What should be the normal level of sugar in dogs' blood and urine? Find out!

Diabetes mellitus is a clinical syndrome caused by absolute or relative deficiency of insulin, characterized by chronic hyperglycemia with the development of decompensation of all types of metabolism, primarily carbohydrate, and occurring in both acute and chronic forms.

Causes of diabetes. Diabetes mellitus in dogs occurs as a result of insufficient production of insulin by the beta cells of the pancreatic islets of the pancreas, or when there is a malfunction in the body when the hormone insulin produced goes unnoticed by target cells. As a result, the dog's blood glucose levels rise sharply. In the dog’s body, the activity of almost all organs and tissues is disrupted.

Scientists identify several groups of factors that lead to this condition in an animal:

• Genetic (the following dog breeds are at risk: Beagle, Doberman, Poodle, Labrador Retriever, Scotch Terrier, Pomeranian, Spaniel, Dachshund, and other dwarf dog breeds).
• Autoimmune disorders in which the normal functioning of the pancreas is impossible.
• Viral infection (canine distemper, canine parvovirus enteritis, canine adenovirus, infectious hepatitis in dogs).
• Pancreatitis (pancreatitis in dogs).
• The action of various cytotoxic substances.
• Long-term hormonal therapy.
• Irregularities in feeding a dog, leading to obesity.
• Features of gestation or estrus.

Causes of the disease

The pathology manifests itself in metabolic disorders, which occurs due to an increase in glucose in the blood. Under the influence of insulin, sugar is absorbed by the body's cells and serves as a source of energy. The mechanism of diabetes development is as follows: for various reasons, the pancreas is not able to produce enough insulin, sometimes it does not secrete it at all.

Thus, the cells of the body do not receive the hormone produced, and their absorption of glucose stops. Carbohydrate starvation occurs, accompanied by exhaustion.

The critical age for the onset of diabetes mellitus is considered to be 4-14 years, while experts are sounding the alarm in connection with the “rejuvenation” of the disease. So, 10 years ago, pathology was diagnosed in animals that had reached 7 years of age.

When talking about the reasons that contribute to the development of diabetes, it would be wrong to focus solely on the age of pets, since the disease can manifest itself in a dog at any age. Provoking factors include:

• overweight, obesity;
• pathologies of the pancreas (inflammation, chronic insufficiency);
• changes in hormonal levels during pregnancy, estrus, due to medication, etc.;
• unbalanced diet.

The disease is diagnosed more often in females than in males.

Predisposition and characteristics of breeds

It is impossible to determine the actual cause of diabetes. The disease may be hereditary. However, there are factors that have the greatest likelihood of developing pathology and increasing glucose in the dog’s body:

1. Pet obesity.
2. Use of hormonal drugs.

Most often, unsterilized females from 7-9 years old suffer from diabetes.

The following breeds also have a predisposition:

• Keeshonds;
• miniature pinschers;
• poodles;
• dachshunds;
• pugs;
• beagles;
• Samoyed husky;
• miniature schnauzers;
• all types of terriers.

A drop in sugar in adult dogs may be due to:

1. Addison's disease. Complex pathology with quite complex diagnostics.
2. Disorders of the liver or endocrine system.
3. Blood circulation abnormalities in the liver.

Hypoglycemia is especially common in small, toy dogs. Basically, the disease is observed in these breeds:

• Pomeranian and Pomeranian Spitz;
• chihuahua;
• Great Dane;
• Rottweiler;
• bearded collie;
• Portuguese Water Dog;
• beaver;
• Toy, Yorkshire, Wheaten and West Highland White Terriers.

Symptoms

Pathology can be suspected based on the following signs:

• polydipsia (increased thirst);
• frequent salivation, the consistency of saliva is sticky and viscous;
• polyuria (increased urination), while the dog goes to the toilet often, but urine is released in large quantities;
• polyphagia (gluttony), which is characterized by eating the usual portions with great speed;
• weight deficiency to the point of exhaustion - the dog’s ribs are clearly visible, the stomach falls in;
• cardiopalmus;
• unpleasant sour odor from the mouth;
• dull, tousled coat, alopecia;
• cataract;
• dry skin, skin diseases;
• enlarged liver;
• poor blood clotting and slow wound healing;
• vomiting, diarrhea (in rare cases).

The dog's behavior also changes. She becomes lethargic, apathetic, moves little and shows no interest in walks. If the dog is a street dog, then it is much more difficult to notice his characteristic signs, except that painful thinness immediately catches the eye.

