Clinical management of diabetes mellitus in dogs

This thesis presents important new findings on glycaemic monitoring, and insulin and dietary therapy of dogs with diabetes mellitus, and so provides valuable evidence on which to base treatment recommendations. Improved protocols for sampling blood glucose concentration in dogs are described, including a new method for obtaining capillary blood that has fewer technical problems than existing methods. The serial blood glucose concentration curve that is commonly used for monitoring diabetic dogs is shown to have large day-to-day variability. Pharmacological evaluation of subcutaneous porcine insulin zinc suspension indicates that the majority of diabetic dogs will require twice-daily dosing with this insulin preparation. New information reveals that hyperglycaemia-induced insulin resistance is likely a clinically relevant feature of spontaneous diabetes mellitus in dogs and has important implications for insulin therapy. Traditionally recommended high-fibre, moderate-carbohydrate, moderate-fat diets are shown to not be advantageous for diabetic dogs compared with a commercial, adult maintenance diet with moderate-fibre, ultra low-carbohydrate, and high-fat content. Finally, new evidence is presented that subclinical exocrine pancreatic disease appears to be common in dogs with diabetes mellitus and seems to be associated with hypertriglyceridaemia. These findings are expected to improve the clinical management of diabetes mellitus in dogs