Chapter 46 Insulin therapy is the mainstay of treatment for both diabetic dogs and cats (see Chapters 44 and 48), but because diabetes is a disease of disordered metabolism, nutritional therapy is a key component of the management of these patients. Although different mechanisms for development of diabetes exist for dogs and cats, concurrent pancreatitis or other conditions (e.g., obesity) may be important factors for both species that influence the nutritional plan. The general goals of dietary therapy in any diabetic dog or cat are broad based and include the following: 1. To achieve and maintain optimal body condition 2. To provide a nutritionally complete, balanced, and palatable food that is readily consumed (so that intake is predictable) 3. To provide nutritional support for any concurrent diseases requiring nutritional modification 4. To maintain consistency in the timing and type (e.g., ingredients and calories) of food to assist in achieving optimal glycemic control 5. To control the amount and types of dietary starch, because the primary determinant of postprandial glycemia is starch, present in the diet. Diabetic dogs also have abnormalities in lipid metabolism secondary to the lack of insulin production, including hypertriglyceridemia; hypercholesterolemia; and increases in lipoproteins, chylomicrons, and free fatty acids. In contrast to humans, who have increased risk of cardiovascular disease and stroke secondary to hypertriglyceridemia, the major consequence in dogs is the increased risk of pancreatitis, which complicates the management of diabetes and increases the risk for secondary complications and morbidity (see Chapters 58 and 137). In most diabetic dogs, the lipid values improve with the administration of insulin and feeding a diet containing lower fat and higher fiber content. Current recommendations by nutritionists suggest feeding a diet that contains less than 30% of metabolizable energy from fat; however, there are very few published data on the influence of dietary fat or the optimal level of fat in dogs with diabetes.
Diet and Diabetes
Dietary Management of Canine Diabetes Mellitus
Dietary Carbohydrates, Fat, and Protein
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