Average level in puppies

The average blood glucose levels of a puppy are the same as those of an adult dog. Hypoglycemia can be detected in puppies up to 4 months after birth. This happens for several reasons:

1. There is not enough glucose in mother's milk.
2. Litter too big.
3. Prematurity or low birth weight of the baby.
4. Congenital liver dysfunction.
5. Hypothermia.
6. Frequent diarrhea, which leads to dehydration.
7. Fear of extraneous noises. Thunderstorms, thunder, fireworks and a large number of people can greatly frighten a puppy.
8. Long breaks between meals. The baby can sometimes get too busy and forget to eat.
9. Infectious diseases.

Vivid signs of low sugar in the body are:

• weakness;
• chills;
• drowsiness;
• lethargy;
• refusal of food;
• convulsions and fainting. This happens in acute forms of the disease.

To help your baby, it is enough to give him a small amount of sweet water every 5 hours. Add a teaspoon of honey or sugar to the water. You can also give an injection of 5 percent glucose. Food for the tailed baby and its mother should be rich in protein and sugars.

Important! If the puppy refuses the food offered to him, it is necessary to replace the dish. Prolonged fasting should not be allowed. After six months, the problem with low sugar should disappear. Otherwise, you need to consult a doctor.

When a baby begins to develop diabetes, the following signs are typical:

1. The puppy drinks a lot and becomes lethargic and inactive.
2. A large amount of saliva is produced.
3. Urination becomes more frequent.

If your puppy has high sugar levels, the following should be excluded from the diet:

• carrots, beets and potatoes;
• any sweets;
• fatty dairy products;
• fatty meat and fish;
• bakery products;
• fatty broths;
• pasta;
• canned food;
• oatmeal and white rice.

Diagnostics in a veterinary clinic

To make a correct diagnosis, the doctor will need to not only examine the dog to identify signs characteristic of diabetes, but also conduct a number of necessary instrumental studies. To confirm or exclude the diagnosis of diabetes mellitus, the following is indicated:

• urine test for acetone;
• general and biochemical blood tests;
• hormonal tests;
• glucosametry;
• ECG;
• Ultrasound of the pancreas (other organs as necessary).

If a doctor diagnoses diabetes mellitus, he will prescribe appropriate treatment, which will depend on the form of the pathology, the dog’s age and state of health.

Why are glucose and insulin needed?

In order for the body to convert nutrients into energy, two things are needed: glucose and insulin.

Glucose is the body's fuel. The body receives glucose when it breaks down nutrients. This type of sugar is a source of energy for the organs and cells of the body. From the gastrointestinal tract, glucose enters the blood, and the blood carries glucose throughout the body.

Insulin is produced by the pancreas. This hormone is responsible for ensuring that glucose enters cells and organs. Insulin tells cells to take up glucose and other nutrients.

Insulin is the key that opens the glucose channel. Through this channel, glucose enters the cell and nourishes it.

Treatment method and prognosis

The principle of treating diabetes mellitus is to stabilize the general condition, eliminate symptoms and, most importantly, bring glucose to normal levels (no more than 8-10 mmol/l).

Normalization of glycemic metabolism is carried out with the help of insulin injections, as well as the management of primary and secondary pathologies. It is impossible to completely cure diabetes, so you will have to monitor your blood sugar levels and prevent them from rising in the blood throughout the life of your pet.

Important: for type 1 diabetes mellitus, so-called short-acting insulin is used, for type 2 diabetes, long- or medium-acting insulin is used. When insulin is administered, glucose is brought to a level above the upper normal limit. This measure is due to a reduction in the risk of hypoglycemia - a sharp drop in sugar.

The drug is administered using special injection pens or insulin syringes. The dosage of the medicine is prescribed by the veterinarian based on the condition of the dog. At first it is minimal (0.5 units/kg body weight), then it can gradually increase. To select the dosage, the doctor will need to observe the dog’s condition for several days, and sometimes even months.

Convenient places for insulin administration are the abdomen, chest, and withers. Use your fingers to form a fold of skin, after which a needle is carefully inserted into its base.

The specialist monitors the dynamics of changes in glucose levels, usually using blood tests (every 2-4 hours) as the most convenient method. The veterinarian also evaluates the dog’s general health and behavior: frequency of urination, weight gain, increased appetite. If the dosage of insulin is selected correctly, then the main signs of diabetes disappear.

