Diabetes mellitus is a common endocrine pancreatic disorder of cats and dogs. The incidence of diabetes in cats and dogs is reported to be anywhere from 1 in 100 to 1 in 500 pets.
Diabetes is classified as type I or type II. Type I diabetes is also called insulin-dependent diabetes. In this disorder, there is destruction of the beta cells (insulin-producing cells) of the pancreas. Treatment involves replacing insulin through insulin injections given 1 to 2 times per day.
Type II diabetes is also called non-insulin-dependent diabetes, as insulin is usually not required for treating pets with this disorder. Insulin resistance and dysfunctional beta cells, rather than permanent destruction of beta cells, are seen in pets with type II diabetes.
Type I diabetes is the most common type. Most (if not all) dogs with diabetes have type I diabetes; approximately 50 to 70% of cats have type I diabetes, with the remainder having type II diabetes.
Causes of type I diabetes include immune-mediated destruction of the beta cells of the pancreas in dogs and amyloidosis (deposition of amyloid protein in the pancreas) in cats. Other causes of diabetes in dogs and cats include obesity (probably the most common cause of type II diabetes in cats), genetics, infection, pancreatitis, and administration of certain medications (corticosteroids, progesterone compounds).
PRINCIPAL NATURAL TREATMENTS
Treatments for pets with diabetes include: natural diet/high-fiber diet/high-protein/low carb, exercise, glandular therapy, chromium, and vanadium.
Dietary therapy is useful in both dogs and cats with diabetes. Most diabetic dogs require insulin as they have type I diabetes (insulin-dependent diabetes). Many cats may not require insulin, as they have type II diabetes (non-insulin-dependent diabetes). These cats are most likely to respond to therapies that may include dietary therapy, nutritional supplementation, and exercise.
While not proven, some holistic veterinarians believe that years of feeding corn-based foods to cats (which amounts to feeding a high-carbohydrate food to a true carnivore, which is not natural) may be contributing to the high incidence of diabetes in cats.
The homemade diet recommended for dogs with diabetes is composed of 50 to 55% high quality complex carbohydrates (oats, vegetables, potato) with no simple sugars (such as sucrose, which may be included in commercial processed diets, especially soft-moist foods). Fat is restricted (no more than 20%), and moderate amounts of protein (15 to 30%) are included.
Diets high in complex carbohydrates (fibers) allow slower digestion and absorption of carbohydrates, which helps prevent wide fluctuations in blood glucose levels by minimizing postprandial glucose concentrations (postprandial refers to the period after a meal is eaten when blood glucose is most likely to spike to a high level, usually within 1 to 4 hours after eating). High complex carbohydrate diets also appear to increase the sensitivity of the cells of the body to insulin, which can improve blood sugar regulation. Carbohydrates such as vegetables, oats, and potatoes are more slowly digested and absorbed than rice and are preferred sources of carbohydrates for inclusion in the diets of diabetic dogs.
Soluble and insoluble fibers are carbohydrates commonly included in diets for dogs with diabetes. Soluble fibers (such as guar gum, which can be sprinkled on food at 8 gm/400 kcal of food) reduce blood sugar levels by absorbing water and forming gels that slow movement of food from the stomach, reduce absorption of glucose, and increase the passage of food throughout the intestinal tract (which serves to slow glucose absorption). Insoluble fibers (such as wheat bran added to the diet at 8 gm/400 kcal of food) have similar effects. Pumpkin, squashes, and similar vegetables can be used to add fiber to pet diets. Products such as sugar-free Metamucil can also he added to the pet's diet to provide additional fiber.
Dogs and cats with diabetes who are thin should not be fed high-fiber diets initially as they may continue to lose weight. These pets should be fed wholesome maintenance diets with small amounts of fiber added slowly once normalization of weight is achieved.
Diet for Dogs with Diabetes
Note: Before you start to feed your dog or cat a home-prepared diet, it is strongly recommended that you discuss your decision with your veterinarian or a holistic veterinarian in your area. It is essential that you follow any diet's recommendations closely, including all ingredients and supplements. Failure to do so may result in serious health consequences for your pet.
1 1/4 cups oatmeal or rolled oats, cooked
3 1/2 ounces (1/4 cup) kidney beans
1 large hard-boiled egg
1 cup mixed vegetables, cooked and drained
This diet provides 452 kcal, 24.5 gm protein, 8.9 gm fat, and supports the daily caloric needs of a 12- to 13-pound dog.
1. Substitute 1/3 pound chicken or turkey breast and 2 cups of potato cooked with the skin on for the rolled oats and the kidney beans. If this substitution is made, also add 30 gm (1 ounce) of wheat bran to the diet.
