About 10 per cent of Hongkongers suffer from diabetes, according to the Hospital Authority, and the figure is increasing. The condition is also on the rise in our pets.
"Diabetes is the second most common endocrine disorder in cats, with an estimated incidence of 0.5 per cent [one in 200 cats] and is also common in dogs, with one in every 500 dogs affected," says Dr Jamie Gallagher, assistant senior veterinary surgeon at the Society for the Prevention of Cruelty to Animals (Hong Kong).
Gallagher says obesity is a contributing factor, especially in cats. "Overweight cats are four times more likely to develop diabetes than their healthy-weight counterparts so, with obesity on the rise, it's no surprise the incidence of diabetes is also increasing."
If your cat or dog is overweight, you should seek advice from a vet on the best dietary plan, and research the most appropriate way for your pet to exercise more.
Diabetes is an endocrine disorder of blood sugar (glucose) metabolism, which is normally controlled through the hormone insulin, which acts to reduce blood sugar. With feline sufferers, the body does not respond effectively to the insulin it produces (type 2 or insulin-resistant), while in dogs, the body does not produce enough insulin (type 1 or insulin-deficient).
"This causes too much sugar in the blood, which can make the animal much more likely to get infections and have other negative consequences, including kidney failure and cataracts. Left untreated, diabetes can affect multiple organ systems resulting in ketoacidosis [DKA], when toxins [ketones] build up in the body; this is a life-threatening emergency and can be fatal," Gallagher says.
The vet says that the most common symptoms are increased thirst and urination, increased appetite despite weight loss, and lethargy. Dogs may develop cataracts, and cats can show weakness in their hind limbs. "In more severe [DKA] cases, the animal can have the above symptoms, plus be very weak or lethargic, even collapse, and exhibit vomiting or diarrhoea."
If, as an owner, you notice any of these symptoms, it is better to have it checked, even if it turns out to be nothing.
"Diagnosis of diabetes is fairly straightforward based on clinical signs, physical examination, and blood and urine tests," Gallagher says. "An elevation in both blood sugar, and finding sugar in the urine, along with appropriate clinical signs, is diagnostic for diabetes."
This can include a full blood panel that will indicate if other organ systems are affected, such as the kidneys. A urine culture may also be taken to ensure there is no urinary tract infection, which Gallagher says is a common concurrent problem in diabetic animals. "Bacteria like the sugar in the urine."
Controlling and treating diabetes is a multipronged approach. The vet says insulin is likely to be prescribed, usually requiring twice-daily injections at home. "An in-depth consultation with the owner to discuss the disease process, monitoring in the hospital and at home, medication handling and administration, and lifestyle adjustment is necessary. While it may seem scary at first, owners quickly learn how to give injections and monitor their pets," Gallagher says.
As with humans, diet plays a vital role in the regulation of diabetes and can help minimise insulin use, and, Gallagher says, it is important to realise requirements are different for cats and dogs.
Cats should be fed a high-protein, low-carbohydrate diet. The vet says some cats can go into remission and be managed on diet alone if the disease process is caught early enough. Diet recommendations for dogs will depend on their body condition (fat or thin) at diagnosis. "Feeding regular meals 12 hours apart can also help to control blood glucose."
Further at-home monitoring may include checking the urine with "dipsticks" for glucose, monitoring water intake and weight, and checking a pet's blood glucose.
"Understanding diabetes and the subsequent care required will seem daunting at first to many pet owners, as it's a lot of information to process," Gallagher says. "However, with good home care and regular veterinary communication, diabetes is a treatable disorder, with many afflicted dogs and cats having long, happy and healthy lives."
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