Canine Diabetes Insipidus
Canine
Diabetes Insipidus
Diabetes Insipidus (DI) is a disorder of water balance. The animal
is unable to concentrate urine, so the urine volume is very high
and the urine is dilute. "Insipid" means tasteless - referring to
the dilute urine. This disease is rare in dogs. The condition is
usually permanent, and the prognosis is good. Without treatment,
dehydration leads to stupor, coma, and death. This is a completely
different disease from Diabetes Mellitus.
Types
of Diabetes Insipidus
Central
Diabetes Insipidus - caused when the pituitary gland does not
secrete enough antidiuretic hormone (ADH) also called vasopressin.
This type of DI may be the caused by a congenital defect, trauma,
a tumor on the pituitary gland, or unknown causes.
Nephrogenic
Diabetes Insipidus - caused when the kidneys do not respond
to the ADH that is produced by the pituitary gland. This type of
DI may be caused by a congenital defect, drugs, or caused by other
metabolic disorders. Signs include polyuria (excessive urination)
and polydipsia (excessive drinking).
Diagnosis
Diagnosis includes ruling out other diseases such as hyperadrenocorticism
(Cushing's disease), Diabetes Mellitus, hyperthyroidism, renal failure,
liver disease, pyometra (infection of the uterus), and other disorders.
Images of the pituitary gland may be taken to determine if there
is a tumor. A water deprivation test or an ADH trial with DDAVP
may be done. These tests determine if the animal is able to produce
more concentrated urine as water is withheld or following the injection
of DDAVP (the drug used to treat DI).
Treatment
Central DI is treated with desmopressin, a drug that mimics the
actions of ADH. It is available under the trade name DDAVP and as
a generic. DDAVP is available in several formulations: as a nasal
spray pump; as a liquid for use with rhinal tube; as an injectable
liquid; and in tablets. Most pet owners use the nasal spray or rhinal
liquid formulations and use them as eye drops, nose drops, or inject
it subcutaneously.
Nephrogenic
DI is commonly treated with thiazide diuretics. These drugs help
to concentrate the urine. An oral drug called chlorothiazide acts
on the kidneys to help concentrate the urine. Other treatments may
include chloropropamide, which increases the effects of ADH on the
kidney. (But chloropropamide is not always successful.) Nonsteroidal
anti-inflammatory drugs (NSAIDS) may be used in dogs.
Lastly,
no therapy may be chosen and the dog can survive as long as plenty
of water is always available. You cannot limit their water intake.
Low
Blood Sugar - Hypoglycemia (Insulin Shock)
If an animal's blood sugar level becomes so low that the energy
needs of the cells are not met, the cells begin to suffer and lose
their ability to function. Especially true with nerve and muscle
cells that have high respiratory rates and that need continuous
oxygen and glucose for survival, a lack of glucose results in rapid
deterioration of function. The usual signs in a dog that the blood
sugar level is too low are trembling, agitation and muscle incoordination.
Ultimately a seizure may occur. These animals need a quick source
of energy in the form of carbohydrates and will not survive hypoglycemia
if oral or intravenous sugars are not administered.
Any
diabetic dog should be closely monitored for signs of hypoglycemia,
especially if the animal vomits or skips a meal and insulin has
been administered. The insulin will drive much of the circulating
glucose into the cells and if there is no recent dietary source
of additional glucose, hypoglycemia may result. As well, if the
diabetic animal engages in an unusual session of vigorous physical
activity, it may deplete the glucose stores in the body and become
hypoglycemic.
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