Other health problems, ageing and end of life in diabetic dogs

When diabetes isn't the only worry

Once the insulin routine settles, other worries often turn up: the thirst, weight loss, cloudy eyes, or whether he can still have his flea treatment.

I'm an owner, not a vet, and nothing here replaces your vet. His insulin amount comes only from your vet's written plan.

One thing comes before everything else. If your diabetic dog is weak, wobbly, trembling, spaced out, vomiting, collapsing, having a seizure or won't eat, this is an emergency. Open the emergency page and contact your vet or an emergency clinic straight away. Our page on when a diabetic dog needs a vet the same day lists the signs to act on now, what to say on the phone and what can wait for an ordinary appointment.

If you're right at the start, read Starting out with a diabetic dog first.

Everyday life with a diabetic dog: notes, mealtimes and time alone

A short daily note is the single most useful thing you can bring to the vet. Our page on what to write in a notebook for a diabetic dog keeps it to a few lines a day: what he ate, including treats, how he seemed and the time of his injection. Add one more line only if something mattered, like a reading, a walk, vomit or a question. Take the last week to each visit. The seven-day log is a printable way to do it.

If you have other pets, mealtimes can get chaotic. Feeding a diabetic dog alongside other pets works best when you feed him separately and watch him eat, so you know what actually went in. You don't need to put every pet on his food. If he steals food or leaves his meal around insulin time, call the vet rather than trying to even it out yourself.

Many owners worry about work. Whether you can leave a diabetic dog alone while you work depends on how settled his diabetes is, the care plan and how long you're out. Take your real timetable to the vet. A camera can't step in if he gets ill, so have a backup person who has been shown how to care for him and can actually come over.

If your dog lives outdoors or on the terrace, it's harder to notice changes in drinking, peeing or a low. Most vets suggest diabetic dogs live indoors where possible. Even bringing him in at night or in the hottest hours helps you watch him, and keep a big bowl of clean water in the shade.

Big changes at home can unsettle any dog. Fireworks, guests or a house move can affect appetite and glucose, so keep meals, insulin times and walks as normal as you can and give him a quiet room. Shaking from fear can look like shaking from a low, so watch for weakness, wobbling or confusion too. Don't give calming tablets or human medicine without asking your vet, and if he won't eat at insulin time, call your vet before the injection.

Drinking a lot, accidents and urine infections

A bowl that's always empty is often the first thing that worries owners. With Cooper, the extra drinking and peeing were what I noticed before he was diagnosed. Our page on why a diabetic dog drinks so much explains that it usually eases once the diabetes is better controlled, but kidney disease or Cushing's, a hormone condition, can cause it too. Write down how often you fill his bowl, and if it's new, book a visit.

Please never cut back his water to stop accidents or get through the night. The thirst is part of the illness, and an empty bowl only hides the sign your vet needs to see. If he can't keep water down or seems weak, call the vet soon.

New accidents aren't naughtiness. Extra thirst can cause them, but so can a urine infection in a diabetic dog. Straining, blood, a new smell or peeing that looks painful all mean a vet visit. Sometimes the only clue is that his glucose, which had been steady, isn't any more. Don't give him tablets left over from last time, and if he's also vomiting, flat or not eating, call your vet the same day.

Weight: losing it, gaining it and measuring meals

Weight is one of the clearest signs of how diabetes is going. If your diabetic dog is losing weight, it helps to know that weight loss is often one of the first signs of diabetes, and many dogs put some back on once treatment settles. If he keeps losing, see your vet. Don't just feed him more: any change to his amount should come from your vet.

The opposite worry is just as common. If your diabetic dog needs to lose weight, losing extra weight does help, but a crash diet is a big food change for a diabetic dog. Your vet can work out how much he should eat and how to split his meals. Until then, keep his walks the same as usual and be honest about treats and who else feeds him.

Either way, the food has to be the same every day. Measuring a diabetic dog's meals with a kitchen scale, or the same cup every time, is one of the easiest ways to keep his glucose steady. If the bag or his weight changes, don't work out a new amount yourself. Ask your vet, then write it down on the food checklist. For the bigger picture on food, see Feeding a diabetic dog: food and routine.

Big dogs are hard to weigh. Our page on how to weigh a big dog at home suggests weighing yourself, then again holding him if you can lift him safely, or asking the clinic to weigh him when you pass. Use the same scale each time, and feel his ribs and look at his waist from above between weigh-ins. The weight tracker keeps the weigh-ins on one page. If weight loss comes with thirst, vomiting or tiredness, call sooner.

Walks, exercise and busy days out

Many diabetic dogs enjoy their walks again once they start feeling better. Walks for a diabetic dog suit most dogs best when it's the same walk at about the same time each day, because exercise can lower blood sugar. Excitement counts too: playing with another dog in the park is much harder work than a quiet walk on the lead.

