Single Paw Oliver Gilmore.png

F.A.Q.

Be advised - Use this information as a reference and be careful NOT to make changes to your dog's routine without consulting someone who knows the specific details about your dog and their health history.

Single Paw Oliver Gilmore.png

More questions and answers will be regularly added.

If you have a question not listed here, please email directly.

settings.tab.title.demo

INSULIN

I still have a lot of insulin at 42 days, can I keep using it?


No. You might feel wasteful, but the insulin is essentially useless. 42 days is when an opened bottle expires therefore will lose its effectiveness. Using this bottle could lead to increased BG numbers/hyperglycemia, ketoacidosis.




I didn’t realize I was using the same bottle for more than 42 days, what will this do to my dog?


If using expired insulin, you most likely will be seeing symptoms of diabetes return (increased thirst, frequent urination, etc.) The expired insulin isn’t directly toxic for your dog, but it is not actually doing what it is supposed. Be sure to check for ketones in the urine. Because you essentially no longer treating your dog properly with expired insulin, they might start suffering from ketoacidosis. Water is crucial and necessary. High levels of ketones in the urine are dangerous. If your dog will not drink water no matter what you try. Bring your dog to a vet or an emergency because your dog will need SubQ fluids ASAP.




Can I use Novolin instead of Vetsulin?


Short answer: Yes, many diabetic dog owners do use Novolin and have great success. Specifically Novolin N. HOWEVER, do not switch insulin without consulting someone who is familiar with your dogs needs. Novolin requires a different syringe (U-100). Typically it is recommended as well to drop the dosage by 1 unit or a half unit when swtiching from Vetsulin to Novolin N. If you vet is against using it, ask why? Keep in mind that when Vetsulin was taken off the market in 2013, Novolin was used. See the section on insulin for more information on about types of insulin.




How do I store Insulin?


Unopened bottles need to be refridgerated.
Once open, although instructions don't explicitly say to refridgerate (they say to keep between 77 and above 33), many have better luck and more consistency refridgerating. Not everyone has a home that can ensure temperatures under 77, especially during hot weather months. Ideally keep in safe and secure location in your fridge where it won't need to be moved around a lot. The vegetable drawer is a popular spot because it can stay at a fairly consistent tempeture and not frequently used. If it's in the refridgerator door it's more likely to move around throughout the day as you open and close your fridge, and be more inconsistent in temperature. Many actually notice insulin staying consistently potent for longer when keeping it refridgerated.




Do I roll or shake the insulin?


Vetsulin - Shake Novolin - Roll Mix until cloudy evenly throughout. Avoid shaking or rolling too much becasue that can break down the protiens.




How long does insulin last?


Open bottle last about 42 days. Although, it often starts losing potency at at 32 days or so. Again, testing will help you understand that better. Keep a journal, labeled your bottle when you started using it so you know exactly when it was opened. Put a reminder in your calendar to purchase new insulin (I do about a week or so in advance, because unopened bottles last about 6 months it says) You can also buy multiple bottles at a time and store them. Unopened Insulin last till the expiration date on the bottle when properly stored.




What syringes should I use?


Depends on the insulin. Novolin N is a U-100, the orange cap Vetsulin (Hummilin is U-40, red cap) Sryinges also come in all sorts of sizes. Some hold 30 units, some hold 100 units etc. Some show half unit markings some only show full units. The main thing is making sure you are using the correct syringe type with the insulin. If you are dealing with smaller does it is good to find syringes with half unit markings, because if you increase or decrease it is best to do by half unit and if you only have full units markings it would be hard to do half units properly/consistently. The guage of the needle refers to its thickness. The higher the gauge number the thinner the needle. A 31 guage is smaller than a 30 and 29 gauge. If your dog is struggling with shots, possibly try a smaller guage needle (31) if you're using bigger. Also, needle length. Common lengths 1/2in, 8mm, 6mm.




How should I warm insulin before injection?


Cold insulin can sting and be painful for you dog, so you want to be careful not to inject it straight from the fridge. - Take the insulin from the fridge as you're preparing your dogs meal. That way it will have time be closer to room tempeture before injecting. If you forget to take it out of the fridge to warm up, and need to inject, fill the syringe and you can -Hold it between your palms -Hold it between your lips (must be capped) -Place it behind your ear for a few minutes. Do this till it is closer to room tempeture and will be more comfortable for your dog when injecting. DO NOT directly heat or microwave the insulin.




How much insulin should I give?


