Guest blog by Christie Long, Chief Veterinarian at PetCoach.co
Diabetes: there is probably no other diagnosis in the companion animal world that requires so much of the pet parent. When I make a diagnosis of diabetes in a cat or a dog, the first thing I do is have a serious conversation with the owner to make sure that they are up to the challenge of taking care of a diabetic pet, because not everyone is.
I tell pet parents that they must be capable of giving injections, monitoring blood and urine glucose levels, and making sure that they are home for their pet every 12 hours to feed and administer insulin. Diabetes is probably the most difficult chronic condition we manage in companion animals. But having unregulated or poorly regulated diabetes subjects the animal to a host of complications, so if you’re going to accept the challenge, do so whole-heartedly.
If you’re going to protect your pet against heartworm disease, you can’t give the preventive every other month. If you’re going to treat your pet’s diabetes, be ready to take all the steps your veterinarian recommends to do so.
Become a glucometer ninja
Glucometers that are specific for pets have revolutionized the management and monitoring of diabetic pets, because they allow us to obtain valuable information about how the patient reacts to diet and insulin dosing without bringing them into the veterinarian’s office for repeated testing. Cats are especially sensitive to the effects of a stressful veterinary visit, and it’s quite common to see high blood glucose measurements in non-diabetic cats when a blood sample is obtained in the veterinarian’s office.
Glucometers have gotten really easy to use, and require no more than a tiny drop of blood to make an accurate measurement. Difficult-to-regulate feline diabetics can often benefit from a once- or twice-daily glucose measurement, and it’s not hard to teach them to tolerate a quick prick to the ear margin or paw pad.
Use your senses
Sometimes despite all of the advanced laboratory testing and high tech gadgets we enlist in our fight to regulate diabetes in our pets, our best tools are our five senses. One of the most accurate signs that a diabetic pet is well-regulated is a lack of symptoms of diabetes – increased thirst, increased urination, and increased appetite (often with weight loss). Use your sense of sight and watch your pet closely for these signs.
Get right up in your pet’s face and smell its breath. An animal in diabetic ketoacidosis, a life-threatening complication of unregulated diabetes, has breath that smells like acetone, which is the main component in most nail polish removers. Using your sense of touch to hold a urine test strip under your pet’s urine stream will also help you detect ketoacidosis, since most test strips measure urine ketones, and their presence in the urine is one of the first signs that your pet is on its way to a crisis.
If you hear your diabetic dog bumping into the furniture or walls, it’s likely an indication that it’s developing cataracts, which are a common follow-on condition to canine diabetes. Dogs with cataracts need to be closely monitored for development of glaucoma, a painful condition involving high pressure inside the eye. And just to round out this discussion of the 5 senses, I’ll remind you that “diabetes mellitus” means essentially “honey sweet urine” in Greek, so somebody at some point in time had to make the ultimate sacrifice and taste diabetic urine to give the disease its name.
Don’t skip the rechecks
Even if you’re closely monitoring your pet at home, and feel that things are going well with respect to keeping diabetes at bay, you still need to take your pet to your veterinarian for routine recheck appointments. Why? Because your veterinarian is trained to pick up on subtle clues that you can miss, such as a tooth root infection that will ultimately complicate blood glucose regulation.
Even if you’re monitoring blood glucose at home with a glucometer, there are some important lab tests that should be routinely scheduled. Measuring fructosamine levels routinely is key to understanding glucose regulation over a longer period of time – 2 to 3 weeks – in diabetic cats, since their blood glucose levels tend to measure a bit high even with good regulation. And all diabetics should have routine urine cultures performed, since urinary tract infections are extremely common, but the signs don’t always look remarkably different from the routine signs of diabetes.
Learn to brush your pet’s teeth
Wait, what??? What does teeth brushing have to do with diabetes? We’re starting to understand that chronic infection complicates regulation of diabetes, and one of the most common sources of infection in dogs and cats is dental disease – specifically, tooth root abscesses. Regular brushing will keep the bacteria-laden plaque film at bay in your pet’s mouth, and lessen the chances of infection.
Keep great records
Embrace your inner nerd! Especially if you’re monitoring glucose at home, make a spreadsheet and track glucose measurements, and share this information regularly with your veterinarian. In difficult to regulate diabetics, knowledge of this up-to-the-minute information can prove extremely valuable to your veterinarian as he or she seeks to get your pet as stable as possible. It’s also helpful to track food consumption as well, particularly if your pet’s appetite waxes and wanes.
Become an insulin handling pro
Insulin is an extremely unique drug, and using it properly and to its full efficacy absolutely depends on handling it properly. It has to be stored in the refrigerator, but it should be brought to room temperature once in the syringe before it’s injected. Some insulins should be rolled gently between the palms until thoroughly mixed, and others should be shaken. Your veterinarian will help you understand which kind your pet is receiving.
Compared to most drugs, insulin is very unstable, and dosing must be exact. A few trips through an airport surveillance machine may lessen its efficacy, so never take your pet’s insulin in a carry-on bag. Always inspect your pet’s insulin before you give it, to be sure there is no abnormal color or particles. Even a few bubbles in the syringe can make dosing inaccurate, so be observant. And always use the appropriate syringes for the type of insulin your pet is receiving. If you have any doubts, call your veterinarian.
Guest blog by Christie Long, Chief Veterinarian at PetCoach.co
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