The diagnosis and treatment of insulin-dependent and non-insulin-dependent diabetes mellitus in the dog and the cat

Abstract

Diabetes mellitus is often a frustrating disorder to treat. Many animals appear resistant to the effects of insulin, while others, especially cats, are very sensitive to its effects and therefore prone to bouts of hypoglycemia. Because of difficulties in glucose regulation, many veterinarians have referred to the treatment of diabetes mellitus as an art rather than a science. Fear of over-regulation with resultant hypoglycemia has led to the practice of "loose control" (wide fluctuations of glucose are allowed to occur throughout the day). Fortunately, long-term side effects of poor glycemic control seen in people (eg, retinal, glomerular, vascular, and nerve problems) are uncommon in dogs and cats; however, excessive polyuria and polydipsia, weight loss, and recurrent urinary tract infection in most cases is unacceptable. This chapter will focus on many of the problems associated with regulating the uncomplicated diabetic and discuss newer glucose control techniques, the use of oral hypoglycemic agents, and the role of diet in the acute treatment and long-term management of diabetes mellitus in the dog and cat.