Veterinary Medicine - May 2008 - (Page c5) Managing diabetes mellitus in dogs: An overview However, because diabetic dogs are usually middle age to older animals with concurrent disorders, further diagnostics are warranted, including a complete blood count (CBC), serum biochemistry pro le, complete urinalysis, and urine culture. Abdominal ultrasound and thoracic radiographs may also be warranted. Test results common in diabetic dogs include a normal CBC, and a serum biochemistry pro le revealing increased alanine transaminase, aspartate aminotransferase, and alkaline phosphatase activities; lipemia; and hypercholesterolemia. The urine speci c gravity may be variable, although most diabetic dogs have hypersthenuria. Glucosuria is always present in diabetic patients, and proteinuria, bacteriuria, or ketonuria may also be present. Perform a urine culture and sensitivity testing even if white blood cells are not detected in the urine sediment. Dogs with diabetes mellitus are often immunocompromised; therefore, they may have a urinary tract infection with few or no white blood cells in the urine sediment. administration. Examples of such diets are Purina Veterinary Diets DCO (Nestlé Purina) or Prescription Diet w/d Canine (Hill’s Pet Nutrition). You can feed diabetic dogs the new diet regardless of weight or body condition score. Many diabetic dogs lose weight because of poor glycemic control. The new diet should improve glycemic control and ultimately result in weight gain. The diet also facilitates weight loss in diabetic and nondiabetic overweight dogs. Exercise may also promote weight loss and improve glycemic control independently of the e ect on body condition, as it does in people.3 It is extremely important for clients to understand that vigorous or episodic exercise can result in adverse hypoglycemia. Therefore, you should recommend moderate and routine exercise and ask clients to alert you of any changes in the extent of exercise, which should be made gradually. “Diabetes mellitus is a complex disease, and managing it is equally complex. “ Insulin Insulin is one of the central components of diabetic therapy in dogs and you may choose from several di erent insulin products. Most commercially available insulins are human analogue insulins produced by recombinant DNA techniques. Human insulin di ers from canine insulin by one amino acid. Regulation of insulin secretion Diet and exercise Treat and monitor stable diabetic patients as outpatients.You should place these patients on an appropriate diabetic diet with a high concentration of insoluble ber and complex carbohydrates, yet limited in calories and fat.You can change from the patient’s normal diet to the new diet immediately; however, if the patient is hesitant to eat the new diet (a rare problem in polyphagic diabetic dogs), mix the new diet into the old diet and gradually replace the old diet over the course of a week. The diet should contain a total daily caloric intake based on the desired body weight and should be divided into two meals o ered twice a day at 12-hour intervals and just before insulin Glucose is the primary regulator of insulin secretion. Glucose that enters beta cells in the pancreas is metabolized to adenosine triphosphate (ATP), which results in the closure of ATP-sensitive potassium channels. Closure of these potassium channels decreases potassium e ux and results in beta cell depolarization and the opening of voltage-sensitive calcium channels. The increased cytoplasmic 5
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