Thank you for the further information.
First, I do want to let you know that this is the stage of diabetic management in our pets that tends to be the most challenging and 'bumpy' for vets, pets, and owners. As I am sure you can appreciate, when stabilizing a diabetic, we have to start our treatment at a low dose and titrate the dose up according to our test findings until we get them to a stable point. (There are no shortcuts to this approach since if we were to give too high a dose, this too could be harmful) Therefore, this gradual stabilization approach does mean that in the early stages, we may find that even with our current treatment he may still show signs of being an uncontrolled diabetic (the elevated thirst, hunger, urination and weight loss) and his blood glucoses can be out of the normal range (as you have noted). But as we continue to work to gently increase the dose (depending on the monitoring findings and clinical signs), we should start to get them stable and the signs to settle.
Now you noted that he has only had 2 glucose curves in the past three months and still was showing 'high' blood sugar readings and showing signs that are consistent with current poor control of his diabetes. This concerns me because if he is not controlled, then these signs are not going to settle and therefore we still need to be working with his vet to get him to the insulin dose his individual body requires. That said, if you find that your wee one is quite stressed by glucose curves, then you could speak to his vet about checking a Fructosamine level. As I noted above, this is a test that can give us an idea of his blood glucose control over the past 2 weeks. This can be useful in these cases to give us an idea of the overall level of his diabetic control.
As well, while I prefer this option for monitoring once my patients are stable, some diabetic pet owners do perform glucose curves (more information
) at home. The nice thing about these is that we get to see what their blood sugar is up to in their natural environment. So, a potential option or at least one to keep in mind once he is more stable.
Depending on the findings of the next curve or fructosamine, I do suspect he will require another increase in his insulin. And this is the protocol we need to continue until we get him to that dose that works for him (some pets stabilize after a few curves/fructosamine tests, but some can be more complicated and take more). So, you have made a start with his treatment but it sounds like his diabetes is not yet stable and therefore these signs are likely related. Therefore, you do want to continue with the management of this condition.
Just to note, I would also suggest that it is worth checking with his vet regarding the initial blood work that was checked to see the state of his other organ. The reason is because we can sometimes see diabetes secondary to other conditions (ie overactive adrenal glands, liver issues, tumors, etc). Now it does sound like very early days for your lad's diabetic management and it is quite likely that you are just seeing these signs due to his being unstable. So, I'd not assume something else was afoot just not. Still, it is something to keep in mind, if down the road you find that his diabetes cannot be controlled and you are really struggling. In those cases, we'd have to consider whether something else was triggering his diabetes or if something else was inducing these signs as well as the diabetes.
Overall, your dog's situation and history thus far, do suggest that he is not yet stable with his diabetic therapy. Therefore, it would be prudent to ring his vet and discuss the next steps here for getting him stable. I'd not be overly worried about other conditions playing a role just now, but if you continue to struggle to stabilize him, then these will need to be ruled out as well. Finally, I do just want to point out a good wee reference for you to learn more about your dog's condition (HERE
I hope this information is helpful.
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. Thank you & have a great day. : )