"My dog has diabetes? What do I do?" For the last 24 years, I've heard dog owners ask these questions, often with great anxiety.
As veterinarians, we're well trained in diagnosing and treating disease but not so in handling anxious—and at times overly
concerned—clients. In the case of a chronic disease such as canine diabetes, we have to do an excellent job of handling clients'
concerns, or it may be the owners' misperceptions about canine diabetes rather than the diabetes itself that results in the
loss of a patient. Anything we can do to decrease owners' anxieties about the diagnosis of diabetes will likely contribute
more to the long-term management of their dogs' disease than any discussion of the disease itself. I've developed a trouble-shooting
top 10 list to help us assure owners of newly diagnosed dogs that it's going to be OK.
Top 10 client concerns
10. "But according to Uncle Billy Bob's Diabetic Pet website...."
The Internet should be like cable TV, but instead of parental controls, you should turn on veterinary controls. Not all websites
are the best sources of information. Assemble a list of websites that you and your staff approve of and provide that to clients.
A good website explains diabetes, discusses its clinical signs, explains how it's diagnosed and monitored, and reviews injection
techniques. Many good websites originate from owners of diabetic dogs. See Helpful websites for my recommendations.
9. "I can't give my dog an injection! Isn't a pill easier?"
In general, no, it's not easier. While some owners are great at giving oral medications, most aren't and struggle with compliance.
Many owners, after attempting to give pills at home, ask to switch to injections. There's also no question that insulin is
the preferred treatment for diabetes in conjunction with dietary management. Oral medications used to treat diabetes are not
as effective at controlling diabetic clinical signs as insulin injections are. You can teach clients how to give injections
with minimal stress for both themselves and their dogs.
8. "The food costs how much?"
We should recommend the best diets available that have data to support their use for diabetic management. Evidence shows that
in dogs high-fiber diets can help control diabetes; however, many commercially available high-fiber diets require a prescription
or need to be purchased through veterinary clinics. This means they cost more than the average diet. I recommend high-fiber
diets for diabetic dogs but recognize that owners may not be willing to spend the money.
Owners may say, "Sure doctor, I'll feed my dog any diet that you recommend." But that's not always true—food can be an uphill
battle. As a fall-back position, try to have owners agree not to feed semi-moist foods (any diet in a foil pouch), which can
result in postprandial hyperglycemia, and to continue their dogs' current diets and feeding schedules. Then the only variable
we need to manage is the insulin dose.