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Diabetes in dogs: glucose, fructosamine and monitoring

Diabetes mellitus means the body cannot keep blood sugar under control, almost always because the pancreas makes too little insulin. Dogs with diabetes need insulin for life, and blood and urine tests guide both the diagnosis and the follow-up.

Written by the AI DiagAnimals editorial teamReviewed by the AI DiagAnimals TeamUpdated Our editorial policy

The essentials

Diabetes is diagnosed on a persistently high blood glucose with sugar in the urine, in a dog that drinks and urinates more. Fructosamine, which reflects the previous 2–3 weeks, confirms a lasting rise. Many diabetic dogs also have a high ALP and ALT, and other diseases such as Cushing’s or pancreatitis are common. Ketones in the blood or urine with vomiting or weakness signal diabetic ketoacidosis, an emergency.

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Which dogs get diabetes

In UK first-opinion practices, about 0.34% of dogs had diabetes. Neutered males were at higher risk than entire males, Yorkshire Terriers had higher odds than crossbreeds, and being overweight, pancreatitis and Cushing’s disease were linked to diabetes [1].

How diabetes is diagnosed

  • Blood glucose that stays above the reference interval. See blood sugar in dogs.
  • Sugar in the urine: glucose spills into the urine when blood glucose exceeds about 180–200 mg/dL in dogs. A single positive sample does not prove diabetes, because stress can raise glucose briefly [2].
  • Fructosamine: reflects the average glucose over the previous 2–3 weeks, and helps tell diabetes from a short-lived rise [3].
  • Ketones in the urine or blood show the body is burning fat for energy, a step towards ketoacidosis [4].

How to read the fructosamine line

Here is an example line from a newly diagnosed dog.

An annotated line from a lab report · Illustrative example
AbbreviationResultUnitLaboratory intervalFlag
FRUC Fructosamine540µmol/L200–360H
  1. Abbreviation Fructosamine, sometimes FRUC or FRU.
  2. Result 540 µmol/L in this illustrative line: the glucose has been high for weeks, not just during the visit.
  3. Unit µmol/L.
  4. Laboratory interval An illustrative interval; each laboratory sets its own. Fructosamine can be falsely low when blood proteins are very low [3].
  5. Flag H: above the interval. In a treated dog, a lower value points to better control [3].

What the rest of the blood work shows

In a study of 221 diabetic dogs, the blood count was mostly normal, but ALP was raised in 90%, ALT in 78% and the serum was cloudy with fat in 42%; 21% of the urine cultures were positive [5]. The same study found Cushing’s disease in 23% and acute pancreatitis in 13% of the dogs [5].

These associated diseases matter: Cushing’s makes diabetes harder to control, and a dog needing more and more insulin is often tested for it [2]. Diabetic dogs have a much higher risk of pancreatitis [6].

Complications to know about

  • Cataracts: in 200 diabetic dogs, half had cataracts within about 6 months of diagnosis and 80% within about 16 months [7].
  • Diabetic ketoacidosis: in 127 dogs, 65% had ketoacidosis when diabetes was first diagnosed, most often with another disease such as pancreatitis; 70% of treated dogs survived to discharge [4].
  • Low blood sugar from too much insulin: weakness, trembling or seizures.

How control is monitored

Vets combine the dog’s signs (thirst, urination, appetite, weight), glucose curves at home or in the clinic, and fructosamine. A well-controlled diabetic dog has few signs and no episodes of low blood sugar [8].

Related articles

Cushing’s disease in dogs

Common in diabetic dogs and a cause of poor control.

Read the article

En français : le diabète du chien.

The emergency complication: diabetic ketoacidosis.

Questions to ask your veterinarian

  1. Do the glucose, urine and fructosamine results confirm diabetes?
  2. Are there ketones in the urine or blood?
  3. Should we look for Cushing’s disease, pancreatitis or a urinary infection?
  4. How will we monitor the insulin dose: curves at home, fructosamine, or both?
  5. What should I do at home if my dog shows signs of low blood sugar?
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Frequently asked questions

What can be mistaken for diabetes in dogs?

A short-lived high glucose from stress, and other causes of thirst such as Cushing’s disease or kidney disease. Fructosamine and repeat tests help tell them apart [2, 3].

What can trigger diabetes in dogs?

Diabetes in dogs results from a loss of insulin production. Pancreatitis, Cushing’s disease and being overweight are linked to it [1].

Which dog breeds get diabetes the most?

In a UK study, Yorkshire Terriers had higher odds than crossbreeds; an inherited form is described in Keeshonds [1, 2].

What is the life expectancy of a dog with diabetes?

Many dogs live for years with insulin and regular monitoring. Older age and pancreatitis were linked to a higher risk of death in one study [1].

I just found out my dog has diabetes. What should I do?

Ask your vet to show you how to give insulin, how to recognise low blood sugar, and which follow-up tests are planned.

Sources

  1. Mattin M et al. An epidemiological study of diabetes mellitus in dogs attending first opinion practice in the UK. Vet Rec. 2014;174(14):349. doi.org/10.1136/vr.101950
  2. eClinPath, Cornell University College of Veterinary Medicine. Glucose. eclinpath.com/chemistry/energy-metabolism/glucose
  3. eClinPath, Cornell University College of Veterinary Medicine. Fructosamine. eclinpath.com/chemistry/energy-metabolism/fructosamine
  4. Hume DZ et al. Outcome of dogs with diabetic ketoacidosis: 127 dogs (1993-2003). J Vet Intern Med. 2006;20(3):547-555. pubmed.ncbi.nlm.nih.gov/16734088
  5. Hess RS et al. Concurrent disorders in dogs with diabetes mellitus: 221 cases (1993-1998). J Am Vet Med Assoc. 2000;217(8):1166-1173. doi.org/10.2460/javma.2000.217.1166
  6. Cridge H et al. Advances in the diagnosis of acute pancreatitis in dogs. J Vet Intern Med. 2021;35(6):2572-2587. doi.org/10.1111/jvim.16292
  7. Beam S et al. A retrospective-cohort study on the development of cataracts in dogs with diabetes mellitus: 200 cases. Vet Ophthalmol. 1999;2(3):169-172. doi.org/10.1046/j.1463-5224.1999.00073.x
  8. Behrend E et al. 2018 AAHA Diabetes Management Guidelines for Dogs and Cats. J Am Anim Hosp Assoc. 2018;54(1):1-21. doi.org/10.5326/JAAHA-MS-6822

Laboratory methods and reference intervals vary. This article explains; it does not diagnose. For a decision about your pet, use the original report and talk to your veterinarian. Our editorial policy.

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