As a dog lover and devoted owner, you want nothing more than for your sweet pup to be healthy and happy. So when your dog is diagnosed with diabetes, it can feel overwhelming and scary. Suddenly you find yourself thrust into the role of both pet parent and nurse, giving daily insulin injections and closely monitoring their diet and symptoms.
But what do you do when, despite your best efforts, your diabetic dog‘s blood sugar levels just won‘t seem to stabilize? When the readings remain stubbornly high even after insulin injections? It‘s a frustrating and concerning situation that many owners of diabetic dogs find themselves in.
First, know that you are not alone. Diabetes is one of the most common endocrine disorders in dogs. It‘s estimated that roughly 1 in 300 dogs will develop diabetes during their lifetime, with certain breeds like Samoyeds, Miniature Schnauzers, and Toy Poodles at higher risk. ((Banfield Pet Hospital, State of Pet Health Report, 2016.))
Caring for a diabetic dog is a major commitment that requires dedication, patience, and a close partnership with your veterinarian. There will be good days and hard days. Times when their glucose levels will swing too high or too low. The key is learning to navigate these challenges and always keeping your dog‘s quality of life at the forefront.
To start, let‘s review some important fundamentals of diabetes in dogs and insulin therapy.
Understanding Canine Diabetes
Diabetes mellitus occurs when the body doesn‘t produce enough insulin or use it properly. Insulin is a hormone made by the pancreas that enables cells to take in glucose (sugar) from the blood and use it for energy.
Without adequate insulin, glucose builds up in the bloodstream, leading to hyperglycemia (high blood sugar). The body‘s cells are essentially starving for glucose, so the dog often feels hungry and loses weight despite a good appetite. Meanwhile, the high blood sugar spills into the urine, causing the dog to urinate more frequently and drink excessively.
Classic signs of diabetes in dogs include:
- Polyuria (increased urination)
- Polydipsia (increased drinking)
- Polyphagia (increased hunger)
- Weight loss
- Lethargy
- Recurring infections (skin, urinary tract)
- Cataracts (cloudy eyes)
Most diabetic dogs depend on insulin injections, typically given twice daily, to control their blood sugar levels. The goal is to keep their glucose in a healthy range – not too high but also not so low that they develop hypoglycemia. It‘s a delicate balance.
Target Glucose Ranges
So what should your diabetic dog‘s blood sugar levels be? Your vet will determine target ranges based on your dog‘s individual needs, but here are some general guidelines:
- Fasting (just before a meal): 100-140 mg/dL
- 2 hours after eating: 120-160 mg/dL
- Lowest reading of the day: 60-100 mg/dL
- Highest reading of the day: 200-300 mg/dL
((Nelson RW, Couto CG. Small Animal Internal Medicine, 6th edition. 2019.))
Regularly monitoring glucose levels through at-home blood testing and/or periodic testing at the vet is important to ensure your dog‘s diabetes is staying well-regulated. This data can also show if adjustments to insulin dosage are needed.
Monitoring Blood Sugar at Home
Many dedicated owners of diabetic dogs check their pet‘s blood sugar levels at home for real-time data on their glucose regulation. At-home monitoring can identify problems early and help avoid dangerous dips or spikes. To test your dog‘s blood glucose at home, you‘ll need:
- A pet glucose meter (human glucometers aren‘t calibrated for dogs)
- Testing strips
- Lancet device
- Cotton balls
Ask your vet to demonstrate proper technique for collecting a little blood from your dog‘s ear or paw pad. They‘ll show you how to use the meter and record your dog‘s readings.
Tips for At-Home Glucose Checks:
- Create a consistent schedule – same times each day
- Test before insulin injections and meals
- Avoid testing when your dog is stressed or very active
- Praise/treat your dog for holding still during collection
- Share glucose record with your vet during checkups
- Call your vet if readings are consistently out of range
Some owners prefer using urine glucose test strips to avoid needles. However, urine testing only shows an average of blood sugar levels from the last few hours. Urine can still contain glucose up to 12 hours after blood sugar has normalized. Blood testing gives you a more accurate, current reading. ((Merck Veterinary Manual. Diabetes Mellitus.))
Types of Insulin for Dogs
Several kinds of insulin with varying durations are used in diabetic dogs. Intermediate-acting insulins like Vetsulin (porcine insulin zinc suspension) or NPH (human insulin isophane) are most commonly prescribed.
| Insulin Type | Onset (hrs) | Peak (hrs) | Duration (hrs) |
|---|---|---|---|
| Vetsulin | 1-2 | 4-10 | 10-14 |
| NPH | 1-2 | 4-12 | 14-24 |
| Glargine | 1-4 | None | 10-24 |
| Detemir | 1-2 | 3-9 | 5-14 |
((Feldman EC, Nelson RW. Canine and Feline Endocrinology, 4th edition. 2015.))