It is very important to remember that too much insulin is just as dangerous for a dog as too little. So, if the owner does not remember whether he administered the drug or not, it is better not to risk it and skip one injection. Otherwise, the dog may develop Somogyi syndrome, which poses a danger to the patient’s life.

If the doctor's instructions are strictly followed and insulin is administered strictly according to the schedule, you can expect that the dog will live a long and full life. However, from the moment diabetes is diagnosed, the veterinarian becomes a constant consultant and observer of the animal’s well-being.

How to take blood and measure sugar from a cat or dog with a glucometer

The accuracy of the measurements depends on how correctly the blood is collected for analysis. In dogs and cats, biomaterial is taken from the auricle at home. The puncture site is first shaved. There is no need to treat with an antiseptic - microdrops can distort the result.

Before the procedure, prepare several test strips and, if necessary, calibrate them according to the instructions for the device. Do not touch the electrode end of the test strip or the reaction chamber. Also, do not touch the reaction chamber of the test strip with wet hands, otherwise the test strip may become contaminated.

Pinch the animal's ear with the index finger and thumb of your left hand - the vessels and their blood supply will be visible in the light a few millimeters from the outer edge.

For small animals, use a scarifier or human syringe pens. For large pets, use 20G infection needles. When puncturing, insert the needle with the bevel facing up. The depth of the puncture should be approximately equal to the diameter of the tool used. After blood comes out, touch the test strip to the drop.

Treat the puncture site with an antiseptic and apply pressure with a tampon to avoid hematoma. If your doctor orders several measurements at short intervals, you can clear the initial puncture of the blood clot, apply pressure to the ear, and draw blood again, rather than making a new puncture.

The results of glucose monitoring must be recorded - this will help the doctor to correctly determine the range of deviations, calculate the dose of insulin and balance the animal’s therapeutic diet. You can buy a veterinary glucometer with test strips from the Corway company.

What to do at home

Treatment of the dog must be carried out under the strict supervision of a specialist; none of the folk remedies for treating diabetes mellitus is effective. Every responsible owner should remember this. Moreover, addiction to various herbs can only aggravate the course of the disease and provoke death.

The owner should be prepared for the fact that blood sugar levels may drop from time to time. Hypoglycemia in dogs manifests itself in weakness, lethargy, loss of consciousness, convulsions, and unsteady gait. If the animal is not provided with timely assistance, it may die.

The first thing to do is feed and water the dog - if he is conscious. Next, you should introduce 1-2 ampoules of glucose into the mouth (drip). If your pet has lost consciousness, you need to sprinkle a little sugar on its tongue (coat it with honey). The time when this condition was recorded should be noted in the log.

Clinical signs

It is very important to promptly identify the presence of diabetes in an animal and begin treatment immediately. In a dog with diabetes, excess glucose gradually begins to accumulate in the blood and then penetrates the kidneys. To compensate for the lack of nutrients, the animal is forced to eat and drink a lot, and urinate frequently. If the necessary measures are not taken at this stage, the pathological condition will begin to affect the animal’s liver. An excessive amount of ketone bodies will concentrate in his blood, which will lead to the development of life-threatening ketoacidosis.

The disease has the following clinical signs:

• polydipsia (increased thirst) - the animal constantly drinks, but the saliva in its mouth remains viscous and sticky;
• copious, frequent urination – the dog often asks to go for a walk, the puddles become much larger than before;
• excessive appetite - the animal eats its portion very quickly and asks for more;
• obvious weight loss - the abdomen recedes, intercostal arches become visible;
• the animal looks lethargic and sick;
• the fur becomes too dry, disheveled, and begins to fall out;
• mucous membranes are dry, saliva is viscous;
• tachycardia (heart rate more than 150 beats per minute);
• weight loss due to good appetite;
• smell of sour fruit from the mouth;
• Diabetic cataracts (clouding of the lens) may occur;
• wounds do not heal well;
• palpation of the abdomen often reveals an enlarged liver;
• skin diseases appear - eczema, dermatitis;
• sexual reflexes fade away.

Side effects of insulin

A typical side effect of insulin administration is hypoglycemia (an abnormal drop in glucose levels). Its typical signs are convulsions, general weakness, a state of stagnation and coma. Hypoglycemia is a dangerous acute condition that requires immediate administration of glucose to the animal. To do this, you can inject the drug intramuscularly or give the dog a piece of sugar. If this side effect develops, insulin injections are not given for some time, after which the drug is resumed, but in a lower dosage.

