Page 2980 - Cote clinical veterinary advisor dogs and cats 4th

DOs but if your dog doesn’t want the next meal either, a trip in for
• Realize that DM is a very treatable disease but that the proper evaluation is likely necessary.
management of a diabetic animal requires significant commitment • Ask your veterinarian questions about information you do not
of time, finances, and attention. • Ask if home glucose monitoring would be helpful for your dog.
understand.
VetBooks.ir • Offer food immediately if you notice that your diabetic dog who is • Understand that in some dogs, DM can be difficult to treat, and
• Realize that serious and life-threatening complications can arise,
especially if DM is left untreated or is treated inappropriately.
a second opinion from a veterinary internal medicine specialist
receiving insulin seems disoriented but is still alert and responsive. may be helpful. You can discuss this with your veterinarian
If your diabetic dog who is receiving insulin appears unconscious, and a list of these specialists is available at www.acvim.org or
apply a sugary solution like corn syrup or maple syrup to the www.vetspecialists.com for North America; www.ecvim-ca.org
gums. In either of these cases, contact your veterinarian or local for Europe.
emergency veterinary hospital immediately.
• Keep all recommended follow-up appointments with your DON’Ts
veterinarian since they are essential in keeping your pet’s blood • Do not postpone a visit to your veterinarian if you observe any
sugar levels well regulated. symptoms of illness or of DM since early diagnosis and treatment
• Have your veterinarian or veterinary technician show you how can aid in preventing serious and life-threatening complications
to give all medications and demonstrate the correct method for of the disease and improving the quality of your pet’s life. The
insulin handling, administration, and disposal. initial screening may only require a physical exam and routine
• Double check the insulin and syringe type each time you get a blood and urine tests.
refill. • Do not increase the insulin dose without discussion first with
• Ask your veterinarian how long you can use the same bottle of your veterinarian as this could cause dangerously low blood
insulin. For small dogs, there may be leftover insulin in the bottle sugar levels.
at the time it reaches its expiration and should be discarded. • Do not give any medications that are not prescribed by your
• Handle and use insulin as directed veterinarian for the specific animal in question.
• Wipe the stopper of the insulin vial with alcohol then let it • Do not stop any medications if your animal is feeling better
dry before use without consulting with your veterinarian first.
• Either roll or shake the insulin to create a suspension (depend- • Do not assume that all sources of information are accurate or
ing on insulin type) complete (i.e., internet sites, outdated pamphlets or books, pet
• Keep the insulin cool and dry (refrigerator is ideal); never store workers, friends, etc.). Ask your veterinarian for recom-
freeze, and never allow it to sit in the sun or in a hot car mended sources of information.
• Check that the insulin is not discolored and does not contain • If you are giving insulin injections at home, do not reuse or
“chunks” after rolling/shaking that might indicate it has been dispose of needles or syringes in the trash. Rather, collect them
contaminated and needs to be replaced. in a puncture-proof container (e.g., empty bleach jug) and bring
• Handle and give all medications exactly as directed by your it to your veterinarian for disposal.
veterinarian. If you feel your pet is having side effects from any
medications or you are finding it very difficult to medicate your WHEN TO CALL YOUR VETERINARIAN
animal, contact your veterinarian for advice before discontinuing • If your pet’s symptoms change, worsen, or any new problems
the treatment. arise.
• Ask what you should do if your dog skips a meal. You may be • If you are unable to give medications as prescribed or if you
instructed to give a half dose of insulin with one skipped meal, require a prescription refill.

Unlocked
Engaged
Injection button
Dose indicator
Piston rod
Pen body

Insulin reservoir
300
250
Cartridge holder 200
150
with incremental units 100
50
0
Cannula
Outer cannula cap
Pen cap
Diagram of typical insulin pen components. (Adapted from Gesenhues S, Ziesché R (eds): Praxisleitfaden Allgemeinmedizin.
Berlin: Urban & Fischer, Elsevier, 2010. Fig 17-3.)

From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.