Tatum Point Animal Hospital now offers home management of pets with diabetes. In appropriate cases, this approach allows better control of the disease. The following is a discussion of diabetic management and how we approach treatment.
Managing Diabetes
Tatum Point Animal Hospital
Diabetes Mellitus is a fairly common endocrine disorder affecting approximately 0.5-1% of the domestic pet population in the United States (Panciera et al. 1990).While diabetes is a serious disease that requires life-long management, with treatment, your pet should continue to live a normal, happy life. We hope to help you better understand what you can expect of the long-term management plan for your pet. It is important to note that Diabetes is a complex disorder and that additional care may be needed to best control your pet’s disease.
There are three phases to diabetic management:
1. |
|
Acute or Initial phase (diagnosis):
GOAL: STABLIZE PET AND COMMENCE INSULIN THERAPY.
During this phase, your pet has been diagnosed with diabetes, or has suffered a complication of their diabetes, such as Diabetic Ketoacidosis or Hypoglycemia. This is the most intensive phase of therapy. Some pets will be managed from home, while others may require hospitalization. ALL of these pets will require at least two veterinarian exams in the first four weeks of treatment with blood/urine tests, and one blood glucose curve. The type of blood and/or urine tests will depend on the individual pet’s disease.
|
2. |
|
Interim (“Honeymoon” phase):
GOAL: ESTABLISH AN EFFECTIVE INSULIN DOSE THAT RESULTS IN GOOD GLYCEMIC CONTROL
This phase starts once the pet has started insulin therapy, and any serious initial complications have been resolved. The “honeymoon phase” refers to the first 8-24 weeks of insulin therapy while the pet’s body is adjusting to having adequate blood insulin levels again. The pet’s blood glucose levels and insulin requirements may change suddenly and profoundly during this phase. These pets should be closely monitored by both the owner and the veterinarian. Generally we will perform veterinarian exams every 4-8 weeks, with accompanying blood glucose curves during this phase until the pet’s insulin dose has stabilized and the pet’s blood work show good overall control of the blood glucose (glycemic control).
|
3. |
|
Long-term Management:
GOAL: MAINTAIN STABLE, LASTING GOOD GLYCEMIC CONTROL WITHOUT DIABETIC COMPLICATIONS.
Once a fairly stable dose of insulin has been established, and good glycemic control has been achieved, we enter the Long-term Management phase. Diabetes is a disease that can have very little affect on the pet if it is proactively managed by the owner and the veterinarian. So long as the pet is doing well at home, we plan to perform veterinarian exams every 3 months. Bi-annual blood and urine tests are necessary to maintain a clear picture of the pet’s disease process. However, the specific tests needed will be chosen based on the individual pet’s status at home. Also, any complicating factors that are influencing the diabetic state will be taken into consideration. These complications can be Obesity, Pancreatitis, Hypothyroidism, Cushing’s disease, and chronic Urinary Tract Infections. So long as the pet remains under good glycemic control, they remain at this level of monitoring. Pets that develop secondary disease or who have diabetic complications will require additional care.
|
|
