Communication with Your Veterinarian and Expectations with Pet Diabetes

By |2019-05-10T11:24:24-04:00Updated: September 19th, 2018|Pet Care, Pet Diabetes, Pet Newsletter|9 Comments

Unfortunately, sometimes communication with your vet falls short. Let’s fix that.

I’ve been part of the ADW Diabetes team since 2011. In that time I have fielded thousands of emails from readers who have felt disappointment or frustration or even helplessness about their pet’s diabetic condition. And sometimes they may mention something derogatory about their family veterinarian. Most veterinarians do their best to be your hero!

I’m a practicing veterinarian, too. We vets try so hard! A few simple suggestions may help you form a more harmonious relationship with your veterinarian.

Be Your Pet’s Health Care Advocate

We must be our pet’s healthcare advocate. Just as when you get sick yourself, you must learn all you can about your condition to improve the chances of a successful outcome. You must also learn about your pet’s diabetes. After all, diabetes can be a long term condition for cats and is nearly always a long term condition for dogs. Education is key to good blood glucose regulation.

Be Organized

Communication with your veterinarian is very important. There are things you can do to establish and maintain good communications with your vet. From my perspective, as a practicing veterinarian, I love it when my diabetic pet owners keep good records. Most glucose meters come with log books for writing down glucose levels. Folks usually fill up the log book or perhaps lose the log book, then perhaps come in for an appointment with scraps of papers in an unorganized file. That wastes time during the consultation. Try to keep it organized!

Several years ago ADW and I made a log book including things I felt pertinent. Or, for my clients who are more computer savvy, I love it when my clients email their pet’s blood glucose curve numbers to me at my clinic. It’s so easy for me or my staff to copy and paste it into the records at the clinic.

Be Kind

Please always be friendly to your vet. Yes, we understand that diabetes is an expensive and perhaps scary disease, but it isn’t our fault that your pet is diabetic. We are on the same team, and we want your pet to live a long and healthy life despite the diabetes. We make recommendations for tests to help your pet feel better.

Communicate

Communication is key to avoiding mistakes! Communication includes your family! If I have more than one person potentially giving insulin injections to a pet, I want a calendar on the fridge. I want each caretaker to mark off when the morning or evening injection was given. I’ve seen a pet get double-dosed by family members who were unaware that the pet already had the insulin dose administered. It takes a village to regulate a diabetic pet in our hectic lives. Keep track with a calendar and communicate with each other.

Know the Plan

Keep communication open with your vet about the plan. When you leave an appointment ask when you should come back. Know that even when you think your pet is under perfect blood glucose control you’ll need to run blood glucose curves at least every couple months in case we need to tweak the dose. You’ll want a quarterly check-up and both a blood profile and urinalysis/culture at least twice yearly. We want you to keep track of your pet’s body weight and clinical signs and let us know if anything changes. Know the plan!

Have Realistic Expectations and Know the Big Picture

Know what may happen. Read. Educate yourself on diabetes. If you understand the big picture expectations about diabetes it may light a fire under you to run those curves and do home testing!

Expectations for dog owners:

Dog looking upDiabetic dog owners are often unaware of the risk of diabetic cataracts for diabetic dogs. They can occur in diabetic cats as well, but are much less common than in diabetic dogs. On average, 3/4 of diabetic dogs will go blind from diabetic cataracts within 2 years of diagnosis of diabetes. I believe if more diabetic pet owners understood this they would have more incentive to run the blood glucose curves and keep to the 12 hour dosing schedule and have regular check-ups with the family vet!

Great blood glucose regulation will dramatically decrease the risk of diabetic cataracts for dogs. There are oral supplements available that can dramatically decrease the risk of cataracts in dogs. Speak with your vet about this to get their opinion. If cataracts do occur there is surgery to remove them, but it’s so much better to avoid them in the first place.

Expectations for cat owners:

Cat eating canned foodFeline remission is our goal when we first diagnose a cat with diabetes. If you act promptly and get your cat on insulin and feed low-carb canned food and do home blood glucose testing, we may be able to get your cat into remission and off of insulin. That’s truly exciting! Diet and weight loss might be enough to keep your cat in remission. This remission might not last forever.

We don’t know how much pancreatic function remains when we get a cat into diabetic remission. We need to keep the kitty slim and continue the low-carb diabetic diet to improve the likelihood of continued remission. If the kitty becomes diabetic again, we simply reinstitute the insulin injections.

Have a question or comment? Then post below! I always enjoy hearing from my readers!


NOTE: Consult your veterinarian first to make sure my recommendations fit your pets special health needs.

