You can use the ideas and questions below or modify them to better fit your pet's situation. Discussing these issues with your vet may help you be prepared to deal with an emergency and be able to decide what to do when things don't go as planned.  And believe me, there will be days when things don't go as planned!

Vets are very busy professionals, but most of the vets I have taken my pets to are happy to take the time to discuss things, explain terms, and answer questions. They realize that you must understand things in order to take care of your pet. But you have to be prepared for your appointment. Before your next appointment, think about the things you want to discuss. Write them on a piece of paper and leave space to take notes - similar to how this page is formatted. This will help you organize your thoughts and will help you and the vet get the most out of your visit. As the vet explains things, take notes.  If you forget something or think of other questions later, call and ask the vet to call you back when he has some free time.  Make sure you've scheduled plenty of time with the vet to discuss the items that interest you. 

General questions about your vet's practice

• How much experience does the vet have treating diabetic pets? If the vet has little or no experience, that may be fine.  But if you are not comfortable with that situation, you might want to consider asking for a referral to a vet who has more experience. Maybe there's another vet in the same practice that can be part of the diabetes management team. Or maybe there is a another vet in town who has a lot of experience treating diabetic pets. You may want to ask specifically about cats or dogs. There are some differences in managing diabetes in cats and dogs, and there are differences in the other effects of diabetes. You have to choose the vet who you think will be best able to help your pet.

• Do you consult with a specialist or other vets when you're not sure about a patient's case?. Is there a specialist nearby that you refer clients to if there are complications managing the diabetes? Particularly for dogs, who is the eye vet specialist your vet refers to (dogs are prone to developing diabetic cataracts and may need to be evaluated by a specialist).

• What are your regular office hours?

• Does the vet have an emergency number you can call?  What is it?

• What do I do if there is an off-hours emergency (nights and  weekends)?

• Who or what clinic does the vet refer to during off hours or when the vet is on vacation?  Get the name, address, and phone number of the clinic.

• Good communication is absolutely essential. If you don't understand the vet's instructions, or if you don't understand some of the technical words the vet might use, there may be misunderstandings that effect your pet's health. It is very important for you to ask the vet to explain things so you understand everything. Will your vet have a reasonable amount of time to discuss things with you or get back to you with an answer if you call with a question?

• Your vet's general style is also important.  You both have to be on the same team, with a common goal to do what is best for your pet. If you think a different approach may be better for your pet, you may be reluctant to follow the vet's instructions - and that may lead to serious problems for your pet.  For example, if you want to treat the diabetes very aggressively and think home blood glucose monitoring is a good method for managing your pet's diabetes, you need a vet who will support home bg testing and help you interpret the results.  Style is a tough one, but you can usually work out your differences or find a vet that you feel more comfortable with. You may want to ask your vet if he or she has a pretty set method of care of if he is open to trying different treatment methods.

General questions about diabetes

• How will the diabetes and insulin interact with other conditions my pet has or with other medications my pet is taking? Remember to tell your vet if you are giving your pet any dietary supplements or herbal preparations.

• What other health problems should I watch for? Examples: cataracts for dogs, hind leg weakness for cats, signs of infections? 

At home recordkeeping and monitoring

• What kind of records should I keep to help you to evaluate my pet's condition?  Most owners keep a calendar or chart noting the insulin dose, time of injection, notes about eating, home urine testing or bg testing results, and other observations like vomiting, diarrhea, lethargy. Here are some samples of home care notebook pages.

• How should I monitor my pet's condition at home?  For example, measuring water consumption, watching for excessive thirst, urination, hunger, weight loss or gain, lethargy (lazy or sleepy), urine glucose or ketone monitoring results, home blood glucose monitoring results.

Beginning treatment or insulin therapy

• If the vet wants to try to manage the diabetes using a prescribed diet or oral drugs, how long will the vet use this approach if it doesn't seem to be working? This question is more appropriate to diabetic cats.

• Vets have preferences about which insulin they try first.  Sometimes this is based on what the literature lists as the "first choice" insulin, and sometimes it is based on the vet's personal experiences. Ask why that insulin was chosen.  Ask how long you will stay with that insulin if it doesn't seem to be working. There are many different insulins available, and sometimes it takes a few tries before finding the one that works best for your pet.

• How frequently will the vet want to monitor your pet's condition?  Weekly, every other week, once a month?

• What information will the vet use to determine how well your pet's diabetes is controlled? Your daily observations, blood glucose curves done at the vets?

• Will the vet perform blood glucose curves (testing the blood glucose every hour or two for a full day)?  How often will this be done?

• After your pet's diabetes is better controlled, how frequently will the vet monitor your pet's condition? Monthly, every 3-4 months? And what information will be used (bg curve, general health check, fructosamine test).

• Can you give me some idea of the expenses involved for testing, checkups, etc. 

Injection schedule

• How important is it for me to give the insulin injection at a certain time?

• How many minutes or hours late can I give the shot and not have to adjust the dose?

• If I am later than that (the answer to the previous question) what do I do?
  Do I skip this shot or do I give less insulin (how much less)?
  Do I give the next shot at the regular time?

• What do I do if I think I missed a shot or gave an incomplete shot but I'm not sure? Do I give another shot?

Insulin and Feeding

• What should I do if my pet vomits his meal after I've already given the insulin injection?

• How much insulin should I give if my pet refuses to eat?

• How much insulin should I give if my pet only eats part of his meal?

• I fed my pet, but forgot to give the insulin shot.  What do I do?

• I found my pet eating extra food, candy, or garbage.  What should I do? 
  Do I give extra insulin?

• My pet looked sick last night and this morning she just doesn't look "right". Do I give the usual amount of insulin?

• My cat is throwing up hairballs (and food).  Do I give the usual amount of insulin?

Hypoglycemia

• Be sure your vet explains hypoglycemia (low blood sugar) and how serious it is.
• Be sure you know how to treat hypoglycemia - and try not to panic. You must stay calm in order to help your pet.
• Always have corn syrup (Karo) or another sugar source available (pancake syrup, honey)
• Be aware that many pets do not show any signs of hypoglycemia, even when their blood glucose is very low.

• What are the physical signs of hypoglycemia? What might my pet do when she is hypoglycemic?

• How do I treat hypoglycemia based on behavioral observations.

• My pet looks sleepy and is lethargic. What should I do?  
  Do I give food or Karo?   How much?

 

• My pet is stumbling, has wobbly legs, is whining or meowing strangely. What do I do?

 

• My pet is having a seizure, or my pet is unconscious. What do I do?

 

• How do I treat hypoglycemia based on home blood glucose monitoring results.

• The bg is 50 and I think it may go lower.
  Do I give food, or Karo?   How much?

 

• The bg is 50, but I think it will go higher soon.  What do I do?

 

• The bg is under 50, what do I do?

 

• For all these hypoglycemia situations: when do I call the vet, or when do I immediately take my pet to the vet or emergency clinic?

Miscellaneous Questions

• What do I do if I can smell a strange chemical smell on my pet's breath? This is a sign of ketoacidosis and is potentially life threatening.

• Can my pet keep up with his or her usual physical activities (walks, running, swimming, hiking)?

• Other notes

http://www.petdiabetes.org
Updated June 2002
Copyright. All rights reserved.
This site is for information purposes only.  Please consult your veterinarian.