This varies for each dog. Ideally, your vet will give you a reasonable starting amount, and gradually increase. The AAHA guidelines recommend starting dose (2x/day) of .25 - .50 units insulin per kg of weight. For a 40 lb dog, that would be 4.5 units (conservatively) to 9 units on the higher end. A 16 lb dog your starting dose would be around 2 (1.8) - 3.5 (3.6) Do this for about a week and after running a curve adjust accordingly. There are exceptions to this, and variance between large dogs and small dogs. Large dogs may be able to increase by a couple units at a time. Please discuss with you vet about and bigger insulin dosage increases to avoid side effects/rebound. And please consider getting a second opinion if the information provided by your vet seems questionable.




When should I increase insulin dose?


Increases only recommended after a week of a consistent dose, and a full 12 hour curve has been done. Increases of a half unit can lower BG by 50 points. 1 unit can lower by 100. You need to base your dosage on the lowest number on the curve to know that an increase won’t potentially put you in a danger zone. (Dropping below 100) Drastic increases can cause a lot of disruptions too, spikes and drops and inconsistent numbers, known as rebound/somogy.





AT HOME TESTING

What are the best places to get a blood?


It depends on your dog and their comfort level. Common test spots - Carpal pad - Elbow callus (easier for larger dogs) - Base of tail - Tip of tail - Underside of top lip - Marginal Ear vien




I'm struggling to get a good blood drop to use for testing. What do I do?


Try massaging the area to increase circulation. Also, warm the area the before using your lancet. That will help bring blood closer to the surface of the skin. Ways to warm the skin - Use a rice sock (A sock with dry rice inside, Heat for about 10 - 20 seconds depending on how powerful your is microwarve.) Or if you have any sort of heating pouch. Be sure whatever you warm the area with is dry, as to not get water on the testing site which could interfere with the blood drawn. The "genteel" is wonderful lancet option that makes getting a blood drop much easier. https://shoppettest.com/genteel-lancing-device/ Advocate safety lancets are also a popular choice. 26 gauge tends to be the go to.




What is a curve?


See tab "Home Testing" for information relating to running a curve.





FOOD

Do I need to use prescription food?


Nope. There are many food options beyond the main two recommended Royal Canin Glycobalance and Hills W/D that a suitable and beneficial for your dogs. When choosing a food that your diabetic pup will eat be aware of ingredients. Look for high protein (Ideally >26), and lower fat (Ideally 10-12%) Also, keep can an eye on fiber content. Too much can prevent them from gaining weight, A good recommended amount of fiber is between 8-9% Fiber helps slow absorption of glocose in the blood stream. If food is lower in fiber, green beans are a treat that are good for additional fiber, also adding some pure canned pumpkin to each If underweight, less fiber. Overweight, more fiber Our pups can sometimes be picky eaters. Finding a food that works for them is possible, and don't feel restricted by prescriptions.




What treats are acceptable?


Your treat options are more limited now, because many options have ingredients that will cause BG spikes. Pure bites are great! A little on the pricey side. Chicken jerky Frozen Green beans are great. Raw green pepper, kale Broccoli Spinach Califlour Zucchini Turkey meatballs (with kale, egg whites, and pure pumkin) Low low fat options, and protein are your best bets. You don’t want anything with sugars in them Egg whites Boiled chicken Possibly dehrydrated chicken liver, BG test to make sure 100% Pure pumpkin (NOT PUMPKIN spice) can be a good treat. You can ever freeze them in little cubes to give to you dog. Not all the time, but also good source of fiber if they seem to be backed up. Avoid treats that have molassess, flour, potatoes becuase it will raise bg levels. Even if they are listed as diabetic freindly, check the ingredient list.




Can I give my dog carrots?


Carrots are NOT recommended because they are higher on the glycemic index and can cause spikes in the BG.




What about fiber?


Too much can prevent him from gaining weight, You want a higher fiber content if possible to because it slows absorption of glocose in the blood stream Around 8.5% fiber is good base. If food is lower in fiber, green beans are a treat that are good for additional fiber, also adding some pure canned pumpkin to each Possibly, If underweight, less fiber Overweight, more fiber Ideal weight, stick near 8-9 The reason you would want high fiber for a pancreatic dog is twofold. First, fiber can block the absorption of some fat in the digestive system. Second, fat makes a dog feel full, so many dogs on low-fat diets are constantly hungry. Fiber helps dull that hunger.





GENERAL

My dog isn’t drinking water, what do I do?


Encourage drinking water by adding something enticing to it. For example, sprinkle Parmesan cheese, or add some tuna water, or a little bit of low sodium chicken broth. If you have a food syringe, you can try squirting water into their mouth to drink. Not at all ideal, but if your dog is showing ketones in urine, water is crucial. One tip is to add water to their dry food (if they eat dry food). Allow it to absorb a bit before feeding, (and you can leave water mixed with the dry food.) That way you know they are getting water with their meals. This also can help with digestion. If your dog continues to refuse, and ketones in urine show levels small and above. Contact vet. If showing high, take to an emergency room for immediate subQ fluids.




