Diabetes Control
Diet is an integral part of the treatment for diabetes. It is
important to feed a maintenance diet which meets your dog's
individual caloric needs and varies as little as possible. For a dog
receiving insulin two times a day, the optimum feeding schedule is
to feed four meals a day. One at the time of each insulin injection,
one in the early afternoon and one in the late evening. It is
probably best to feed a high carbohydrate, medium fibre diet. You
can just add fibre to your dog's normal dog food using a fibre
source such as psyllium (Metamucil), pumpkin pie filling or other
fibre source. There is some difference between fibre sources
(soluble vs. insoluble) and how well they work, but it may not be
clinically significant. Or you can buy a commercial food containing
the proper quantities of fibre.
Some of these foods are Prescription Diets w/d, Science Diet
Maintenance Light, Theradiet Reducing (dry), Purina Fit and Trim,
Purina Dog Chow - Low Calorie Formula and Cycle 3 Light (canned).
The canned version of Theradiet Reducing may have more than the
optimal amount of fibre and this is also true of Prescription Diet
r/d. These food vary in fibre content but no one knows for sure what
the optimum amount is.
There are a lot of different recommendations on how to start insulin
therapy (dosages to start with) so it is entirely possible that your
vet chose a starting value that falls within one of the recommended
ranges in the literature. We usually use about 0.25U per pound of
body weight as a start but I have used up to 0.5U per pound in
situations in which it seemed necessary to gain control of the
situation as quickly as possible.
We think that most clients with dogs can learn to draw blood using
the devices that come with glucometers and recommend that owners of
diabetic animals purchase a glucometer.
We usually recommend spot checking the blood glucose the first two
to three days after starting insulin and then running a "glucose
curve" after that.
A glucose curve is simply a plot of the blood glucose level over the
course of an entire day. By taking blood samples and measuring blood
glucose at 2 hour intervals for 6 to 8 (or even 12)samples during
the day it is possible to get an idea of the effect of the
administered insulin. Often it is possible to identify a problem
such as over administration of insulin, which results in very low
glucose levels part of the day and very high "rebound" levels
another part of the day. The more "level" the curve is during the
day, the better. For us, this is the best way to fine-tune the
insulin levels. Most of the time our clients catch on to what we are
looking for very quickly and do most of the fine tuning themselves.
Not all pets will allow collection of blood easily. For these pets,
the glucometers are not useful. It is a real challenge to try to
stabilize a diabetic animal using information gathered at long
intervals. It is expensive for the owners if we try to do the blood
glucose curves too often. Getting the timing of when to do these
down is one of the challenges of diabetes regulation.
Some vets do feel that monitoring the glucose in the urine and
trying to keep it negative or only very slightly positive is an
effective method of monitoring insulin administration. We thought we
did OK with this before glucometers were available but we think our
clients do better monitoring blood levels.
Once a stable state is reached, longer testing intervals are OK. It
is tempting to try to constantly fiddle with the insulin dosage but
for most of our clients that seems to cause more trouble than just
testing at reasonable intervals using glucose curves.
