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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