Many owners of diabetic dogs use a hand-held monitor to check blood glucose levels at home. These monitors are marketed for human use and available at drug stores or wherever diabetic supplies are sold. Some brand names include Ascensia, Accu-Chek and OneTouch. AlphaTrack is available specifically for animals.
Regardless of the type of monitor you're using, each requires a sample of your dog's blood on a test strip in order to produce a reading. The blood sample is obtained with a "lancet," a small, sharp needle used to draw blood. There are many places that can be used to get a blood sample including ear flaps, base of tail, lip of mouth, elbow calluses (often seen on larger dogs), the "thumb" (the paw pad located above the paw, at the ankle area) and even normal "warts" or moles that often form as a dog ages. Your veterinarian will help you identify suitable locations.
When a drop of blood appears on the surface of the skin, the test strip (pre-inserted in the monitor) is then used to "sip" the blood sample into the monitor. A reading will be given within 5 to 10 seconds. It appears as a number which indicates the amount of glucose in the bloodstream at that time.
American-made monitors display the number in mg/dL while monitors meant for use in other countries use the mmol/L system. A printable Blood Glucose Conversion Chart
It's important to regularly check the calibration of your home monitor against that of your veterinarian's equipment. As a further test, whenever your dog's blood needs to be sent to a laboratory, it's a good chance to check your monitor's reliability against the equipment used at the lab. Knowing that your monitor is, for instance, accurate within five points, allows you to take those five points into consideration when reading your dog's blood glucose levels.
What is a healthy blood glucose level? This question depends upon a number of factors but the most important thing to keep in mind is that all dogs are different. Some dogs do well at higher numbers on the scale while others do well at lower levels.
The following guidelines are approximate and intended only as a general rule of thumb.
*mg/dL - American monitor
mmol/L - Canadian, U.K., Australia, and other countries
less than 40 mg/dL
less than 2.3 mmol/L
These numbers indicate hypoglycemia (dangerously low blood glucose levels). Rub any type of high-sugar syrup (i.e.: Karo, pancake syrup, honey) on the dog's gums. Contact a veterinarian immediately for further instructions. Hypoglycemia symptoms include weakness, staggering, increase in appetite, intolerance to exercise, depression/lethargy, seizures, and any other behavior that may be unusual for your own dog. Some dogs show no symptoms. If your dog's blood glucose is within these low ranges, don't wait to see symptoms. Use the syrup as instructed and contact a veterinarian.
Considered to be the lowest in the "safe" range just prior to the next scheduled insulin shot. Depending upon readings found in recent curves, these numbers are the lowest you'll want to see.
These numbers are considered the "target range" for a diabetic dog throughout the day.
These numbers are at the low end of the "renal threshold" and may be considered hyperglycemic (dangerously high blood glucose levels) depending upon readings found in recent curves. See below.
More than 360
More than 20
Consistent readings at these higher levels require veterinary consultation. Hyperglycemia (excess glucose spilling into the urine) can result in ketoacidosis which is an emergency situation. The condition can be measured with a Ketostix or Ketodiastix, both of which are available wherever diabetic supplies are sold. High readings like these may be the result of infection, stress, or mismanagement of insulin (i.e.: forgetting a shot or insufficient dose). It can also be an error on the part of the monitor or insulin that has been compromised (i.e.: past the due date or not handled properly). If hyperglycemia continues without proper veterinary guidance, secondary health problems may occur such as kidney damage and blindness.
In order to ensure that your dog's diabetes is properly regulated, your veterinarian will suggest a series of tests that will be used most frequently during the initial phase of treatment and occasionally in the future.
A curve involves a blood check with a hand-held monitor ideally every two hours for at least 12 hours. This shows how the blood glucose level fluctuates throughout the day in tandem with food, exercise and other variables. A curve can be accomplished by the owner at home or at the veterinary clinic.
A fructosamine test is available from your veterinarian. It requires a blood sample to be sent to a laboratory and results show the average blood glucose level obtained over the past two or three weeks. It's not intended to take the place of a 12-hour curve but it's a valuable tool in assessing ongoing management.
is caused by lack of insulin, the hormone that plays an important role in metabolizing sugar within the body. Diabetes insipidus
is a lack of a hormone called vasopressin which controls water resorption by the kidneys. Diabetes mellitus
is the most common form of dog diabetes and that's the type we'll be addressing in this article.
Diabetes mellitus (DM) means the pancreas has ceased or reduced its production of insulin. Insulin is a naturally-occurring chemical that the body needs in order to process glucose. Glucose is a simple sugar that provides the body with "fuel" for energy.
Without sufficient amounts of insulin, the cells that need glucose can't open properly to receive this necessary delivery. In other words, without insulin to move the glucose to the waiting cells, the body is starved for energy.
Why did your dog become diabetic? Current research indicates that DM may be caused by infectious viral disease, immune deficiency disorders, Cushing’s disease, pancreatic infections, steroid use, or genetic disposition.
It's a common belief that some purebred dogs are more at risk (i.e.: Cairn terriers, miniature Poodles, miniature Schnauzers, Dachshunds and Beagles, among others) but a recent European study (2007) indicates that mixed-breed dogs comprise the largest group. Female dogs are more at risk due to reproductive hormone activity. Unspayed females of any breed suffer the highest incidence of DM.
