Spectrum of Care in Canine Diabetes

Presentation Description / Summary: In the last few years, the number of treatment and monitoring options for canine diabetes has dramatically increased. From new insulin formulations, continuous glucose monitoring (CGM) and non-CGM monitoring options, it is increasingly more complicated to choose the right combination of treatment and monitoring for the specific patient. In this lecture, we will describe the spectrum of care in canine diabetes, from what we consider “optimal” to alternatives that might be appropriate when limitations are encountered (financial limitations, physical and mental limitations, compliance issues, etc.). The key message of this lecture is that treatment and monitoring choices should be tailored to the patient, the owner, and the specific clinical scenario, taking into account potential long-term challenges. We will present what, in our opinion, is the best insulin for dogs but also alternatives that are less costly and in some situations, more appropriate. We will discuss the pros and cons of basal insulin vs. intermediate-acting, and when and why to combine the two. We will describe how the choice of treatment goals depends on the specific treatment and monitoring strategy and how we might modify our goals based on limitations in monitoring. This will include monitoring with clinical signs only, blood and interstitial glucose measurement, fructosamine, and hemoglobin A1c. Throughout, the cost and practicality of each option will be considered.

Learner Outcomes: At the end of this lecture, the audience will be able to: 1. Describe the spectrum of treatment and monitoring options for diabetes in dogs 2. Be able to select a combination of treatment and monitoring options for specific clinical scenarios, taking into account owners financial, physical, and other limitations.