829
edits
Changes
Jump to navigation
Jump to search
no edit summary
===Management===
===Management===
The non-ketotic diabetic animal can be managed as an outpatient and a great deal of the monitoring and treatment of the disease will then devolve upon the owner. In dogs, almost all cases of diabetes mellitus are insulin-dependent and insulin is therefore a necessary part of the management regime. Since many cats suffer from non-insulin dependent diabetes mellitus, they can often be managed with a change in diet and oral hypoglycaemic drugs.
The non-ketotic diabetic animal can be managed as an outpatient and a great deal of the monitoring and treatment of the disease will then devolve upon the owner. In dogs, almost all cases of diabetes mellitus are insulin-dependent and insulin is therefore a necessary part of the management regime. Since many cats suffer from non-insulin dependent diabetes mellitus, they can often be managed with a change in diet and oral hypoglycaemic drugs.
====Insulin====
====Insulin====
Recombinant insulin is available in a variety of different preparations. Soluble (or neutral) insulin is short-acting and administered by infusion but, when mixed with zinc and protamine, it has a much longer duration of action. '''Lente''' insulin (a zinc salt preparation) is used most commonly in dogs and it may given once or twice per day. '''Protamine zinc insulin''' (PZI) is usually used in cats as this species seems to be able to degrade insulin more quickly and it has a longer duration of action than the Lente preparations. Bovine insulin is usually used in Lente preparations but, in dogs that are thought to have developed antibodies to this, porcine insulin may be used as it is homologous to canine. An initial insulin dose should be selected and this should not be changed suddenly for three days to allow the animal to respond fully. Insulin has more predictable pharmacokinetics if given intra-muscularly.
In cats, PZI is usually given once per day, followed by a meal after approximately 30 minutes. A second dose of insulin is not usually required and, if it is required, a zinc-insulin preparation should be used instead of PZI as the latter may cumulative activity.
In dogs, once daily dosing is often used but twice daily dosing (with injections at 12 hour intervals) is also an acceptable protocol. Meals are offered 30 minutes after each injection.
====Diet====
====Diet====
=====Dogs=====
The diet fed to diabetic animals should be consistent and, at least initially, it should have a good caloric density to allow animals to regain weight. The diet should be low in simple carbohydrates which may induce the secretion of glucagon and other hormones antagonistic to insulin. A constant feeding schedule should be maintained, with the animal being fed twice per day at the same times.
It has been shown in dogs that feeding a higher fibre content may achieve better stabilisation in cases of diabetes mellitus because this substrate is metabolised slowly.
=====Cats=====
Similarly to dogs, the diet should be consistent and not contain a large proportion of simple carbohydrates.
====Hypoglycaemic Drugs====
====Hypoglycaemic Drugs====
===Monitoring===
===Instability===
===Instability===