Changes in insulin requirements 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
- metoestrus in dogs - changes in progesterone concentrations
- corticosteroid or progestogen administration
Changes in Insulin Requirements in Diabetic Dogs
"It is not unusual for insulin requirements to change suddenly even after a long period of stability. "
Dose adjustment
Dose adjustment should be based on the clinical response and the results of serial blood glucose samples. 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. at least 3-4 days.