This page is a tribute to our angel – Baby Sassy — the wonderful yorkie you see in our diabetes videos.
I often get asked for more advice about caring for Diabetic Dogs so perhaps these additional tips will help you. We love our dogs just like our kids – always have. I’m sure you feel the same. Please know that although it’s scary at first to care for a dog with diabetes, YOU CAN DO IT and your dog needs you. After a month or so, it will all become like normal for you.
Keep in mind that I am not a vet and I do recommend you talk to your vet for specific advice on your pet, however I’m happy to relate my experiences learned from selling insulin products for years and later caring for my own pet with Diabetes.
WHY Check Blood Glucose at home vs just letting the vet do it?
Although I am not a vet, I am very disappointed to hear that many vets do not encourage you to check Blood Sugar (BS) – if you are capable of doing it (which you are) then why would you not want to know what Your dog’s BS is at? Knowledge is power and when you are talking about diabetes that knowledge is so important. **Like I said in the videos, how do you know how much insulin to give if you do not know the BS prior to injection?** Doing a BS reading gives you this knowledge. Otherwise, if you don’t know the BS and you give insulin and Your dog is already low, that would be dangerous. If he is high and you don’t know that, then you won’t give enough insulin and he’ll just stay high so the insulin dose your gave won’t accomplish very much. The key to the entire operation is knowing the BS. It’s so easy to get a reading that it’s foolish NOT to know.
We strongly recommend you keep a journal. Make notes about when your dog ate (make food notes if the meal is different than normal), what time you tested the BS, how much insulin you gave, and how the dog is acting.
(Optional) When you first start checking BS at home, we recommend you test often so you get an idea of what is happening to your dog throughout the day — record all of this in your journal. A good schedule to start would be: prior to first meal, (eat), 30 minutes after meal (give insulin), 2 hours post-meal, and perhaps 4 hours post meal. Then repeat the process at dinner. That would be 6-8 tests for a few days – again with the goal of understanding how your dog is feeling during the entire day.
After you start to see the trends, then you can reduce the number of tests to something like 2-4 tests per day. At a minimum, I feel you need to do 2 tests per day – one before each injection (so that would be the test you do 20-30 minutes after the dog eats). Again, we believe you NEED to know the BS before you inject in order to give the right amount of insulin for your dog at that time.
How much insulin should I give?
All too often I hear from folks that their vet said to just give the same insulin dose at the same time every day – without doing a BS test. This just seems very dangerous to me — as I said before, if you don’t know the BS, what happens if you give insulin and the BS is low? That extra insulin could cause real problems for your dog and drive them into a dangerous low BS event (hypoglycemic shock) — which could result in trip to the ER vet if the dog doesn’t recover quickly. On the other hand, if the BS is already high and you do not give enough insulin, then the BS will stay high and your dog will continue to feel terrible – also, without enough insulin, all that food he just ate will not get processed by his body and he will likely end up just peeing out the nutrients and getting no benefits from the food or the insulin dose. As I said before, a best practice is to keep a Journal of your pet’s feeding times, what his blood sugar was, and when/how much insulin you gave him. Then you can spot trends and fine tune the amount of insulin needed vs blood sugar readings. Every dog is different as to how much insulin they need – it depends on their size, how much they eat, and how much of their pancreas is still producing insulin on its own. We used a sliding scale of insulin amount provided based on our Sassy’s blood sugar readings. For example:
Blood Sugar < 90 = 0 units of insulin
BS 90-150 = 1unit
150-200 = 1.5u
200-250 = 2u
250-300 = 2.5
300+ = 3u and recheck in 30minutes
**IMPORTANT: our Sassy was a small yorkie (7 lbs) and Your pet’s needs could be much higher. I recommend you start with a small amount (1-2units) and recheck often in the beginning (perhaps every 2 hours just to see how he is reacting). Each meal, you can increase the dose if the blood sugar is still high. Our goal was always to keep Sassy’s blood sugar in the ‘normal’ range (80-130) and we were happy if she was at least under 150, 2 hours post injection. Like I said you just want to avoid the extremes (BS < 70 or > 400). Most vets are happy if your pet is < 250 but that’s really quite high and that’s more for people that don’t check BS daily and just give same amt of insulin every time – which is dangerous and not giving your chance to lead a normal life. If you have the ability to simply check blood sugar and give injections then Your pet can lead a more normal life.
What happens if blood sugar is below 70?