Initial symptoms most often include excessive hunger, excessive thirst and excessive urination. If diagnosis is not made and insulin not begun, additional symptoms can occur including loss of appetite, decrease in body weight, vomiting, depression, liver and bladder disease, blindness, dehydration, increased incidence of all types of infections, and profound lethargy.
Food and exercise are very important components in achieving regulation. There are many combinations to try and one will work best for your own dog. Whether you choose a diet specifically formulated for diabetics, continue with your dog's current diet, or switch to raw or home-cooked, your mission is to find the food that works best with the type of insulin you're using in conjunction with exercise regime. If regulation isn't occurring as quickly as your veterinarian would expect, he or she may suggest altering one of the components which can include decreased or increased exercise, change in insulin type or dose, or a change in diet. If you're lucky, your dog will reach regulation rather quickly with only a few compromises but you'll still need to monitor for symptoms that one or more of the components require alteration.
Your dog's route to regulation may change throughout his life depending on many factors. Remember that you're striving to control your dog's diabetes on a daily basis while allowing him to continue life as a normal dog. "Normal" may sound impossible when beginning the journey but, as you watch your dog improve by leaps and bounds, you'll realize how gratifying the process can be.
This term means "abnormally low blood sugar" and can occur in diabetic dogs as well as puppies, pregnant or nursing, or high-energy working or sporting dogs. Non-diabetic humans often experience hypoglycemia when suffering a slight headache or perhaps minor trembling following a skipped meal. A blood check would reveal a low glucose level and a meal will ease the symptoms. Puppies, pregnant, nursing, and super-active dogs are at risk for the same reason. They need nourishment to restore their glucose reserves.
Since we inject the same dose of insulin into our diabetic dogs twice daily, a consistent amount and quality of food is required immediately prior to injection in order to "feed" that insulin dose. Insulin requires food. Food requires insulin.
Hypoglycemic symptoms can include weakness, staggering, increase in appetite, intolerance to exercise, depression/lethargy, seizures, weakness and any other behavior that is unusual for your own dog. To add to the confusion, some dogs show few or no symptoms. A quick blood glucose check (using a monitor at home or at a veterinary clinic) will quickly verify a hypoglycemic episode. If you suspect your dog is in trouble, regardless of the range of symptoms, rub any type of high-sugar syrup (i.e.: Karo, pancake syrup, honey) on the dog's gums and contact a veterinary immediately for further instructions.
There are several varieties available for humans that also work on animals. Vetsulin (also known as Caninsulin) is specially formulated for dogs. Your veterinarian will suggest the most suitable product depending on many factors. The initial dose is given at approximately half the suggested amount depending upon your dog's weight and will be increased by small increments over the next few weeks. Adjustments in dose are made in the quest to reach the "magic number" which is a healthy and stable blood glucose level.
Watching for signs that your dog's diabetes is kept under control can require much more than your memory! Many owners find that keeping a daily journal is the best way to keep track of changes in diabetic symptoms. The notations should include:
- morning and evening blood glucose levels (if you're using a monitor at home)
- injection times and dose
- ingredients of meals plus any applicable food supplements and other medications.
- content and time of snacks ingested including "forbidden" snacks such as food tidbits stolen from the kitchen table and food bowls belonging to other pets as well as outside sources such as sidewalks, neighbors' lawns, or well-meaning people who offer your diabetic dog a treat before you can say "Please - no treats! He's diabetic!"
- amount of water consumed and frequency/quantity of urine output.
- Stress and changes in routine can cause fluctuations in blood glucose levels. If your dog has had a particularly eventful day (i.e.: a trip to the vet clinic, visitors at your home, thunderstorms, fireworks, the yappy dog next door), note those factors in the journal
- changes in activity level, sleeping patterns and any other unusual behaviors
Some of these notes can seem unnecessary but if your dog begins showing symptoms that may be of concern, the journal could provide a pattern leading to identifying the problem.
This is the term used to describe consistently healthy blood glucose levels and can be accurately verified through curve testing. Some dogs are regulated within a few weeks while others take longer. Striving for regulation begins as soon as a dog is diagnosed and insulin treatment has begun. Regulated dogs can become unregulated at any time in the future due to factors such as illness, stress, and normal ageing issues. Curves need to be performed to ensure blood glucose levels are kept in the healthy range and your veterinarian will suggest a schedule for these tests.
Diabetic dogs are particularly prone to secondary health issues, some of which include:
- Acromegaly - an endocrine disease caused by excessive growth hormones
- Blindness - caused by cataracts due to sustained periods of high blood glucose levels
- Cushings disease - "hyperadrenocorticism"- an adrenal gland hormone deficiency
- Exocrine pancreatic insufficiency - "EPI" - usually caused by pancreatic acinar atrophy.
- Hyperglycemia - dangerously high blood glucose levels
- Hypoglycemia - dangerously low blood glucose levels
- Hypothyroidism - thyroid gland hormone deficiency
- Infections of any kind - due to compromised immune system
- Ketoacidosis - an acute metabolic complication
- Pancreatitis - inflammation of the pancreas
- Urinary tract infection - common in diabetics, particularly females