If your dog needs insulin, he or she most likely has Type 1 diabetes. Managing a diabetic dog comes with a steep learning curve that includes monitoring their blood sugar and giving them life-saving insulin. In almost all cases, once your dog needs insulin, he requires it every day for life. This can feel overwhelming for many dog parents.

With the right knowledge, a little practice and a good veterinarian, you can manage your dog’s diabetes like a pro! Your veterinarian may recommend changes to diet, exercise and environment, but insulin is critical for diabetic dogs. Feeling confident with insulin — including how and when to give it — as well as what type of insulin you may use, is the first place to start.

Why does your dog need insulin and how does it work?

Insulin is a hormone produced by your dog’s pancreas. This hormone helps regulate the glucose in the bloodstream. Without insulin, the sugar in your dog’s blood builds up to a dangerously high level. This can result in life-threatening electrolyte imbalances and one very sick dog.

Dogs that are diabetic usually suffer from Type 1 diabetes. This means that the cells in their pancreas that make insulin have stopped working. Type 1 diabetes can be caused by many factors, including:

• chronic pancreatitis
• some autoimmune disorders
• obesity
• Cushing’s Disease

Unfortunately, Type 1 diabetes in dogs cannot be healed and how to treat it requires daily insulin for life.

How do I get started with insulin for my dog?

The most labor-intensive time in your dog’s journey with diabetes is in the beginning. Your dog may be recovering from a recent crisis of high blood sugar, and determining your dog’s ideal insulin type and dose requires a period of trial and error.

Here are the steps to follow to get your dog’s blood sugar properly regulated.

1. Learn to give insulin to your dog. Your veterinarian will send you home with a bottle of insulin and special insulin syringes to give the insulin. Insulin needles are very small and the insulin is injected right under the dog’s skin. Use the area between your dog’s shoulder blades to give these injections. Pick up the skin to create a tent. Place the needle into your dog by pushing through the tented area of skin. Push the syringe’s plunger to inject the insulin. This might feel scary at first. With a little practice, and once you realize the needles are quite small and are rarely uncomfortable for your pup, administering injections feels much easier.
2. Check your dog’s blood glucose. You may be asked to bring your dog in for blood glucose checks, or you may be sent home with a blood glucose monitor. The ability to check your dog’s blood glucose levels at home with a monitor like the Alphatrak will save you money and visits to the veterinary hospital.

In the beginning, your veterinarian may need to perform a blood glucose curve that requires blood glucose values every two hours. This gives your veterinarian information about your dog’s blood glucose throughout the day and in relation to insulin administration. This can be done in a clinic or at home. The advantages of performing these curves at home include a more comfortable day for your dog and a more accurate reading, as stress caused by a veterinary visit can change blood glucose levels.

1. Learn when to give insulin to your dog. Most insulin types need to be given every 12 hours and are often timed with breakfast and dinner. Insulin should only be given if your dog has eaten their meal first. If your dog wakes up and decides not to eat, that dose of insulin should be skipped. You can also use your at-home blood glucose monitor to decide if it’s appropriate to give your dog’s next dose of insulin. If the glucose values are already normal or low, consider skipping this dose. When in doubt, give your veterinarian a call for further instruction.
2. Keep a dog health journal. This is useful for all parties involved in caring for your dog. Here are the important data points to keep track of during the initial management of your dog’s diabetes.
   1. Weight. Checking this weekly or every other week can be helpful. This can be done at your veterinarian’s office or using a home scale or baby scale if your dog is small enough.
   2. Appetite. Recording your dog’s appetite can be helpful information for your veterinarian. This only needs to be done in the initial stages of managing your dog’s blood sugar.
   3. Thirst/Urination. Increased blood sugar causes your dog to drink and urinate more than usual. When your pup returns to normal drinking and urinating habits, their blood sugar is most likely becoming more regulated.
   4. Blood glucose. If you are monitoring your dog’s blood glucose at home, write it down with the time and date.
   5. Insulin and food administration. Record when and how much insulin you are giving your dog. Keeping track of your dog’s eating habits, including snacks, is also important.

Types of insulin and syringes

Several types of insulin can be used for your dog, and your veterinarian may start with one type and move to another. These vary in cost and in duration of action. They also have different syringe types that they are compatible with.

Insulin syringes are either U-100 or U-40. The U-100 syringes are compatible with insulin that has 100 units per milliliter of insulin. The U-40 syringes are compatible with insulin that has 40 units per milliliter of insulin. Mixing up the syringes could cause your dog to get too little or too much insulin.

Below are common insulins used in dogs and their associated syringe types:

1. Vetsulin. This is compatible with U-40 needles and needs to be given once to twice daily depending on the dog. However, this brand of insulin usually comes in a dosing pen that is easy to use. Be sure to hold the pen under the skin during administration for 5 to 7 seconds to ensure all the insulin is dispensed.
2. ProZinc (PZI). This is also compatible with U-40 needles and requires twice daily dosing.
3. Lantus (glargine). This long-acting insulin is compatible with U-100 needles and is given twice daily.
4. Humulin N (NPH). This insulin is a common choice and is compatible with U-100 needles.

Ultimately the type of insulin you settle with will depend on your veterinarian’s preference, what is available, cost and how your dog responds.

Dangerous side effects of insulin in dogs

The most dangerous effect of insulin is low blood sugar. When your dog is given insulin, their cells are more able to utilize the body’s glucose. If levels of sugar in the blood become too low, your dog gets sick and could die if not treated. If your dog skips a meal, do not give him or her their insulin dose.

Always properly mix insulin before administration. Symptoms of low blood sugar include:

• seizures
• lethargy
• trembling
• fainting
• vomiting

If you suspect your dog has low blood sugar, give corn syrup (ask your vet about how much to give) and seek emergency veterinary care.

Managing Type 1 diabetes may feel intimidating at first. You and your pup will soon be in a rhythm with a new confidence in your daily routine. Surround yourself with a support team that includes a veterinarian you like and trust, pet sitters or a neighbor who can help give your dog’s insulin if you are gone and an online community of other dog parents that are also caring for a diabetic dog. You are your dog’s best medical advocate, and your furry friend is so lucky to have your love and support.