Newer insulin analogs like Glargine and Detemir are being used more in dogs. These long-acting insulins are slowly absorbed, resulting in a steady release throughout the day without major peaks. This can mean better glucose control and less risk of hypoglycemia for some dogs. ((Palm CA. Diabetes Mellitus in Dogs and Cats, Advances in Treatment. Vet Clin Small Anim 48 (2018) 817–824.))
The Diabetic Dog Diet
Along with insulin and monitoring, diet plays a key role in managing diabetes in dogs. The ideal diet for a diabetic dog is high in protein and fiber with complex carbohydrates to slow glucose absorption. A consistent feeding schedule is also important to prevent blood sugar fluctuations.
General Diabetic Dog Diet Guidelines:
- Feed meals at the same times each day
- Offer food just before or with insulin injection
- Choose foods high in insoluble fiber (5-15% of calories)
- Limit simple sugars/carbs which can spike glucose
- Aim for low-fat foods (<20% of calories)
- Avoid free-feeding, keep portions controlled
- No table scraps or treats that aren‘t low-carb
Many commercial prescription diets are available that meet these nutritional requirements for diabetic dogs, including:
- Purina Pro Plan Veterinary Diets DM Dietetic Management
- Hill‘s Prescription Diet w/d Multi-Benefit
- Royal Canin Veterinary Diet Glycobalance
Work closely with your veterinarian to choose the best food for your dog‘s individual needs. Monitor your dog‘s weight and adjust food amounts accordingly. Maintaining a healthy body condition can improve insulin sensitivity and diabetes control.
Insulin Resistance and Regulation Difficulties
So why might a diabetic dog‘s glucose levels remain high even with insulin injections and an appropriate diet? There are a few potential reasons:
Insufficient insulin dosage
Finding the right insulin dose for your dog can take some trial and error. Your vet will likely start conservatively and adjust the dosage up based on blood sugar readings and clinical signs. Don‘t get discouraged if it takes some tweaking to find the "sweet spot" for regulating your dog‘s glucose levels.
Insulin resistance
Insulin resistance is a complex phenomenon where the body doesn‘t respond properly to insulin. This results in the need for higher and higher insulin doses over time to achieve the same blood sugar lowering effects. Some causes include obesity, other hormonal diseases (Cushing‘s disease, hypothyroidism), chronic pancreatitis, and certain medications (steroids). Addressing underlying conditions or changing to a different type of insulin may help. ((Hess RS, Saunders HM, Van Winkle TJ, Ward CR. Concurrent disorders in dogs with diabetes mellitus: 221 cases (1993-1998). J Am Vet Med Assoc. 2000;217(8):1166-1173.))
Inappropriate insulin handling/administration
Insulin is a fragile hormone that must be stored and handled properly. It should be refrigerated (not frozen) until opened and then stored at controlled room temperature for 30-60 days. Avoid shaking or agitating the vial, as this can damage the insulin molecules. Discard insulin that has expired, looks abnormal (clumped, frosted, discolored), or wasn‘t properly stored. Also make sure you are drawing up the insulin properly into the syringe and injecting the full amount into the dog. If insulin leaks out after the injection, that dose may not be effective.
Rapid insulin metabolism
Some dogs, especially smaller breeds, metabolize insulin very quickly. This can lead to inadequate duration of effect and the need for more frequent injections (3x/day). Using longer-acting insulin formulations may help in these cases.
Is Diabetic Remission Possible?
A small percentage of diabetic dogs may experience spontaneous remission of their disease and no longer require insulin therapy. This is more likely in cases of mild, recently diagnosed diabetes where the pancreas may regain some insulin-secreting ability with proper treatment. Female dogs who develop temporary diabetes during heat cycles or pregnancy can often discontinue insulin once their cycle ends or they have puppies.
Most diabetic dogs, however, need lifelong insulin to control their disease. Even if a dog maintains good glucose levels for an extended period, never discontinue insulin without direct veterinary guidance.
Managing a Diabetic Dog Long-Term
Caring for a diabetic dog is a daily labor of love that takes dedication and commitment. Once you establish a routine of insulin, feeding, and monitoring it will become second nature. However, you may still face challenges along the way.