2. Add 1 1/2 to 2 bonemeal tablets (10-grain or equivalent) or 1/2 teaspoon of bonemeal powder to supply calcium and phosphorus with a multivitamin/mineral supplement, using the label instructions. Alternatively, use a natural product from Standard Process (1 Calcifood Wafer or 2 Calcium Lactate tablets for each 2 bonemeal tablets).
3. When possible, use natural vitamins made from raw whole foods, rather than synthetic vitamins (although both can he used in combination), as the natural vitamins also supply plant phytochemicals, enzymes and other nutrients not found in chemically-synthesized vitamins.
4. Use either Catalyn from Standard Process (at a dose of 1 Catalyn per 25 pounds) or Canine Plus from VeteriScience (following label dosages) as the natural vitamin in this recipe.
Diet for Cats with Diabetes
Most doctors also recommend similar diets for diabetic cats. However, cats are true carnivores and require meat in their diets. Therefore, the diet that may prove most helpful for diabetic cats uses the maintenance diet with added fiber. However, keep in mind that cats will usually not accept diets high in fiber.
1/3 to 1/2 pound of ground meat (turkey, chicken, lamb, beef)
1/2 to 1 large hard-boiled egg
1/2 ounce of clams chopped in juice
4 teaspoons chicken fat or canola oil
1/8 teaspoon potassium chloride (salt substitute)
100 mg taurine
If using 1/2 pound of chicken and 1/2 egg, the diet will provide 471 kcal, 53.1 gm of protein, and 27.4 gm of fat. An adult indoor 10-ponnd cat requires approximately 300 kcal of energy per day, an adult outdoor 10-pound cat requires approximately 360 kcal of energy per day, and a 5- pound kitten requires approximately 300 kcal of energy per day.
1. Substitute tuna (4 ounces in water without salt), sardines (4 to 6 ounces in tomato sauce), or other fish (such as 5 ounces of salmon) for the meat protein. For occasional variety, substitute 1/2 to 2/3 cup of tofu. Since cats are true carnivores, most doctors prefer to recommend tofu on only an occasional basis.
2. Add 1/3 cup of potato (cooked with the skin), rice, or macaroni, although cats do not have a defined dietary requirement for carbohydrates.
3. Supply vitamins and minerals as follows: 3 to 4 bonemeal tablets (10-grain or equivalent) or 3/4 to 1 teaspoon of bonemeal powder to supply calcium and phosphorus with a multivitamin/mineral supplement, using the label instructions. Alternatively, use a natural product from Standard Process (1 Calcifood Wafer or 2 Calcium Lactate tablets for each 2 bonemeal tablets).
4. When possible, add natural vitamins made from raw whole foods, rather than synthetic vitamins (although both can he used in combination), as the natural vitamins also supply plant phytochemicals, enzymes, and other nutrients not found in chemically synthesized vitamins. Use either Catalyn from Standard Process (at a dose of 1 Catalyn per 10 pounds) or NuCat from VetriScience (following label dosages) as the natural vitamin in this recipe.
5. For extra nutrition and variety, use fresh, raw or slightly steamed vegetables, such as carrots or broccoli (approximately 1/2 to 1 cup per recipe) as a top dressing for the diet. (Many cats, however, will not eat vegetables.) Most vegetables provide approximately 25 kcal per 1/2 cup.
6. The nutrient composition of the diet will vary depending upon which ingredients are used. The actual amount to feed will vary based upon the pet's weight (feed less if weight gain, more if weight loss).
7. Extra fiber can be added by supplementing with kidney beans (1/8 cup), oatmeal (1/4 cup), wheat bran (1/4 ounce), pumpkin or squashes, and sugar-free fiber products such as Metamucil.
Chromium is a trace mineral in the body. Chromium's role in maintaining good health was discovered in 1957, when scientists extracted a substance known as glucose tolerance factor (CTF) from pork kidney. GTF, which helps the body maintain normal blood sugar levels, contains chromium as the active component. GTF binds to and potentiates the activity of insulin.
Chromium is necessary for pancreatic beta cell sensitivity (beta cells make insulin), insulin binding, insulin receptor enzymes, and insulin receptor sites. Supplemental chromium tends to balance glucose metabolism, benefiting both hypoglycemic (low blood sugar) and diabetic patients. One explanation for this is that chromium may improve C-peptide levels, leading to enhanced pancreatic beta cell function.
Supplementing with chromium can lower blood lipids, which may make it beneficial in people and pets with elevated blood cholesterol levels.
Chromium's most important function is to help regulate the amount of glucose in the blood. Insulin regulates the movement of glucose out of the blood and into cells. It appears that insulin uses chromium as a cofactor to allow glucose to pass through the cell membrane and enter the cell.
