Diabetes in dogs

Summary

What is diabetes in dogs?

Diabetes Mellitus (diabetes) in dogs is a chronic disease that affects 1 in 400 dogs and is most commonly diagnosed in middle-aged dogs between 7-9 years of age. Female dogs are three times more likely to develop diabetes compared to male dogs.

Diabetes in pets is classified as Type 1 or Type 2, as it is for humans. Type 1 diabetes affects dogs, and occurs when the animal has insufficient insulin, the hormone that regulates blood sugar levels. It is treated by providing an external insulin source. On the other hand, Type 2 diabetes usually affects cats, and occurs when the cat has an inadequate response to insulin, or insulin resistance.

Diabetes is a metabolic disease. Metabolism is the process by which the body makes energy from food that has been eaten. Food is made up of proteins, carbohydrates and fats., and is broken down by the digestive system into sugars and acids, which are the body’s fuel. This fuel can be used immediately, or it can be stored in the cells for future use. When this process is disrupted by abnormal chemical reactions in the body due to disease in the liver or the pancreas, a metabolic disorder can develop.

Unfortunately, there is no cure for diabetes, but the disease can be effectively managed. Successful management of diabetes can be achieved by means of insulin therapy and feeding an appropriate diet. Untreated or poorly controlled diabetes can cause complicated, life-threatening health problems for your dog.

Expert advice from Dr Felicia:

Diabetes in dogs is thankfully a relatively uncommon disease, and while treatment is fairly intensive and long-term, it can be very rewarding as dogs feel so much better after treatment and can go on to live happy long lives with this disease.

How much does diabetes in dogs cost?

According to PetSure claims data 2022, the average claim cost for diabetes in dogs was $1,504.

2025 claims data shows that the average monthly cost of insulin therapy was $122, resulting in a potential annual cost of $648- $1,260 (with 12 monthly purchases).

^ØBased on PetSure claims data, 2022 calendar year. Reimbursement for these claims under a pet insurance policy would be subject to limits, such as annual benefit limits or sub-limits, benefit percentage, applicable waiting periods and any applicable excess. Cover is subject to the policy terms and conditions. You should consider the relevant Product Disclosure Statement or policy wording available from the relevant provider. Please note that values calculated are based on all claims for that condition and medically related conditions in each calendar year.

Because it is difficult to predict the costs of veterinary care, it can help to have measures in place to help prepare for the unexpected. Pet insurance can help by covering a portion of the eligible vet bill if the unexpected does happen.

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What is glucose and how much is normal?

Glucose is a type of sugar that is found in carbohydrates. Glucose is essentially the fuel, or energy source, for the body’s cells and organs.

Glucose is absorbed from the intestines into the blood, which is then transported throughout the body. The normal level of glucose in the blood is 80-120 mg/dl (4.4-6.6 mmol/L) and it may rise to 250-300 mg/dl (13.6-16.5 mmol/L) following a large or high-calorie meal. However, if your dog suffers from diabetes, blood glucose levels can rise above 400 mg/dl (22 mmol/L).

One of the main aims of diabetes treatment is to keep the glucose levels within a specific range. The key to achieving this is through insulin injections and dietary management.

What is insulin and why is it so important?

Insulin is an important hormone produced by beta-cells in the pancreas that controls the amount of glucose in the blood.

After a dog eats, the digestive system breaks down the food into various components, including glucose, which is carried into the dog’s cells by insulin. Insulin is effectively a chemical messenger that allows the cells to absorb glucose for energy and storage. Insulin helps in preventing blood sugar levels from getting too high or too low. Blood sugar levels that are too high is called hyperglycemia, and blood sugar levels that are too low is called hypoglycemia.

Without insulin, the body can’t regulate its blood sugar and transport glucose to the cells and organs of the body, where it is needed for energy or stored for future energy requirements. In the absence of insulin, the body’s fat and protein are broken down instead, resulting in muscle wasting and weight loss, despite the animal being ravenously hungry.

Expert advice from Dr Felicia:

Being insulin-deficient often means our undiagnosed diabetic patients are often a lot slower and less willing to expend energy compared to before. Once we add insulin back into their system they often are much brighter and happier.

Types of diabetes in dogs

Dogs can be affected by Type 1 or gestational diabetes.

Type 1 diabetes occurs where there is insufficient insulin production by the pancreas. The pancreas doesn’t produce any or enough insulin to properly regulate blood sugar levels in the dog, and external insulin injections are required for the dog to survive.

There is a third type of diabetes, known as gestational diabetes, which is only temporary, occurring when the female dog is on heat or in season. Once she gives birth or is no longer in heat, the gestational diabetes disappears. This is not medically classified as type 1 or type 2 diabetes.

