How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. B. Your Own Question

Dr. B.
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 6518
Experience:  General practice veterinary surgeon with extensive experience in a wide range of species.
60269376
Type Your Veterinary Question Here...
Dr. B. is online now
A new question is answered every 9 seconds

My Westie was diagnosed with diabetes mellitus 3 months ago.

Resolved Question:

My Westie was diagnosed with diabetes mellitus 3 months ago. He has daily insulin injections, he drinks and eats more than he has ever done. He is still losing weight at an alarming rate. I would be grateful for your advice. He has regular appointments with our local vet.
Submitted: 11 months ago.
Category: Veterinary
Expert:  Dr. B. replied 11 months ago.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

 

Can you tell me if he has any blood work since becoming a diabetic?

If so, was it a blood glucose curve (where he stays in the hospital for blood sugar checks every few hours)?

Or did he have a fructosamine tested (where the sample tests for a different type of sugar and gives a idea of his control over the past fortnight)?

What were the results?

Was his insulin dose changed?

 

Have any other general bloods (ie kidney, liver, adrenal gland function) been checked either at diagnosis or since?

Any other testing?

 


Customer: replied 11 months ago.

Yes he has had blood glucose curve carried out twice. The results were "high" and his insulin dosage was increased. No other testing as far as I know.


 

Customer: replied 11 months ago.

I now give him 2 injections of insulin a day, 12 hours apart. He has had 2 glucose curve tests and his insulin was increased. I do not know of any other testing.

Customer: replied 11 months ago.

He has had 2 glucose curve tests. His unsulin was increased. I do niot know of any other testing.

Expert:  Dr. B. replied 11 months ago.
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.

If you need any additional information, do not hesitate to ask!

Dr. B.

-----------------------------------------------------------------------------------------------------------------

Remember that if you have any lingering questions or concerns, please reply so that we may continue our conversation. I will be happy to work with your further and do everything I can to provide you with the service you seek. Please remember to rate my answer when you are satisfied so that I may receive credit for my assistance. Thank you & have a great day. : )
Dr. B., Board Certified Veterinarian
Category: Veterinary
Satisfied Customers: 6518
Experience: General practice veterinary surgeon with extensive experience in a wide range of species.
Dr. B. and other Veterinary Specialists are ready to help you
Expert:  Dr. B. replied 11 months ago.
Hi Anne,

I'm just following up on our conversation about your pet. How is everything going?

Dr. B.

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
< Last | Next >
  • It was so professional, so personally concerned (as we were) and you answered all of our questions. George and I are so happy that I found "JustAnswer" on my Google search -- you are now in my "Favorites" list! And, yes we do love our kitty - she makes our life complete! Bev & George Boca Raton, FL
  • Wonderful service, prompt, efficient, and accurate. Couldn't have asked for more. I cannot thank you enough for your help. Mary C. Freshfield, Liverpool, UK
  • This expert is wonderful. They truly know what they are talking about, and they actually care about you. They really helped put my nerves at ease. Thank you so much!!!! Alex Los Angeles, CA
  • Thank you for all your help. It is nice to know that this service is here for people like myself, who need answers fast and are not sure who to consult. GP Hesperia, CA
  • I couldn't be more satisfied! This is the site I will always come to when I need a second opinion. Justin Kernersville, NC
  • Just let me say that this encounter has been entirely professional and most helpful. I liked that I could ask additional questions and get answered in a very short turn around. Esther Woodstock, NY
  • Thank you so much for taking your time and knowledge to support my concerns. Not only did you answer my questions, you even took it a step further with replying with more pertinent information I needed to know. Robin Elkton, Maryland
 
 
 

Meet The Experts:

 
 
 
  • Dr. Andy

    Medical Director

    Satisfied Customers:

    2630
    UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
< Last | Next >
  • http://ww2.justanswer.com/uploads/VE/vetforyou/2012-6-20_33122_PearlPhoto.64x64.jpg Dr. Andy's Avatar

    Dr. Andy

    Medical Director

    Satisfied Customers:

    2630
    UC Davis graduate, Interests: Dermatology, Internal Medicine, Pain Management
  • http://ww2.justanswer.com/uploads/1I/1ISUDVM/2011-3-1_22028_Honeymoon2005075294928803490646858.64x64.jpg Dr. Bruce's Avatar

    Dr. Bruce

    Veterinarian

    Satisfied Customers:

    1656
    12 years of small animal veterinary medicine
  • http://ww2.justanswer.com/uploads/RY/rydergar/2012-6-6_192240_IMG0328.64x64.JPG Dr. Gary's Avatar

    Dr. Gary

    Veterinarian

    Satisfied Customers:

    1451
    DVM, Emergency Veterinarian, BS (Physiology)
  • http://ww2.justanswer.com/uploads/PC/pcbobber/photo.64x64.JPG Dr. Bob's Avatar

    Dr. Bob

    Veterinarian

    Satisfied Customers:

    1306
    35 years in practice
  • http://ww2.justanswer.com/uploads/doggfone1/2009-07-16_133633_vet_pic.jpg Dr. Scott's Avatar

    Dr. Scott

    Veterinarian

    Satisfied Customers:

    865
    12 years of small animal, equine and pocket pet experience in medicine and surgery.
  • http://ww2.justanswer.com/uploads/AN/andrewDVM/2012-4-27_12585_iStock000011751407XSmall.64x64.jpg Dr. Drew's Avatar

    Dr. Drew

    Veterinarian

    Satisfied Customers:

    1889
    Small Animal Medicine and Surgery
  • /img/icons/shirt.jpg Dr. Jenn's Avatar

    Dr. Jenn

    Veterinarian

    Satisfied Customers:

    1225
    Practicing small animal medicine since 2004 , also involved in working with animal rescue groups.