Diabetes monitoring

If your pet has been diagnosed with diabetes they will probably need life-long treatment. It is also really important to monitor them regularly. If diabetes is well controlled your pet can live a long and healthy life free from many of the problems that the disease can cause. Your veterinarian will want to see your dog regularly to check on its progress but there are many things that you can monitor at home which will help to provide a complete picture of your dog’s health for your veterinarian. At intervals your vet may want to take blood samples from your pet to see how well the diabetes is controlled. If you have any concerns about any aspect of your dog's treatment, discuss them with your veterinarian.

If your dog has diabetes they are unable to regulate their blood sugar (glucose) levels naturally. Your pet will probably have been prescribed insulin by your veterinarian to prevent blood sugar levels going too high.

High levels of sugar in the blood can result in consequences which can severely impact your pet’s quality of life. These include the problems you probably first noticed in your pet such as weight loss, drinking excessively and increased appetite. Dogs with poorly controlled diabetes also tend to have poor general health and low immunity, which can increase the risk of infections. The presence of diabetes can also lead to complications when a dog develops another health problem, whether it is a simple gastrointestinal upset or something more serious. In that case, diabetic pets may become suddenly very ill with high blood sugar levels and they might develop a condition called ketoacidosis or ketosis. This is a life-threatening emergency and urgent veterinary help might be needed to save your pet’s life. Therefore it is recommended that your pet receives prompt veterinary attention at the first sign of any illness.

Diabetic dogs are fortunately not prone to the same long term complications as people with diabetes. However, a common complication of diabetes in dogs is blindness due to cataract formation. Cataract formation can occur slowly or quickly. Inflammation associated with the cataracts typically requires life-long treatment. Vision can be restored by surgical removal of the cataracts.

On the other hand, if blood sugar levels drop too low (this is often called a ‘hypo’), your pet may have episodes of wobbliness, confusion and ultimately could collapse. Some diabetic dogs are more prone than others to low blood sugar. The majority of episodes of low blood sugar are associated with no signs or only mild signs; however, in some cases, low blood sugar levels can result in more serious signs of seizures, coma and death.

Overall health

The most straightforward thing to monitor at home is your pet’s overall general health. Take note of how your dog seems and if they are out of sorts or show any unusual signs or changes in appetite always consult your veterinarian.

Water intake

If you are able to measure how much your dog is drinking this can provide very useful information for your veterinarian. It is often difficult to accurately measure a dog’s water intake because, if they go outside, they will often drink from ponds and puddles or other water sources in preference to drinking from a bowl at home. However, water consumed at home gives a guide to changes in how much your dog is drinking overall. When you fill your pet’s water bowl in the morning measure how much you put in. If they drink all this in the day record also how much more you have to add. If they don’t drink the whole bowl in one day then the following morning you can measure how much is left and use this to calculate the total volume drunk over 24 hours. Once you know roughly how much your pet normally drinks in a day you can simply provide them with a bit more than that in the bowl each morning and establish a routine of monitoring water intake each day. It will then be very easy for you to spot if they suddenly start drinking more. If your diabetic dog shares the water bowl with other pets, then it is often still useful to measure the volume drunk by all the animals each day. It is not generally recommended to separate the pets to measure water intake. Try to be aware of how often you see your dog drinking – if you notice a change in how much your pet drinks, contact your veterinarian for advice.

Body weight

Diabetes may start in obese animals but in untreated diabetics there is often weight loss (due to loss of calories in the urine). When you first start treatment your veterinarian will want to get your pet’s weight into an ideal range; therefore thin animals will be fed so that they gain weight, whereas calorie restriction will be recommended for overweight dogs. Once their ideal weight is achieved their food intake will be adjusted to ensure that their weight remains the same. If you have scales at home, it is recommended that you weigh your pet on a weekly basis and keep a record of the weight. Your veterinarian will also weigh your pet every time they see them for a routine check, and many veterinary practices have scales in the waiting room and will allow you to take your pet in to regularly weigh them at your convenience. As the key to successful treatment of diabetes in dogs is for the dose of insulin to be closely balanced with their food intake, it is recommended to keep food intake exactly the same at each meal. If, despite the same feeding regimen, you notice a change in your pet’s weight then contact your veterinarian for advice. Weight loss may be an indication that the diabetes is getting out of control, whereas weight gain can indicate that adjustment of the insulin dose and/or meals is required.

