It never ceases to amaze me the love and care some folks take with regulating a diabetic pet. It gives me great joy when clients check their pet’s blood glucose – whether before giving an insulin injection OR running a blood glucose curve OR even if it is when something doesn’t seem quite right. Being involved and taking the time to educate oneself on the pet’s medical condition: That spells love.
Now, some folks couldn’t be bothered to check a pet’s blood glucose. I’ve met them! They want to give the same insulin dose day in and day out. They don’t want to own a blood glucose meter nor learn how to use it. This is very old school and how vets used to practice ages ago. Diabetic pets didn’t live as long back then as they can today. This is how diabetic pet owners, and veterinarians, were when I started in this biz 3 decades ago. Back then there was no Internet to educate dedicated clients. Back then blood glucose meters weren’t as accurate and required more blood per sample than they do today.
These days most folks are savvy to the Internet. Even if the veterinarian doesn’t initially encourage home glucose testing, people with a diabetic pet can Google diabetic pet care and find educational sites such as ADW Diabetes and self educate. If nothing else it gives people a starting point for a conversation with the family veterinarian. Some veterinarians don’t suggest home testing to diabetic pet owners. That’s a pity. Education is key to a well-regulated diabetic pet. Furthermore, education and home testing can minimize dangerous errors when things aren’t going smoothly!
When we have a diabetic pet, the day to day routine varies with each of them. Most diabetic pets are good eaters. I’m talking about the clean plate club. These good eaters make diabetes much easier to manage than when a pet is finicky or skips meals. For these pets in the clean plate club, if we feed them equal portions every 12 hours, we can usually give equal doses of insulin day in and day out. Consistency is your friend when it comes managing to a diabetic pet.
Some diabetic pets are anything but consistent. Whether from nausea or other illness, a diabetic pet may not want to eat when it’s time for the insulin dose. You should chat with your vet about anti-nausea meds and diagnostics to check if there is other concurrent illness, but there are actually some pets that lack food motivation. These critters make it a whole lot more difficult to manage their diabetes. THESE are the pets that I hope have dedicated humans who will check their blood glucose before receiving insulin. These are the pets who would benefit from a “sliding scale” insulin dose based on the blood glucose value and whether the pet ate a little or ate a lot. This is not something I can provide. This is something you should work out with your veterinarian who has knowledge of your pet’s tendencies and health. It would be improper for me to tell anyone how much insulin to give a pet I’ve not personally examined. Before anyone asks, I won’t tell you how much insulin to give your pet. I am able to give general guidelines only for pets I’ve not examined.
Let’s not forget to mention “tight diabetic control” that some diabetic cat owners achieve with hope of getting a cat into diabetic remission. Diabetic cats are much like type 2 diabetic humans. Some diabetic humans who are flirting with diabetes can control their diabetes with weight loss and proper eating. This means very little refined carbohydrates. For humans this means no donuts and no candy and minimal refined carbs such as bread and rice and pasta. For kitties this means no kibble. If a patient (human or feline) has a high blood glucose, the high blood glucose hinders the insulin producing cells of the pancreas from making insulin. This is called “glucose toxicity”. When we get newly diagnosed diabetic cats on insulin and a low carbohydrate diet, we may achieve diabetic remission.
Diabetic remission in cats may last for a short period or may be forever. Veterinarians don’t have a way of telling how long remission will last, but certainly we encourage folks to continue feeding low carb (canned) food to any cat that achieves remission. I advise no more kibble ever to these cats in remission or else you may find yourself giving insulin injections again. Tight diabetic control means these pet owners check the blood glucose before each injection of insulin and adjust the insulin dosage based on the blood glucose reading and how much the pet eats. Many diabetic cats will go into remission with insulin (the same dose each time) and low carb canned food and weight loss, but the chances are better when the owner adjusts the dosage each time based on the blood glucose at that time. I’ve never seen a diabetic dog go into diabetic remission, but it is possible if the diabetes is gestational in an intact female.
Folks who take the time to check a pet’s blood glucose often will likely have a longer lived diabetic pet. I will do nearly anything for my pets. They are my family. If one of my pets were diabetic, I’d check the blood glucose often. If I had a finicky diabetic, I’d likely check the blood glucose before each injection.
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.
Is it safe to allow a diabetic dog with cushing’s to skip his meal in the morning? He is supposed to get insulin in the morning and evening, 12 hours apart. But if he doesn’t eat, is it safe for me to let him decide he can’t eat? And if I do give it to him later, then he will be getting his insulin in less than 12 hours apart. This is the most difficult part of having a dog with diabetes and cushing’s.
