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Diabetic Clinic Support

Diabetes is a complex disease

Diabetes is a complex disease which requires significant involvement from the pet owner in order to achieve a successful outcome. 

With so much new to learn, the diabetic pet owner requires high quality ongoing support and reassurance from the practice team, and the veterinary nurse is ideally placed to provide much of what is needed. Our Diabetic Clinics are a formal opportunity for a full and open discussion.

Even for an experienced pet owner, managing a diabetic pet can be very daunting at first. Taking the time to discuss the condition and its management will provide vital reassurance and the essential information needed for owners to persevere. Through these clinics we aim for better care with a consistent practice-wide approach, with improved clinical outcomes for the patient.

The basic key information for all owners:

  • What diabetes is including potential causes and the common clinical signs of diabetes
  • Diabetes Mellitus is a life-long condition, however with appropriate treatment, affected pets can live a healthy normal life
  • Successful management depends on regular and consistent quantities of exercise, diet and insulin
  • Several different strengths/formulations of insulin are available. When using Caninsulin, the appropriate syringes/cartridges must be used
  • Insulin must be handled, mixed and stored appropriately
  • How to draw up and administer insulin properly using Caninsulin syringes or VetPen
  • What a “hypo” (hypoglycaemic episode) is, the clinical signs that are commonly seen and what to do if it occurs
  • Broached shelf life (28 days) must be respected. Unfinished insulin vials/cartridges as well as Caninsulin syringes/VetPen needles must be disposed of properly
  • When to contact the practice for advice
  • Cats can go into diabetic remission and the signs of this to watch out for
  • Diabetes stabilisation can take up to three months and all family members need to take ownership of their pet’s diabetes

Most of all, owners need to be aware that the practice team is there to help and to answer questions as and when required

How to recognise and deal with a “hypo”

If blood sugar falls too far your pet will experience various signs/symptoms of a hypoglycaemic episode (a “hypo”). These vary dramatically and can become life-threatening: a good rule of thumb is that if you suspect a “hypo” treat it immediately: this means applying liberal amounts of the dextrose gel we gave you directly onto his/her gums. This works very, very well, albeit not instantly. “Hypos” are most likely of you have given insulin but for some reason the pet has lost his/her carbohydrate source eg. not been fed/vomited his/her whole meal, or at times of increased exercise.

There is no such things a typical “hypo”, but most show some twitching before they “go floppy” or start to seizure. The video below shows the sort of twitchiness we often associate with low blood sugar, and this puppy’s food craving is a nice confirmation of the problem.

Applying the dextrose gel will prevent deterioration, and by the time you have the vet clinic on the telephone your pet will often be coming out of the episode! Timely intervention matters: only after you have applied the gel should you telephone us for advice! 

Stabilisation Clinic

Diabetes stabilisation commences with a conservative dose of insulin (often administered twice daily) and the pet being sent home on a consistent and regular management regime of exercise, insulin and diet. The aim of the stabilisation phase of diabetic control revolves around titrating the insulin dose to the pet’s needs. This stabilisation phase may take up to several months depending on the individual
diabetic.

We use a combination of weight change (or lack of change!), thirst, appetite, demeanour, and blood tests to assist in stabilisation. Serum fructosamine is an excellent tool to use: it gives us a guide to the average glucose levels over the preceding 14 days: exceptionally useful!

At each stabilisation clinic we will assess whether there have been any changes in the animal’s water intake, food consumption, urination, general demeanour as well as if they have seen any vomiting, diarrhoea or neurological signs. In depth questioning regarding diabetes management e.g. diet, exercise, insulin storage, injection of insulin etc. is also important. We will examine and weigh your pet at each visit and you are encouraged to discuss any concerns you might have. Your pet may require hospitalisation for a blood glucose curve and/or other blood/urine samples.

Based on clinical signs, history, examination and further diagnostic tests, the dose of insulin may be adjusted in consultation with the veterinary surgeon.

Maintenance Clinics

The main aim of the maintenance phase of diabetes management is to achieve a good quality of life for the pet though continued effective diabetic management. Of course you should seek advice if something of concern arises between clinic appointments.

During this period, changes in water intake, appetite, urination, or the pet’s weight or demeanour can all indicate that control may be compromised. During the nurse clinic you will be asked a series of questions vital to ensuring that such clues are not missed.

The importance of diet, exercise consistency and routine cannot be overstated: if you are having problems with any aspect of this please do discuss with the vet nurse. We will usually perform a physical examination including body weight, and often collect a blood sample for serum fructosamine assessment if appropriate. In addition, on occasion, serial blood glucose measurements can help to establish the timing and peak effect of administered insulin where appropriate.

VetPen

Some clients find using a Vetpen much easier than a standard syringe.

  • simplifies insulin administration and improves dosing accuracy
  • sleek pen design is user-friendly and less intimidating 
  • improves initial acceptance and ongoing compliance
  • helps to make pet owner instruction easier
  • ideal for administration on-the-go

Ask for advice if you would like to try a Vetpen

Cataract formation

We need to accept that cataracts will likely form in most dogs (not cats!) with diabetes. Most will eventually lose their sight: this is not a failure in control, merely a fact of life. Many will adapt to their new situation, but it remains a significant adverse quality of life factor for most. We are very excited now to have the expertise of our eye specialist, Isabel, who can restore sight by removing the opaque lens and often replacing with a shiny new crystal-clear artificial one. Very rewarding work! Check out her advice: cataract-surgery

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