https://www.vetsurgeon.org/f/clinical-questions/30715/when-is-a-diabetic-dog-not-a-diabetic-dog Binky is an almost 11 year old Pomeranian that was diagnosed as diabetic about 6 years ago. She has been well controlled on a dose of 4.5IU Caninsulin BID since then, with no clinical signs and good BG curves initially, and appropriate Fructosamine levelsen-USTelligent Community 10https://www.vetsurgeon.org/thread/241953?ContentTypeID=1Tue, 18 Jul 2023 18:26:54 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:070e2461-62dd-400b-82eb-00d2c3bd4926Mayank Seth<p>Hi Anthony</p> <p></p> <p>I would say that hiding could easily be a sign of mild hypoglycaemia. I would also say that it is very possible to still have a relative overdose of caninsulin having an effect on BG 12 hours after it was given. You don&rsquo;t say how much little Binky weighs but I&rsquo;m guessing 4.5IU is a healthy dose for a Pomeranian. I think there are a few possibilities for what is going on here:</p> <p>-In light of the timing its possible that the dental disease was contributing to some insulin resistance and Binky is just more insulin sensitive than she used to be.</p> <p>-It&rsquo;s possible that something else is making her more hypoglycaemic than previously - I&rsquo;ve seen diabetic dogs develop insulinomas in their old age (a possible cause of the pancreatitis/liver enzyme elevation?) or another tumour of some description? Addison&rsquo;s is always an outside possibility too.</p> <p>-I assume there is no diet change and she is spayed? Recent change of insulin bottle/syringes/responsible adult etc? All obvious things but worth double checking!</p> <p>I think a freestyle and an insulin dose reduction sound like an excellent starting point for this dog. If you reduce the dose substantially/stop insulin and hypo episodes still occur then I would consider looking for the concurrent disease causing hypoglycaemia.</p> <p>Do let us know what you find!</p> <p>Mayank</p><div style="clear:both;"></div>