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YVCipedia ENDOCRINE (HORMONES)
DIABETES IN DOGS - TREATMENT CONCERNS
There are several different types of insulin preparations available. Each diabetic patient can have a different response to each type of insulin. Our decision on which type of insulin to begin treatment with is based on multiple factors.
Insulin should be stored in the door of the refrigerator to maintain a constant temperature. It should be mixed prior to each injection by gently rolling and swirling the bottle, not shaking it vigorously. Observe that the insulin looks uniformly mixed before drawing up the injection.
A bottle of insulin is good until the last drop; partially full bottles do not need to be replaced on a regular basis (many human diabetics replace their insulin regularly, so some pharmacists are unaware that it is fine to use the entire bottle). If the insulin appears discolored or clumps without dissolving then the bottle should be replaced.
There are two strengths of insulin that are used in dogs and cats: U-100 (100 units of insulin in each ml of solution) and U-40 (40 units of insulin in each ml of solution). There also are two corresponding types of insulin syringes, U-100 and U-40. These designations are clearly stated on the bottle and the syringe package. It is very important to only use U-100 syringes with U-100 insulin and U-40 with U-40.
What diet is fed is based on the dog's weight, the presence of illness other than diabetes, and dog and owner preferences. Some general considerations:
CORRECT OBESITY AND MAINTAIN BODY WEIGHT IN AN ACCEPTABLE RANGE
Obesity plays havoc with attempts to manage diabetic dogs. Weight reduction is accomplished by simultaneously feeding a reduced number of calories and increasing the amount of exercise.
MAINTAIN CONSISTENCY IN THE TIMING OF MEALS
Most dogs require insulin injections twice daily. One-half of the daily caloric intake should be fed at the time of each injection, every 12 hours.
Dogs on once-daily injections should be fed one-half of the daily caloric intake at the time of the injection, and one-half 8 to 10 hours later.
Dogs that are used to nibbling throughout the day can still be allowed to do so, but the total amount fed each day must be carefully measured and controlled.
MINIMIZE THE IMPACT OF FOOD ON AFTER-MEAL BLOOD SUGAR LEVELS
This is accomplished by avoiding monosaccharides and disaccharides, propylene glycol and corn syrup. In essence, avoid junk food. It is nearly impossible to know if a dog treat is "junk" by reading the label or information on the internet. As general rules: healthful treats should be fed as no more than 10% of the daily caloric intake, and all of the many different treats made by Hill's (the makers of Science Diet, Healthy Advantage, and Prescription Diet) are nutritionally excellent. If it is not contraindicated to do so, increasing the fiber content of the diet is another good nutritional option for managing blood sugar levels.
Exercise plays an important role in correcting and preventing obesity. Exercise also lowers blood sugar. The daily routine for diabetic dogs should include exercise, preferably around the same time each day, and preferably not at the time of peak insulin effect, which is typically 8 to 10 hours after each injection.
Strenuous or sporadic exercise can lead to dangerous lowering of blood sugar levels. If strenuous exercise cannot be avoided, the insulin dose on the day of the strenuous exercise should initially be reduced by one-half. The dog is then observed for signs of hypoglycemia (see above) or increased thirst and urination for 24 to 48 hours after the exercise; if any signs are noted please consult with us regarding further adjustments in the insulin dose.
HYPOGLYCEMIA = ABNORMALLY LOW BLOOD SUGAR
Diabetes results in excessively high blood sugar. Insulin lowers the blood sugar. If the dose of insulin is too high and/or if there are other complicating factors a patient may become hypoglycemic. Owners who are treating their pets with insulin should be aware of the signs of hypoglycemia, and they should be prepared to treat it at home.
Signs of hypoglycemia include: weakness, wobbliness, muscle twitching, collapse, and seizures. The signs (other than seizures) may appear suddenly or gradually and they may be persistent or intermittent.
If severe signs of hypoglycemia occur suddenly at home the owner should rub a sugar solution (for example, Karo syrup, molasses, maple syrup) on the dog's gums, being very careful not to place their fingers in the the dog's mouth. Once the pet is somewhat stable it should be fed a small meal, and then brought to the veterinarian.
OTHER PROBLEMS WITH TREATMENT OF DIABETES
Problems other than hypoglycemia can occur while we are managing a diabetic dog. Be alert to any general signs of illness such as lethargy and loss of appetite, as well as recurrence of the common signs of diabetes - increased thirst and urination. Other than as was previously discussed regarding strenuous exercise, we do not recommend that owners adjust insulin dosage at home without contacting us first.
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