Well that’s a tough question to answer! I’d like you to chat with your veterinarian who has examined your pet about this. If your pet doesn’t eat it may be that there is some nausea involved. A high blood glucose could also make your or not want to eat. Hopefully you are doing home glucose testing to help guide you with insulin choices. Perhaps you and your vet who has examined your pet can sort a sliding glucose scale (ie lesser amount given) when he doesn’t eat much based on the glucose level at the time. I do hope you are giving vetoryl twice daily. It can be used once daily for mt cushingoid gos, but it should be given every 12 hours for diabetic dogs. Do have a chat with your veterinarian about your question. 🙂
This information is fantastic! Thank you for providing education and pet love!
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Dr. Sutton you are amazing. Thank you for all the information you have shared. My dog has diabetes; he was diagnosed in October 2017. He gets Vetsulin 2x’s a day every 12 hours. He is a very picky eater; and it worries me. He seems to be hungry all the time; but he is very, very picky when it comes to food. If he doesn’t eat much and I have to leave the house he will search for leather shoes, purses, tissues etc. Today I came up stairs and he was eating my leather shoes. I did tell my Vet and he told me that I should leave food down for him to eat and see if that helps.
Hunter will be 13 in September, I don’t know his real birthday because I adopted him from the shelter. He is also blind and I don’t think his smelling sense is that great, along with not being able to hear that well.
I have purchased canned dog food and he will take a few bites and that is it. I started taking the remainder of the food and putting it on a baking sheet and making treats for him (that is what he thinks he is getting). He will eat the dog food that way. It is very time consuming; most of the time I make him ground turkey or turkey patties. He eats eggs, steak-um ms with the eggs and lots of chicken.
I sure could use some help in what else I can do for him. Thank you so much!
When I have a diabetic who has a poor appetite I worry about ongoing pancreatitis. Pancreatitis is a common cause of diabetes and it definitely causes nausea. Ask your vet for some angina uses meds to have on hand. You might even try a week trial of some Cerenia or Zofran to see if it makes a difference as it might help us determine if there is nausea. Certainly hyperglycemia could cause nausea.
Next, you could ask our vet for an appetite stimulant. We’ve used mirtazapine in vet med for years now. It is hit or miss in efficacy for appetite stimulation. Last year a new drug called Entyce was released. It’s a grhelin analog. Grhelin is the hormone that makes you hungry. I’ve found it very helpful for say a dozen patients since it came out last fall. Of course I hope this doesn’t cause him to eat more of our shoes and purses!
When did you last run a blood glucose curve?
Have you ever run across a case that the dogs BG just runs high? Our 10 year old lab was diagnosed 3/3/17. At that time, she weighed 82 lbs. She had just had a normal annual physical 3 weeks before, with blood work, all normal.
I noticed she had 2 urine accidents in the house, which she had never done before, took her right in and her BG was in the middle 750 range.
Since that time, we have tried Novolin-N – could not get her numbers lowered. Currently and for the last year, she’s been on Vetsulin. She began to lose her vision last August. She had successful cataract surgery and is like a new puppy again. She has been 100% clinically healthy this entire time. We have tried several changes to her dosages, but it’s either way to much or too little, so the sweet spot seems to be 16 units 2X’s per day. She is on WG food, which I measure out. She gets 1 -2 approved treats per day and 1 small carrot.
Every time I do a curve on her, her numbers range anywhere from 300’s up to the 500’s. No rhyme or reason, we have never been able to get them to stay consistently in the “normal range”. She gets blood work done at the vet’s office and urine tests every three months. Everything is always 100% normal. She has maintained her current weight of 65 lbs. for the last year.
It’s frustrating to me to see this happy and seemingly healthy dog have numbers that are so high in spite of all the things we tried. Any thoughts?
When our dog, Lucky, was first diagnosed with Diabetes, we continued to feed her twice a day but her blood sugars ranged from 32 to 585! She was extremely difficult to regulate. But as a nurse I always gave my diabetic patients timed snacks throughout the day. What I did was divide her daily portions into q3h snacks. Her blood sugars have become extremely well regulated. I realize everyone can’t feed their dog/cat every 3 hours but it does work!
Actually, diabetic pets typically do better when receiving the majority of their calories when they get their insulin, every 12 hours. Humans can inject themselves with insulin and react if their blood glucose gets low or high by eating or giving themselves a bit of insulin. For pets, consistency and food at the time of insulin injections works best for good regulation. Nonetheless, do what is working for your pet. I’m glad she has such a dedicated human!
