Changes in Insulin Requirements in Diabetic Dogs

It is not unusual for insulin requirements to change suddenly even after a long period of stability.

Changes in insulin requirements

This can be due to a number of factors:

• infection (e.g. urinary tract infection (cystitis), pyoderma)
• altered exercise regime
• weight loss or gain
• other concurrent illness (e.g. renal failure, heart failure)
• other concurrent endocrine disease, such as Cushing's disease or hypothyroidism in dogs or hyperthyroidism in cats
• metoestrus in dogs - changes in progesterone concentrations
• corticosteroid or progestogen administration

Dose adjustment

Dose adjustment should be based on the clinical response and the results of serial blood glucose samples and not just a single sample. Ideally a blood glucose curve should be made before the insulin dose is changed.

Urine glucose and ketone monitoring can be used to check whether a blood glucose curve should be made, it should not be used alone as a basis for dose adjustment.

Dose adjustment should be made in steps of 10%, rounded down to the nearest whole unit. Changes in dose should be made after a period of adjustment to a particular dose or regime, i.e. after 3-4 days.