Our nine-year old Springer spaniel is very active, but is vomiting greenish/yellow bile. Our veterinarian said sugar was found in his urine, but the bloodwork is not back yet. What conditions could this possibly be?

Diabetes mellitus, pancreatitis and kidney problems may cause these symptoms.

The presence of sugar in the urine most often reflects high levels of blood sugar; sugar spills over into the urine because the renal, or kidney, threshold has been exceeded. In other situations the level of blood sugar is normal, but the kidneys are leaky to sugar, which can be a congenital problem in the Basenji breed and others. Spillage of sugar from the kidneys can also be an acquired defect associated with toxic or inflammatory kidney problems. Blood tests should discriminate between a problem of high blood sugar and a kidney disorder.

Elevated levels of blood sugar (hyperglycemia) combined with the presence of sugar in the urine (glucosuria) and clinical signs of increased thirst and urination are the criteria for diabetes mellitus, or sugar diabetes. Transient signs of diabetes can be associated with pancreatitis, an inflammatory disease that causes abdominal pain, vomiting, loss of appetite, fever, and sometimes jaundice. The pancreatic inflammation may affect the insulin-secreting cells of the pancreas, reducing blood levels of insulin, and permitting blood sugar levels to rise.

Vomiting is also seen with complicated diabetes when metabolic acids called ketones accumulate. Most ketotic diabetic patients are depressed and sick, unlike the dog you have described. Ketones are detectable in the urine, as well. Pyelonephritis, or kidney infection, could cause sugar in the urine and vomiting, without causing elevations of blood sugar.

There are numerous causes of vomiting that may be independent of any pancreatic or kidney problem. Please refer to the encyclopedia articles on "Vomiting, Canine," "Pancreatitis, Canine," and "Diabetes Mellitus, Canine" for more information. Your veterinarian should have a better understanding of your pet's condition, having ruled in or ruled out some major problems with laboratory testing.

08/21/00