Because it is difficult to predict the costs of veterinary care, it can help to have measures in place to help prepare for the unexpected. Pet insurance can help by covering a portion of the eligible vet bill if the unexpected does happen.

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Symptoms of diabetes in dogs

If your dog shows any of these symptoms you should consult with your vet to determine if your dog is diabetic.

• Sudden change of appetite
• Ravenous appetite
• Vomiting after food intake
• Reoccurring urinary tract infections
• Sudden weight loss
• Lethargy
• Dehydration
• Increased water consumption
• Excessive thirst
• Excessive urination
• Cataract formation in the eye, possibly causing blindness
• Chronic skin infection
• Poor hair coat

Expert advice from Dr Felicia:

The most commonly presenting signs in dogs with diabetes are weight loss despite an ravenous appetite, accompanied by increased drinking and urination. Dogs can also often develop cataracts which can impair their vision.

Diagnosis of diabetes in dogs

The diagnosis of diabetes is based on clinical signs, physical examination and the detection of high levels of glucose in the blood stream and urine.

The vet can perform certain tests to check if your dog has diabetes. This entails testing for excessive glucose (sugar) in the dog’s blood and urine, because persistently high glucose levels are the hallmark of diabetes. Blood tests can also show other indicators of diabetes, such as elevated liver enzymes and blood ketones, in addition to high sugar levels.

Once diagnosed treatment should be started as soon as possible, as untreated dogs are at risk of developing diabetic ketoacidosis which can be life-threatening.

Causes of diabetes in dogs

The exact cause of diabetes is still unknown, however genetics, obesity, the immune system and chronic pancreatitis have been shown to play a role in the development of diabetes in dogs.

Diabetes can affect any dog, although overweight dogs are more prone to getting diabetes. Obesity and a high-fat diet are associated with the development of chronic pancreatitis, which is an implicating factor in diabetes. Additionally, overweight dogs who have diabetes are more difficult to manage and treat, so your vet will recommend that your dog lose weight if the animal is overweight or obese.

Dogs with hyperadrenocorticism, or Cushing’s disease, a disorder of excessive glucocorticoid secretion in the body, are at greater risk of developing concurrent diabetes. This is because the excess cortisol causes increased insulin resistance in the body.

Some research has shown that certain breeds are more predisposed to diabetes than others, suggesting that genetics plays a role in some breeds. Some of the breeds with a higher incidence of the disease are Beagles, Dachshunds, Golden Retrievers, Pinschers, Labradors, Westland Highland Terrier and Tibetan Spaniel Terriers.

It is recommended to neuter female diabetic dogs as the disease can cause complications when the female is in heat. The hormones that are released during the oestrus period can have a negative impact on the illness.

Treatment for diabetes in dogs

Treatment for diabetes in dogs is life-long as remission does not occur. Treatment consists of two components, the first being regular and adequate insulin intake and the second being diet.  The two go hand in hand.

Insulin

Life-long insulin injections, either daily or twice-daily, will be required for a diabetic dog. Through glucose monitoring curves to track a dog’s blood sugar levels throughout the day, the vet will establish the correct amount of insulin you need to give your dog.

Expert advice from Dr Felicia:

It is important to discuss with your vet what your preferences and limitations are around treatment. Vets can try once daily insulin to start though dogs will often need twice daily treatment for good control. The use of syringes or insulin pens can be adjusted according to your preference.

Diet

It is very beneficial for diabetic dogs to have a good diet and a lean body composition. Your vet will recommend a suitable diet, which might change over time, depending on your dog’s activity levels in its senior years.

Diet plays a very important role  in the treatment and adjustment of insulin levels; the days of giving your dog food scraps from your dinner table are unfortunately over. Controlling the carbohydrate intake in your dog’s diet will stabilise the insulin levels. There are specifically designed low carbohydrate dog foods for diabetic dogs that release glucose into the dog’s bloodstream much more slowly than normal dog food.  Your vet will most likely prescribe one of these special low carbohydrate dog foods.

Expert advice from Dr Felicia:

Complex carbohydrates and fibre within the diet are the main components that help to reduce the post-prandial (after-meal) blood glucose spike.

Consistent feeding times and quantities of food are crucial; any change in food intake can affect the insulin levels your dog requires. Please speak to your vet if you wish to change foods or increase or decrease the intake, as this will affect the treatment plan. Once your dog’s insulin intake and diet are well established, the maintenance costs aren’t excessively high. However, the diagnosis and establishing the treatment plan can be costly.

Exercise

Let’s not forget that exercise also plays an important role for diabetic dogs. A healthy lifestyle with plenty of exercise will help to prevent weight gain, and a leaner dog is ultimately a healthier and happier dog.

What happens if you don’t treat your dog’s diabetes?

