One of the intriguing aspects of my work is the number of animal parallels with human medicine. Pets can be afflicted by nearly all of the same conditions as humans: no species has exclusive rights to an illness.
People are often surprised when I tell them that their pet has a condition that they have previously regarded as a human-only problem. And animal treatments are often surprisingly similar to human treatments.
Diabetes is one of the most classic examples: most people know a friend or family member who has diabetes, yet they are surprised to hear that pets can suffer from this problem too.
The full name is Diabetes mellitus, derived from two Greek words. First, "diabetes" meaning "to go through" or "to siphon", referring to the excessive production of urine in the condition. And second, "mellitus", which means "sweet", referring to the fact that there is copious sugar in the urine of a patient with diabetes.
There is another type of diabetes, known as "diabetes insipidus", which is entirely different. "Insipidus" means "weak", and animals with this condition lack the ability to concentrate their urine because of a hormonal deficiency. Affected animals produce copious quantities of dilute urine, but there's no sugar in it at all.
Diabetes mellitus (or "sugar diabetes") is, by far, the most common type of diabetes, so it's common for people to simply refer to "diabetes", and affected animals are said to be "diabetic".
The condition occurs because of an abnormality in the way that the body regulates the blood sugar or glucose. The hormone insulin, produced by the pancreas, normally keeps the blood glucose between set levels: not too high, and not too low. If the blood glucose starts to go up, the pancreas produces more insulin, and this brings the blood glucose down again. If the glucose goes too low, less insulin is produced, and the blood glucose goes back up. In diabetes, the glucose level of the blood goes sky high, causing glucose to spill over into the urine. The presence of glucose in the urine draws fluid through the kidneys with it, which is why affected pets drink so much and pass so much urine.
There are two main types of diabetes mellitus, and again, many people will be aware of these from humans who have suffered from the problem.
In Type 1 diabetes, the body's immune system attacks the pancreas, stopping it from producing insulin. This tends to be a rapid onset problem, seen more often in younger people and its onset is not affected by factors like lifestyle, diet and body weight. Injectable insulin is always needed to control this version of diabetes. Type 1 diabetes is the most common form seen in dogs.
In contrast, Type 2 diabetes occurs more often in older people, over the age of forty, and is linked to factors like diet, exercise and body weight. Again the pancreas stops producing so much insulin, but additionally, the cells around the body become resistant to insulin, doubling down on the problem. Injectable insulin may still be needed, but attention to the lifestyle factors mentioned can help, and oral medication may be sufficient to solve the problem. This version of diabetes is found in cats, but not dogs.
To some extent, these definitions do not matter too much to owners: as far as they are concerned, their pets have diabetes, and help from the vet is needed to get them sorted. The good news is that help is available: most diabetic pets can be successfully treated, and can go on to live very normal lives.
As with many illnesses, prevention is better than cure, and if pets are kept lean and fit, with a healthy diet and plenty of exercise, they are less likely to develop diabetes. The disease is more common in middle aged dogs, it's three times more likely to develop in females compared to males, and overall, it develops in one in five hundred dogs.
It's become more common in cats in recent years, only affecting one in a thousand cats in 1970, whereas it now affects over one in a hundred cats. This increase is thought to be due to cats eating too much (and becoming obese), doing less exercise (they are more often kept indoors) and living for longer.
The signs of illness are usually, but not always, dramatic. Owners notice that their pets are drinking uncharacteristically high amounts of water, draining their water bowl. And often they have accidents indoors, leaving puddles in unexpected places. Often weight loss is also noticed, despite their pets having a ravenous appetite. Sometimes the signs are far more subtle than this: there's a lot of individual variation. Sometimes a vaguely unwell pet is taken to the vet, and when the diagnosis is made from blood and urine tests, it's a surprise to everyone.
Blood and urine tests are always the only way to be sure of the diagnosis, and these are often done repeatedly for the rest of the animal's life, checking to ensure that the blood glucose is being kept at the right level.
Treatment - in nearly all cases - involves once or twice daily injections of insulin. This sounds daunting at first, but most people quickly learn how to do it, and most pets rapidly adapt to their new routine.
November is Pet Diabetes Month: to find out more, visit my own website, at www.petethevet.com