About the Author:

Dr. Joi Sutton is a 1993 graduate from Oregon State University. She has practiced both in emergency medicine and general practice. Dr. Sutton has done extensive international volunteer work though Veterinary Ventures, a nonprofit organization that takes teams of veterinarians to undeveloped countries for humane medical care. She also runs a small animal practice in South Florida.

9 Comments

  1. Barbara November 15, 2019 at 9:15 am - Reply

    Frequent mention is made about “adjusting the dose of insulin” for diabetic dogs. Mine is a 14 year old Pomeranians with frequent pancreatitis episodes. He is on a very strict diet of I/D low fat dog food with crumbles of turkey or chicken (cooked).My dog is hungry all of the time and I need to give small portions between his 2 meals a day. The dog has lost weight and currently is only 5 pounds.
    Does the dose increase or decrease for the “extra” snacks?
    I do see my vet regularly but they want to do all of the testing and I would like to learn the basics of this myself.

    • Dr . Joi Sutton November 15, 2019 at 9:46 pm - Reply

      Presumably extra food would increased the dosage of insulin, but if he is losing weight you should first run a curve to make sure the diabetes is under control. Ideally you’d give larger meals at the time of the insulin injections rather than snacks between the injections. I’m glad you are doing home testing. Do a curve and show the results to your veterinarian to help evaluate. Great question!

  2. carolyn Mahnke July 18, 2020 at 11:18 am - Reply

    What do you know about use of Libre continuous blood glucose sensor used with dogs??

    • Dr . Joi Sutton July 19, 2020 at 5:04 pm - Reply

      I’m a big fan of the Freestyle Libre 14 day monitoring syste, particularly for pets that are difficult to regulate.
      There is a great YouTube video by Dr Patty Latham, an internal medicine specialist who is at the forefront of hormonal diseases, on the placement of the sensor. If you have a newer phone you can down load the app and avoid buying the sensor. I wish the manufacturer would allow ADWDiabetes to sell them for pets. For now ADW has them only for human patients.
      I’ve used a sensor for several patients in my general practice.

  3. Anonymous July 20, 2020 at 1:13 pm - Reply

    I am trying to learn more about when a cat is considered in remission. The term “normal range” is often used. Is that 80-120, or do you quit giving insulin at a higher number?

    My cat’s morning (about 10 hour fast) level is usually around 135. If I give him 1/4 unit insulin (ProZinc) he drops below 80 so I don’t give him insulin. He went 4 days without insulin.

    Yesterday he started at 154. I gave no insulin. Two hours after eating (Tiki cat chicken) he was at 145. At lunch time (my vet recommends 4 meals, I know you recommend 2, I give 2 larger w insulin check, and 2 smaller, one at 6 hours between larger and other 3 hours after dinner- before bed) he was still at 145 so I gave him 1/4 unit. Two hours later he was at 110. Dinner time BG was 125 so no insulin.

    Today started at 154 again so I gave 1/4 unit with breakfast. 3 hours later he is at 101.

    1/4 unit is so little, and hard to draw, but seems to bring him into the 80-120 range. I am scheduling an appointment with my vet, but wondering your thoughts.

    Diagnosed 11 weeks ago. Most he ever received was 1 unit.

    Only eats Tiki Succulent Chicken and Tiki Luau Tuna (although occasionally manages a few bites of his sister’s NF if I get distracted)

    About 2 lbs overweight- Weighs 14, vet says 12 would be good.

    Indoor cat, but plays with toys and walks around a fair amount.

    About 11 years old. Rescued along with 113 other cats from one house. Stomatitis made hard to age.

    Diabetes brought on by prednisolone he was taking for liver issues. Immediately taken off. Only meds takes now is Denamarin, and the insulin.

    His BG has gone over 200 3 times, but generally well controlled.

    Thank you.

    • Dr . Joi Sutton August 11, 2020 at 9:46 pm - Reply

      Do chat with your vet, but it seems to me your kitty is in remission or nearly so. Taking away the pred and weight loss will hopefully do the trick. Great job!!!
      Keep an eye on the glucose level periodically even when he is off the insulin.
      🙂 Joi

  4. Anonymous July 28, 2020 at 12:08 am - Reply

    Dr, Sutton, did you miss this question?

    • Anonymous July 28, 2020 at 10:14 am - Reply

      Glucose 7/24/2020 155 (no insulin for 4 days)
      5/1/2020 431
      7/30/2019 298

      Fructosamine 7/24/2020 209

      He lost 11 oz. over 3 months. Now at 13# 8

      • Dr . Joi Sutton August 11, 2020 at 9:48 pm - Reply

        Do share these numbers with your veterinarian who has the full clinical picture as he or she has examined your pet.

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