Based on chromium's close relationship with insulin, this trace mineral has been studied as a treatment for diabetes. The results have been positive: Chromium supplements appear to improve blood sugar control in people with diabetes.
Chromium has principally been studied for its possible benefits in improving blood sugar control in people with diabetes. Reasonably good evidence suggests that people with adult-onset (type II) diabetes may show some improvement when given appropriate dosages of chromium. Individuals with childhood-onset (type I) diabetes may respond as well. Finally, chromium also appears to help treat problems with blood sugar control that are too mild to deserve the name "diabetes." Putting all the results together, it does appear that chromium supplementation can be helpful in treating diabetes, both type I and type II. However, more work needs to be done to determine the optimum dosage.
Tissue levels of chromium in people and pets are often low due to limited uptake of chromium by plants as well as limited absorption by people and pets.
As mentioned, it has been theorized that many Americans may be chromium-deficient. Preliminary research done by the U.S. Department of Agriculture (USDA) in 1985 found low chromium intakes in a small group of people studied. Although large-scale studies are needed to show whether Americans as a whole are chromium-deficient, we do know that many traditional sources of chromium, such as wheat, are depleted of this important mineral during processing. Some researchers believe that inadequate intake of chromium may be one of the causes for the rising rates of adult-onset diabetes. However, the matter is greatly complicated by the fact that we lack a good test to determine chromium deficiency.
While chromium is found in drinking water, especially hard water, concentrations vary so widely throughout the world that drinking water is not a reliable source. The most concentrated sources of chromium are brewer's yeast (not nutritional or torula yeast) and calf liver. Two ounces of brewer's yeast or 4 ounces of calf liver supply between 50 and 60 mcg of chromium. Other good sources of chromium are whole-wheat bread, wheat bran, and rye bread. Potatoes, wheat germ, green pepper, and apples offer modest amounts of chromium.
Calcium carbonate interferes with the absorption of chromium. People may have a difficult time absorbing and synthesizing chromium if it is not attached to a substrate such as picolonic acid (chromium picolinate) or nicotinic acid (chromium nicotinate). In people, concerns have been raised over the use of the picolinate form of chromium in individuals suffering from affective or psychotic disorders, because picolinic acids can change levels of neurotransmitters.
Recently, there has been the suggestion that chromium picolinate may cause damage to DNA, especially when combined with ascorbic acid. Alternative forms of chromium, such as that in the GTF form that can be extracted from foods such as yeast, contain no picolinic acid and may be safer. Additionally, while there are many forms of chromium available for supplementation, supplementation with an organic form (such as GTF) is recommended as this organically bound form of chromium is absorbed better and is more available to the pet than inorganic forms of chromium. More research is needed on this topic, although the use of the GTF form may he preferred until results are in.
Chromium appears to be safe in people when taken at a dosage of 50 to 200 mcg daily. However, concern has been expressed since chromium is a heavy metal and might conceivably build up and cause problems if taken to excess. Recently, there have been a few reports of kidney damage in people who took a relatively high dosage of chromium: 1,200 mcg or more daily for several mouths. For this reason, the dosage found most effective for individuals with type II diabetes -- 1,000 mcg daily -- might present some health risks. Similar concerns are probably applicable for pets.
For pets with diabetes that may respond to chromium supplementation, a decreased dosage of insulin may he needed; medical supervision is essential before decreasing insulin.
The recommended dosage for the use of chromium in pets with diabetes is 50 to 300 mcg per day. Typically, a dosage of 200 mcg/cat of chromium picolinate is recommended. However, since picolinate may cause damage to DNA, more research is needed in this area. Using the chromium GTF natural supplement would be a safer alternative, although research using this form to determine the proper dosage has not been done. Work with your veterinarian to determine whether chromium supplementation can be used in your pet.
Calcium carbonate supplements may interfere with the absorption of chromium. The maximum safe dosages of chromium for young children, women who are pregnant or nursing, or those with severe liver or kidney disease have not been established; similar concerns are probably warranted in pets.
Vanadium is a mineral, and evidence from animal studies suggests it may be an essential micronutrient.
In people as well as pets, there are no well documented uses for vanadium, and there are serious safety concerns regarding its use. However, vanadium has been proposed to be of benefit to patients with diabetes as vanadium has insulin-like properties and may inhibit protein tyrosine phosphatase (FTP).
Studies in rats with and without diabetes suggest that vanadium may have an insulin-like effect, reducing blood sugar levels. Based on these findings, preliminary studies involving human subjects have been conducted, with promising results.
Based on promising animal studies, high doses of vanadium, like chromium, have been tested as an aid to controlling blood sugar levels in people with diabetes. However, animal studies suggest that taking high doses of vanadium can be harmful.
