The cells of the body require a sugar known as glucose for food and they depend on the bloodstream to bring glucose to them. They cannot, however, absorb and utilize glucose without a hormone known as insulin. This hormone, insulin, is produced by the pancreas. Insulin is like a key that unlocks the door to separate cells from the sugars in our bloodstream.
Glucose comes from the diet. When an animal goes without food, the body must break down fat, stored starches, and protein to supply calories for the hungry cells. Proteins and starches may be converted into glucose. Fat, however, requires different processing that can lead to the production of ketones rather than glucose. Ketones are another type of fuel that the body can use in a pinch but the detection of ketones indicates that something wrong is happening in the patient's metabolism. Ketones may therefore be detected in the urine of starving animals because of massive fat mobilization is required for ketone formation. Ketones can also be detected in diabetic ketoacidosis, a severe complication of unregulated diabetes so it is helpful to periodically monitor for ketones in a diabetic patient's urine. The point is, for now, that in times of extreme fat burning (such as in starvation), ketones are a byproduct.
Ketones in urine for three days or more in a row warrants a visit to the veterinarian.
IN A DIABETIC ANIMAL THERE ISN'T ENOUGH INSULIN
The cells cannot receive glucose from the blood because there is no insulin to permit it.
The body is unable to detect the glucose in the blood and is fooled into thinking it is starving.
Protein, starch, and fat break-down occur as they do in starvation.
Yet all along there has been plenty of glucose in the blood. In fact, by now, there is a large excess of glucose as all resources have been mobilized. Still, without insulin, this bounty of fuel cannot get to the tissues that need it.
The normal kidney is able to prevent glucose loss in urine. In a diabetic animal, there is so much glucose in the blood that the kidney is overwhelmed and glucose spills into the urine and is lost.
Glucose is able to draw water with it into the urine. This leads to excess urine production and excess thirst to keep up with the fluid loss.
Thus the main clinical signs of diabetes mellitus are:
It is usually fairly clear from the history and tests showing dramatic glucose elevations in the blood (and usually glucose in the urine, too) that diabetes mellitus is the diagnosis. Some pets are able to substantially raise their blood sugars from stress (such as might occur when a sensitive, sick, and anxious patient goes the vet's office). This could create misleading test results. If there is any question about the diagnosis, a test called a fructosamine level may be requested. This test reflects an average blood glucose level over the past several weeks so if this is also elevated, a one-time elevated glucose can be distinguished from the persistent elevations of true diabetes mellitus. The fructosamine test is also sometimes used in monitoring therapy for diabetes mellitus.
In dogs, sugars can enter the lens of the eye causing rapid cataract formation. Because a cat's lens is different, this phenomenon primarily occurs in dogs.
Another common symptom of diabetes mellitus is urinary tract infection. All the sugar in the urine makes the bladder an excellent incubator for bacteria. Antibiotics are necessary to clear up such an infection and some monitoring may be needed to help detect these infections.
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