Dog Diabetes: What Dog Owners Need to Know About Successful Management

Diabetes is a well-known disease in humans, but it will also affect about 1 out of 300 dogs at some point in their lives. There’s no cure for diabetes, but with a little extra care, diabetic dogs can live a normal, happy life. 

So what exactly is diabetes? How do you manage diabetes in a dog? And how is gut health involved? Keep reading to learn what the latest science says about canine diabetes. 

Diabetes (the official name is diabetes mellitus) is a chronic disease in which the body’s cells don’t get enough glucose. Glucose is the sugar molecule that all cells use for energy. Insulin, a hormone produced by the pancreas, helps deliver glucose to the cells.

The glucose-insulin system can fail for two reasons. That’s why there are two types of diabetes: insulin deficiency and insulin resistance.

• In insulin deficiency diabetes, also called insulin-dependent diabetes, the body’s cells can’t get the glucose they need because the pancreas doesn’t produce enough insulin. This typically occurs due to damage to the cells of the pancreas. In humans, this kind of diabetes is labeled type 1. Insulin deficiency is the kind of diabetes most commonly seen in dogs.

• In insulin resistance diabetes, the pancreas produces enough insulin, but the body doesn’t make proper use of it, so cells don’t get the glucose they need. In humans, this kind of diabetes is labeled type 2. Older and obese dogs are more susceptible to this form of diabetes. 

Can a dog with diabetes really have a normal life?

“Absolutely!” says Terri Fox, who runs the Southern California dog rescue organization Foxy and the Hounds. “Dogs do very well once you get the insulin regulated and figure out what they need. Then they live very good, normal lives.” Fox’s own diabetic dog, a Miniature Poodle named Squirrel, is thriving now that her diabetes is being properly managed.

Early detection is the key to a good outcome. So what symptoms should a dog parent be looking for? Because the symptoms of diabetes can develop gradually, they may not be obvious right away. Here are the clinical signs dog parents should be aware of.

Early signs of diabetes:

• Increased Thirst
• Frequent Urination
• Weight Loss
• Increased Appetite

Advanced signs:

• Decreased Appetite
• Lack of Energy
• Cloudy Eyes
• Vomiting
• Chronic or Recurring Infections (especially infections of the skin and urinary tract)

If you notice any of these signs, see your veterinarian (DVM or similar). The earlier diabetes is detected and managed, the better chance a dog has of enjoying a normal, healthy life.

Diabetes isn’t the result of any single cause, and any dog can develop this disease. But multiple factors can influence a dog’s risk. Here are some of the main risk factors for diabetes in dogs:

• Obesity. A dog who is 20% or more above their ideal body weight is considered obese. Among many other negative health effects, obesity puts a dog at significantly higher risk of developing diabetes. Obesity causes chronic inflammation, which contributes to insulin resistance. It’s also a risk factor for pancreatitis, a condition of inflammation within the pancreas (the organ that produces insulin). Frequent bouts of pancreatitis can damage the pancreas and increase the chances of a dog developing diabetes. 

• Age. Older dogs are at higher risk of developing diabetes. Though the disease can occur in younger dogs, most diabetic dogs are diagnosed between the ages of 7 and 10 years.

• Sex. Diabetes occurs twice as often in female dogs as in male dogs. That’s because unspayed females produce the hormone progesterone, which can increase blood sugar levels and cause insulin resistance. Dogs that receive injections of progesterone for breeding purposes are also at an increased risk for insulin resistance.

• Pregnancy. Because of their elevated progesterone levels, pregnant dogs sometimes develop temporary insulin resistance, a condition that’s also called gestational diabetes.

• Long-term steroid use. Over time, corticosteroid (steroid) medications—which are commonly used to treat inflammation—increase the level of glucose in the blood and may lead to insulin resistance.

• Certain diseases. A number of diseases can affect the body’s ability to produce or use insulin properly. Pancreatitis can damage the cells that produce insulin, causing insulin deficiency. Other diseases that may increase a dog’s risk of developing diabetes include Cushing’s disease (hyperadrenocorticism), heart disease, kidney disease, autoimmune disorders, and some infections.

• Breed. Any dog of any breed can develop diabetes, but genetic factors do seem to influence a dog’s lifetime risk for the disease. According to the American Kennel Club, breeds at higher risk include Miniature Poodles, Bichons Frisés, Pugs, Dachshunds, Miniature Schnauzers, Pulik, Samoyeds, Keeshonds, Australian Terriers, Fox Terriers, Cairn Terriers, and Beagles.

Untreated diabetes can cause serious problems throughout the body. When the glucose-insulin system breaks down, two unhealthy processes happen at the same time: the body’s cells don’t get enough glucose (energy), and the glucose that isn’t going to the cells builds up to harmful levels in the blood.