Another side effect is Somogyi syndrome, a physiological phenomenon consisting of the animal’s body reacting to a sharp decrease in glucose levels. This syndrome can develop when the animal is given too high doses of medication. They first cause a sudden drop in glucose levels, and then an uncontrolled release of diabetogenic hormones into the animal’s blood. This leads to the development of hypoglycemia in the animal, which usually goes unnoticed by the owner. Only a specialist can save a dog from the consequences of chronic insulin overdose.

What else can a veterinarian do?

In addition to the fact that the veterinarian can make the correct diagnosis, prescribing what to treat in this case, he will also help build nutrition for the dog. And this will change the way of life that was familiar to this time. The doctor will also tell you about the subtleties that cannot be ignored. And this means that you always have insulin at hand, especially on the road. Only opened packaging lasts for 1 to 2 months.

Don't be embarrassed to ask your doctor. His help will help you properly help your pet. You will learn how to store insulin itself and how to give injections. And periodic monitoring by a veterinarian will prevent you from missing something important with such a disease.

Diabetes mellitus in dogs

Skomorovsky Kirill Aleksandrovich therapist, endocrinologist, neurologist, DVM, BSc

Diabetes mellitus in dogs, cats and humans has much in common. However, the mechanism that leads to the development of diabetes and its manifestations often differ significantly depending on the animal species. And therefore, approaches to treatment are also not the same in everything. Therefore, we cannot blindly transfer everything we know about diabetes in humans to dogs.

For example, it is incorrect to divide diabetes in dogs into type 1 and type 2 diabetes, as is common in humans. In addition, many drugs that work well in humans work poorly or not at all in animals. There are other differences too. So, we will only talk about dogs.

What happens normally

All cells in our body require glucose (“sugar”) as their main source of energy. Glucose enters the body through the intestines from food or from internal reserves (liver glycogen, muscles, etc.). From the intestines or from internal reserves, glucose is carried to places of consumption by the blood. However, for most cells, it is not enough for the blood to bring them glucose; it is also necessary for a hormone called insulin to transmit the corresponding signal to the cell, and the cell is able to perceive this signal. This hormone is produced in the body in the so-called islets of Langerhanz in the pancreas.

So, after eating, glucose from the intestines enters the blood and its level in the blood increases. The pancreas senses this increase and releases insulin into the blood. The cells of the body perceive the insulin signal and transfer glucose from the blood into the cytoplasm (inside the cells). The level of glucose in the blood drops, the cells feel “full”, and the pancreas stops releasing insulin into the blood.

What happens with diabetes

In diabetes, one or both of the following occurs:

• the pancreas loses its ability to produce enough insulin
• body cells lose the ability to perceive the insulin signal

In both cases, the cells “do not understand” that there is already enough glucose in the blood and do not transport it inside. As a result, blood glucose levels remain high while cells starve. Hence, one of the symptoms of diabetes is high blood glucose.

Normally, the kidneys do not pass glucose from the blood into the urine. However, when blood glucose levels rise above a certain limit, the kidneys cannot cope and glucose begins to be excreted in the urine. Thus, another symptom of diabetes mellitus appears - high glucose in the urine.

When there is a lot of glucose in the urine, it then “pulls” water from the blood. As a result, the volume of urine increases and the animal begins to urinate a lot. Water is removed from the body, the body becomes dehydrated, the animal feels thirsty and begins to drink more. Hence two other symptoms of diabetes: polyuria and polydipsia (excessive drinking and urination).

Since cells cannot bring glucose in, this situation is essentially starvation for the body. It includes compensation mechanisms: the animal becomes hungry and begins to eat more than usual (although this is not beneficial, since glucose remains in the blood and then leaves in the urine), and internal energy reserves are also mobilized. When glycogen stores in the liver and muscles are no longer sufficient, the body begins to use protein and fat reserves. Due to protein breakdown, muscle mass decreases. This is how another symptom of diabetes appears - increased appetite along with weight loss.

With the massive breakdown of fats in the body, many ketone bodies are formed. Ketone bodies can also be found in urine. One of the ketone bodies is acetone, so animals that are seriously ill with diabetes may smell acetone in their breath. In addition, the acidity of the blood increases (pH decreases). This situation is called diabetic ketoacidosis and is critical. Without intensive treatment, it can lead to death in a matter of days, or even hours.

High blood sugar has a detrimental effect on many systems: diabetic cataracts (the lens of the eye becomes cloudy), due to damage to the nerve fibers, weakness of the hind limbs and a plantigrade gait appear (rare in dogs). The presence of sugar in the urine creates excellent conditions for the growth of bacteria, so cystitis is also a common complication of diabetes.

