First, do not expect changes overnight. The body requires time to adjust to the presence of administered insulin or to any changes in insulin dose or type. Patients are often treated for a few weeks before their excessive urination and drinking behavior begin to noticeably resolve. Expect at least one or two recheck glucose curves at your animal clinic a week or two after an insulin dose adjustment is made.
Some veterinarians will keep diabetic patients hospitalized for the first day or two after insulin administration has begun, just to make sure that the dog or cat is not excessively sensitive to the initial dose. Although diabetics tolerate amazing ranges of blood glucose, when glucose gets too low due to an overdose of insulin, weakness, mental dullness, and occasionally seizuring may result. If you notice a change in mental attitude, sudden inappetance, or lethargy after your pet begins insulin therapy, call your veterinarian immediately.
Although some veterinarians and much of the medical literature recommend monitoring urine glucose through the use of urine dipsticks, our experience as a tertiary referral center and a veterinary teaching hospital has led us to monitor urine dipsticks only to assess for ketones or alert us to possible dysregulation. We strongly discourage the use of dipstick urine glucose measurements as the sole criterion for making dosage adjustments. Insulin dose escalations based only on the presence of glucose in the urine can lead to dangerously low blood sugar levels.
The best way to monitor diabetes regulation at home is to be aware of changes in the frequency and volume of drinking and urination. Your pet should also have a glucose curve assessed within a month of any changes in insulin type, dose or the frequency of administration. Some veterinarians also advocate regular scheduled glucose curves several times yearly even if no changes in drinking or urination are reported by the client. This may be especially important when a pet’s drinking and urinating habits cannot be diligently observed and also because diabetics sometimes have gradually increasing insulin requirements.