||What is Diabetes Insipidus?
Diabetes insipidus (DI) is a disorder of water balance. The animal is unable to
concentrate urine, so the urine volume is very high and the urine is dilute.
"Insipid" means tasteless -- referring to the dilute urine. This disease
is rare in both dogs and cats. The condition is usually permanent, and the
prognosis is good. Without treatment, dehydration leads to stupor, coma, and
death. This is a completely different disease from Diabetes Mellitus
(DM), a disorder of
sugar metabolism involving the hormone insulin. We include the
information here because people are often looking for resources and we had
some owners of pets with DM who also have experience with DI.
Types of diabetes
- Central Diabetes Insipidus
- caused when the pituitary gland does not secrete enough antidiuretic hormone
(ADH) [also called vasopressin]. This type of DI may be the caused
by a congenital defect, trauma, a tumor on the pituitary gland, or unknown causes.
- Nephrogenic Diabetes Insipidus
- caused when the kidneys do not respond to the ADH that is produced by the pituitary
gland. This type of DI may be caused by a congenital defect, drugs,
or caused by other metabolic disorders
- polyuria (excessive urination)
- polydipsia (excessive drinking)
- Images of the pituitary gland may be taken to determine if
there is a tumor.
- A water deprivation test or an ADH trial with DDAVP may be
done. These tests determine if the animal is able to produce more concentrated urine as
water is withheld or following the injection of DDAVP (the drug used to treat
- Central DI is treated with desmopressin,
a drug that mimics the actions of ADH. It is available under the trade
name DDAVP and as a
generic. DDAVP is available in
several formulations: as a nasal spray pump; as a liquid for use with
rhinal tube; as an injectable liquid; and in tablets. Most pet
owners use the nasal spray or rhinal liquid formulations and use them as
eye drops, nose drops, or inject it subcutaneously.
- Nephrogenic DI is commonly treated with
thiazide diuretics. These drugs help to concentrate the urine. An oral drug
called chlorothiazide acts on the kidneys to
help concentrate the urine. Other treatments may include chloropropamide, which
increases the effects of ADH on the kidney. But chloropropamide is not always
successful. Nonsteroidal anti-inflammatory drugs may be used in dogs.
- No therapy may
be chosen, and the pets can survive as long as plenty of water is always
available. You CAN NOT limit
their water intake. When Sonny's DI
first started, he would lay in front of his water bowl and just drink
and drink and drink. Of course he also had to go outside very
frequently, and his urine was like water - literally.
Stories and Resources
- Ziggy, Puff,
and Simone are three kitties with DI. Ziggy also has diabetes mellitus (yes, both
diseases can occur together ... remember they are totally separate diseases).
We use the generic 0.01% nasal spray form
for all three of our cats. Originally, we used it as eye/nose drops, but it
cost an awful lot of money using it that way. Eventually, we found
some veterinary papers and texts that suggested using the nasal spray
form as a subcutaneous injection. We found several big benefits from
switching to injections. First, the cats tolerated it better -- they
hated eye drops and hated nose drops even more, often flinging whole
drops of the drug around the room. Second, while the eye drops
controlled the DI symptoms for about 8 hours, the injections
controlled the symptoms for 14-16 hours. Third, use as an injection
required lots less of the drug. A bottle lasted for about 28 days when
used for eye/nose drops. When used for injection, it lasts over 150
days. We are currently paying about $130 for a 5 mL bottle of generic
0.01% nasal spray. You can imagine how the cost of treating the cats
dropped when we switched to injecting the nasal spray.
You don't want to use the injectable form. You DO want to use
the nasal spray form. The reason is that the injectable form is 25
times less concentrated than the nasal spray, so you have to use 25
times the volume! In addition, I understand it is even more expensive
(though I have not priced it myself).
The dosage seems to be unique to each animal rather than being based
on the animal's weight. All three or our cats get injections of 0.02 mL (this
is a VERY TINY volume … about 1/10th the size of a drop of water)
twice a day. Our cats range in weight from about 7 pounds to 18
pounds. We have had email contact with several people who have DI
dogs, and know one owner also injects the
nasal spray and gives the same dose we use for the cats.
We use insulin syringes for the injections (the 3/10 cc kind). The
needles are so fine and sharp, the cats do not even notice the
injections. We estimate the cost of treatment at about $35 per month.
The injections have made a really big difference to us. It is a
lot less expensive and the cats no longer run from us when it is time
for meds, and they no longer have about 4 hours when they are so very
Ziggy, Puff and Simone's owners MJ and Pat
are always happy to talk to anyone with a pet who has diabetes
insipidus. They are working on a central
DI web page that you can check for more information. (Jan. 2002)
is my Samoyed. We used DDAVP Rhinal nasal solution, 2.5 ml bottle. We used
it as an eye drop. Just like in the nose, the DDAVP is absorbed across
the mucous membranes when used as an eye drop. The bottle (without the
little tube) is not designed to be used as eye drops, so it is not
always easy to get one drop out of the bottle.