This is important – low BS could lead to dangerous hypoglycemic episodes. Be sure to watch her closely. I would recommend you give her a small amount of Karo syrup or molasses or something with fast acting simple sugar because BS below 70 is potentially dangerous and you want to get that up. Karo syrup should raise it quickly. If she wont take it, rub it on her gums with your fingers. Then recheck her in 20 minutes. If BS is below 50 and you can’t get it up, go to emergency vet immediately.
How long do I have to wait after a meal to give insulin?
People often ask if they must wait 30 minutes post meal to inject – it’s not an absolute. Most vets prescribe NPH insulin (aka Novolin, Humalin, Relion N) and if that’s what you are using then this is an ‘intermediate’ acting insulin and doesn’t really peak for about 4-8 hours anyway. If you watch the video on the different insulins (above) then you’ll see I talk about that more. I think NPH is around the 3minute mark of that video. That being said, the delayed peak is probably why many dogs may get hungry in the middle of the day (ie because the insulin is sucking up the most blood glucose at that time and Your dog is craving more food). NPH is a fine insulin, although I do believe 70/30 (aka Novo 70/30, Humolin 70/30, N/R, and other names) is better because it has NPH in it PLUS it gives you a faster acting insulin to cover the meals they just ate – the end result is keeping Your dog in a more normal BS range for as long as possible. This is just my opinion, please do not switch insulins without consulting your vet first
What type of Blood Glucose Meter should I buy – does it have to be a canine-specific meter?
While it would be ideal to have a canine-specific BG meter like Alphatrax or other brands you can get from your vet, I don’t think this is a ‘must.’ Why? First off it’s too expensive, not practical, and (in my opinion) doesn’t give you that much of a significant advantage vs a ‘human’ BG meter you can buy from Walmart or pharmacies. The canine meters will likely cost you $50-300 for the meter alone and if you are testing 2+ times a day, the strips will probably run you $1-3 per strip – that would add up to significant costs very quickly and I fear would cause you to test less often – which would defeat the whole purpose. I have done my own tests of the Alphatrax vs Walmart Relion, Accucheck, and Freestyle meters. If we assume the Alphatrax is the baseline, its true that none of the human meters exactly match the results of the Alphatrax, HOWEVER, they get pretty close. I have read where some tests show the human meters consistently read lower than the canine meters by about 20-30%. In MY tests, the human meters are on average about 20-40 points lower from the Alphatrax BUT I found the difference is mostly at HIGHER blood sugar readings – since your greatest concern would be at the lower readings (because you want to ensure your dog avoids being too low) this difference is (in my opinion) not clinically significant enough to cause me concern and therefore I use the more practical human meters. Think about it for yourself — if the differences are generally at the HIGHER BS readings, does it really matter if the ‘exact’ BS reading is 400 or 450? Both of those are high and the bottom line is your dog needs more insulin. If you use a scale like us, then once you get over 400, you are probably at the highest dose of insulin you are going to give anyway, so it doesn’t matter if the BS reading from the human meter is a bit off from the Alphatrax, right? We use the Relion Confirm meter – it costs about $15 at Walmart. The strips for this meter costs only 50cents a strip. At those prices, you can test all you want without going broke. And that is the KEY – if you want to know how your dog is feeling and more importantly how they are responding to all your efforts to give them insulin, then you NEED to test the BS yourself at home. And if you are going to do this quickly, easily, and cost-effectively, then you’ll likely just want to get a human BG meter.
How much does a BG test cost at the Vet vs Home?
Lately I have had a lot of emails from folks telling me their vets are charing $90, $150, and even $250 to do a BG test at the office — and worse yet they are NOT wanting their pet owners to do the BG testing at home. That is a real shame. Sure, the test done at the vets (probably called a ‘fructosamine’ test on your bill) is going to be the most accurate way to test your dog’s BG, but who can afford to go to the vet every day or every week and have that test done? BG testing at home is still accurate enough to give you a really good idea of what’s happening with your dog. If you are like me, you want to know how your dog is feeling every day, right? Not just once a week or once a month at the vets office. The good news is that you CAN get the information you need by doing the BG test yourself at home. Then perhaps you only need to do the vet’s test once every 3 months and compare how it matches up to the average of your testing. That would be much more cost-effective AND give you a better overall picture.
Does it matter how much I feed my dog vs how much insulin I give?