In various studies in people, vanadium has been used at doses thousands of times higher than is present in the diet, as high as 125 mg per day. However, there are serious safety concerns about taking vanadium at such high doses. Many doctors do not recommend that people exceed the nutritional dose of 10 to 30 mcg daily (some people with diabetes are prescribed 50 to 100 mcg/day).
To date, most doctors feel that studies using vanadium were all too small to be taken as definitive proof. More research is needed to definitely establish whether vanadium is effective (not to mention safe) for the treatment of diabetes.
New organic forms of vanadium have been synthesized -- vanadyl acetylacetonate, vanadyl 3-ethylacetylacetonate, and bis (maltolato) oxovanadium. These forms appear to be safer than vanadyl sulfate and are well tolerated in diabetic cats.
In small studies in cats, the use of vanadium did improve clinical signs and reduce blood glucose levels with minimal signs of toxicity.
In pets with diabetes, dosages of 0.2 mg/kg daily for vanadium and 1 mg/kg daily for vanadyl sulfate seem safe. Some holistic veterinarians adapt the recommended human dose of vanadium to pets, using 50 mcg/day for small dogs and cats, 75 mcg per day for medium-sized dogs, and 100 mcg per day for larger dogs. The dosage of 34 of a capsule of Super Vanadyl Fuel (Twin Laboratories, Hauppauge, New York) given once daily on the food of diabetic cats appears safe. However, you should not administer vanadium (or chromium) to your pets unless under veterinary supervision.
With insulin-resistant type II diabetics, vanadium may help balance glucose levels by increasing glycogen synthesis (glycogen is a storage form of glucose). Because vanadium mimics many of the effects of insulin, it may improve blood sugar balance. In some studies, vanadium supplements have been shown to lower plasma glucose levels, improve insulin sensitivity, increase glucose uptake, and decrease blood fat levels in type I and type II diabetes.
Studies of diabetic rats suggest that, at high dosages, vanadium can accumulate in the body until it reaches toxic levels. Based on these results, high dosages of vanadium can't be considered safe for human use; similar concerns are probably reasonably applied to dogs and cats.
Glandular therapy is also used in the treatment of diabetes. This therapy uses whole animal tissues or extracts of the pancreas. Current research supports this concept that the glandular supplements have specific activity and contain active substances that can exert physiologic effects.
While skeptics question the ability of the digestive tract to absorb the large protein macromolecules found in glandular extracts, evidence exists that this is possible. Therefore, these glandular macromolecules can be absorbed from the digestive tract into the circulatory system and may exert their biologic effects on their target tissues.
Several studies show that radiolabeled cells, when injected into the body, accumulate in their target tissues. The accumulation is more rapid by traumatized body organs or glands than healthy tissues, which may indicate an increased requirement for those ingredients contained in the glandular supplements.
In addition to targeting specific damaged organs and glands, supplementation with glandular supplements may also provide specific nutrients to the pet. For example, glands contain hormones in addition to a number of other chemical constituents. These low doses of crude hormones are suitable for any pet needing hormone replacement, but especially for those pets with mild disease or those that simply need gentle organ support. Glandular supplements also function as a source of enzymes that may encourage the pet to produce hormones or help the pet maintain health or fight disease.
Finally, glandular supplements are sources of active lipids and steroids that may be of benefit to pets. The dosage of glandular supplements varies with the product used.
OTHER NATURAL TREATMENTS
Other therapies include exercise, omega-3 fatty acids, vitamin B6, alanine, glutamine, DMG, glycoproteins, N-acetylcysteine (200 to 1,500 mg/day), proanthocyanidins; herbs: bilberry, burdock root, calendula, dandelion leaf, dandelion root, garlic, gymnema, marshmallow, Panax ginseng, and yucca.
These can be used in conjunction with conventional therapies, as they are unlikely to be effective by themselves in most patients with severe diabetes. The natural treatments are widely used with variable success but have not all been thoroughly investigated and proven at this time.
As with any condition, the most healthful natural diet will improve the pet's overall health.
Conventional therapy for pets with type I diabetes is with the injectable drug insulin, which works to lower blood sugar. Oral hypoglycemic agents (which lower blood sugar) can he used but are not routinely prescribed for most diabetic pets. In cats with non-insulin-dependent diabetes (and possibly in any pet with type I or type II diabetes), dietary therapy (usually a higher fiber diet containing increased amounts of soluble and insoluble fiber designed to reduce obesity and minimize fluctuations in blood glucose) and exercise (when possible) may be effective in lowering blood sugar and controlling clinical signs.
Excerpt from The Natural Health Bible for Dogs and Cats: Diabetes used by permission of Prima Publications.
Copyright © 2001 by Shawn Messonnier, D.V.M. All rights reserved. Excerpt from The Natural Health Bible for Dogs & Cats, Prima Publishing, Roseville, CA.