Diabetic Dog Discharge Instructions

 

Diet and Feeding Instructions

High fiber diets are recommended for the management of canine diabetes.  While there are several acceptable diets out there, Science Diet's W/D is a good one to use.  It has about 16% Crude Fiber (CF).  There are other foods available, and a quick look on the analysis table will tell you if it has about 16% CF or not.

In many cases, addition of insoluble (non-digestible) fibers to the diet helped glycemic control, meaning that blood sugars were more stable throughout the day.  This can be accomplished by adding a teaspoon to a tablespoon of unflavored Metamucil, depending on the dog's size.

Fiber blunts the increase in blood sugar levels that occur after eating, delays the emptying of food from the stomach, and slows the digestion of carbohydrates (glucose sources). All this means that blood sugar levels are inclined not to jump as high after eating compared to those of patients fed low fiber diets.

If the diabetic dog is overweight - and many are -  fiber also helps the patient feel full after eating, thus encouraging weight loss. This may not be so desirable in a diabetic dog that is underweight, and many are.

You will also need to have on hand a bottle of Karo^® Syrup, and some "special food," which is food you will use to tempt your patient to eat when perhaps he or she doesn't want to.  It needs to be low-carbohydrate things, like canned W/D, meat of any kind, cottage cheese, or other cheese.

 

The goal is to get the patient to eat two meals a day at twelve-hour intervals.

 

Insulin Administration

 

Handling and Storing Insulin  

Insulin is a sterile suspension, and care must be taken to keep it that way.  We're talking both sterile and suspended.  Insulin must be kept refrigerated.  Be careful to not touch the rubber stopper with your fingers.  Do not attempt to wash or clean the syringes in any way.  Do not touch the needles.  When you take the insulin out to use it, it is important to mix it well.  However, DO NOT SHAKE insulin.  It is delicate and can be damaged by shaking.  Roll the bottle gently to mix.  If the insulin changes colors, you will need a new bottle.  Otherwise, a bottle should last from 6 to 8 weeks, perhaps longer.

 

Dosing and Administration. 

After rolling the bottle to mix it up, insert the needle into the bottle and draw up more than the required dose.  Be sure and get all the air out of the syringe. Flick the syringe with your finger if necessary to make the air bubbles rise to the top.  Then push the plunger back in to the required dose.  Then insert the needle under your pet's skin and inject.  Needles and syringes may be re-used a few times.

Insulin should only be given with meals. 

Diabetic animals should not be allowed to eat free-choice.  Feed them meals, generally twice a day.  When it is time to administer insulin, first feed you pet.  If your pet eats immediately, go ahead and inject the insulin as usual.  If you pet does not eat immediately, do not inject insulin.  We need to get the pet to eat first.  Injecting insulin when they haven't eaten can cause serious problems.

The first thing to do is to wait a few minutes and see if you pet will eat.  If that doesn't work, then try a little "special" food.  You can try canned food, broth,  or even try warming the food up a little.  You can also try hand-feeding your pet.  As a last-ditch effort, you can try some treats that are low in carbohydrates, like meat or cottage cheese.  If you pet eats, go ahead and inject insulin as usual.  

If you pet still doesn't eat, it could be a problem, and your pet needs to be examined by the veterinarian before any insulin is given.

The most common problem you can get into with insulin is hypoglycemia. 

Hypoglycemia is low blood sugar.  If you pet develops hypoglycemia, your pet will appear lethargic, slow, or sleepy.  Your pet may even have siezures.  If you suspect your pet has hypoglycemia, the first thing to do is to try feeding your pet.  If that does not help, give your pet Karo Syrup orally and call the veterinarian's office for help.  Hypoglycemia can be deadly if allowed to progress.

If you have a dibetic pet on insulin therapy, you are quite likely to sooner or later have a hypoglycemic episode.  Don't panic!  Do get help!

There are several ways we monitor the effect of our insulin therapy. 

On a day to day basis, we watch to see how much water the pet is drinking.  Pets with poorly-controlled diabetes will drink a lot of water.  They will also urinate frequently.  From time to time, we will bring them into the clinic and do glucose curves.  We measure their blood sugar levels throuought the day to make sure things are going well.

 Periodically, we will want to bring the pateint into the clinic for overnight and conduct a glucose curve.  We monitor the blood sugar levels every few hours to get an idea of how the insulin is working.  There is some preparation necessary for the glucose curve.

• If you typically feed and give insulin at 7:30 AM or later, do not feed the patient or give insulin before bringing him or her into the clinic.  Do bring the food you usually use, and do bring the insulin.
• If you typically feed and give insulin before 7:30 AM, feed and give insulin as usual, then bring the patient it at 8:30.  Be sure and bring the insuklin and the food as well.