Veterinary Medicine - May 2008 - (Page c4) An overview Rebecka S. Hess, DVM, DACVIM Assistant Professor of Internal Medicine School of Veterinary Medicine University of Pennsylvania Philadelphia, Pa. Managing diabetes mellitus in dogs: Diabetes mellitus is a complex disease, and managing it is equally complex. Treatment of diabetes mellitus in dogs typically includes insulin therapy, an appropriate diet, and an exercise regimen, all of which must be constantly monitored and adjusted throughout the patient’s lifetime. Communicating clearly with clients and preparing them for the need to monitor and modify treatment is vital for successfully treating a diabetic dog. Clients must be committed to extensive care, monitoring, and frequent o ce visits. They must understand that these steps are necessary—not because you cannot provide optimal care—rather, this is simply the nature of the disease. If clients know at the onset that the dose of insulin is likely to change several times a year and that their dog will have well-regulated periods mixed with periods of suboptimal regulation, feelings of frustration they might have down the road will be replaced with understanding and patience. All of these considerations contribute to e ective treatment for the patient and a long-lasting, productive relationship between you and the client. Signalment and clinical signs The average age of onset for diabetes mellitus in dogs is 7 to 9 years. Samoyeds, Australian terriers, miniature schnauzers, miniature and toy poodles, and pugs are at an increased risk for diabetes mellitus, whereas German shepherds, golden retrievers, and American Sta ordshire terriers are at decreased risk for the disease.1 The classic history and clinical signs typically associated with diabetes mellitus in dogs include polyuria and polydipsia, weight loss, polyphagia, and blindness due to cataracts. Physical examination ndings may vary from normal to severely compromised and can be nonspeci c. Dogs with diabetes mellitus can have an underweight, normal, or obese body condition.Their hydration status can also vary from normal to dehydrated. In a stable diabetic dog, hepatomegaly and cataracts are common, whereas lethargy and weakness are observed less frequently. Diabetic dogs often have concurrent disorders that in uence their history, clinical signs, and physical examination ndings.The most common concurrent disorders in diabetic dogs are hyperadrenocorticism, urinary tract infection, hypothyroidism, acute pancreatitis, and neoplasia.2 Diagnosis The diagnosis of diabetes mellitus is based on history, clinical signs, physical examination ndings, and persistent hyperglycemia and glucosuria. 4
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