Financial considerations
Insulin, syringes, glucose meters, test strips, prescription food, frequent vet visits – there‘s no denying that caring for a diabetic dog can be expensive. One study found that owners spent an average of $50-200 per month on their diabetic dog‘s care, not including the initial diagnostic and stabilization period which can be over $1000. ((Aptekmann KP, Armstrong J, Coradini M, Rand J. Owner experiences in treating dogs and cats diagnosed with diabetes mellitus in the United States. J Am Anim Hosp Assoc. 2014;50(4):247-253.))
Consider pet insurance to help offset the cost of lifelong care. Many plans cover a significant portion of prescription medications and diabetic management expenses. Some pharmaceutical companies also offer rebates on insulin products to ease the financial burden.
Consistent care
Diabetic dogs need a regular daily routine to thrive. Insulin must be given at the same times each day, 12 hours apart, often for the rest of the dog‘s life. This can be challenging for owners who work long hours or travel frequently.
If you must kennel your diabetic dog or leave them with a sitter, make sure the caregivers are experienced with diabetic pets and understand the importance of timed meals and insulin dosing. Always leave detailed written instructions and keep insulin in a clearly labeled container. Consider doing a trial run for a night or two before an extended period away.
Emotional aspects
Many owners of diabetic dogs report feeling worried, overwhelmed, and/or guilty, especially when their pet‘s glucose levels are unstable. The time, expense, and stress of managing the disease can take a real emotional toll. One study found that owners of diabetic dogs had higher anxiety and a stronger pet attachment compared to owners of healthy dogs. ((Niessen SJM, Hazuchova K, Powney SL, et al. The Big Pet Diabetes Survey: Perceived Frequency and Triggers for Euthanasia. Vet Sci. 2017;4(2):27.))
Connecting with others who understand the challenges of life with a diabetic dog can be extremely helpful. Look for in-person or online support groups for owners of diabetic pets. Knowing you are not alone in this journey can make a world of difference.
Be kind to yourself and celebrate the small victories – the in-range glucose readings, the good checkup at the vet. Remember that you are doing your absolute best to give your dog a good life, even on the difficult days.
Assessing Quality of Life
Ultimately, your dog‘s quality of life and comfort should be the guiding factor for all treatment decisions. This can mean making the heartbreaking choice of euthanasia if their health declines despite your most dedicated efforts.
Uncontrolled diabetes takes a major toll on a dog‘s body over time. Consistently high blood sugar can lead to:
- Muscle wasting and extreme weight loss
- Diabetic ketoacidosis (DKA) – a life-threatening complication
- Organ damage (liver, kidneys, pancreas, heart)
- Recurrent infections (skin, urinary tract)
- Diabetic neuropathy – nerve damage causing weakness/pain
- Complete blindness from diabetic cataracts
- Vastly diminished quality of life and wellbeing
Have an honest conversation with your vet about your dog‘s prognosis and what kind of life they can expect long-term. Consider not just your dog‘s physical health, but their emotional health. Are they still enjoying their favorite activities? Do they seem happy more often than not?
Warning signs that euthanasia may be the most humane choice:
- Continued weight loss despite good appetite
- Muscle wasting/weakness – trouble getting up or walking
- Lethargy – no interest in play, sleeping most of the time
- Severe diabetic neuropathy causing pain/loss of leg function
- DKA episodes requiring hospitalization
- Frequent infections that are hard to clear
- Blindness along with other disabilities
- Incontinence from high urine output
- Doesn‘t seem "like themselves" anymore
Choosing to end a pet‘s suffering is the ultimate act of love, even though it breaks our hearts to say goodbye. There is no shame in putting your cherished companion‘s needs before your own.
If you make the difficult choice to euthanize, think of it not as "giving up" but as giving your dog the most peaceful, dignified passing. Surround them with love and let them drift off embraced by the person who fought the hardest for them.
Honoring Your Bond
Caring for a diabetic dog is not an easy road, but it is a journey undertaken with great love. Even when their earthly days come to an end, the extraordinary bond you shared will live on forever.
Find special ways to memorialize your sweet dog. Plant a tree in their honor. Have a beautiful piece of art made with their ashes. Donate to diabetes research or a fund that helps owners afford diabetic pet care. Celebrate their life by sharing stories and photos. They may be gone from sight, but never from your heart.
To every owner doing their absolute best for their diabetic dog: you are seen, you are validated, you are not alone. The sleepless nights, the endless injections, the joy of a good glucose reading, the ache of a bad day, the sacrifice, the bottomless well of love you pour into your dog – it all matters. Your dog is so deeply loved. You are a wonderful caregiver and advocate for your sweet pup. Even when the journey is over, you will never regret fighting this battle by their side.