Generally speaking, you would think the more your dog eats, the more insulin they will need to process that food but I would NOT change your dose based on how much you feed. IF you are going to use a sliding scale to change your insulin dose, that scale needs to be based on your dog’s BG readings since that is going to be the number that tells you more accurately how much insulin your dog needs at that time. That is the safest way to dose your insulin.
What Food Should I give my diabetic dog?
There are now a lot of quality foods specific made for diabetic dogs and you will likely do fine with any of them – provided you give your dog the right amount of insulin they need (based on their BS reading post-meal) to process that food and get the nutrients out. That being said, we are big believers in home-cooked, fresh food based on the principles of The Whole Pet Diet. These vids could help you:
You don’t necessarily need to cook if you don’t have time (although it doesn’t take as long as you think), just get a quality food WITHOUT a lot of grains/fillers. If you are going to switch to a homemade dog food (or do any food switch) you would want to do that gradually, perhaps just replace 1 meal a day at first. I can tell you though that early on when we used store bought foods, our girls had more GI issues, however after changing to homemade stews, our girls RARELY ever had any problems with bad stools.
How regimented are the insulin shots?
Assuming you are feeding twice a day (breakfast/dinner), then if you use the NPH or 70/30 insulin that I talk about in the videos then you should give 1 shot after each meal. We used the following method: feed, wait 30 minutes, check blood sugar, depending on level give XX amount of insulin. 30 minutes post meal should be plenty of time for your pet to begin processing the food he ate and then be ready for a shot with less risk of low blood sugars. If you don’t check blood sugar prior to injecting and/or you don’t wait at least 15 minutes, then you could risk the insulin you’re injecting causing low blood sugar which could be very dangerous for your pet. It’s always better to be a BIT high than too low.
What if I happen to miss an insulin shot due to something unforeseen?
It’s probably not a big deal occasionally. Your pet would just have high blood sugar for an extended period. That’s better than being too low but you want to avoid any extreme. If you go too long and his high blood sugar would eventually rebound to low blood sugar so you want to be sure to always feed before you give any insulin in my opinion.
What about In between meal snacks?
>>if Your pet is still very active (runs around a lot outside) and/or you notice him sluggish in the afternoon, check is BS and see if he’s running low – he may need an afternoon snack to replenish himself but in that case you will NOT usually need to give another insulin injection because a snack is not a main meal and the 70/30 lasts about 12 hours anyway. If he’s low, he needs carbs for food not just protein – a piece of wheat bread dipped in chicken broth, peanut butter (carbs/protein), watermelon/fruit. If he is very low (under 60), then he needs FAST acting carbs – like molasses or Karo syrup to get him sugar immediately – rub this on his gums if he refuses to take it. If you are using 70/30 or NPH twice a day, remember that it does ‘peak’ about 4-8 hours after you give it so it would be very normal for your dog to want/need food around that time.
If you haven’t yet watched this vid, it could explain more:http://www.youtube.com/watch?v=Oq0hQiH8zM4
What about exercise for dogs with diabetes?
Regarding exercise vs glucose, the insulin is not what goes up, but actually the BS could rise. Here’s a good explanation from the web: “When you exercise your muscles need more glucose to supply energy. In response, your liver increases the amount of glucose it releases into your bloodstream. Remember, however, that the glucose needs insulin in order to be used by your muscles. So if you do not have enough insulin available, your blood glucose levels can actually increase right after exercise. Basically, stimulated by the demand from your exercising muscles, your body is pouring glucose into your bloodstream. If you do not have enough insulin available to “unlock the door” to your muscles, the glucose cannot get into your muscles to provide needed energy. The end result is that glucose backs-up in your bloodstream, causing higher blood glucose readings.” All that being said, it does NOT necessarily mean that Your dog needs more insulin after exercising. If he is LOW after a walk, then he needs a fast carb snack like we talked about before, but if he is high it will usually come back down on its own as the glucose goes out of the bloodstream again.
If I live at a higher or lower sea-level is that going to affect my BG readings or my insulin?
While sea level locations may affect insulin needs, from a clinical standpoint (ie real life), I would not get hung up on worrying about this. Before you get into fine-tuning vs sea-level you first need to master the basics – that’s doing your BG readings consistently, keeping your journal, and using the sliding scale to adjust your insulin vs the BG readings. For 99% of folks, just doing those basic things will make a positive difference for you. If you are still concerned about the higher-lower sea level, do additional research on the subject and tinker with MINOR adjustments but I doubt you will need to get to this stage.
Hope this info helps. God Bless
The Helpful Dad