Who has diabetes

It most often appears in dogs between 7 and 9 years of age. Among dogs, unsterilized females are more likely to get it.

What is the reason

In dogs, the main cause is hereditary predisposition.

Without delving into the mechanism of development of diabetes, we can say that in most cases it is impossible to establish the exact cause of its occurrence. However, there are factors that predispose to diabetes and, together, can lead to it. These factors are:

• overweight
• treatment with hormonal drugs
• pancreatitis
• the period of the first 1-2 months after estrus or pregnancy
• other hormonal disorders.

How to make a diagnosis

To make a definitive diagnosis of diabetes, it is not enough to detect any one of the above-mentioned signs, since for each of them there can be many other causes besides diabetes. For example, polyuria and polydipsia can be caused by chronic renal failure, blood glucose can rise simply from stress, cataracts can simply be “senile”, and increased appetite along with weight loss can be caused by worms. For this reason, if you or your doctor suspects an animal has diabetes, it is often necessary to carry out a whole range of examinations, which are necessary both to make an accurate diagnosis and to detect associated problems and complications. These examinations may include: blood tests (general, biochemical, acid-base balance, serial glucose measurements, hormone tests), urine tests, assessment of the amount of fluid intake and urine output, x-rays, ultrasound, ECG.

What to do next

So, we know that our animal has diabetes mellitus, that is, the body’s cells do not take glucose from the blood inside. In most cases, to overcome the lack of insulin or low sensitivity to it, it is necessary to introduce insulin from outside.

It is impossible to predict in advance exactly how much insulin will be needed for any given animal. However, based on the weight of the animal and previous experience, you can start with a certain dose, and then adjust the amount and frequency of insulin administration in accordance with the body’s reaction. For the most accurate and quick dosage selection, the best way is to construct a glucose curve. To do this, blood glucose is measured every 1-2 hours after insulin administration for 8-24 hours. Thus, you can find out at what interval after administration insulin begins to act, at what period its action peaks, how long and how strongly it acts.

The next step is to select the optimal time to feed the animal. Depending on the type of insulin used (short, intermediate or long-acting), on the type of food and on the individual characteristics of the animal, it may be recommended to feed simultaneously with insulin administration, some time after administration, split and frequent feeding in small portions, or providing constant access to food.

Further observation is carried out by the owner with regular monitoring by the attending physician. The animal's condition may change, insulin sensitivity may increase or decrease, and concomitant diseases may appear. For this reason, it is necessary to periodically come for follow-up examinations, conduct laboratory tests, and sometimes repeat the construction of the glucose curve.

It is necessary for the doctor or assistant to explain in detail and show the owner how to store, how to draw and how to administer insulin.

It is important to remember that the effects of too much blood glucose affect the body gradually, while a drop in blood glucose below normal levels (hypoglycemia) can be fatal very quickly. Therefore, when using insulin, the goal is not to bring glucose to a normal level, but to keep it slightly above the upper limit of normal. This way we will be sure that we will not get hypoglycemia.

For the same reason, it is not as scary to “under-dose” insulin as to overdose it. Therefore, if you injected insulin, but were not sure that you were in the right place (for example, you felt that the fur became wet at the injection site), or you do not know whether someone at home injected insulin before you, never re -inject insulin. It is better to miss an injection once than to inject twice by mistake.

Since there are often some difficulties with purchasing insulin in pharmacies, it is recommended to always have one spare sealed package of insulin at home. It is usually recommended to throw away an opened package of insulin after 1.5-2 months, even if it is not completely used up.

Feeding

Usually, immediately after a meal, glucose in the blood increases very strongly, and the body of a diabetic animal cannot cope with such a load. Therefore, the point of feeding for diabetes is to ensure that the flow of glucose from food into the blood is as slow as possible. This is usually achieved by selecting special sources of dietary fiber in the right proportion. In addition, the food must contain a limited amount of calories and a sufficient amount of protein. The best solution is to feed with special medicated food. If for any reason this is not possible, you should discuss other options with your doctor. As we mentioned above, the frequency and time of feeding are selected individually.

As for the amount of food consumed per day, it is very important to feed the animal in such quantities that it remains thin. Obesity reduces the sensitivity of cells to insulin, which means it worsens diabetes.

When to sound the alarm

If the animal develops weakness, unsteady gait, trembling, loss of consciousness, convulsions, it is necessary to offer the animal to eat (if it is conscious), and if it refuses food, spread honey, sugar syrup or glucose solution on the oral mucosa (tongue, gums). and contact your doctor immediately.

