Diagnosing for Diabetes Just Got Better

How do you know if a pet is a diabetic? Historically, the focus has been on measuring blood glucose levels.

It turns out there may be a better test to determine the big picture. Testing for fructosamine does just that. Fructosamine is a compound formed by the non-enzymatic reaction between fructose and ammonia or an amine.

Fructosamine testing looks beyond the hour-to-hour and day-to-day blood glucose fluctuations to provide the animal’s average glucose over the previous weeks or even months.

While blood glucose curves may change by the hour, fructosamine offers a truer larger picture of what’s happening, which is significant in dogs and even more so in cats.

Most cats don’t come into the veterinary clinic pleased to be there (though the Fear Free initiative should change this over time). The fear, anxiety, and stress resulting from being forcibly stuffed inside the carrier, the car transport, and the exam at the hospital impacts the blood glucose levels of most cats. It’s a fact that their fear factor impacts the blood work. Though veterinarians can project their views based on the numbers they see, these numbers are somewhat subjective to interpret.

A fructosamine test may help the veterinarian to quickly and confidently differentiate a temporary, stress-related, visit-induced spike in blood glucose from diabetes mellitus in an animal with no diabetic signs at home. Rather than measuring the “right now” snapshot of blood glucose, fructosamine offers a longer term and truer picture with more objectivity.

Of course, it’s suggested that veterinary professionals educate pet owners regarding symptoms of diabetes in dogs and cats, and ask if any combination of the symptoms are present.

Symptoms of diabetes in dogs:

• Change in appetite
• Excessive thirst/increase in water consumption
• Weight loss
• Increased urination
• Accidents in the house (when a dog is clearly house trained)
• Unusually sweet-smelling or fruity breath
• Lethargy
• Dehydration
• Urinary tract infections
• Vomiting
• Cataract formation, blindness
• Chronic skin infections

Symptoms of diabetes in cats:

• Increased thirst
• Sudden increase in appetite
• Sudden weight loss (despite an increase in appetite)
• Increased urination
• Accidents outside the litter box
• Increased lethargy
• Vomiting

Many pets with diabetes show any combination of the above symptoms, but some don’t exhibit any outward signs. And often a pet’s symptom can go unnoticed or be excused by the owner – like cats or dogs who vomit, it’s just what they do. That’s why seeing a veterinarian twice a year is important. The only way to definitively diagnose diabetes is through blood work. And the fructosamine level might be the most objective measure, offering that grand picture of what’s been going on inside the pet.

Though not a symptom of diabetes in cats, obesity is a common problem for diabetic cats, and the weight problem is related to their most common Type 2 diabetes.

Type 2 diabetes occurs when the cells in the cat’s body don’t respond to the insulin that is being provided. As a result, the cat becomes hyperglycemic (high blood sugar), which may lead to having excess sugar in the urine.

With proper insulin therapy, a shift to a higher protein and lower carb diet, weight loss, and exercise (to enhance weight loss and adjust metabolism), many lucky cats may go into diabetic remission.

In dogs, Type 1 diabetes is by far the most common, as the pancreas is not able to produce enough insulin to regulate the glucose in the bloodstream, leading to persistent high glucose levels in the blood. The cause of this type of diabetes in dogs is greatly unknown, though there’s little doubt that genetics is a significant factor. Many of these dogs are overweight or obese, just because so many dogs are overweight or obese in the U.S., but unlike in the cat, too many pounds – while generally unhealthy – doesn’t cause the diabetes. These dogs require insulin therapy, and remission is highly unlikely.

The bad news is that diabetes is way up in dogs and cats. The good news is that diabetes is considered treatable (as mentioned, cats may even go into remission). However, in order to treat, appropriate diagnosis is necessary.

At your pet’s next preventive care visit, ask your veterinarian if your dog or cat is at increased risk of developing diabetes and if the fructosamine test could help detect the disease.