Diabetic dog glucose curve (opinion needed)

RE: Diabetic dog glucose curve (opinion needed)

Martin Atkinson — Wed, 09 Dec 2015 09:27:42 GMT

[quote user="Virginia Campbell"] I will always get the owners to demo injection for me[/quote]This is probable the single most important thing other than the diagnosis, poor client technique is probably the greatest cause of failure. And don't assume they will continue to do it properly, if there is any unexplained failure to stabilise the patient I get them in for a review of their technique. I've said this many times before but pet owners never cease to confound me by the ways they can find to not comply with treatment. Einstein is always right!

RE: Diabetic dog glucose curve (opinion needed)

Virginia Campbell — Tue, 08 Dec 2015 23:06:18 GMT

I do what Emily does. I will always get the owners to demo injection for me (drawing up sterile water for injection from a spare 1ml bottle that comes with the cat vaccines if not time for insulin yet at discharge) and if they're not overly confident I'll get them to bring it in after feeding the next morning for me to supervise their injecting again.

RE: Diabetic dog glucose curve (opinion needed)

Busybee — Tue, 08 Dec 2015 22:34:32 GMT

If possible, I do still hospitalise for the first day, citing the reason as being checking for any signs of hypoglycaemia. But it's also a chance for the owners to get their head around the diagnosis without the worry of giving the first injection, feeding, watching the dog like a hawk...

I give them our 'newly diagnosed diabetic' info pack so they can go away and read the info and come up with questions whilst we have the animal for the day. At discharge, I spend time going through everything with the owners, demonstrating then watching them inject and tend to follow up with a phone call the next day to see how they get on. As long as ok, I would next see the dog in 7-10 days to re-curve as it can take this long for the body to respond properly to the insulin.

RE: Diabetic dog glucose curve (opinion needed)

Martin Atkinson — Tue, 08 Dec 2015 10:38:16 GMT

+1 for what Emily says. I used to hospitalise dogs for the first day to 'stabilise' them - in effect this was performing a curve. In practice I've never found a problem with hypoglycaemia on day one so I don't bother with this procedure any more. Provided that the dog is not just borderline DM and you start at minimal dose there is little danger of hypoglycaemia, you need some time for the animal to adapt and I would perform the first curve after 7-14 days.

Emily's advice on performing a BG at 4 hrs post dose is sound as this is when the nadir is likely and you're unlikely to miss this due to an overswing as they tend to be more chronic. Also if you do too much you may put some clients off due to the cost and they may be reluctant to come in for monitoring when it is more important.

RE: Diabetic dog glucose curve (opinion needed)

Emily Rainbow — Tue, 08 Dec 2015 07:38:53 GMT

I don't curve newly diagnosed dogs for at least 5-7d after starting insulin. Owners are coached on hypoglycaemic signs and are asked to have honey in the house incase. In those I'm worried about going hypo (hardly any to be honest) I might check a BG 4hrs after injecting and then 5hrs after and maybe 6hrs if necc but I don't do a full curve.

I tend to start small dogs on 0.5iu/kg BID and larger ones on 0.24iu/kg BID. Some of my colleagues work out the above doe and then round down a little to start to be sure of no hypo.