Diabetes Mellitus with Hyperosmolar Coma in Dogs
Situated in the abdomen near the stomach, the pancreas plays a crucial role in regulating blood sugar (glucose) levels in a dog’s body by producing insulin, a polypeptide hormone. When a dog consumes food, its blood sugar rises accordingly, prompting the pancreas to release insulin to maintain healthy blood sugar levels. This allows other organs in the body to absorb and utilize sugar for energy.
However, in cases of diabetes mellitus, the pancreas fails to produce sufficient insulin, resulting in persistently high blood sugar levels, known as hyperglycemia. Elevated blood sugar triggers several responses in the dog’s body. Initially, it produces excess urine, leading to increased urination frequency. Consequently, the dog experiences heightened thirst as it tries to compensate for fluid loss. Over time, dehydration becomes a risk due to excessive urination.
Insulin deficiency also means that the body’s organs do not receive adequate energy from sugar, leading to constant hunger despite increased food intake and lack of weight gain.
If left untreated, diabetes exacerbates, causing blood sugar levels to soar further. The resulting increase in urine production exacerbates dehydration. Eventually, the combination of severe hyperglycemia and dehydration impairs normal brain function, potentially causing depression, seizures, and coma. Fortunately, such severe outcomes are rare since symptoms typically prompt a visit to the veterinarian before the dog’s health deteriorates to that extent.
Symptoms and Types
Diabetes Mellitus Without Other Problems:
- Increased thirst (polydipsia)
- Frequent urination (polyuria)
- Increased appetite without weight gain
- Persistent hunger
- Weight loss
Diabetes Mellitus With Other Problems:
- Reduced activity level
- Lethargy
- Vomiting
- Loss of appetite (anorexia)
- Decreased interest in regular activities (depression)
- Unresponsiveness to calls or stimuli
- Lack of awareness of surroundings (stupor)
- Seizures
- Confusion
- Loss of consciousness
- Coma – extended periods of unresponsiveness and inability to be awakened
Causes
Diabetes Mellitus Without Complications:
- Insufficient insulin production by the pancreas
Diabetes Mellitus With Complications:
- Insufficient insulin production by the pancreas
- Prolonged elevation of blood sugar levels and dehydration alter brain function
Diagnosis
To diagnose your dog’s condition, you must provide a detailed history of its health and the onset of symptoms. Your veterinarian will conduct a thorough physical examination, considering the symptoms you’ve described and any potential triggers for the condition. They will order a complete blood count, biochemical profile, and urine analysis to assess your dog’s blood sugar levels, hydration status, electrolyte balance, and organ function. These tests will also help identify any other underlying diseases that may be complicating your dog’s diabetes mellitus.
Treatment
If your dog has been diagnosed with diabetes mellitus and remains alert, active, and eating, it will initiate insulin therapy and adhere to a specialized dietary regimen. Some dogs may be prescribed oral medications instead of insulin injections to manage blood sugar levels.
For dogs with diabetes complicated by issues like depression and dehydration, hospitalization for several days is necessary. During this time, they will receive fluid therapy and insulin to stabilize blood sugar levels. Additionally, a tailored diet will be implemented to regulate blood sugar.
In severe cases where the dog is in a coma, experiencing seizures, or displaying extreme lethargy, immediate medical attention is crucial as it indicates a life-threatening condition. The dog will be admitted to the intensive care unit for intravenous fluid administration and electrolyte management. Blood sugar and electrolyte levels will be closely monitored and insulin therapy initiated to lower blood sugar levels. Medications may also be prescribed to address symptoms like vomiting.
Throughout the hospitalization period, veterinarians will monitor and address any concurrent diseases such as heart or kidney failure, intestinal bleeding, or infections. Stabilizing a diabetic dog’s condition is a gradual process to avoid exacerbating health complications by rapidly lowering blood sugar levels. It’s important to note that dogs severely affected by diabetes, particularly if concurrent diseases are present, may face challenges in recovery.
Living and Management
Once your dog’s blood sugar levels have stabilized, and it can independently eat and drink, it will be discharged to go home with you. Most dogs that have experienced severe diabetes will require insulin therapy. While some may be eligible for oral medications to manage blood sugar, only your veterinarian can determine the suitability of such treatment for your dog. Your veterinarian will provide thorough guidance on administering insulin injections and formulating a suitable diet to regulate blood sugar levels. It’s crucial to adhere strictly to your veterinarian’s instructions regarding meals and medication schedules. Never adjust the insulin dosage or frequency without consulting your veterinarian first.
Initially, your dog will require frequent follow-up appointments, and there may be instances where hospitalization is necessary for close monitoring of blood sugar levels, typically every two hours. While some diabetic dogs may experience remission, most will require insulin and a specialized diet for their lifetime. Your veterinarian will advise you on how to recognize signs of potential remission in your dog.
Prevention
To prevent dehydration, seizures, or coma resulting from diabetes in your dog, it’s crucial to maintain a consistent health and diet regimen and attend all scheduled follow-up appointments with your veterinarian. This ensures that your dog receives the correct insulin dosage.
Monitoring your dog for any alterations in appetite or behavior, including changes in energy levels, is essential. Diabetes increases the risk of infections, so prompt treatment is necessary if any health issues arise. Consult your veterinarian immediately upon observing any changes in your dog’s health or behavior.