DI Central

What is diabetes insipidus (DI)?
• Rare condition that prevents the body from conserving water … if the pet does not have water available at all times, it can dehydrate and die

• It is NOT related to sugar diabetes

• There are two types

• Central (CDI) - the problem is in the brain
• Nephrogenic (NDI) - the problem is in the kidneys
• Causes can be
• Genetic - it can be passed through the generations
• Trauma - usually to the head
• Tumor - usually brain
• Unknown - also called idiopathic

If the animal is born with the problem, no matter what its actual cause is, it is called a
congenital condition.

• Symptoms
• PU/PD (polyuria - means pees a lot / polydipsia - means drinks a lot)
No one measures urine output, but you can measure water intake
• CAT - Daily intake in excess of 100 mL/kg for a cat is abnormal. This would be about 12 oz or 1.5 cup of water for an 8 pound cat.
• DOG - Daily intake in excess of  90 mL/kg for a dog is abnormal. This is about 1.38 oz per pound … so if your dog weighs 23 pounds, consumption of more than a quart of water a day would be abnormal.
• Urine has low specific gravity (SG): usually less than 1.012 and often less than 1.008
• May lose weight
• May be a bit dehydrated with a scruffy, dry looking coat
• May be incontinent or break house or litter training
• Rarely, may have a fever of unknown origin

Diabetes insipidus is a relatively rare and definitely rarely diagnosed disease that makes it impossible for your pet to "concentrate" his/her urine and conserve water.

Normally, the hypothalamus (a gland in the brain) produces a hormone called ADH or anti-diuretic hormone. ADH is stored in and released from the pituitary (another gland in the brain.) When it is needed, this hormone travels through the bloodstream to receptors in the kidneys. Once there, it is used to allow the animal to concentrate their urine and recycle water in the body. Without the hormone and the ability to use it, your pet gets very thirsty, drinks a lot and pees out large amounts of dilute urine.

Sometimes, the hypothalamic-pituitary system stops making/releasing ADH. There is just no ADH (or very little) to help with water recycling. This type of diabetes insipidus is known as "central diabetes insipidus" or CDI. It is also called Pituitary DI and it is sometimes called Neurogenic DI. This can happen because your pet has a genetic problem or because of an injury to the head, a brain tumor or for no known reason. Your pet can be born this way or the problem can appear to develop later in life.

Sometimes the kidneys lose the ability to use ADH. There is plenty of hormone available, but it cannot be picked up and used in the kidneys. This type of diabetes insipidus is known as "nephrogenic diabetes insipidus" or NDI. This can happen because your pet has a genetic problem or is on drugs that make it hard for the body to use ADH or has another endocrine or metabolic disorder or for no known reason. Your pet can be born this way or the problem may develop later in life.

Both CDI and NDI produce the same symptoms in your pet. Their urine has a very low specific gravity (it is not concentrated). They will drink a lot and pee a lot. Sometimes they are a little dehydrated and have a rough fur coat. Sometimes they lose weight. Sometimes they will be incontinent or your pet will urinate in an inappropriate place. Often, dogs can no longer make it through the night without urinating. Occasionally, the pet will run a fever that cannot be attributed to another cause. Unfortunately, these symptoms can be caused by other diseases as well as DI. So, tests will need to be done to rule out other causes and to establish a diagnosis of DI.

While the symptoms are the same, the treatments are different. It is relatively easy to treat CDI. It is harder to achieve reduction in symptoms through management of NDI.

No matter which type of DI your pet might have, it is VERY IMPORTANT to be sure you keep large amounts of water available to them at all times. Because they cannot recycle water in the body, they need to drink. Without water, they can dehydrate and die in a matter of hours.

Diabetes Insipidus Topics
  • It all started with Puff ... DI Central home
  • What is diabetes insipidus
  • How is DI diagnosed
  • What are the problems with the water deprivation test
  • A safer way to determine if your pet has CDI
  • If your pet has been diagnosed with nephrogenic diabetes insipidus
  • Traditional treatments
  • Treatment of central diabetes insipidus by subcutaneous injection of desmopressin
  • References
  •      Where your vet can get more information and help
  • How to treat by subcutaneous injection of desmopressin
  •      What you need
  •      How much to use
  •      Breaking into the bottle and transferring the drug
  •      Pictures to guide you the first time through
  • What about using the pills?
  • How to keep the cost down
  •      A cost comparison - eye/nose drops vs. injections
  • Puff's opinion - Use the injections … here's why
  • A picture gallery of pets with diabetes insipidus
  • Puff's story
  • You can email Puff for more information or to ask questions.
    Click here to email Puff
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     Information on these pages is the result of personal experience and study.
    It was not written by a veterinarian and is not intended to be used as if it was.