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Diabetic Neuropathy in Dogs: Causes, Symptoms, and Treatment Options

Diabetic neuropathy is a condition that affects dogs with diabetes, causing damage to their nervous system due to consistently high blood sugar levels. While this complication is more common in cats, it can develop in dogs at any time following their initial diagnosis of diabetes. The most prominent symptom of diabetic neuropathy in dogs is progressive weakness or paralysis in their hind legs, which is the result of excessive glucose levels in their bloodstream.

The development of diabetic neuropathy is believed to involve abnormal glycosylation of proteins, affecting the vasa nervorum - the blood vessels that supply peripheral nerves. This compromised blood flow leads to nerve damage and, consequently, a range of symptoms that impact a dog's quality of life. In cases of diabetic neuropathy, the primary treatment is insulin therapy to regulate blood sugar levels and prevent further damage.

It is crucial for dog owners to be aware of the signs of diabetic neuropathy and seek early intervention. Along with hind leg weakness or paralysis, affected dogs may eventually lose bladder and bowel control, and if left untreated, the condition may lead to tissue death or gangrene, with fatal consequences. Managing diabetes and its potential complications requires constant vigilance, dedication, and a strong partnership with a trusted veterinarian.

Causes and Risk Factors

Diabetes Mellitus

Diabetes mellitus is a key factor in the development of diabetic neuropathy in dogs. Most dogs with this condition suffer from Type I or insulin-dependent diabetes, where the immune system mistakenly attacks insulin-producing cells in the pancreas, resulting in a total or partial loss of insulin secretion1. As a consequence, high blood sugar levels damage the nerves, potentially leading to neuropathy.


Genetic predisposition can also play a role in the onset of diabetic neuropathy in dogs. Some breeds may be more prone to developing diabetes and subsequent neuropathy due to their genetic makeup. If a dog's close relatives have had diabetes or neuropathy, the likelihood of the dog developing these conditions may be higher.

Age and Gender

Age and gender can also impact a dog's risk for diabetic neuropathy. In general, middle-aged and older dogs are more likely to develop diabetes than younger ones2. Furthermore, female dogs may have a slightly higher risk of being affected by diabetes, possibly due to hormonal variations during their reproductive cycle.


Obesity is a significant risk factor for diabetes in dogs, and it can consequently contribute to the development of diabetic neuropathy. Excess weight puts extra stress on the liver and pancreas, causing them to work harder to secrete insulin and other hormones3. Over time, pancreatitis and other complications may arise, which can further exacerbate the risk of developing neuropathy.

Maintaining a healthy weight is crucial for dogs, as it can help to prevent obesity-related health issues such as diabetes and neuropathy. Owners should monitor their dog's weight, provide a balanced diet, and ensure regular exercise to keep their pets healthy.

Signs and Symptoms

Neuropathic Signs

Diabetic neuropathy in dogs is a condition that results from damage to the nerves due to persistently high blood glucose levels. Some of the main neuropathic signs include:

  • Muscle weakness
  • Lack of coordination
  • Partial paralysis
  • Changes in sensory responses
  • Inability to feel extreme temperatures

These symptoms can lead to difficulties in movement and make it challenging for your dog to carry out normal activities.

Systemic and Diabetic Signs

In addition to the neuropathic signs, there are also systemic and diabetic signs that can be observed in dogs with diabetic neuropathy. These symptoms include:

  • Excessive thirst (polydipsia)
  • Frequent urination (polyuria)
  • Increased appetite (polyphagia)
  • Weight loss
  • Lethargy and sleepiness
  • Urinating in inappropriate places

Recognizing these signs early can help in the timely diagnosis and treatment of diabetes and the management of complications like neuropathy. Persistently high blood glucose levels can lead to serious consequences like diabetic ketoacidosis (DKA), which manifests as vomiting, lethargy, poor appetite, panting, and weakness. This is an emergency situation that requires immediate hospitalization.

It is crucial to monitor your dog's blood glucose levels, manage insulin resistance, and provide appropriate medication as prescribed by a veterinarian in order to prevent the progression of diabetic neuropathy. Timely treatment and management can significantly reduce the pain, discomfort, and complications arising from this condition.

Diagnostic Process

Physical Exam

A veterinarian will begin the diagnostic process by performing a thorough physical exam on the dog. This is to evaluate the dog's overall health condition, and to look for any clinical signs that might be related to diabetic neuropathy. During the physical exam, the veterinarian will assess the dog's muscle tone, reflexes, and their ability to walk and move their limbs.

