Some emergencies don’t start with a massive crisis; they start with small things that are easy to dismiss. Diabetes in pets is often a manageable condition, but it can become life-threatening very quickly without early recognition of the warning signs. And that’s where it can get difficult for owners, because they’re subtle or frequently misinterpreted as normal behavioural changes.

At Nexus Emergency Vet, our 24/7 facility is the first of its kind in Adelaide. We provide urgent care for a full range of injuries and illnesses, including diabetes, with a strong focus on the human–animal bond. When a pet experiences an emergency like this, timing matters. Acting quickly can prevent serious complications. Here’s what to look for.

Increased thirst and urination are among the first changes, but owners can often attribute them to hot weather, increased activity or ageing. Diabetes leads to elevated blood glucose levels. Once the kidneys reach their threshold, glucose spills into the urine and pulls water with it. This increases urine volume. Compensatory thirst follows, which means pets may start drinking more frequently or emptying water bowls faster than usual.

Changes in appetite are another thing to look out for. In early or poorly regulated diabetes, cells can’t properly use glucose, which can drive hunger even when a pet is eating enough. Some pets seem constantly hungry, start looking for extra food or show scavenging behaviours that are out of character. Appetite doesn’t always stay consistent either. It can drop off over time as the imbalance worsens or complications begin to develop.

Lastly, mild lethargy and reduced engagement can point to diabetes, but they’re often written off as routine variation or ageing. When energy isn’t properly utilised at a cellular level, it can lead to low-grade fatigue, even if your pet is still eating and moving around. What owners may notice is less enthusiasm for walks, play or interaction. It can be subtle, and it doesn’t always happen all the time.

Gradual weight loss can be hard to notice when you see someone every day, whether that’s people or pets. In animals, it can be even harder. When the body can’t properly use glucose for energy, it starts breaking down fat and muscle instead. A pet may still be eating well or even seem hungrier than usual, so weight isn’t always the first thing an owner focuses on. Without regular monitoring, these changes often go unnoticed until they become more obvious.

Changes in coat condition or grooming habits are also of concern, particularly in cats. They’re often dismissed as ageing or minor issues rather than a sign of underlying systemic stress. Ongoing metabolic imbalance can affect skin and coat health, leading to a dull, dry or unkempt appearance. In cats, grooming may reduce, which can leave the coat looking greasy or matted, and this tends to develop over time.

Episodes of weakness or unsteady movement can be short-lived and inconsistent, which makes them difficult to immediately link back to a metabolic cause. However, fluctuations in glucose can affect muscle function and nerve health. If your pet seems wobbly, hesitant or less coordinated than usual, take note.

Diabetic ketoacidosis is one of the most serious complications of diabetes. It happens when the body begins breaking down fat for energy at a rapid rate, producing ketones that build up in the bloodstream. Some of the earliest indicators are vomiting, diarrhoea or dehydration. As ketones accumulate, they disrupt normal metabolic balance, which can cause nausea, vomiting and reduced fluid intake. When this is combined with increased urination, dehydration can set in quickly and further destabilise the condition.

Rapid or laboured breathing may follow as the body tries to expel carbon dioxide in response to the acid base imbalance. As acid levels rise in the bloodstream, breathing patterns change to compensate. These breathing difficulties are often assumed to be due to primary respiratory issues.

Eventually, pets experiencing diabetic ketoacidosis will show a noticeable decline in alertness. Some animals withdraw or become less responsive, disoriented or unusually quiet. Others may just seem confused. It can look like fatigue, but it’s systemic deterioration. The brain is affected by both dehydration and abnormal glucose and ketone levels.

If your pet collapses, shows signs of severe weakness or cannot stand, that’s indicative of a diabetic emergency, and their condition is now critical. At this point, the body is no longer able to compensate for severe dehydration, electrolyte disturbances and acid-base imbalance, and energy supply to vital systems is significantly impaired.

A distinctive sweet or unusual odour on the breath is commonly associated with ketones circulating in the bloodstream. That’s due to acetone, one of the ketones produced during fat breakdown. It may start subtly, but it becomes more noticeable as ketone levels rise.

Finally, if your pet is vomiting persistently, refusing to eat or is substantially lethargic, they need urgent veterinary attention. Fluid loss means loss of electrolytes, which compounds dehydration and instability, while a complete loss of appetite means that the body is under serious stress and no longer functioning as it should.

Diabetes doesn’t just affect one system at a time, which is why it can go from manageable to critical so quickly. Fluid loss, rising ketones and shifting electrolytes all start feeding into each other until the body can no longer compensate. From there, deterioration is swift.

And not only does deterioration move quickly, the earliest signs can be missed or passed off as something else. That’s why, especially if you know your pet has diabetes, it’s important to notice changes and get help early.

At Nexus, we’re fully equipped to treat patients experiencing diabetic ketoacidosis, and our staff are highly experienced. If you notice any of these signs or symptoms, come straight in. If you need guidance on any pet health concern, feel free to contact our 24/7 nurse chat.