How do you control diabetes? Education and follow-up (Sponsored by Abbott Animal Health)

Dogs and cats with diabetes can be managed to reduce clinical signs for years after their diabetes diagnosis, but it takes a committed owner to achieve these results.

"Technicians play a major role in the education, the success of the treatment plan, and the continued support and maintenance of the pet's diabetes," says Julie Legred, CVT, president-elect of the National Association of Veterinary Technicians of America (NAVTA) and a veterinary technician career specialist for Banfield, The Pet Hospital, headquartered in Portland, Ore.

When a pet is first diagnosed with diabetes, owners have many concerns. And those worries can turn to outright panic when they find out they need to give daily insulin injections and take blood for home glucose monitoring.

Yet people with diabetes learn to check their blood sugars several times a day and to give themselves insulin injections if needed. Because there are an estimated 23.6 million people with diabetes in the United States, veterinary clients are likely to know someone with diabetes. So they understand the disease and can relate to the care their pets need.

"Use this to your advantage when explaining canine or feline diabetes," suggests David S. Bruyette, DVM, DACVIM, medical director at VCA West Los Angeles Animal Hospital in Los Angeles.

Once the veterinarian diagnoses the disease and explains it to clients, technicians should reinforce the importance of diet, exercise, and weight loss and explain what needs to be done at home. Then they need to teach owners how to take a blood sample to monitor blood sugars and demonstrate how to give the insulin injection.

It is important to address the client's fears and make the client part of the management team, says Heather Lynch, LVT, Tatum Point Animal Hospital in Phoenix.

Frequent follow-up phone calls are integral to this approach, adds Catherine Holly, CVT, secretary of NAVTA, president of Rhode Island Veterinary Technician Association, and a veterinary technician at Atlantic Animal Hospital, Charlestown, R.I.

"We have to make sure everyone knows what is going on and everyone is on the same page," Holly says. "You can teach the most skittish of the skittish how to give injections and take blood samples."

The experts offer these suggestions to manage diabetic patients:

• Be positive and confident but realistic.

• Set achievable treatment plans and goals.

• Have clients bring pets in for periodic weight checks if a pet is placed on a diet.

• Make sure owners understand the serious conditions that can occur if the diabetes is not properly managed.

• Emphasize the importance of a routine. For example, feeding, giving insulin, and exercising the pet should occur around the same time every day.

• Provide client education materials the entire team has read.

• Create a standard home-monitoring discharge protocol for technicians to follow.

• Make sure the technicians are comfortable with blood collection before they show the owners how to do it. Sara Ford, DVM, DACVIM, chief of internal medicine at the VCA Emergency Animal Hospital and Referral Center in San Diego, suggests technicians take the animal in the back and take blood from several areas to find the best site before showing the owner how to take a blood sample. "Some animals' ears and lips bleed easily, and you don't want a gusher in the room that will scare the owner," she says.

• Talk about costs. "Even the most committed client can be worried about the cost of diabetes treatment and management," says Dr. Bruyette. Emphasize the fact that proper management should result in fewer clinic visits and costly complications.

• Plan for ongoing support, including information seminars, follow-up phone calls, and office visits.

• Remind owners to call you if they have any questions or concerns or see any signs of a crisis.

• Don't be judgmental. Be prepared to help find a new home for a pet if the owner cannot manage the animal's health.

"Technicians should let pet owners know they are there to talk with, confide in, and help them," says Legred. "Make them understand that diabetes is a treatable disease, and their pets can live normal lives if they comply with treatment and care every day."