When we suspected DI, Sonny didn't have a DDAVP injection - we just
started with the drops. We saw an improvement very quickly. Rather
than going through other tests which can be expensive, our vet said it
wouldn't hurt him to try the drops and rule in or out DI. We did do
all the blood work and urinalysis several times though, to rule out
renal insufficiency or renal failure. Our vet has had a couple of other DI cases over the years... which
really is a lot because DI is pretty rare (in both humans and in
dogs). He told us he's had great results from using the DDAVP as an
We started with a dose of 1 drop twice a day. My vet said we should
monitor Sonny's water intake and adjust the dose ranging from 1 drop
once a day to 2 drops twice a day depending on how he was doing.
Sonny's drinking became normal again, and eventually we were able to
lower the dose to 1 drop, once a day. The DDAVP is expensive,
but a 2.5 ml bottle lasted us about 3-4 weeks.
DI certainly is rare in dogs, cats and humans. But Sonny did something
even stranger... he recovered from it. He no longer is on DDAVP and
hasn't been for close to a year now. That's even more rare! There are
times when DI may be a temporary condition if caused by trauma, such
as a head injury in some cases. Sonny had no head (or other) trauma
though, so we don't know exactly what the cause was or why his
symptoms disappeared after a couple of years. That's not something
that normally happens.
A dog with DI should be able to live a
long and healthy life. Our Sonny will be 13 years old in March. He has
some added complications though - he's also diabetic (Diabetes
Mellitus, and is on insulin now) and hypothyroid as well. But those
are not related to the DI at all, and it's extremely rare to have a
dog with DI and DM at the same time. Sonny was diagnosed with DI about
1-1/2 years before the DM, and there is no connection between the two.
--Contributed by Kerry (Jan.
- Shirley has a suggestion for
method of using the nasal Desmopressin (DDAVP) solution as an eyedrop.
Her blue merle Shetland Sheepdog Ferris
has DI and this helps her get the eye drop in his eye and not waste
any of the very expensive medication. Here's her method:
- Purchase a bottle of
Clear Eyes eye drops from the drug store.
- Wash your hands and
prepare a clean work surface.
- Using a paper towel or
napkin, take the top off the Clear Eyes bottle and pour out the
- Let the Clear Eyes
bottle dry out by putting it upside down on a clean paper towel
(don't touch the top of the bottle and don't put anything inside
the bottle to try to dry it).
- Take a clean knife or
scissors and snip the top off the bottle of Desmopressin
- Pour the Desmopressin
into the the Clear Eyes bottle.
- Again using a paper
towel, replace the Clear Eyes bottle tip, making sure it is
securely in place.
- During use, keep the
bottle as clean as possible and replace the Clear Eyes bottle
every 3 months (or 3 bottles of Desmopressin in Ferris' case).
I did lose a few drops (expensive and
precious, I might add) the first few times I used it. The drops come
out of the bottle very easily, so I make sure I have Ferris' eye ready
to receive the drop before I even turn the bottle over.
I have tried other eye drop bottles but
found the Clear Eyes one to be sleekly designed and thus I can get
every drop of Desmopressin out of it.
- Sunny Bear
is a 9 year-old male
Rottweiller. He is our sunshine, and our very good
friend. He is gentle giant, even though he weighs 146 pounds. We have a very fixed income and were very afraid we might not be able to
afford the medicine that he requires. Here in Alaska, the medicine cost $154 for a 5-ml bottle, and sometimes he takes twice that amount in a month.
Putting our sunshine and our friend to sleep was not even an option, but I was
at a great loss as where to go for help. I looked up the company that makes the
medicine and asked many questions as to where what how, we could find
help, and it paid off. The sales representative was also a pet owner and
about the cost of the medicine. I found that this medicine is only available
as a prescription for humans, and I thought that was strange. I talked with our local
pharmacy and learned that they could compound Sunny Bear's medicine for
us. Now instead of the medicine costing us $154.00
a month, we now get the same medicine for $40.00 a month. We can fit that into
our budget and Sunny Bear can have his needed medicine.
-- Contributed by Rick Handel (May 2000)
- The 5 Minute
Veterinary Consult: Canine and Feline
Tilly and Francis W.K. Smith, Jr. 1997.
- Veterinary Drug Handbook. Second Edition. Donald
C. Plumb. 1995.
- Pocket Companion to the Fourth Edition of Textbook of
Veterinary Internal Medicine Stephen J. Ettinger.
- The Cornell Book
of Cats: A Comprehensive and Authoritative
Medical Reference for Every Cat and Kitten. Mordecai Siegal (Editor), et al.1997.
Updated June 2002
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