When diabetes in dogs remains untreated, the dog will develop secondary problems with potentially devastating effects on the animal’s body.

The effects of untreated diabetes can include:

• Cataracts (leading to blindness)
• Enlarged liver
• Urinary tract infections
• Weakness
• Constant lethargy
• Ketoacidosis, a potentially life-threatening acute condition that can be accompanied by rapid breathing, dehydration, lethargy, vomiting, or sweet-smelling breath. It can be triggered by factors such as stress, post-surgery, long periods of fasting, infection in the body or an underlying, untreated health condition combined with low insulin levels. If you are the owner of a diabetic dog, it is helpful to have urine dipsticks so you can test your dog’s urine for ketones. If your dog shows any signs of being unwell and the ketone test is positive, visit your vet immediately.

Expert advice from Dr Felicia:

Not treating Diabetes is not recommended due to the development of life-threatening illness as a result of prolonged starvation of the cells of the body. Some owners with dogs with other comorbidities including diabetes may elect for euthanasia.

 Management and monitoring of diabetes in dogs

Although some cases may be more challenging than others, most occurrences of dog diabetes can be managed successfully and without complications. You, the owner, will play a vital part in monitoring glucose levels and injecting your dog with insulin.

Your veterinarian will work with you to determine the best management plan for your dog. From diagnosis to implementing the treatment plan, frequent visits to the vet will be necessary to adjust medication and to get the combination of diet, insulin dosage and home monitoring right. In addition, life-long glucose monitoring is required for all dogs with diabetes and regular blood and urine tests are needed for long-term management.

Your vet will guide you through learning the ropes on living with a diabetic dog and provide advice and instruction on the following important topics:

• When to measure glucose levels
• How to use an in-home glucose-monitoring system
• Insulin medication and how to administer it
• Strict diet plan and exercise recommendations
• Warning signals to look out for when your dog might have a diabetic emergency and require a visit to the vet

Collecting and testing of blood samples to check glucose levels

Dogs can be monitored in the clinic to check their blood glucose levels, but since the blood glucose curve is subject to day-to-day variability, your vet may recommend home monitoring of blood glucose. This is usually achieved by applying a continuous glucose monitor to your dog, which then you will need to scan at regular intervals to download data about your dog’s blood glucose levels.

Other ways to monitor blood glucose at home include using a glucose home monitoring kit, where you will be required to collect blood samples from your dog and test them.

Generally, blood is collected from the hairless part of the dog’s earflap. It is recommended that you warm up your dog’s ear by holding it in between your hands until warm; by doing so, it is easier to collect blood and more comfortable for the dog. Once your dog’s ear is warmed up, use a clean prick needle from the monitoring kit to prick into the hairless part of the ear. A small drop of blood will appear. Quickly collect the drop of blood onto the glucose test strip from your kit. Depending on the type of home-monitoring kit, you will either insert the test strip into the home reader to read the results, or the test strip itself will tell you the results.

Press some clean cotton wool onto your dog’s ear to absorb any remaining blood and to stop the bleeding and potential bruising.

When should you test your dog’s glucose levels?

When and how often should you test your dog’s glucose levels depends on each individual dog, the treatment protocol and the insulin being used. Your vet should give you guidelines on when to test, which may be:

• When you think your dog is feeling unwell
• In the days following a recent adjustment in insulin dosage to evaluate the response
• If your dog seems more hungry or thirsty compared to before, or has lost weight

What should you do if your dog has a diabetic emergency?

Diabetic emergency situations include the following situations:

1. You test glucose levels and they are extremely low. This is an indication of low blood sugar, also known as hypoglycaemia.
2. You test glucose levels and they are extremely high, remaining above normal even after giving insulin. When glucose remains extremely high, the production of excessive ketones can result in diabetic ketoacidosis which can be life threatening.

If either of these occurs, please contact your veterinarian immediately, as your dog might require an insulin adjustment or treatment for other medical problems that might arise during the diabetic emergency.

Expert advice from Dr Felicia:

Any unwell diabetic dog should visit their vet promptly as they can deteriorate rapidly particularly if they are unwell due to diabetic ketoacidosis. It’s definitely better to be safe than sorry!

Here a few warning signals to look out for:

• Excessive drinking
• Sudden reduction or loss of appetite
• Frequent urination – can’t hold urine
• Constipation, diarrhoea or vomiting
• Sudden unusual behaviour change
• Muscle twitching, seizures
• Depressed mood
• Blood in urine

In conclusion

The diagnosis of diabetes can be a big shock to most dog owners and to the prospect of measuring blood levels and administering insulin injections can be daunting. However, once the dog’s insulin levels are adjusted and the condition stabilises, a familiar routine will develop and the process becomes easier. With early detection and proper treatment and management, many dogs with diabetes go on to live long, happy and healthy lives.