Case 1

It is important to note that before we decide to increase Felicia’s insulin dose, we should make sure there are no problems with insulin administration. Are the owners giving the insulin properly? Are they handling and storing the insulin the right way? These factors can make it look like your patient isn’t regulated when in fact it is just a matter of owner education.

In Felicia’s case, there are no owner issues so you increase her insulin dose to 3 U twice daily.

Two weeks later she comes back for her recheck exam, and the owner is effusive in her praise for your veterinary skills! Felicia is acting like her old self again; she is eating normally and has gained a little weight.

This is her latest glucose curve:

Based on her glucose curve you know that Felicia’s nadir is about 150 mg/dl which is not too low. The curve also tells us that the insulin duration of action is appropriate. This information, coupled with the improvement in her clinical signs, means she is currently well-regulated. Good job!

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