the dog will consistently eat, normalizes body weight, is not high in fat, doesn’t have a high carbohydrate load (high fiber + increased digestible complex carbohydrates), doesn’t have high glycemic index, and has adequate protein content
o Remember: the key is consistency in timing and meal caloric count! |
