Q: Pebbles, my 9-year-old terrier, was diagnosed with diabetes several months ago. I give her insulin injections and monitor her diabetes with urine test strips. Is there a better way to determine how well her diabetes is being controlled?
A: Diabetes mellitus arises most often in middle-aged dogs, usually around 7 to 9 years of age. Three-fourths of diabetic dogs are female.
Clinical signs include increased drinking and urination, increased appetite with decreased weight and lethargy. Some diabetic dogs also develop cataracts and urinary tract infections.
While humans can experience different kinds of diabetes, dogs almost always have insulin-dependent diabetes, similar to Type 1 diabetes in humans. In both forms, the pancreas does not produce insulin as it should.
Insulin has many roles, one of which is to move blood sugar, or glucose, into the cells of the body, where it produces energy the tissues and organs require to function normally.
When insulin can't drive glucose into the cells, the glucose levels in the blood increase and glucose is excreted in the urine.
For a number of reasons, however, urine testing does not provide a valid representation of diabetic control. So, you must test the glucose in Pebbles' blood or tissues.
There are several ways to do this. The most common method is to test a drop of her blood at home using a pet glucose meter, such as the AlphaTrak or VetMate. These meters are more accurate in pets than human glucose meters would be.
It may seem challenging, but my clients easily learn the technique and are pleased they can check their pets' blood sugars on a routine basis and whenever they're concerned the pet doesn't seem quite right.
Or, your veterinarian can check Pebbles' blood glucose levels at the animal hospital periodically throughout the day.
An even easier method is to monitor Pebbles' glucose levels in her tissues with a sensor called the FreeStyle Libre that is attached to her skin. The sensor, which is replaced every two weeks, reports glucose levels wirelessly to a scanner or your smartphone.
Finally, testing fructosamine or hemoglobin A1c levels in the blood reflects average blood glucose over time. However, these tests can't identify the glucose highs and lows, so they don't replace more frequent blood glucose measurements.
Regardless of how you monitor Pebbles' blood sugar, you'll also need to pay close attention to her clinical signs to be sure her diabetes is well controlled.
Q: We put fresh water out for our cats daily, but they prefer to drink from the toilet. Why?
A: I'm shuddering as I picture any cat drinking from the toilet. Please keep your toilet lid down to prevent this risky behavior.
Drinking toilet water can poison your cats if you use cleaners, scents or other chemicals in your toilet. It also can spread disease-causing bacteria, viruses and parasites from you to your cats, even after you flush.
Cats are drawn to toilets because the porcelain keeps the water cool, and frequent flushing freshens the water. Similarly, in the wild, cats are drawn to drink from a stream's cool, flowing water, which is likely healthier than stagnant pond water.
You can provide cool, fresh, well-aerated water by placing several porcelain or ceramic water bowls throughout your home. Cats don't like their whiskers to touch the side, so be sure the bowls are wide. Occasionally drop a few ice cubes into them.
Scrub them daily with soap, because simply rinsing and refilling them doesn't actually clean them.
Consider a pet fountain. My cats love theirs, because the water bubbles up and flows like a waterfall into a pool. The porcelain fountain has two filters, but it still needs to be scrubbed weekly.
One of my cats jumps onto the bathroom counter to drink from the sink whenever I'm there. For high-tech kitties, consider a touch- or motion-activated bathroom faucet. To keep food preparation areas sanitary, don't let your cats jump onto kitchen counters to drink from the kitchen sink.
Lee Pickett, VMD, practices companion animal medicine in North Carolina. Contact her at