ACCREDITED CPD
Glucose curves have limitations
• Curves on sequential days are rarely the same.
There are lots of variables - the food, exercise, hormone levels...
• Time to nadir can vary from day to day in THE
SAME ANIMAL
°°
NB Don’t try to save money and cherry pick
what times you want to sample. A lot can
happen in a 3-4 hr gap and you could be
missing a very low nadir. Several studies have
shown that glucose curves and the timing
of the nadir will vary from day to day in the
same dog/cat, even when they are stable. So
you cannot assume that a dog that had its
nadir at 11 am on a previous curve will do the
same again tomorrow even with a very good
owner who sticks to EXACTLY the same
feeding and exercise regime.
°°
The only thing a random blood glucose is
useful for is to confirm that a hypoglycaemic
event is currently happening.
Stress plays havoc with curves – so try and have the
clients do them at home
• Only start a curve after the animal has been stable
and nothing has changed in the management for
5-7 days
• It is important to only change the dose if your glucose curve agrees with the clinical signs and history. If not, try another curve
Problem cases
These are usually animals whose clinical signs persist
despite high insulin doses (> 2 IU/kg/dose), animals
who have repeated unexplained hypoglycaemic episodes or animals whose insulin requirements appear
to fluctuate. To solve these, consider the following
steps:
Visit 1: (a long consultation!)
Status quo: client should have a diary and should be
recording. Look at diary and determine trends
Food: take a careful history to determine how closely
client is sticking to the prescribed schedule. Ask about
treats, rewards, what happens during braai’s and parties, how are they coping with small kids dropping
food, how are they pilling dog. The carbohydrate
load may be important esp in cats: amount of carbohydrate in diet as well as the glycaemic index of the
source.
Insulin storage and administration
Storage: in fridge, not next to the freezer compartment, in the \