Our 10-year old Cavalier King Charles spaniel called Patch was diagnosed as being diabetic four months ago. Since then, despite frequent tests, it's proved impossible to find an insulin dose which prevents the glucose level in his blood from becoming too high. Patch is coping well although some days he seems short of energy. Have you any thoughts about this ?

Patch's situation isn't really that unusual, so don't worry too much at this stage. Controlling sugar diabetes (or diabetes mellitus as it is also known) in the early stages after diagnosis is difficult. It can often take several months to find not just the right dose of insulin, but also the best type of insulin for treatment purposes.Blenheim Cavalier King charles spaniel

Complicating factors during this period may include the so-called “Somogyi overswing”. This happens when the initial insulin dose is too high, causing the blood sugar to plunge, and could explain why Patch has been short of energy on occasions. The body reacts by producing hormones which block the effects of insulin, to raise the blood sugar back above normal to a hyperglycaemic state. Excess glucose is then passed out in the dog's urine, suggesting that the insulin has not worked, whereas actually, it's worked too well !

It's not just a question of relying on insulin either, to stabilise this condition successfully. The use of a recommended prescription diet is equally important, and you yourself must establish a strict routine for Patch, ensuring that mealtimes are fixed at the same time every day and exercise periods do not vary significantly either, as this will otherwise impact on the blood sugar levels.

Even the way in which the insulin itself is handled can also be crucial, and yet this is easily overlooked. It may seem very obvious, but do read the labelling very carefully. The insulin must be stored correctly, usually in a refrigerator. A common mistake is to shake the bottle to mix its contents, rather than rolling it gently in the hands as instructed. This can make a critical difference, causing a froth which affects the potency of the solution. The presence of air bubbles in the suspension when it is drawn into the syringe will also have a detrimental effect on the treatment. Run through all this with your vet if you are in any doubt.

If the problem continues however, it may be necessary for Patch to be hospitalised, so that a series of glucose measurements can be taken through the day. On-going monitoring probably about every three months will be essential in any case, to keep a check on his progress, once the condition is under control.

*This historic photograph taken in 1921, from the collection of the International Museum of Surgical Science in Chicago, shows Dr Frederick Banting and Dr. Charles Best, on the roof of the Medical Building at the University of Toronto, with one of the first diabetic dogs whose life was saved by insulin.

This success convinced the researchers that they had identified the pancreas as the source of this hormone. Banting was awarded a Nobel prize for his discovery in 1923.
© Peterme