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Diabetes treatment is not simply “high sugar = more insulin.”

The real challenge is finding the right dose for the individual patient—and that can take careful monitoring, patience, and a few adjustments along the way.

This senior dog was presented to AVCI with several findings commonly associated with diabetes mellitus—increased appetite, excessive thirst and urination, progressive loss of muscle mass, and declining body condition.

Diabetes mellitus is not exactly the same in every patient. In people, it is often grouped into Type 1 diabetes, where the body produces little to no insulin, and Type 2 diabetes, where insulin is still produced but the body does not respond to it properly. In veterinary medicine, dogs and cats commonly show different patterns.

Dogs more commonly develop an insulin-dependent form that resembles Type 1 diabetes, meaning they usually require lifelong insulin therapy once diagnosed. Cats more commonly develop a form that resembles Type 2 diabetes, where insulin resistance plays a larger role and, in some cases, remission may be possible with appropriate treatment, weight management, and dietary control.

For this patient, starting insulin was only the first step. The more difficult part was determining a dose that could control persistent hyperglycemia without pushing blood glucose too low.

During monitoring, one blood glucose reading reached 52 mg/dL. This is clinically important because it indicates hypoglycemia and suggests that, at that point in the treatment cycle, the insulin effect was stronger than desired. In diabetic management, “more insulin” is therefore not automatically better.

This is why treatment often requires serial glucose measurements, assessment of clinical signs, body weight monitoring, appetite evaluation, and careful dose adjustments over time. A single glucose value can be useful, but it should always be interpreted together with the patient’s overall response and what the pet parent is observing at home.

The goal is not to make every glucose reading perfectly normal. The goal is to achieve safe and practical glycemic control while avoiding both prolonged hyperglycemia and clinically significant hypoglycemia.

Over several weeks, the AVCI veterinary team worked closely with the pet parent to evaluate the patient’s response and gradually establish a more suitable insulin regimen.

Encouraging improvements followed:

• Less excessive urination and thirst
• Improved body condition
• Progressive weight gain
• Better control of diabetic signs

This case also highlights how important pet-parent participation is. Changes in water intake, urination, appetite, activity, body weight, and behavior can all provide valuable information between veterinary visits.

If your dog is drinking or urinating more than usual, losing weight despite eating well, becoming weak, or has already been diagnosed with diabetes, visit AVCI for proper evaluation and continued diabetic management.

At AVCI, diabetes care is not just about lowering a number on a glucose meter. It is about understanding the individual patient, monitoring trends, and adjusting treatment carefully over time.

Case handled by Dr. Jessica E. Bacalan.