Managing Diabetic Pets

Introduction

• Host: Cassie from Vetfolio
• Guest Speaker: Dr. Catherine Scott Moncrief, Professor of Small Animal Internal Medicine, Purdue University
• Topic: Helping owners care for diabetic pets, focusing on monitoring and treatment plans

Continuous Glucose Monitors

• Primary Tool: Continuous glucose monitor (CGM), commonly the Freestyle Libre
• Versions of Freestyle Libre:
  • Freestyle Libre 14 Day: Validated for dogs and cats, recommended but may be hard to find
  • Libre 2: Similar to 14 Day, differences in Bluetooth compatibility, not as widely validated
  • Libre 3: Newer, smaller, less information available, potential future preference

Placing the Freestyle Libre

• Options for Owners:
  • Prescription for pharmacy pickup
  • Purchase through the veterinary hospital
• Steps to Placement:
  • Prepare skin area (clip and clean)
  • Load sensor into applicator
  • Deploy sensor with careful placement
  • Activate with reader or cell phone (60-minute activation)
• Post-Placement:
  • Ensure sensor is working before sending pet home
  • Protect sensor from removal by pet or other animals

Monitoring and Interpretation

• Data Interpretation:
  • Evaluate clinical signs along with glucose data
  • Key metrics: blood glucose nadir and insulin duration
  • Aim for blood glucose nadir of 80-150 mg/dL, keeping levels below 300 mg/dL
• Challenges:
  • Owners may struggle with initial setup or interpretation
  • Importance of client communication and education

Comparison with Traditional Glucose Curves

• Advantages of CGM:
  • Continuous data collection, sensitive to hypoglycemia
  • More comprehensive view of glucose control
• Considerations:
  • Potential discrepancies between interstitial and blood glucose
  • Sensor errors possible; need familiarity with technology

Ancillary Management Strategies

• Diet and Lifestyle:
  • Low carbohydrate diets for cats, high fiber for dogs
  • Weight control and exercise
  • Consistent feeding routine
• Monitoring for Other Illnesses:
  • Addressing comorbidities like pancreatitis in cats, Cushings in dogs
• Insulin Management:
  • Correct type and dose of insulin critical
• Owner Education:
  • Proper insulin storage and administration

When to Use Freestyle Libre

• Preferred Cases:
  • Newly diagnosed diabetics
  • Unstable diabetics, ketoacidosis under vet care
  • Regular monitoring instead of traditional curves
• When Not to Use:
  • Technology failures or past issues

Case Examples

• Success Stories:
  • Detecting nocturnal hypoglycemia
  • Identifying rapid insulin metabolism
• Cautionary Tales:
  • Owners over-monitoring or misunderstanding data

Conclusion

• Sponsor: Beringer Ingelheim Animal Health
• Safety Note: Proper usage and monitoring of ProZinc insulin
• Resources: Vetfolio for additional veterinary discussions

Key Takeaways

• Continuous glucose monitoring offers advanced insights into diabetic management but requires thorough understanding and communication with pet owners.