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Healing & Alternative Health
Dr. Carson's Holistic Animal Care:
SIGNS OF AGING IN THE DOG AND CAT, PART XXI:
Organs of the Abdomen: Diseases of the Pancreas: Diabetes Mellitus - Non-Insulin Treatment
by Kathleen M. Carson, D.V.M
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What is the treatment for Diabetes mellitus (DM)? Since DM is such a complex disease, the treatment plan is often complex, too. In this month’s column, I’ll discuss non-insulin treatments.
A.) Attention to a diabetic dog or cat’s diet is crucial in the control of the disease. 1.) Reducing obesity is very important in diabetic animals; obesity can cause insulin resistance. 2.) It is ideal that the blood glucose (BG) stays as even as possible. One of the ways of doing this is by offering several small meals per day. However, with our busy lives, this isn’t always possible, so other means have been developed to bring this about.
One of the ways of accomplishing both these ideals is through a diet high in fiber and complex carbohydrates and low in calories. The higher fiber content slows the passage of the food through the digestive tract, and complex carbohydrates are broken down slowly into the simpler sugars. Slower passage through the GI tract and the slower conversion of complex carbohydrates to the simple sugar, glucose, keep the BG at a more even level in the hours after a meal. [This is contrasted to a diet which is higher in the simple sugars (in a human diet, this would include such things as a candy bar or a piece of cake), which brings about a sudden rise of the BG, followed by an equally precipitous drop in BG.]
Examples of diets high in fiber and complex carbohydrates and lower in calories are Hill’s r/d and w/d.
A special diet which has been developed for the feline diabetic is one which is high in protein and low in carbohydrates (CHOs). This mimics a cat’s natural diet in the wild: cats are carnivores, ie, meat-eaters; this diet is naturally high in protein. (On the other hand, dogs are omnivores; in the wild they eat more of a varied diet.) A cat’s body is made to derive its energy sources from protein. This is a slower process than deriving them from CHOs, so their BG tends to be more even in the hours after a meal.
If a cats is fed a high level of CHOs in addition to protein, then he can end up with a BG level which is chronically higher than normal (hyperglycemia). This puts stress on his pancreas to produce more and more insulin. Eventually, pancreatic exhaustion can come about, and the cat can become diabetic.
Returning their diet to a more normal high protein/low CHO diet takes away the extra stress on a cat’s pancreas. On this more natural diet, some diabetic cats lose their need for insulin altogether, or they need a much lower dose.
Examples of feline high protein/low CHO diets are Hill’s m/d and Purina’s DM.
B.) Exercise is another very important consideration in a diabetic dog or cat. Active muscles need glucose for fuel. Increased exercise means lower BG. Exercise is important for diabetic animals; it is crucial to the weight reduction necessary in most diabetic animals. However, it is very important to be consistent in the amount of exercise your diabetic animal gets. A sudden increase in exercise will reduce her BG faster than normal. Unless the dose of insulin given is reduced, this very low BG may lead to collapse, convulsions, and even death.
C.) If your diabetic cat has type II DM, or non-insulin-dependent DM (NIDDM), his diabetes may be controlled by drugs which are called oral hypoglycemic agents. Remember that cats with NIDDM produce insulin, but their bodies can’t utilize it properly; this is called insulin resistance. The oral hypoglycemic agents promote insulin secretion and also improve tissue responsiveness to insulin.
Probably the most commonly used oral hypoglycemic agent is a drug called glipizide (the best-known brand name for this drug is Glucotrol®).
Statistically, about 15% of cats with NIDDM respond completely to oral hypoglycemic agents, and 15% respond partially. The latter category of cats would also require low doses of insulin.
If the disease in these non-insulin-dependent cats progresses to the point where their pancreases no longer are able to produce any insulin at all (insulin-dependent DM or IDDM), then the oral hypoglycemic agents will no longer be effective; those cats will have to go on insulin (or go to higher doses if already on it).
These drugs in some patients have adverse side effects: vomiting, liver damage, and icterus (jaundice). A cat on these drugs needs to be monitored carefully, both clinically and through laboratory tests.
Next month I’ll discuss insulin therapy for diabetic dogs and cats.
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Dr. Kathleen Carson, DVM
Veterinarian & Author
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Dr. Carson received her Doctor of Veterinary Medicine degree from the University of California at Davis in 1968. She's been a small animal practitioner (dogs and cats ) for all the years since, except for a short stint at the San Diego Zoo when she first graduated.
She belongs to the American Veterinary Medical Association and the American Holistic Veterinary Medical Association.
Since 1974 she's lived and practiced in the South Bay Area near Los Angeles. She started the area's first house call practice in 1976 and the first pet crisis/loss group in 1989. The human-animal bond is of special interest to her.
She started exploring complementary veterinary medicine in 1987. Her practice became 100% holistic in 1996. She utilizes acupuncture, herbs, supplements, Bach Flower Remedies, homeopathic remedies, nutrition and medications for her patients in her practice.
She's currently taking a leave of absence from her house call practice due to health reasons but continues to do phone consultations and to write.
E-mail:
Critterhlr@aol.com
website:
http://www.holistic
vetconsult.com
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