Managing Canine DM without injecting insulin

Re: Managing Canine DM without injecting insulin

Stephen Courtney — Sat, 08 Mar 2014 17:24:14 GMT

I had a rottie bitch like this a few months ago.

I'm not 100% convinced the owners were being 100% truthful about the dogs reaction to insulin injections at home, but when i euthanased the dog they seemed genuinely upset. and she was NOT a nice dog at the vets either, so i am tempted to believe that they couldn't do the injections. a pity they hadn'#t trained the dog properly in the first place, i rather think she had trained them...

i had told them that if they were unable to get the dog to accept the injections then they should PTS her before she started to suffer. And that is what we did.

Re: Managing Canine DM without injecting insulin

Laura Marshall — Sat, 08 Mar 2014 15:48:36 GMT

I think you'd still need to tent the skin. Equally you have to hold it in situ for 5 seconds. Thre are videos on the caninsulin website about use and set up. It does look fiddly!

Re: Managing Canine DM without injecting insulin

Anthony Todd — Tue, 11 Feb 2014 10:23:14 GMT

[quote user="shanley barber"] VetPen[/quote]

Is the needle long enough to go S/C without the "tenting" preamble, which gives the dog time to get ready to bite, becoming a conditioned reflex?

Re: Managing Canine DM without injecting insulin

shanley barber — Sun, 09 Feb 2014 19:27:26 GMT

Yes, I've got an elderly client who couldn't manage the injections with needles and syringes, but loves the VetPen. She says the dog doesn't feel the needle going in as much, as it is silicone-coated. It was fiddly to start, but a she would never go back to the traditional needles. It is more expensive, however!

Re: Managing Canine DM without injecting insulin

Evelyn Barbour-Hill — Sat, 08 Feb 2014 15:56:30 GMT

[quote user="Anthony Dennison"] People I know who have used the vetpen have said they are a pain in the arse.[/quote]

To balance one anecdote with another, those of my clients who have used the vetpen have liked it.

That's about all the advice on diabetes mellitus I would dream of giving.

Re: Managing Canine DM without injecting insulin

Robin Grimmer — Sat, 08 Feb 2014 09:21:36 GMT

I really think the owner wants this dog PTS. I wouldn't be too hard on them. It's an old dog, and although as vets we know we can treat diabetes, it's a big commitment from the owner, not to mention costs etc.

Re: Managing Canine DM without injecting insulin

Louise Buckley — Sat, 08 Feb 2014 08:58:04 GMT

[quote user="Michael Woodhouse"]

As it is a protein hormone I understood it would be digested

[/quote]

I would have thought but I do vaguely remember coming across some research in this area so it is surely worth a look?

Re: Managing Canine DM without injecting insulin

Michael Woodhouse — Sat, 08 Feb 2014 00:47:22 GMT

As it is a protein hormone I understood it would be digested

Re: Managing Canine DM without injecting insulin

Louise Buckley — Sat, 08 Feb 2014 00:04:30 GMT

Raw pancreas? I believe there *may* be some very old research looking at the efficacy of raw pancreas on diabetes management (no, I am not getting confused with digestive enzymes here as it has been used for this too). Could be worth a literature search.

Re: Managing Canine DM without injecting insulin

Virginia Campbell — Fri, 07 Feb 2014 22:53:13 GMT

[quote user="Anthony Dennison"]the owner is trying to look for excuses for euthanasia [/quote]

Then euthanase it. If he doesn't really really want to fix it then he will go about treatment in a half arsed fashion giving the full whack of insulin some days and nothing on the rest when he's made a half arsed attempt at waving the syringe over the dog, and the dog will stumble along till it gets cataracts and he suddenly decides to euth, or it goes into a full on miserable puking DKA crisis and gets euthanased out of hours some Sunday afternoon. Whereupon he will blame you.

It's annoying when they want to be told "there's nothing we can do" isn't it?

Unless he really does want to manage its diabetes but is truthfully just very scared of needles or something.

Or scared of its feet going gangrenous and needing amputated. I've deflected a couple of panicky requests for euth of a newly diagnosed diabetic when it turns out the owners thought its feet might fall off.

Re: Managing Canine DM without injecting insulin

Anthony Dennison — Fri, 07 Feb 2014 22:12:50 GMT

I thought this might be the case... luckily he is at least getting a little insulin (I'd hope). People I know who have used the vetpen have said they are a pain in the arse.

The cynic in me is thinking the owner is trying to look for excuses for euthanasia rather than treatment. He seemed disappointed when I told him it was DM rather than kidney disease and that it was treatable...

Re: Managing Canine DM without injecting insulin

John Flynn — Fri, 07 Feb 2014 20:46:26 GMT

caninsulin pens are 29G needle, might make a little difference and i had 1 ownre that couldnt do injections that got on ok with these instead (of course could have ben coincidence)

Re: Managing Canine DM without injecting insulin

Andrew Kent — Fri, 07 Feb 2014 20:04:59 GMT

There's no realistic alternatives for the reason Virginia describes, and if the dog is ketonuric it would be a good job to get this sorted ASAP or the dog will get fairly sick.

Re: Managing Canine DM without injecting insulin

Virginia Campbell — Fri, 07 Feb 2014 18:51:03 GMT

Had a quick look on VIN for you...as you would expect you are not the first person to ask this question. Internal med people there explained that oral medication such as glipizide rely on stimulating the pancreas to produce more insulin. But dogs have type 1 diabetes - they just haven't got the beta cells to respond. Also, as well as not working in dogs, glipizide has potential SEs - vomiting and liver compromise - 8% cats on it developed cholestatic jaundice though this was usually reversible when withdrawn.

Weight control and m/d or other diet etc reduces insulin resistance, but probably won't do much on its own in a dog...once they present clinically affected with DM, they don't have much insulin left to resist!

Still though, give the propensity for Westies to develop diabetes, I'm sure we all have had some nasty characters to manage (although have also euthed others due to temperament precluding treatment). Successes I have heard of were

- one dog that the owners could only inject when they put him in the bath- the only place where he didn't try to bite them (more difficult to heave a Staffie into a bath I suppose)

- one dog where Mrs lifted the hindquarters up like a wheelbarrow while Mr injected - again, weirdly the snappy beast would stand still for this

- several where the owners got very handy with a muzzle

- several where getting the dog onto any sort of height helped

A lot of our patients come in daily for a week at the start for the owner to inject under supervision (or the owner visits the clinic to inject if the dog is being stabilised as an inpatient) till they gain confidence and the dog learns not to bullshit them, but maybe you have already tried this.