Blood Tests

Blood tests are an essential part of the diagnostic process, as they help determine the dog's blood sugar levels. Persistent hyperglycemia is a key indicator of diabetes mellitus, which is the underlying cause of diabetic neuropathy. Blood tests can also help rule out other possible conditions, such as hypothyroidism, which can cause similar symptoms.


Urinalysis is another important diagnostic tool used in determining if a dog has diabetic neuropathy. This test checks for the presence of glucose and ketones in the dog's urine, as well as any signs of urinary tract infections. A positive test for glucose and ketones, along with persistent hyperglycemia, is a strong indicator of diabetes mellitus.

Electrodiagnostic Tests

In some cases, electrodiagnostic tests may be required to confirm the presence of diabetic neuropathy. These tests include nerve conduction studies and electromyography, which help assess the functioning of the dog's peripheral nerves and muscle tissue. Abnormal results from these tests can further support the diagnosis of diabetic neuropathy.

The diagnostic process for diabetic neuropathy in dogs is designed to be thorough and accurate, as it is crucial to identify and treat the underlying cause of the condition in order to improve the dog's quality of life. With the proper combination of physical exams, blood tests, urinalysis, and electrodiagnostic tests, a veterinarian can confidently diagnose diabetic neuropathy and begin the appropriate treatment plan for the affected dog.

Treatment Options

Insulin Therapy

Insulin therapy is a crucial part of managing diabetic neuropathy in dogs. It involves administering insulin injections to help regulate blood sugar levels. Your veterinarian will determine the appropriate type and dosage of insulin for your dog, which could vary depending on factors like age, breed, and overall health. It's essential to follow the prescribed insulin regimen closely and monitor your dog's blood sugar levels to ensure proper glycemic control.

Dietary Management

A balanced diet plays a significant role in managing diabetic neuropathy in dogs. Your veterinarian may recommend a diet that includes good-quality protein, fiber, and complex carbohydrates. These nutrients can help slow down the absorption of sugar in the bloodstream, reducing blood sugar spikes and promoting better glycemic control. Additionally, it's essential to maintain a consistent feeding schedule to avoid sudden changes in blood sugar levels.

  • Good-quality protein
  • Fiber
  • Complex carbohydrates

Medications and Supplements

Aside from insulin injections, certain medications may be prescribed by your veterinarian to help manage diabetic neuropathy in dogs. For instance, some dogs may benefit from vitamin B12 injections, which can help strengthen the nervous system and potentially alleviate symptoms of neuropathy.

In addition to medications, there are several supplements that may help support the overall health of diabetic dogs. These may include antioxidants, omega-3 fatty acids, and other essential vitamins and minerals. Always consult with your veterinarian before introducing any new medications or supplements to your dog's regimen.

  • Vitamin B12 injections
  • Antioxidants
  • Omega-3 fatty acids

Exercise Routine

Implementing a regular exercise routine is another vital aspect of managing diabetic neuropathy in dogs. Exercises such as daily walking or play activities can help lower insulin requirements and provide better glycemic control. Keep in mind that the appropriate exercise regimen for your dog may vary, so be sure to consult your veterinarian for personalized recommendations.

By considering all of these treatment options, you can actively work towards preventing and managing diabetic neuropathy in your dog. Always communicate with your veterinarian regarding any concerns or changes in your dog's condition, and remember to stay consistent with their recommended care plan.

Complications and Prognosis

Diabetic neuropathy in dogs can lead to various complications affecting the health and quality of life of the affected animals. In this section, we will discuss the long-term effects and proactive management strategies for dealing with this condition.

Long-Term Effects

Diabetic neuropathy primarily causes progressive weakness or paralysis in a dog's hind legs due to high glucose levels damaging the sheaths, or coverings, of their nerves. These elevated glucose levels can also result in:

  • Ketoacidosis: Dogs with diabetes may suffer from diabetic ketoacidosis, characterized by rapid breathing, acetone-like breath odor, vomiting, diarrhea, and seizures, potentially leading to death if left untreated.
  • Cataracts: Diabetes might cause cataracts in dogs, manifesting as cloudiness in their eyes that affects their vision.
  • Nephropathy: High glucose levels can also lead to kidney damage or nephropathy, affecting the organ's ability to filter waste from the blood efficiently.
  • Retinopathy: Long-term diabetes might cause damage to the blood vessels in the retina, resulting in impaired vision or blindness.
  • Seizures: As mentioned earlier, diabetic ketoacidosis might cause seizures in some dogs, which could be a sign of a more severe underlying issue.

