A Partially Eaten Breakfast | Ask Dr. Joi

By | 2017-08-29T09:35:11+00:00 September 7th, 2017|Pet Care, Pet Diet & Nutrition, Pet Newsletter|5 Comments

I get some great questions from clients. They inspire me with article ideas and keep me in tune with diabetic pet owners. I enjoy interacting with our readers, and sometimes the questions are worthy of a newsletter. I bet if one person has this question and takes the time to write me, there are likely lots of folks with a similar question. Today’s question involved partially eaten food when you have a diabetic sweetie.

I have a 20lb diabetic Bichon, who as do all Bichons, has a sweetly stubborn streak a mile wide! My question: If he eats 2/3 of his morning meal (not such a morning eater) and has his insulin shot without a peep, is it ok to give him that last bit of food as a mid-day snack after he has his morning walk? I want to assure you that I am a real rules follower but I just can’t figure out if it’s more important for him to eat ALL of his food or just say goodbye to it.

Answer: I guess his blood glucose curve numbers hold the real answer to how well he is controlled when you split up his breakfast versus discarding the uneaten portion. I think a blood glucose curve would give us a better understanding of how much splitting his breakfast affects his diabetes than what his fructosamine or A1c levels might offer us.

In general, however, I’d prefer he:

  1. Got 2 equal meals each day
  2. Ate these 2 equal meals 12 hours apart, at the time of his insulin injections
  3. Had no mid-day snacks (his leftover breakfast if he doesn’t eat all his breakfast at one sitting would constitute a snack)

There is a caveat to no mid-meal snacking: If you think he may be hypoglycemic then of course feed him. If you think he might have a low blood sugar, it’s best to check his blood glucose at that time to know if he really is hypoglycemic. If in doubt and he acts voraciously hungry, and you don’t have your blood glucose meter handy, give him a snack.

How you might achieve two equal meals each day may vary. Perhaps you might figure out how much he eats morning and night, total combined amount, and split that into two equal portions so that he might be a bit hungrier come morning. My impression from your email is that he eats better in the evening. How is his body condition? If he is pudgy, as a fair number of diabetic pets are, you might drop his total volume fed. The smaller portions might benefit his waistline. If he is a slim pet with a poor appetite at breakfast, you might consider giving an appetite stimulant. Does he have any nausea? Sometimes pets may eat less if they feel nauseous, and we vets have some dandy anti-nausea meds available for use these days. Of course, if you adjust the portion fed your vet may have you adjust the insulin dosage as well.

Purina Fortiflora

Unfortunately, what I prefer (2 equal meals, 12 hours apart) isn’t always how things play out. Finicky or non-food-motivated diabetic pets can be so frustrating to regulate. If we cannot convince your pet of the wisdom in consistently eating 2 equally portioned meals so that we can hopefully give an equally dosed injections of insulin with each of those meals, then it means more effort from the humans in the scenario.

If you just can’t seem to get him to eat consistent portions, then you may need to adjust/lower the insulin dose each time based on how little he eats. You can work this out with your veterinarian who has examined him.

Diabetic pet owners come in all levels of commitment. Some folks are all for checking their pet’s blood glucose before each injection and using the glucose level along with the amount the pet eats to determine how much insulin to give for that dose. I love having really motivated clients like this! Highly motivated clients such as these are the type that get on board with tight diabetic regulation for newly diagnosed diabetic felines, and those are the type 2 diabetic cats most likely to go into diabetic remission.

On the other hand, some diabetic pet owners are resistant to ever checking a blood glucose level at home for their pets. Heck, some diabetic humans are even resistant to checking their own blood glucose or managing what they themselves eat… Trying to get them to check a blood glucose on their diabetic pets can be difficult if they won’t even do it for themselves. Conversely, some folks may not care as much for their own health as they care for their diabetic pet’s health.

After 30 years in the vet biz, I find it hard to predict who will step up to the plate for attentive diabetes management of their pet and who will be lackadaisical about medical care for their diabetic pet. Since it doesn’t seem like I will have a crystal ball anytime soon, we can depart this philosophical conundrum. If we can’t get a diabetic pet to eat consistent portions, it means their humans must elevate the glucose monitoring efforts and formulate a plan with their veterinarian.

Have a question or comment? Post below or email me at joi.suttondvm@adwdiabetes.com. I always enjoy hearing from my readers!


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

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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.

5 Comments

  1. Marie Loomis September 8, 2017 at 6:57 pm - Reply

    Interesting question and answer! I wanted to share my experience with my diabetic cat, who is a slender 8 pounds and not food motivated. Since I joined a diabetic cat forum on tight regulation, I’ve learned more about handling diabetes than picking the brains of every vet around me. It’s ALL about checking that blood glucose (at home of course!). I no longer feed with shot, but I do offer food. She eats when she eats. I shoot according to the Lantus Scale strictly according to her numbers, and you can shoot at 150 but never below. You just need to confirm a rise first, as your pet may be falling rather than rising, and we never want to shoot a falling BG. If BG is above 220, you do not have to confirm a rise – just shoot according to scale. If not using Lantus, surely there’s a scale for the insulin you’re using. My cat often prefers multiple meals a day, and I can’t say enough for a meat diet – raw or cooked – with food-sourced supplements for nutritional balance. When’s she’s voraciously hungry, I know her numbers are in the double digits. But all of this only applies if you’re willing to do home BG testing to confirm where your pet’s numbers truly are. You mention shooting every 12 hours, which makes me think you’re using Lantus (Glargine). If so, the scale is as follows, and I assume it’s the same for dogs as for cats – please double check this! I’m not a vet. Lantus Scale: 150-250, give .75u/ 251-400 give 1u, and 400+ give 1.25u. When you get to the part about figuring out where the heck .25 or .75 units are on your syringe, with Lantus (an insulin of drops), simply gently push out two drops to get that half unit mark going for you. Technically, it’s 2.5 drops, and even that can be done if you carefully push out another half drop. There are 5 drops per half unit, etc. Hope this helps!

    • Dr Joi September 17, 2017 at 3:10 pm - Reply

      Yes, my go to insulin for cats is lantus. Some vets prefer pzi or levemir for cats. They are also good choices for cats. I’ve never used lantus in a dog.
      Folks with diabetic pets should work out a protocol with their own vets based on their pets’ glucose numbers and type of insulin, but what you suggest is exactly what I had in mind. :). Joi

  2. Gail Knowlton September 29, 2017 at 5:28 pm - Reply

    My 10 year old spayed female miniature schnauzer has been diabetic for a year, and her health seems to be good. For the past several months she’s had a thick discharge from her ‘girl bits’. She licks herself a lot, and when the fur is dry it’s stiff.
    Is this related to her diabetes? A normal aging thing for a female dog? Or something I should be rushing her off to the vet for?
    Gail

    • Cat October 5, 2017 at 10:00 am - Reply

      That sounds like she has an infection. My puppy had the same thing, it was a yellowish discharge from her girly bits. She did have a minor infection. I’d take your pup to the vet to get her checked out especially if she’s diabetic! Infections and make her glucose go wild.

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