So you’ve embraced the diagnosis of diabetes. You’re giving insulin, and your anxiety attacks are milder now. With diabetes, you always must be on the watch for complications. Here’s what you need to know.
If your pet’s insulin dose is not quite regulated, he or she will likely be drinking a lot of water, and therefore urinating more. If water consumption goes back down to a normal level, then you know the diabetes is becoming controlled. This is perhaps the best way to tell how a pet’s body is responding to insulin.
The other extreme is low blood sugar, or hypoglycemia. While high blood sugar is not good, it really is not fatal. Extremely low blood sugar ca be deadly if not addressed! Signs are the pet acting drunk or out of it. Some may seem dazed, or stumble when they walk. Severe cases will lose consciousness, or even seizure! What to do? They need sugar – now! Maple syrup or karo syrup are great for rubbing on gums. Make sure it is a regular sugar syrup, and not anything sugar free or “lite.”
Once they’ve been sugared (and your hands are sticky) wash your hands, call your vet to let them know you’re on the way, and get your pet to the vet. The syrup on the gums will help them get to the vet clinic, but many pets require additional treatment. Obviously, we’ll want to adjust the insulin dose so this does not happen again!
Assuming all is going well, your vet will want to monitor their blood with either a glucose curve (mainly dogs) or a fructosamine (mainly cats). We can do both on both species, so keep an open mind.
Glucose curves are simple, yet a little labor intensive. We have you give the insulin at the regular time and feed like any regular day. Then take your dog to the vet clinic for a full day. Depending on the type of insulin, we’ll draw a drop of blood every 2-4 hours, measuring the blood glucose. We call it a curve because, if you chart the glucose levels and the time, it (should!) produce a curve, like this.
The blood glucose level is highest when it’s time for insulin. As the insulin works, the blood sugar drops, reaching a low point before rising back up, in time for the next insulin shot. So why do we have to keep your dog all day? Why can’t we just draw the blood 6 hours after the shot?
Not every dog reads the manual. Some dogs have their low point 3 hours after the shot. Some dogs are 9 hours. Then there’s everything in between. To boot, the same dog on the same diet getting the same insulin every day can have drastically different glucose curved from day to day!
We need to know that their blood glucose is falling enough, but not falling too low. We also need to know the high point is not obnoxiously high.
For cats, this is less possible. Put a cat in carrier, drive it to the vet, put it in a cage next to a yapping dog, and wonder why it’s blood sugar is sky high! So for cats, we like to measure fructosamine. In people, we call it A1C. Basically, it’s a single blood draw that give us an idea of how variable the blood sugar has been over the past 4-6 weeks. If it’s consistently high, the fructosamine will be high. If it’s super high, getting a little low, then high, we can still get a high number. If the cat is having low blood sugar, this number can sometimes be low. As you probably guessed, it is not as accurate as a glucose curve, but gives us much more realistic numbers for cats who get super stressed the second they see a vet clinic!
Good news! In the past few years, glucometers for pets have become very affordable! Basically, after two glucose curves it’s paid for itself – and you aren’t driving to the vet twice in one day (not that we don’t like seeing you!). The original was the AlphaTrak, and some other brands have come on the market. Human glucometers do not accurately measure dog and cat blood sugar, so we have to use devices made for companion animals.
They work very simply – use the lancet to prick the ear and get a drop of blood. It’s not as hard as it sounds. After all, you’re a pro at giving injections now! The problem I have with the lancet is it often does not poke deep enough! It bothers the owner much more than it bothers the animal!
Once you get your drop of blood, the glucometer measures the blood sugar. I have both my dog and cat owners using these, and they love them. We’ll schedule a curve, I’ll tell them what times to draw, then the owner reports the numbers. Best part – the dog or cat never left home!
Glucometers are great, but they aren’t great for every pet. For animals who are very difficult to handle monitoring water consumption and checking a fructosamine every so often can be sufficient. We want to do what is least stressful for your pet – and you.
Diabetes is complicated! Check out the rest of the series:
- Pet owners introduction to diabetes
- Guidelines on giving insulin shots to your dog or cat
- Diets for diabetic animals
- Urine problems in diabetic dogs and cats
- Who’s Somogyi and why should you care?
Check out our podcast episode about diabetes. In an hour, we couldn’t even cover every detail, but you’ll learn and laugh with us along the way!