1. Cells Don’t Get Enough Glucose

When insulin isn’t there to signal the cells to take glucose out of the bloodstream, or the cells can’t respond properly to that signal, those cells don’t get the fuel they need to function. The body then tries to compensate by breaking down fat and tissue for energy instead. That’s why untreated diabetes often causes weight loss and increased appetite: the body is starving because it’s unable to use the glucose in food efficiently. In addition, the process of breaking down the body’s own tissues produces high levels of toxic chemicals, leading to potentially life-threatening metabolic problems.

2. High Levels of Sugar Build Up in the Blood

When glucose isn’t being properly distributed to the cells, it builds up in the blood. And high levels of glucose in the blood acts like a poison, which can eventually damage the kidneys, eyes, heart, blood vessels, and nerves. The body tries to get rid of excess sugar in the blood by sending it out in the urine, along with the water that has bonded to the sugar molecules. That’s why unmanaged diabetes typically increases urination, thirst, and water consumption.

Without treatment, diabetes can lead to blindness, kidney failure, diabetic ketoacidosis (a potentially life-threatening complication in which the blood becomes too acidic), seizures, and death. 

To find out whether your dog has diabetes, your veterinarian will do a combination of blood tests and urine tests. If those tests show both consistently elevated blood sugar (hyperglycemia) and glucose in the urine (glucosuria), your dog will be considered diabetic.

Next, your veterinarian will decide on an appropriate type and starting dosage of insulin and will show you how to do the injections at home. The amount of glucose in your dog’s blood will need to be tested regularly in order to establish the right insulin dose.

Since diabetes occurs most often in dogs who are middle-aged or older, your veterinarian might also recommend other tests in order to evaluate your dog’s overall health. Some diseases of the thyroid and endocrine system have similar symptoms to diabetes mellitus and will need to be ruled out.

Dog parents who are suddenly faced with this diagnosis may feel afraid for their dog or anxious about the unknown challenges ahead. There’s no cure for diabetes, only management. (Preventive care is also extremely important: we’ll tell you more about that—and how our DoggyBiome products can help—a little later in this article.)

Some dog parents may believe that managing the disease will be too difficult or too expensive, but it’s actually fairly simple and straightforward once you establish the right insulin and diet regimen with your veterinarian. The goal is to keep your dog’s blood sugar level consistently close to that of a healthy dog. You do that primarily with insulin therapy and by controlling what your dog eats. Here’s what’s involved in managing a diabetic dog.

Insulin

The main treatment most diabetic dogs need is insulin injections, just under the skin, typically twice a day. In Terri Fox’s experience, this is the part people worry about most. But “it’s really very easy,” she says. The needle is so thin that most dogs don’t even notice it. You “pinch the skin and make a little tent, and it goes right in.” Your veterinarian will show you how to do the injections at home.

Figuring out the correct amount and type of insulin for your dog may take some time, says Fox, but “getting the insulin regulated is the most important thing.” And once you and your veterinarian have established the right dosage, “you’re good!”

Diet

Another critically important part of diabetes management is a consistent feeding schedule. Diabetic dogs need to eat, because not eating enough can lead to insulin overdose or hypoglycemia (low blood sugar). They also need to eat the same food at the same time every day. 

A high-protein, high-fiber diet is usually recommended. By feeding your dog a healthy, balanced diet, you’re also feeding the beneficial gut bacteria that perform important functions throughout your dog’s body. 

Commercial dog diets designed specifically for managing diabetes are widely available. Talk to your veterinarian about the best options for your dog.

Daily Exercise

Regular, moderate exercise is strongly recommended for diabetic dogs. Exercise is important not only for maintaining a healthy weight but also for preventing sudden spikes or dips in blood glucose levels. In addition, exercise is good for your dog’s gut health. (We’ll get to the importance of gut health very shortly!)

Monitoring

You can do a lot to help your diabetic dog stay healthy and happy just by paying attention and supporting their well-being:

• Monitor your dog’s weight, appetite, thirst, and urination frequency. Talk to your veterinarian if you notice any changes.
• Check your dog’s glucose levels periodically with test strips or an implanted glucose sensor.
• Schedule regular examinations, including blood and urine tests.
• Watch for signs of possible complications, such as cataracts (common in diabetic dogs), hind leg weakness, high blood pressure (which can cause weakness, seizures, or sudden blindness), and urinary tract infections (diabetic animals have decreased resistance to bacterial and fungal infections). 
• Promote good gut health.

It makes sense that the gut microbiome—the community of bacteria and other microbes that live in the digestive tract—is involved in diabetes, because the bacteria in the gut are responsible for breaking down food and converting it into the glucose that fuels all the body’s cells.