Do I have to take my dog to the vet to get SubQ fluids?


Nope. You can give SubQ fluids at home as long as you have the proper supplies. Speak to your vet about what is needed and ideally walk you through the process. It is safe to do at home, because you’ll need to know how much to give for your dog. Giving Subq fluids at home is important to learn if your dog has kidney problems as well. Discuss with your vet about that and what’s required, and you can be showed. If your Vet refuses to show you or unwilling to provide the necessary information, and tell you to come in every time or go to the ER, consider a new Vet. Some Vets have really refused or won’t tell. If you have the supplies, have someone knowledgable providing you the information to walk you through it. SubQ fluid are not water either. It is a solution, it’s not just regular drinking water.




It’s been weeks and I’m not noticing BG numbers decrease, what am I doing wrong?


You might not be doing anything wrong. Unfortunately, there is no magical time frame for when you’ll see numbers decrease after treatment starts. For some it can be days and others it can be months or even a year. There could be a number of reasons why your pup still has remained high. - Not enough insulin - Where you inject could make a diffference - Type of food. Foods high in fat can cause insulin resistence. Targe fat range is 10-12%. Unless your dog has a history of pancreatitis. Then keep below 10% - Type of treats you're still giving (They may have ingredients that cause BG spikes) It can take up to a week or longer to see a difference after making a change. If dog's BG has been running high for weeks, be sure to check for ketones in their urine. Ketoacidosis is dangerous and you will want to address that immediately. If no ketones, or trace amounts push water, otherwise seek professional assistance. If ketones not present, there is no need for immediate alarm. things you could try are switching the injection site. Maybe the location you’ve been using is causing low absorption.




How soon after injection can I take my dog out for a walk?


Depends on your dog. You can go pretty much right after, although it kinda depends on how active or energitic your dog is on the walk. To much activity right after can speed up the insulin. Best way to know is to test before and after the walk. If you’re worried about them dropping low, or notice them fatigued quicker than usual on the walk have a snack ready with you to give. Protein and even a karo syrup in case of emergency. Without testing you won’t really know. Some people prefer to take a little while after, some right away.




My vet told me 1 shot a day, why does everything I read say 2?


It’s is extremely uncommon to be able to regulate your dog on 1 shot a day. Did your vet give you any reason as to why? Sometimes Vets will tell you to start with 1 shot a day to just see how your dog initially takes to the insulin, and ensure there are no unusual reactions. Also, could be to ease you into giving shots. If they don’t have a game plan or give you any indication about switching to 2 shots after a couple days of only doing 1 shot. It would be in you and your dogs best interest to get second opinion. Unless you current vet has specific details about some other underlying condition with your dog that would prevent them form having 2 shots a day, there isn't really an excuse to prolong giving one shot a day.




When do I give shots?


With meals every 12 hours. What hour though is what is best for you. Remember this is everyday 7 days a week. So pick at time that is fits in your schedule. Also if it's been 12 hours and your dog refuses to eat. DO NOT still give the shot as scheduled. The insulin needs the food to work with otherwise you are putting your dogs life at risk. If you choose 7am, then you would do 7pm, 8:30 am and also 8:30 pm. Consistency is crucial. Although we all know that things come and you can't give a shot at the scheduled time. Keep in mind, you have an hour buffer window when it is time to give your next shot. EX: If you give a shot at 7 am, and you know you will be away at 7pm. You could potentially give the shot at 6pm. Always do a bg test before giving a shot early (and in general) to know BG levels are at a safe level.




My dog ate but forget to give a shot, what do I do?


You have a about an hour window to give a shot. If more than a hour has passed since your dog ate, don't give a shot. Giving a shot too late after eating can be dangerous, becasue the insulin and the food will be out of sync and your dog's BG could drop too low. Be aware there BG levels might run much higher than usual. Encourage drinking water and check urine for ketones. You can get back on schedule with meal and shot at the next regular time.




What do I do if it has been longer than 12 hours since I last fed and gave my dog a shot?


If you need to give both food and a shot, and it has been over 12 hours, you can proceed with both (assuming BG levels are in a safe range) as soon as you can. However, this will alter the next time you give a shot. You will need to gradully walk back the time you give shots to get back on scheudle. EX: if you feed at 7am and can't feed again until 9 pm, you will need to wait a minimum of 11 hours before giving your next shot. The earliest you could give the shot the next morning would be 8 am. (DO NOT give the shot at 7am) That evening you could do 7pm, and the next morning you'll be back to your 7am/7pm) Schedule.




