Pet Health Guide - Pancreas

Diabetes Mellitus

The pancreas is classified as an endocrine organ that is responsible for certain digestive functions. This digestive function is carried out by enzymes (amylase, lipase, elastase, trypsinogen, and chymotrypsin) that are delivered into the small intestine. Just as critical is the production of insulin from specific pancreatic “beta cells”. Insulin is responsible for the utilization and uptake of glucose after a meal.

Type II Diabetes Mellitus (DM) is a pancreatic disorder characterized by inadequate insulin production, target tissue insensitivity and/or insulin transport failure. Diminished insulin release from the pancreas occurs for many reasons including excess steroid use, obesity, and poor (fatty) diets. Excess glucose in the blood and subsequent elimination in the urine is characteristic in diabetic patients.

Type II DM is the most common type of diabetes in the cat with risk factors that include obesity, decreased physical activity, genetics and gender. DM affects cats at any age, however, it is more commonly diagnosed in neutered male cats over 6 years of age, which is the same population at risk for obesity.

Clinical Signs

The onset of diabetes is often insidious. Clinical signs include:

• Abdominal pain
• Excessive drinking (polydipsia) and urination (polyuria) [PU/PD].
• Increased appetites but lose weight
• Cataracts
• Weak & lethargic

Diabetes Mellitus (Type II) & Diet Recommendations (Dogs)

Dietary management of diabetic dogs is aimed at a diet high in complex carbohydrates (starch and fiber), low in soluble carbohydrates (sucrose, lactose, glucose and fructose), low in fat and a low to moderate amounts of high quality protein. Dogs with DM require strict attention to diet selection, feeding method (times), daily activity and medications. An alternative to dry commercial dog foods is to feed a high quality canned dog food containing the essential nutrient quantities of protein, fat, fiber and no sugars. Canned food is preferred over dry because weight loss is improved due to lower caloric content and higher moisture levels. This results in a higher rate of transient DM remission.

Dietary fiber slows the rate of digestion in the small intestine which allows for more thorough digestion of food and the slower release of nutrients into the bloodstream. Fiber, therefore, maintains an even and continuous flow of nourishment without the spikes in hunger often seen without it. Similarly, oat products (oatmeal) also have a regulatory capacity on the liver’s production of glucose thereby maintaining more consistent energy levels through the controlled release of glucose into the circulation. Reducing fluctuations of blood glucose concentrations in diabetic animals results in more predictable eating and weight management.

L-Carnitine (an amino acid) is critical for fatty acid metabolism and energy production, especially in diabetic dogs. It increases the rate of weight loss and promotes lean body mass. Most high quality dog foods already contain this amino acid and list it on the panel of ingredients.

In addition to Vetsulin Insulin replacement for dogs, the following guidelines are for stabilized dogs not undergoing an acute pancreatitis.

Feeding Plan Considerations

1. Restricted protein that is high quality (lean) ~18% dry matter.
2. A diet with minimal fat is essential ~5%-7%.
3. NO SUGARS (including beet pulp) of any kind (food or treats) is permissible.
4. Provide a high amount of complex carbohydrates ~ 40%-50%.
5. Provide a high fiber content ~10%-20%.
6. Diets should have reduced caloric content ~185-250 kcal/cup.
7. Maintain strict feeding schedules. A defined schedule of feeding, exercise and treat giving is critical to managing your dog’s diabetes.

Diabetes Mellitus (Type II) & Diet Recommendations (Cats)

Dietary management of diabetic cats is aimed at a diet low in complex carbohydrates (starch and fiber), low in soluble carbohydrates (sucrose, lactose, glucose and fructose), low in fat and high in good quality protein. Cats have the ability to convert protein to glucose in the liver. Glucose generated from the liver has more regulation over spikes in hunger than glucose derived from feeding carbohydrates. Therefore, diabetic cats provided a high amount of protein in their diets, produce a steady flow of glucose into their bloodstream from their liver at a constant rate compared to glucose derived from dietary carbohydrates and fiber.

Because fat is known to increase insulin resistance and decrease glucose tolerance in the body, it is important to replace carbohydrates with protein and not fat in the diet. This concept of replacing carbohydrates and fat for protein is referred to as a “metabolic shift”. The is similar to the concept used in the well known Atkin’s diet for people. There are some noteworthy exceptions to feeding DM cats a diet high in protein and low in carbohydrates.

Cats with concurrent kidney failure appear to have improved appetites and attitude when switched to lower protein therapeutic diets. Cats with acute pancreatitis appear to respond to therapeutic diets having a larger portion of calories obtained from carbohydrates than protein. Cats with severe liver disease or impairment should not be fed any diet high in protein.

Weight reduction has been shown to improve glucose control and regulation through the pancreas and liver. Some cats having lost weight resolved their Type II diabetes suggesting a strong correlation with obesity. Feeding a low carbohydrate diet reduces blood glucose and reduces insulin requirements with a reduction in the amount of body fat storage. So what’s the best carbohydrate source? Moderate energy from carbohydrates such as corn, oats, barley and sorghum should be fed to cats to promote ideal body weight. Highly processed (white) rice is 100% digestible and quickly absorbed in cats. Diets containing certain fructose sugars should be avoided. Fructose is common in semi-moist foods and uncommon in dry foods.

Cats with DM require strict attention to diet selection, feeding method (times), daily activity and medications. Recent studies support the claim that cats regulate food intake by volume, and fiber rich foods (cereal grains) reduce caloric intake and have a lower glycemic index that are beneficial to cats with DM. Canned food is preferred over dry because weight loss is improved due to lower caloric content and higher moisture levels. This results in a higher rate of transient DM remission.

Feeding Plan Considerations

1. High protein amounts that are high digestible and lean >30% dry matter.
2. A diet with adequate fat is essential ~ 10%-20%.
3. NO SUGARS (including beet pulp) of any kind (food or treats) is permissible.
4. Provide a low amount of complex carbohydrates less than 10%-20%.
5. Diets should have increased caloric content ~3.5 kcal/g.
6. Maintain strict feeding schedules. A defined schedule of feeding, exercise and treat giving is critical to managing your cat’s diabetes.

Note: The veterinary prescription food formulations and their ingredients are specific for liver disease dogs. Potential allergic ingredients (wheat, corn, soy) if included, are discount in lieu of the benefits afforded by this diet.

Canine Prescription Pancreatic Diets

(**) contains beet pulp sugars

Feline Prescription Pancreatic Diets

Dog & Cat Supplements

1. A dietary fiber supplement such as Vetasyl for Dogs and Vetasyl for Cats is an efficient way to achieve the necessary fiber levels that are beneficial to diabetic patients. Vetasyl should always be included in the regulation of blood sugar levels in diabetic dogs and cats.
2. Marine origin Omega-3 fatty acids, should be fed to diabetic dogs and cats because of their high antioxidant properties.
3. A between meal supplement, if needed, can include Nutri-Cal which helps reduce hunger spikes and food cravings.
4. Urine glucose levels can be monitored at home using Glucotest strips. This can help confirm proper insulin levels between veterinary checkups.