Lab tests positive for diabetes

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My Lab, just shy of 13, has always been pretty healthy. About a month ago, I noticed an enormous increase in her water intake. When it continued, I contacted my vet and bloodwork was done and they noted that she had lost a little weight. I knew about some of the possibilities such as diabetes, kidney disease and Cushing’s. The bloodwork came back and her blood glucose was 498, almost the same as the cat you wrote about before. There were other values that were amiss, such as all of her electrolytes and notably her ALP, whatever that is. My vet said that she has diabetes and that we need to start her on insulin. Can you advise me on costs, quality of life and anything else I should know? My husband is a diabetic so I know he can give the shots if needed. How soon do I need to attend to this and since it has been a month already, should I worry about damage already done?

You have a diagnosis and now it is time to manage your dog’s condition. Diabetes mellitus can be successfully managed for very long periods of time that in no way impact longevity. You are not the first, and won’t be the last pet owner to wait awhile before addressing changes such as water intake. The good news is that waiting until now, and even a bit longer, should not have lasting detrimental effects provided that your dog is otherwise seemingly normal. The costs that you are facing are not excessive and I am sure you will do all that you can for your dog. Your dog’s quality of life should not suffer in any way and the shots are easily done and dogs tolerate them well. Besides, you have an expert at home to deliver the shots!

Normal blood glucose in the dog is 63-114 mg/dl according to the laboratory values that I use. So clearly, the diagnosis of diabetes was easily made. It is not unusual for the electrolytes, sodium, potassium and chloride, to be off as well given the condition and the large water intake and resultant urination. Dogs with diabetes can also present with weight loss as noted. The ALP is alkaline phosphatase and it can be elevated secondary to diabetes. Increased by itself, and absent a blood glucose increase, it can be highly suggestive of another condition that you point out, called Cushing’s.

As for what lies ahead, there are predominantly two kinds of insulin used in dogs, NPH and Vetsulin. Which is chosen really depends on a veterinarian’s personal preference but both are effective. For example, a starting dose of Vetsulin is 0.5 IU/kg of body weight initially once a day and then often reduced and divided to every 12 hours, which is what most dogs end up needing. Followup starting a week or two later involves glucose curves and your veterinarian can help you decide how that can be done at home or in the hospital so proper adjustments can be made to dosing of the insulin. Dietary management will also come into play but all should work out well. Good luck!


Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.

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