Hi. I have a diabetic dog I try to keep on the 12 hour feeding/insulin schedule and he’s always hungry. Where on his body do I draw blood from to test it. I bought a test kit.
I wrote an article on that very subject….
Great column today! Both articles on the care and management of feline diabetes were SO good. Thank you!
Thank you for your kind words.
Hi Dr. Joi,
Thank you so much for your help in getting my Alpha Trak2 meter issue resolved with ADW. They’ve sent me a replacement. I do have a question for you, based on this article and your comment about tight regulation. My cat is on Lantus and, given that it is a depot insulin, would tight regulation be appropriate? I check his glucose before each shot. My vet has said that with Lantus, consistency in dosage is important and that changing the dose could cause problems.
I’d like your thoughts on this.
I do love consistency! Equal portions and equal doses do make life easier on a diabetic pet owner. And yet, if you are willing to check the blood glucose before each insulin injection and work out a sliding scale dosage with your vet, you could increase the chance of diabetes remission for your kitty. I’m so glad you got a blood glucose meter! Great job!
Do you have a blood glucose meter you recommend? I bought one for my diabetic cat and the meter wasn’t reading correctly and she ended up being hospitalized. I couldn’t return it either and now I’m too terrified to try another one. Thank you.
There are now several pet glucose meters on the market. My fave is still the Alphatrak 2 meter. It requires such a teeny droplet of blood and is so user friendly that it wins my vote every time.
Also, I’m very sorry your sweetie landed in the hospital.
Dr. Joi, The vets at our local cat hospital recommend only Lantus, as they say it works better than regular insulins, albeit at many times the cost. Do you feel the extra expense is justified? We keep the Lantus refrigerated, but our cat’s current dose is just 3 units, and that requires us to keep the product much longer than the 3-month expiration date.
The key here is to buy a 3 cc pen instead of a 10 cc vial. The 10 cc vial will surely have lots of wasted insulin. In my small town where I practice, the local human pharmacist sells a 3cc pen for about $100. I have my clients take the cap off and use the pen as if it were a vial, using the same syringes. (The pens won’t allow for partial unit doses.)
Lantus is my preferred insulin for diabetic cats. I agree with your vet. 🙂
My 13yr old Shiba Inu became diabetic 3 yrs ago. The nice thing is I am diabetic type 1 on an insulin pump so it was no issue taking his BG and curves. My vet has the confidence in me to regulate his dose and read his curves. He is in perfect health because of the very tight controls (100-150) we placed since I am on tight controls myself. His liver, kidneys and pancreas all normal levels now. His organs are not being strained by high blood sugar numbers. I even educated my neigbors who have a diabetic dog on how to take BG and what dose to give. We have the same vet. They couldnt believe how easy it was. Its not hard to do at all. Its sad that many people will put there pet down, not check there Blood Sugars or just want a set dose for just diabetes. Pets can live a quality life with diabetes. I wish each vet office had diabetes education class like they do for people. Just showing people it only takes a few minutes to take BG and curves are less stressfull at home and numbers are more accurate. We take it inside his lip and its easy. At first he didnt like it but its less painful then the ear. It took three times when he finally stopped pushing us away with his paw. Plus the mouth heals quicker then the ear. He doesnt care about it anymore and just lays down when we take it. He gets lots of pets and love afterwards which is his favorite part.
Oh wow, I also have a Shiba, but she’s a youngin and wont have to worry about diabetes for quite some time.
I had a question though if you don’t mind answering. When researching which breed I should get, diabetes wasn’t in the common ailments for the breed how did your Shiba get it? Was it genetics?
I think genetics may play a role for some pets. Many pets become diabetic secondary to pancreatitis. We know that schnauzers and Yorkers are very prone to pancreatitis. I don’t honk off shibas as a predisposed breed.
Of course, obesity can affect any breed of the human overfeeds the pet. Obesity predisposes a pet to pancreatitis and diabetes.
Ah, luckily I don’t have to worry about obesity, I don’t think. My Shiba food guards / barely eats her food in the time we have it down (a trainer advised we only set it down for 15 mins so she understands she has to eat it or wait till the next feeding time). Some days she’ll eat most of it or all of it if she skipped a meal and we don’t really feed her treats. We might give her at most 5 but on average 2. One for kenneling in the morning before we leave and one if we just feel like giving her one or want her to do something right away rather than just have her staring at us like she doesn’t understand (she does she’s just being stubborn).
In general, so long as you keep the treats to less than 10% of the calories you should be just fine. I know a few dogs who won’t eat their food and instead hold out for “the good stuff”! 😉
Your words are music to my ears!