Why do we need to check for Ketones?


When the body doesn't have enough insulin, ketones (acidic chemicals made in the liver) are produced. High levels in urine are toxic for the body and may indicate diabetic ketoacidous (DKA), a complication in diabetes which can lead to a coma or death.




Can I give my dog bendryl?


Yes. The amount is determined by weight. 1mg per pound.




My dog won't eat, do I still give insulin?


Short answer, no. The insulin needs food to work with, otherwise you risk your dog having a hypoglycemia episode. Without food in their system, the insulin can drop the BG levels to a dangerous low, leading your dog to pass out, have a seizure or worse. If testing at home, and you see that your dogs BG levels are over 200, and they continue to refuse to eat at the scheduled time. You might potentially be able to ONLY give 1/4 dose. If your dog continues to skip meals, consult with your vet about how to proceed. Encourage drinking water as much as you can as well to flush out any ketones in their system.




No one was able to give my dog his shot at the schedule time. What do I do?


It happens, you have options. And also did you dog eat or not. Depending on how long after your shot was given. Let’s say you give your shots at 7am and 7pm. You get home at like 10. If you dog has not eaten and not received a shot, you feed you dog and administer the shot. However, that means the next shot you give can’t be before 9 am the next morning. You need 12 hours between shots, however you have a buffer of an hour on both ends. So next shout could be at 9 (depending on your dogs BG levels. If over 200 proceed with full shot. Then that evening you could go to 8 pm and the following morning you’re back on track at 7am. You might see some strange numbers because you are only doing 11 hours between shots. I wouldn’t necessarily recommend that. The couple times I’ve had to deviate from schedule. I walk back the time by 30 minute increments.




Why can't we rub the injection site right after giving a shot?


Rubbing the injecting site right after can speed up rate of absorption and potentially disrupt the insulin’s process. It can cause faster absorbion potentially leading to hypoglycemia and/or cause irregular BG numbers. You may instinctively want to rub the area after to make it feel better. But find another spot to rub if possible.




My dogs BG seems to go up after exercising. I thought exercise was supposed to lower it?


When excersing your dog could release a stress hormone, cortisol, during exercise and that can inhibit insulin absorption. This mainly occurs when your dog's BG is running high (usually over 350) This may not be the case for every dog. But it does happen, and that could mean they are just over exerting themselves. Finding the right balance of exercise is important. Never exercise either when the insulin is peaking (at it’s lower points) because that could reduce it too much as well. Keep them active for sure if they can, just be aware. This doesn’t apply to everyone. But if this is something you notice, you’re not alone.




When does the insulin peak?


When insulin peaks, means when the BG levels are at the lowest level during the 12 hour cycle. That depends on the dog and type of insulin. Running a curve on your dog will give you a better indication how they are reacting to the insulin. Usually insulin starts working in 1 to 2 hours after injection, and can peak at 4-6 hours. For some it can peak at 8, or even 12. Knowing information will help you better manage your dog if you are away during the day. If you know how many hours after injecting they tend to have the lowest BG, you can check on them or have someone check on them during that time if you are concerned they might drop below 100.




What do I do if I think Hypoglycemia?


Test at home to check to see where BG levels are. Below 70 is your Dangerzone! If below 70 rub syrup on their gums for fast absorption to increase sugar levels Don’t give too much, but test BG frequently to see how quickly it will go up.
Below 100 be cautious and take action, and provide a protein snack and a small carb option. You can also purchase SOS in case of urgent low blood test numbers. "Glucose SOS for Pets is a fast acting glucose gel product that raises your pet’s blood sugar quickly and effectively to treat hypoglycemia (low blood sugar). Hypoglycemia is extremely serious, not only for diabetic pets but for hunting and highly active dogs, toy breeds, puppies and kittens. Low blood sugar can cause seizures, and even death. Unlike traditional remedies (Karo syrup or honey to the gums, treats, etc.), Glucose SOS for Pets provides a standardized, precise and repeatable treatment of concentrated glucose gel in an easy to use syringe."




Does the freesytle libre work?


There are benefits to the freestyle libre, however it should not be used as a replacement to blood testing. The libre is great with helping track trends, showing the general BG curve for your dog. Also it shows you info tends to run about 20 to 30 behind what a blood test will show you, compared to the more immediate blood test. IF you get a low reading on the Libra, double check with a blood test. The libre is not testing the blood but the interstitial fluid. It is also calibrated for humans. BG distribution is different in Humans and dogs Human- 58% plasma and 42% blood Dog 87.5 BG in plasma and 12.5 in Blood Free style libre (difference in blood between human and dog. Difference in glucose in cells vs. plasma will potentially give different readings The libra is a great for convenience and understanding trends.




