What can you expect to learn about diabetes in dogs from a Veterinarian?

Recently I spent time visiting with my veterinarian to get an idea how the diagnosis of diabetes unfolds. 

During the appointment, your veterinarian records the symptoms and completes the exam. If diabetes is suspected, your veterinarian will order bloodwork and a urine sample, this is due to the close connection between Urinary Tract Infections and Diabetes. Wait! Before I go further, allow me to remind you of the symptoms of a diabetic dog:

The warning signs of a dog struggling with high blood sugar

If your dog’s high blood sugar is temporary, or the result of stress or medication, you may not see any symptoms. However, if it is the result of a serious disease, like diabetes, you will likely see some of the following:

• Wounds not healing; infections worsening
• Depression
• Enlarged liver
• Urinary tract or kidney infection
• Bloodshot eyes
• Cataracts
• Extreme fluctuation in weight, gaining or losing
• Obesity
• Hyperactivity
• Excessive thirst or hunger
• Increased frequency of urination

Once your veterinarian confirms your dog is suffering from diabetes, a series of changes will take place.

The doctor will discuss diet first. It is recommended that your dog adhere to a low carbohydrate type kibble or wet food diet. You will need to follow a feeding schedule to learn the process of proper administration of insulin. You must stick to this schedule to be successful in managing your dog’s blood glucose levels. See my Blog, “4 Simple Steps to Manage your Diabetic Dog’s Health” for additional information.

The medication prescribed for a dog with diabetes is insulin. Insulin is what the dog’s body is no longer producing. There are a variety of insulin products on the market, rapid acting, intermediate acting and long acting. It appears that Humulin N, Vetsulin, and Novolin N are most often prescribed, at least in my veterinarian’s clinic. Here is some information on these insulin products.

HUMULIN N is an intermediate-acting insulin with a slower onset of action and a longer duration of activity than that of regular human insulin. After HUMULIN N vials have been opened: Store opened vials in the refrigerator or at room temperature below 86°F (30°C) for up to 31 days. Keep away from heat and out of direct light.

Vetsulin is classified as an intermediate-acting insulin. Store the Vetsulin bottle upright in the refrigerator. Do not freeze. Use contents within 42 days of first vial puncture and maintain a temperature of 77°F (25°C) or cooler.

Novolin N is an intermediate-acting insulin that starts to work within 2 to 4 hours after injection, peaks in 4 to 12 hours, and keeps working for 12 to 18 hours. Store in a refrigerator between 36 and 46 degrees F (2 and 8 degrees C) or at room temperature below 77 degrees F (25 degrees C). Do not freeze or use if the insulin has been frozen. Protect from light and excessive heat.

To determine which insulin and correct dosage the veterinarian will complete a glucose curve. This is to determine whether an insulin dose is adequately maintaining blood glucose levels.

On the scheduled day, your dog is dropped off at your veterinary clinic before he eats breakfast. A fasting blood sample is drawn for testing, then he is fed his normal meal, followed by his insulin dose. Periodically, usually every 2 hours, throughout the day blood samples are drawn to test glucose levels. This process is completed in an 8 -12 hour timeframe.

The veterinarian does take into account the added stress on the dog due to being in a strange environment. Some dog owners opt to bring the dog in for the testing throughout the day to decrease this stress factor. This is an example of the Traditional glucose curve process.

There is another option. It is called the Freestyle Libre glucose monitoring system. It is a continuous glucose monitoring system that consists of a quarter-sized sensor that is pressed into the skin. Typically, a small spot on the dog’s back is shaved to enable the sensor to adhere to the dog’s skin. The sensor has a sampling catheter attached that measures the glucose levels of your dog’s subcutaneous (under the skin) body fluids every minute and stores the information. A digital reader is passed over the sensor to capture data. This data is uploaded to your computer to be evaluated. The sensor is left in place for 14 days and provides continuous glucose readings. The good news is that this reader can be reused for several years, however a new sensor will need to be replaced for reapplication.

The Freestyle Libre is affordable and helps ease the stress on owner and dog, by decreasing those visits to the veterinarian early in the diagnosis. Accurate monitoring of your dog’s diabetes can help to maintain a good quality of life for both of you.

So, exactly what are we looking for? Normal blood glucose levels in dogs are similar to those in humans, about 80-120 mg/dl. Animals whose blood glucose levels are in this range will look and act normal. The good news is they will also act somewhat normal if their blood glucose levels are 100-250 mg/dl. If we can maintain that level for a good part of the day the diabetic dog will act fairly normal, with an acceptable amount of drinking and urinating while maintaining a stable body weight. The goal is not to allow the levels to get higher than 250 mg/dl causing the kidneys to overwork.