And indeed, numerous studies have identified connections between the gut microbiome and diabetes. When compared to healthy individuals, humans with diabetes, obesity, and other metabolic disorders have been found to have intestinal dysbiosis (imbalance of the gut microbiome). Specifically, they have fewer beneficial bacteria and larger populations of harmful bacteria. Dysbiosis is known to lead to issues with regulating metabolism, including increased insulin resistance.

Similar patterns of gut imbalance have been identified in diabetic dogs. For example, one study published in Frontiers in Veterinary Science found larger numbers of bacteria from the family Enterobacteriaceae in the guts of diabetic dogs than in healthy dogs. This family of bacteria is associated with higher levels of inflammation, which can lead to insulin resistance, as well as inflammatory bowel disease (IBD) and other chronic disorders.

Other studies have demonstrated that making changes to the gut microbiome can positively influence the symptoms of diabetes. For example, in humans with diabetes, researchers found that administration of a new microbial cocktail containing the probiotic bacteria Akkermansia muciniphila, Clostridium beijerinckii, Clostridium butyricum, Bifidobacterium infantis, and Anaerobutyricum hallii significantly improved glucose levels after a meal. In another study, changes made to the gut microbiome of mice by feeding the probiotic Eubacterium hallii improved the body’s ability to use insulin properly. 

Another way to modify the gut microbiome is via fecal microbiota transplantation (FMT). This process transfers stool from a healthy donor to the gut of a sick recipient in order to deliver a complete, balanced community of species-appropriate gut microbes. By adding healthy populations of beneficial bacteria to the recipient’s gut microbiome, FMT can correct imbalances, crowd out harmful bacteria, and resolve many of the symptoms caused by a gut imbalance.

Studies in humans have found that FMT may help manage the symptoms of diabetes by decreasing inflammation, increasing metabolism, and reducing gut bacterial imbalances. In a study involving mice, modifying the gut microbiome via FMT reversed insulin resistance in those animals.

Dr. Arnon Gal (University of Illinois College of Veterinary Medicine) presented preliminary findings of a study of the effects of AnimalBiome’s DoggyBiome Gut Restore Supplement (FMT capsules) on diabetic dogs at the 2022 American College of Veterinary Internal Medicine (ACVIM) Forum. In this study, FMT via the Gut Restore Supplement capsules reduced diabetic dogs’ water intake, lowered their required daily dose of insulin, and increased the abundance of several kinds of gut bacteria that produce anti-inflammatory molecules called short-chain fatty acids (SCFAs).

That last effect is important because SCFAs are also involved in stimulating insulin secretion, regulating glucose uptake, and supporting the healthy functioning of the gut barrier. Dr. Gal’s preliminary findings suggest that diabetic dogs who received the DoggyBiome Gut Restore Supplement had improved control of their blood sugar levels.

The first step toward improved gut health is to find out exactly what’s going on in your dog’s gut microbiome with our easy, noninvasive DoggyBiome Gut Health Test. The test kit includes everything you need to collect a small stool sample from your dog and send it back to us for analysis. 

Using DNA sequencing, we can identify all the different kinds of bacteria living in your dog’s gut and detect any imbalances or harmful populations. You get a detailed report with a clear explanation of your dog’s results, as well as actionable recommendations for personalized diet, supplement, or lifestyle changes to improve your dog’s overall health.

If your dog’s Gut Health Test report indicates a significant imbalance, our DoggyBiome Gut Restore Supplement (FMT capsules) can bring the microbiome back into balance by seeding the gut with beneficial, dog-specific microbes. Our oral FMT capsules have been shown to improve digestive and immune health, promoting well-formed poop as well as healthy skin.

Every diabetic dog’s situation is different, so working closely with your veterinarian is the best way to ensure that your dog gets the support they need. Here are some questions to ask:

• What extra costs will be involved in my dog’s treatment?
• How often will my dog need follow-up visits, and what will be involved?
• What if I miss giving a dose of insulin or give too much?
• Can I give my dog treats?
• Are there any restrictions on my dog’s activity?
• How can I manage a diabetic dog in a household with other dogs and cats?
• What should I know about how diabetes affects my dog’s other condition(s)?
• Are there any behavioral issues I should know about?
• Are there any new treatment options available or in development?

If you have pet insurance for your dog, your coverage may include treatment for diabetes. Depending on the terms of your particular plan, pet insurance may cover insulin, more frequent exams and blood work, a prescription diet, Gut Health Tests, and other DoggyBiome products. The best way to maximize the benefits of pet insurance is to buy a policy when your dog is still young and healthy. 

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