Do all diabetic dogs go blind?


Nope. However, carateracts are common in diabetic dogs. Cataracts are common in diabetic dogs due to prolonged high blood glucose. Their eyes become cloudy, leading to blindness. Sometimes it can be reversed with surgery. It is costly. Many dogs can live a happy life blind, and usually functional well accordingly. Not all diabetic dogs have dry eye this is why eye exams are important. Optimmun is cyclosporine immune suppressive can cause secondary eye infection. Studies have shown Tacrolimus 0.02% works better and less likely to cause secondary injection. Optimmune Ophthalmic Ointment Ointment, a prescription medication, is used in dogs for the management of chronic keratoconjunctivitis sicca (KCS or 'dry eye"). Optimmune Ophthalmic Ointment Ointment is an immunosuppressive agent used to reduce inflammation in the eye(s). That depends on what your pups needs are . Dogs with cataracts forming usually should be on NSAIDs eye drops . But your dog may also need additional medication like dry eye drops and glaucoma drops. Should have eye exams annually if you can go see a VO regular vets are not very knowledgeable with diabetic eye issues.





INJECTING

I don't have any unused syringes on me, can I use them?


If the only way your dog can receive insulin in that moment is by reusing a syringe, that is better than not giving insulin at all. HOWEVER, you MUST sterilize the needle. And immediately get new needles at the first chance. Be aware that used needle could lead to infection and be more painful for you dog because it isn't as sharp. This does happen. We run out of syringes/didn’t bring enough to a place you were staying. Be careful not to make a habit out of this, but also don’t beat yourself up and think you failed.




Can I prefill syringes to use on at later time or next day?


Yes, but be advised that Insulin binds to plastic, and could render it ineffective if prefilled for extended periods of time. Typically suggested no more than a week in advance, but can be up to 2 weeks. Prefilling the syringe is a common practice and can help save time as well as provide assistance for those who struggle with loading syringes themselves. Be sure to keep prefilled syringes stored upward (cap facing up) so that the insulin does not clog the needle. -Store prefilled syringe in the refrigerator. -Remove syringe from the refrigerator 5 to 10 minutes before injection to allow it to warm up sligthtly to prevent insulin from stinging during injection. -You can also roll the syringe between your hands to warm it -If using a clear insulin, make sure it is still clear before injuecting -If using a cloudy insulin (NPH) roll the syringe to adequately re-suspend the insulin preparation. (If there are clumps of solid insulin in your prefilled syringe that won't mix, don't use that syringe. The absorption rates of the clumps can be unpredictable.) -NPH LANTUS is recommened NOT to prefill.




How should I warm insulin before injection?


Cold insulin can sting and be painful for you dog, so you want to be careful not to inject it straight from the fridge. - Take the insulin from the fridge as you're preparing your dogs meal. That way it will have time be closer to room tempeture before injecting. If you forget to take it out of the fridge to warm up, and need to inject, fill the syringe and you can -Hold it between your palms -Hold it between your lips (must be capped) -Place it behind your ear for a few minutes. Do this till it is closer to room tempeture and will be more comfortable for your dog when injecting. DO NOT directly heat or microwave the insulin.




My dog won't eat, do I still give insulin?


Short answer, no. The insulin needs food to work with, otherwise you risk your dog having a hypoglycemia episode. Without food in their system, the insulin can drop the BG levels to a dangerous low, leading your dog to pass out, have a seizure or worse. If testing at home, and you see that your dogs BG levels are over 200, and they continue to refuse to eat at the scheduled time. You might potentially be able to ONLY give 1/4 dose. If your dog continues to skip meals, consult with your vet about how to proceed. Encourage drinking water as much as you can as well to flush out any ketones in their system.




My dog flinched and only some of the shot went it? What do I do?


Leave it be. You have no official way of knowing how much actually was administered. Even if you have an idea, you run the risk of overdosing if you try to give more without knowing the exact amount needed.Better to be safe than sorry. Push water and give the shot at next time scheduled time.




What do I do with my used needles?


First..Do NOT just throw them away in your regular trash bins. Each state has different requires for sharps disposal. Used needles typically must be placed in a proper FDA sharps container and brought to a designated disposal site. If looking for at home disposal, you can clip the needle off (there are tools you can buy for safe clipping, which can contain the needles). The clipped syringe can then disposed of safely at home. The needle holder then must be disposed of accordingly based on your states sharp disposal requirements. (Safe clip can hold about 1500 needles)