Two weeks ago I had a client who forced my hand and made me do a pet glucose curve in my clinic. Normally I expect, and strongly encourage, my clients to run their curves at home to avoid the complication of “stress hyperglycemia”. This phenomenon is when the liver turns stored glycogen into glucose when a pet is stressed. It’s the old fight or flight response from the stress of being at the clinic. Her dog is a newly diagnosed diabetic and doing remarkably well on Levemir, but we needed to evaluate the dosage. This owner is quite smart. I really enjoy her. Unfortunately, she feels so guilty getting blood from her little cavalier that checking her dog’s blood glucose completely stresses her out. She believed she couldn’t check a curve at home, so I conceded and ran the curve in the clinic.
This little dog did NOT like being in a kennel at my clinic and got put in the quiet kennel area in the back for noise sensitive pets. I’m certain the pet thought: “Why are these humans treating me like a dog? Why am I in a cage? I better bark nonstop and alert them that I’m in a kennel!”
I’m certain she had some stress hyperglycemia just from being kenneled. At one point during the day I walked into the room to check on her, and she was digging to China at the kennel door. I adjusted the dose, knowing the results would be affected by stress hyperglycemia, and spent time with the owner having another lesson on checking the pet’s blood glucose later that day.
I’m proud to say she did the curve by herself at home last week although she didn’t enjoy doing so. What she told me was that she felt guilty poking her pet to get the glucose for each reading. Maybe this is why some of my most earnest clients dawdle when I ask them to run a blood glucose curve. Ideally we check a curve 5 to 7 days after any change of insulin dose or every 3 months even if we think we have the dose perfect.
Years ago I read a survey result that diabetic humans feel more adverse to poking themselves for blood than to poking themselves with a needle to give themselves insulin. This emotion is likely amplified when the poke and sight of blood involves a beloved pet. Seriously, some folks get woozy at the mere thought of blood or needles.
Let’s get back to my client telling me she felt guilty each time she checked a blood glucose. Yes, a quick poke with a lancing device hurts for a second. But that is really just a handful of brief pokes, a few brief instants of slight discomfort. If a pet is not on the best dosage of insulin, if it is unregulated, it feels crummy all day long, day after day.
What are the signs of poorly managed diabetes? Well, we know when the blood glucose is really high the pet is voraciously hungry, drinks excessively, loses weight and acts lethargic. What about a mildly elevated blood glucose? The pet may not be losing weight nor feeling horrible, but may have subtle clinical signs and feel unwell, unnoticed by the pet owner.
If we anthropomorphize the clinical signs of diabetic humans onto our pets we can assume they may also:
- Feel nauseous when the blood glucose is elevated
- Have a dry mouth
- Have subclinical urinary tract infections
- Have decreased vision
- Feel lethargy or fatigue
So maybe you have dawdled about running your pet’s latest blood glucose curve because you feel badly about poking your pet. Are those handful of pokes with a lancing device worse than your pet feeling lethargic or having a dry mouth all day long? I think not.
Humans get to make the choice about their health. If they are diabetic, they can choose to eat healthy foods and exercise and monitor their sugars. Or, they may eat donuts and candy and have to pee in the night and experience other effects of unregulated diabetes. Folks make these choices for themselves and live with the consequences. Having a diabetic pet is indeed a responsibility. It is our responsibility to our beloved pets to do our best for them when they have medical conditions.
I understand if clients have a busy schedule. As my own vet practice grows I’m back to working 50 to 60 hours a week these days. Anymore I really look forward to weekends so I can catch up on the rest of my life. I understand how precious time is. I also understand that some clients hate the sight of blood, even if just a teeny droplet for a blood glucose check. And now I also understand how a client may fear hurting a pet by using a lancing device.
Really, the vast majority of pets tolerate home glucose testing quite well. The blood glucose readings at home eliminate stress hyperglycemia. It’s a quick poke and if you rub the area prior it doesn’t hurt much. Some lancing devices are better than others. I prefer lancing devices with an adjustable depth so you poke only as deeply as needed to get enough blood for a reading. I send my clients with a little sock of uncooked rice that they can warm in the microwave and hold against the site of blood collection. The warmth causes the blood vessels to dilate so the pet bleeds more easily. And of course, hug and talk to your sweetie to distract your pet from the actual poke. And know that these few seconds of mild discomfort are for the greater good.
You want your pet to be well regulated and feel good all day long!
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.