Urine glucose

When sugar levels in the blood get very high the sugar starts to spill into the urine. It is helpful for urine samples from your dog to be tested regularly for the presence of sugar (glucose). The results from these samples will help your vet to monitor your dog's progress and ensure that the treatment is correct. When you first start treating your dog with insulin your veterinarian will probably ask you to monitor urine samples regularly and record results from a dipstick test. However, it is even more important  to record findings from urine tests in the long term – especially when your pet’s diabetes seems to be stabilized. This is because insulin requirement often decreases in dogs once there is good diabetic control. Collect a urine sample a couple of times a week; this may be done at any time of the day that is convenient, for example, when you walk your dog on a lead. Measure the glucose levels in the urine with a dipstick and record the results in a diary. The dipsticks are not very expensive but, to save money, it is possible to very carefully cut some strips in half long-ways (so that there is still half the detection pad on each stick) which allows you to get 2 sticks for the price of one.

It is important to contact your veterinarian for advice if there are several days in a row when there is no detectable sugar in your dog’s urine. Otherwise take all your records with you to your routine veterinary check-ups.

Blood glucose

Depending on the needs of your dog (and how confident you feel) your veterinarian might ask you to take some blood glucose readings at home. These can be made using a simple machine that measures sugar levels in a tiny drop of blood collected using a pin prick on an ear tip, the inside of the lip, the paw pad or an elbow callus. Your veterinarian would show you how to collect the blood and use the machine. The advantage of measuring blood glucose at home is that it allows you to rapidly obtain this information when your pet is unwell or has a problem, and also provides an additional means of monitoring your dog’s progress. An important point is that it is generally not recommended to adjust the diabetes treatment based on single blood glucose measurements.

Continuous glucose monitoring

Monitors that continuously measure interstitial glucose (the sugar content of the fluid immediately below the skin) are also used to monitor diabetes in dogs. They typically comprise a small adhesive patch that can be scanned with a reader or smart phone App. The adhesive patch may be applied by your vet, or you may wish to learn how to do this yourself. These monitors can provide a lot of information about your dog’s diabetes. This provides valuable feedback for the owner of the dog as well as for the veterinarian. It is important to work closely with your veterinarian to get the most value from this information as it is often complex.

Your veterinarian will need to examine your pet regularly and review your home monitoring notes to follow their progression. Your veterinarian will be looking to see if the diabetes is currently well controlled, or if it is advisable to adjust the insulin treatment, meals or monitoring methods. However, when they take a blood sample during a routine health check, they can only get a snapshot of the blood glucose levels at that particular time. For example, if the glucose level is high when a blood sample is taken does not mean that blood glucose levels are not normal or low at other points of the day. Your veterinarian can measure other substances in the blood (such as fructosamine) which give a broad picture of whether glucose levels in the blood have been regularly high over weeks or months and they may run this test at regular intervals to assess your pet’s diabetes.

Because a single blood glucose measurement only gives a snapshot indication of your pet’s diabetes, it is often recommended to use a continuous glucose monitor, or to take multiple blood samples at regular intervals through the day and view the glucose values on a graph. This creates a ‘curve’ that typically shows blood/interstitial glucose levels rising after a meal and/or falling in response to insulin administration. To make sure the curve shows what happens in a normal day the normal routine must be followed. This is always complicated if your pet will be hospitalized for the duration of the tests because the environment of the veterinary surgery can trigger a stress response which means the insulin doesn’t work quite as well as normal. Therefore it is usually preferable to generate a blood/interstitial glucose curves at home, when meals, insulin injections and exercise are administered at the normal times.

Your veterinarian will set a regular pattern of routine visits for you and your pet. This may be more frequent immediately after diagnosis or when problems develop, and then may be reduced to every 3-6 months if your pet’s diabetes becomes more stable.

Diabetes is an illness that will be with your pet for life. However, by carefully monitoring your pet at home you can help your veterinarian ensure that treatment is the best it can be and that your pet is able to lead as happy and healthy a life as possible.