Proactive Management

Preventing and managing the long-term effects of diabetic neuropathy in dogs mainly involves proper diabetes control and monitoring. Some key strategies include:

  1. Regular checkups: Frequent vet visits will help monitor a dog's overall health and identify any complications early.
  2. Blood glucose monitoring: Regularly checking blood glucose levels allows adjustments to insulin dosage and helps maintain appropriate glucose levels.
  3. Dietary modifications: Providing a balanced diet that meets the nutritional needs of a dog with diabetes is essential in controlling glucose levels.
  4. Exercise: Regular physical activity can help regulate glucose levels and improve overall health.
  5. Eye and kidney exams: Regular eye exams can help detect cataracts, while kidney exams can assess any damage to the kidneys due to high glucose levels.

Proactive management can minimize complications and improve the prognosis for dogs with diabetic neuropathy. By taking a diligent approach to their care, owners can help their pets maintain a better quality of life. Just remember to consult with a veterinarian for personalized advice and guidance.

Prevention and Management

Routine Vet Visits

Regular veterinary check-ups are crucial for the early detection and management of diabetes-related complications in dogs. Diabetic dogs are at an increased risk of developing problems such as infections, kidney issues, and eye disorders. Frequent vet visits can help monitor your dog's overall health, assess their pancreas function, and ensure their immune system is functioning optimally. By identifying changes in your dog's health early, your veterinarian can recommend appropriate treatments to minimize complications.

Weight Management

Maintaining a healthy weight is essential for diabetic dogs, as obesity can exacerbate their condition and hinder blood glucose management. Helping your dog maintain a healthy weight involves a combination of a balanced diet and regular exercise. Dog owners should work closely with their veterinarian to develop an appropriate diet plan that addresses their dog's individual needs. Additionally, engaging your dog in routine physical activities such as daily walks, play sessions, or agility training, can help them burn calories and keep their weight in check.

Blood Glucose Monitoring

Monitoring blood glucose levels is vital for managing diabetes in dogs. By regularly testing your dog's blood sugar levels, you can identify patterns and adjust their insulin dosage accordingly. Home blood glucose monitoring systems are available for dog owners, allowing you to track your dog's levels and share the data with your veterinarian, who can then refine their treatment plan as needed (source). Regular blood glucose monitoring helps minimize the risk of severe fluctuations, reducing the chances of complications such as neuropathy, gangrene, and damage to the eyes and kidneys.

In conclusion, routine vet visits, weight management, and blood glucose monitoring are essential components of a comprehensive prevention and management strategy for diabetic neuropathy in dogs. By addressing these factors, dog owners play a significant role in reducing the risk of complications and helping their dogs maintain a better quality of life.


In conclusion, diabetic neuropathy is an uncommon complication of diabetes mellitus in dogs and cats, which can lead to weakness, ataxia, and muscle atrophy1. While there is no definitive treatment for diabetic neuropathy other than insulin therapy, maintaining blood glucose in an acceptable range (150-250 mg/dL) can help in the resolution of mild cases over several weeks to months2.

It is essential to evaluate the overall health of the diabetic pet, which includes assessing their diet and concurrent medications, and identifying any complications that may be associated with the disease3. It is also important to be aware that diabetic dogs are at higher risk of developing neuropathy due to oxygen deprivation in the cells, and the presence of cancer or autoimmune diseases can exacerbate the condition4.

In managing diabetic neuropathy in dogs, it is crucial to take a proactive approach to their care, which includes regular monitoring of their blood glucose levels and adjusting insulin doses accordingly. With early intervention and appropriate management, it is possible to minimize the impact of diabetic neuropathy on the pet's quality of life.


  1. PetMD - Diabetes in Dogs 2

  2. Daily Paws - Dog Diabetes: Causes, Causes, Treatment, and Prognosis 2

  3. AKC - Diabetes in Dogs: Symptoms, Causes, Diagnosis, & Treatment 2

  4. Jolly Doggy - Diabetic Neuropathy in Dogs