Get Prepared to Monitor and Treat Your Diabetic Dog at Home
Once its diabetes has been diagnosed, your dog has probably been hospitalized for one day or two so that your vet can perform the required examinations, for ruling out other diseases and for establishing the initial prescription in terms of insulin dose and diet type.
At this point, your vet may propose you to perform yourself, at home, the next examinations. On one hand, you are in the best position to observe the symptoms and assess their evolution. On the other hand, blood glucose measurements are more accurate at home where your pet is less prone to develop a stress that increases its glycemia. Moreover, it will not be disturbed in its eating habits, as it is often the case when dogs are hospitalized. Finally, home monitoring is less expensive than hospitalization.
Do not hesitate to do it if you feel you that you can do it. This is by far the best way to take care of your diabetic dog. It entails a good organization and lot of commitment. Your will have to watch symptoms, note them and understand their meanings, make regularly blood glucose tests, weigh your dog and measure the amount of food that has actually been eaten. All these information will be necessary for the treatment adjustments decided by your vet at the next consultation.
Blood Glucose Test
The Blood Glucose Curve is the most informative test of your dog’s glycemic evolution along the day. It shows how your dog responds to its treatment. It is the key test for helping your vet decide on a insulin dose adjustment.
The Blood Glucose Curve test is a series of blood samplings taken every 1 to 3 hours, depending on your vet’s recommendations, and for a 12 hours period. The first sampling takes place just before the insulin injection in the morning. You will measure glucose with a glucometer for each blood sample. Thus, each blood sample makes a point of the Blood Glucose Curve.
Do not be frightened by the blood sampling. It consists only of one tiny drop of blood taken in the ear. Your dog will accept it, especially if you show calmness and self-insurance.
Typically, you will have to perform a Blood Glucose Curve once a week at the beginning of the treatment for adjusting the insulin dose and the diet. Then, blood measurements will progressively become less frequent. They will progressively become routine tests to be performed once every month to once every two months.
Interpretation of the Blood Glucose Curve:
Although it can be difficult or even impossible to attain in some dogs, the ideal goal of the treatment is to maintain the blood glucose concentration between 100 mg/dL and 250 mg/dL. The Blood Glucose Curve provides information on different aspects of the response of your dog to the treatment:
Insulin effectiveness: is the insulin capacity to bring blood glucose down in your dog. The effectiveness is measured by the difference between the highest and the lowest blood glucose values. It is compared to the injected insulin dose. For instance, a poor effectiveness is characterized by a slight blood glucose decrease when a high dose of insulin is injected. It indicates a strong insulin resistance.
The glucose nadir is the lowest blood glucose value of the curve. It is also the point when the injected insulin has its full impact. The treatment goal is to reach a value between 100 and 125 mg/dL (5.5 to 7 mmol/L). Glucose nadir should always be above 80 mg/dL (4.5 mmol/L). Below this value, the dog runs the risk to be affected by hypoglycemia. A glucose nadir above 150 mg/dL (8.3 mmol/L) is too high. Your vet will probably have to raise the insulin dose.
Duration of insulin effect corresponds to the time needed to attain the glucose nadir after insulin injection. If the duration is not adequate, your vet will have to change the type of insulin and/or the number of insulin injections per day (ex: from one to two injections a day).
Real food intake
Feeding compensates for insulin injections. If your dog does not eat or partially eats its meal, the treatment will not work as expected. Your vet needs to know your dog’s eating behavior to understand the reasons for hypoglycemic symptoms or abnormalities in the Blood Glucose Curve. She will probably ask you to note the food leftovers, as it is the most convenient way to record the information. Noting real food intake will also help interpret weight changes. Moreover, it may reveal a palatability issue.
Well treated, a diabetic dog can live a normal and happy life. Any diabetes treatment aims at suppressing or limiting the disease symptoms. Along with specific tests, observing symptoms is one of the main ways to assess diabetes treatment efficacy. Your vet will probably ask you to note regularly, on a daily basis, the symptoms of your pet.
Symptoms of hypoglycemia or signs of ketoacidosis deserve special attention. They should make you seek advice from your veterinary surgeon or an emergency veterinary clinic.
Diabetic dogs may be obese or overweight at initial diagnostic. In more advanced stages of the disease, they usually lose weight. A correct treatment should aim at stabilizing the weight to normal. The dog should be neither too fat, nor too lean. Your vet will also need to know your dog’s weight to adjust the treatment and choose an appropriate diet. Common recommendation asks for measuring weight once a week.
Your vet may want you perform some urine tests at home. It consists of dipping sticks (e.g. Ketostix) in your dog’s urine. These sticks detect the presence of glucose or ketones in the urine. Finding glucose and ketones in the urine shows that your dog’s diabetes is not well controlled.