If your blood or urine glucose levels rise above what they were before, you should contact your doctor within 1-2 days.

If the blood glucose level drops below 3 mmol/liter, it is necessary to offer the animal to eat (if it is conscious), and if it refuses food, spread honey, sugar syrup or glucose solution on the oral mucosa (tongue, gums) and immediately contact doctor.

If your urine glucose level drops to zero and/or ketones appear in your urine, you should check your blood glucose levels.

Diabetic ketoacidosis

Diabetic ketoacidosis is a critical condition that usually appears after an animal has had diabetes for a long time. However, in some cases, diabetes can lead to ketoacidosis in a matter of days. As mentioned above, in this state the body mobilizes large amounts of fat as an energy source. The liver forms ketone bodies from these fats, one of which is acetone. This leads to acidification of the blood and can lead to death within a short time.

Symptoms of diabetic ketoacidosis are: the smell of acetone on the breath, lethargy, refusal to eat, vomiting, diarrhea, rapid breathing, low temperature, coma.

If one or more of these symptoms occur, you should contact your doctor immediately.

Treatment of animals in a state of diabetic ketoacidosis consists primarily of insulin and intensive care. In such cases, insulin is used not so much to lower blood glucose levels as to stop the production of ketone bodies in the liver. For this purpose, short-acting types of insulin are used; the drug is administered very often (every 1-2 hours) and under strict control of blood glucose levels. Droppers are needed in order to restore water, acid-base and electrolyte balance in the body, in order to quickly remove ketone bodies from the body, and also to prevent blood glucose from falling below normal due to the administration of insulin in large quantities. doses

Problem cases

If the patient cannot be stabilized for a long time, the reason may be the following:

• incorrect dialing and/or administration of insulin
• ineffective insulin (expiration date has expired or storage conditions have not been met)
• accelerated insulin metabolism (rapid elimination from the body)
• Somogyi effect (too high a dose of insulin can lead first to a sharp drop and then to a strong and prolonged rise in glucose levels)
• simultaneous use of other drugs (especially hormones)
• changes in internal hormonal levels (sexual cycle in bitches, hyper- and hypo-adrenocorticism, acromegaly, etc.)
• concomitant infections (in particular, cystitis, periodontal disease, dermatitis) and other diseases
• obesity (see above)
• true insulin resistance
• excess fats in the blood
• antibodies against insulin.

What can you do besides insulin?

In most cases, no drug can replace insulin in the treatment of canine diabetes. However, there are a number of measures that can, if not eliminate, then at least significantly reduce the need for insulin in animals. For female dogs, such an event is, first of all, sterilization (removal of the uterus and ovaries). If diabetes appears during the first two months after estrus or pregnancy, then sometimes spaying or simply ending this period completely relieves the animal of the symptoms of diabetes. However, the predisposition to diabetes remains, and it can reappear at any time.

Another important point regarding obese animals is reducing body weight to normal. It is also important to increase the animals’ physical activity (walk longer and play with dogs).

You should switch to feeding special medicinal foods (Hill's w/d, Royal Canin Diabetic, etc.).

Use of oral hypoglycemic agents

Glipizide (as well as glyburide and glibenclamide) – enhances the production of insulin by the pancreas. This drug is not effective in treating canine diabetes. Metformin - increases tissue sensitivity to insulin, and also reduces the release of glucose from the body's internal reserves and the synthesis of glucose in the body.

Metformin could possibly help animals that retain some ability to produce insulin, but side effects (lethargy, loss of appetite, vomiting) limit its use. At this stage, additional research is required to draw conclusions about the feasibility of its use.

Vanadium is an element found everywhere. It probably has insulin-like properties and is virtually free of side effects, but is nonetheless ineffective on its own. Vanadium was studied in the form of dipicolinate. This form is not available for purchase. Vanadium sulfate is sold as a vitamin supplement, but its effectiveness is unknown.

Chromium – in the form of picolinate, enhances the effect of insulin in healthy dogs. However, this effect was not observed in dogs with diabetes.

Acarbose - inhibits digestive enzymes responsible for breaking down starches (the main sources of glucose in the intestines). As a result, glucose enters the intestines more gradually and more even glucose levels are maintained in the blood. The drug is expensive and has side effects (diarrhea, weight loss), so it is used in dogs only if insulin alone is not enough to control hyperglycemia.

Troglitazone – increases tissue sensitivity to insulin