Pet Diabetes Awareness and Prevention Program

by Defeat Diabetes Foundation

Testing and Supplies 

Only your veterinarian can diagnose diabetes and provide appropriate preventive and management programs for your pet.

Your veterinarian may begin by performing a general health examination and asking questions about any signs your pet may be displaying. Then, a sample of your pet’s urine will be tested for the presence of glucose (a type of sugar) or ketones (acids produced by the body as it breaks down fat instead of glucose for energy). If glucose is present in your pet’s urine, your veterinarian will then test your pet’s blood to determine the blood glucose level. A diabetes diagnosis is considered definite when persistently high glucose levels are found in both the blood and urine.

Diabetes is a relatively easy disease to diagnose. Fasting blood sugar in dogs and cats should be between 75 and 120mg/deciliter. When the non-fasting level  is over 200mg/deciliter and other blood parameters are normal, diabetes may be the cause.

Once your pet has been diagnosed with diabetes you will need to monitor your pet at home daily.

Urine Glucose Testing

Many vets recommend urine glucose testing as a method of monitoring your pet's diabetes at home. It is simple and inexpensive. But, it has some serious limitations that must be understood and taken into consideration.

Urine glucose testing is based on the fact that excessive amounts of glucose in the blood will be filtered by the kidneys into the urine.  Once the amount of glucose in the blood exceeds the renal threshold (180 mg/dL), glucose is spilled into the urine.  The renal threshold is the level where the kidneys cannot "process" any more blood glucose and it spills into the urine.  If the blood glucose is high for an extended period of time, glucose is usually present in the urine.  The amount of glucose present in the urine depends on how high the blood glucose was, and how long the blood glucose was high.
 

The level of glucose in the urine is not the same as the level of glucose in the blood.   The urine level is just a reflection of how high the blood glucose was, and how long it was above the renal threshold (the point where glucose spills into the urine).  There will always be a difference between what shows up in the urine and what was actually in the blood, and the urine glucose levels will always lag behind the blood glucose levels.

Also, urine test strips cannot show if the blood glucose has ever gone too low.  The strips are not designed to do this.

Blood Glucose Monitoring

Home blood glucose monitoring is a useful tool to help you and your veterinarian stabilize your pet’s diabetes. It can be used to determine how well the current type and dose of insulin is controlling the diabetes. This determination is best done under typical daily conditions where the pet’s feeding, exercise and stress levels are normal. One common problem with doing glucose testing in the vet’s office is that many pets, especially cats, become severely stressed, refuse to eat, are confined to a cage for long periods of time, then restrained for a blood test. These are not normal conditions and the glucose values obtained at the vet’s office may not accurately reflect the blood glucose levels  on a typical day.

If your pet’s diabetes is pretty well regulated, home glucose monitoring can be used to check levels,  on an occasional basis, or to fine tune the control. You can perform a blood glucose test at any time, quickly and conveniently.

If your pet's diabetes is difficult to regulate, home glucose monitoring can be used to obtain the information that is necessary for your vet to determine the appropriate adjustments to the insulin therapy.

Where to Prick Your Pet

Other sites that owners prick include: a paw pad, the calloused area on the leg, the chin area, a pinch of skin on the rump. Others have had their vet show them how to draw a tiny amount of blood from their dog's leg vein. An unused insulin syringe is perfect for this - it has a very tiny needle.

For the ear prick, there is a small blood vessel that runs around the outer edge of the cat’s ear. To locate the blood vessel, hold a flashlight (or sit near a bright lamp) with the light shining into the inside of the ear. Look on the back (furry side) of the ear. You should see a thin red line - this is the blood vessel that you will prick.

If you are pricking a cat's ear, it must be warm. It is very hard to get a drop of blood from a cold, or even cool, ear. Warm the ear by massaging your cat's head and ears,  use a warm washcloth inside a plastic bag, or a rice bag you can heat in the microwave. Whatever you use, make sure it will not burn your pet.

•  Keep everything very clean. Thoroughly wash your hands with soap and water. Have a clean work surface or put out a clean towel to lay things on. Do not touch the tip of the lancet.

• The prick site must be clean and dry before you prick it. If the prick area is dirty wash it with warm water. You must wait until the area is completely dry before you can perform the prick. Moisture will cause the blood drop to spread out and it will be difficult to perform the BG test. Moisture will also dilute the blood sample and cause a faulty BG reading.
  
  If you are pricking a cat's ear, it must be warm. It is very hard to get a drop of blood from a cold, or even cool ear. Warm the ear by massaging your cat's head and ears or use a warm washcloth inside a plastic bag or a rice bag you can heat in the microwave. Whatever you use, make sure it will not burn your pet.
  
  If you are pricking a paw pad, it will also help if the paw is warm.
  
  
• Gently restrain your pet. This procedure requires keeping the pet calm and still for a few minutes. The pet must be relatively relaxed. If you cause a lot of stress to your pet while trying to restrain it you may not get a useful glucose reading. This is particularly true of cats, because stress can cause their glucose levels can become elevated very quickly.  Of course, there may be a little struggling, but if the pet becomes highly agitated, wait 15-30 minutes and try again. Ask your veterinarian to show you how to properly restrain your pet. NEVER use excessive force.
  
  

• Controlling bleeding. After you get the blood sample in the meter, let the meter do its work and attend to the pet’s ear (or wherever you did the prick).  Hold a gauze square firmly (not too tight) at the prick site for about 30 seconds. This should be more than enough time for the bleeding to stop. If the site continues to bleed, keep applying gentle pressure for another minute. Don't "peek" to see if the bleeding has stopped. Just firmly hold the spot and keep your pet calm. If the bleeding does not stop, or if a large bruise forms, call your veterinarian for advice. 
  
  
• Bruising. A small red spot may form after the prick. This is where a small amount of blood has leaked from the blood vessel and is trapped beneath the skin. A small bruise is ok (the size of a grain of rice) and will go away in a day or two. Watch for any large bruising, swelling, fluid accumulation, warmth in the area, or infection. If you think any of these are happening call your veterinarian for advice.
  

• Insulin
• Matching insulin syringes
• Sharps container for used syringes.
• Urine glucose test strips
• Urine ketone test strips
• Urine collection device
• Corn syrup or maple syrup for low blood glucose episodes

Phone number of your vet and phone number of an animal hospital that is open 24 hours a day, 7 days a week for emergencies.

In addition to the items in the care kit, the veterinarian may suggest that you use specially formulated food for your pet.

Also, consider attaching a medical alert tag to your dog's or cat's collar that lets others know that your pet takes insulin for diabetes.

If you travel, identify one or two kennels with staff that are experienced in caring for diabetic pets. Your veterinarian may also be willing to board your pet if there are no adequately trained kennels in your area.