A long hike or a trip to the hills can be lovely, but if you're planning a long hike or a busy day out, talk to your vet beforehand about food and insulin, because extra exercise can make his sugar drop. Carry water, his low plan and the vet's number. Build up slowly, rest in the shade, and watch him closely that evening and night, because a low can show up later.

If your dog is weak or wobbly after a walk, this is an emergency. Stop the walk and contact your vet or an emergency clinic straight away, because a hard walk can drop his blood sugar too low. If your vet gave you a written plan for a low, follow it while you get help. Don't finish the walk to see if it passes. If he collapses, go straight in, and see the emergency page.

Hot weather, the rainy season, skin and ears

Hot days are harder on a diabetic dog and on his insulin. The basics of caring for a diabetic dog in hot weather are simple. Keep clean water out, keep both him and the insulin out of the heat, and walk in the cooler hours. Follow the storage instructions for his exact insulin, and if you think it got too hot, ask the pharmacy or your vet, because you can't tell by looking. If he's very distressed, weak, collapses or struggles to breathe, get to a vet urgently.

Wet, humid weeks bring their own trouble. Looking after skin and paws in the rainy season matters because diabetes can make infections more likely, and an infection can make diabetes harder to keep steady. Dry him well after every walk, especially paws, ears and skin folds, and don't put creams or home remedies on sore skin without asking your vet.

If you're seeing skin infections, hair loss or ear yeast in a diabetic dog, diabetes can be part of it, but it doesn't automatically mean his diabetes is out of control. Hair loss can also come from other hormone problems, and the vet may need to take a sample. Don't use old antibiotics or ear drops. A sore ear or sore skin hurts, so get it treated.

Cloudy eyes, cataracts and going blind

Noticing cloudy eyes is upsetting, but if your diabetic dog is going blind from cataracts, you're not alone: cataracts are common in diabetic dogs, especially when the diabetes is hard to control. Most dogs cope well if their sight goes slowly. Tell your vet what he can't do any more. Whether cataract surgery is right is a decision for a veterinary eye specialist, and diabetes or age alone don't settle it. Be honest with them about whether you can manage the aftercare.

Not every eye change is a cataract. Red, painful, dry or cloudy eyes can have other causes, and pain isn't something to wait out. If he's squinting, rubbing the eye or his sight changes suddenly, call your vet the same day. Don't use old eye drops from the cupboard unless the vet says they're right.

When you're scared of him losing his sight, any product that promises to help is tempting. On whether eye drops or supplements prevent cataracts, most vets wouldn't rely on them. Some drops treat inflammation but don't clear a cataract. Ask an eye vet whether the exact product has real evidence behind it, and never put human drops in his eyes.

If he does lose his sight, most blind dogs learn their home again. Keeping a blind diabetic dog safe at home means keeping the furniture where it is, talking to him before you touch him, blocking stairs he might miss and keeping his water in one spot. Walk him on a lead on a route he knows. Some owners use a word as a cue for a step and another for his bowl.

Diarrhoea, stomach upsets and pancreatitis

An upset stomach is more worrying when your dog needs insulin with his meals. If your diabetic dog has diarrhoea or an upset stomach and it's putting him off his food, call your vet today. If he's vomiting, weak, refusing food or can't keep water down, call right away. Insulin lowers blood sugar, so his food and insulin need to be planned together, and the insulin decision belongs to your vet. Don't try fasting him or giving human stomach medicine.

Pancreatitis means an inflamed pancreas, the same organ that makes insulin, and a lot of diabetic dogs have had it at some point. Our page on food after pancreatitis in a diabetic dog explains that many vets use a very low-fat diet, which can matter more than the diabetes diet, and your vet will work out which comes first. Keep fatty extras out of his reach, and don't make a low-fat meal at home without asking. If he's vomiting, in pain or refusing food, call your vet the same day.

When your diabetic dog has another illness

A second diagnosis can feel like a lot, but your vet treats both conditions together, as one plan. Take his full medicine list and your daily notes to every visit, and never change either treatment without your vet.

With diabetes and Cushing's in a dog, the body makes too much cortisol, which can make insulin work less well. Extra thirst alone won't tell you which one is acting up, and one bad day doesn't automatically mean the Cushing's is worse. With diabetes and an underactive thyroid, some signs overlap with other illnesses, so ask how it was confirmed and how the vet will check the treatment is working. If he suddenly becomes very weak or unusually sleepy, call the vet rather than waiting for the next check-up.

Test results can be frightening on paper. Kidney problems or protein in the urine don't automatically mean kidney failure, and high liver enzymes in a diabetic dog don't mean liver failure on their own, because diabetes can raise some of them too. Ask what's confirmed and which tests need repeating, and don't change his food or start a liver supplement before the vet has explained it. Keep his water bowl full unless your vet tells you otherwise.

An insulinoma is easy to mix up with diabetes, but it's close to the opposite: a tumour that releases insulin and can cause dangerously low blood sugar. If your dog is weak, collapses or has a seizure, call your vet or an emergency clinic straight away. Never starve your dog at home to try to bring on an episode for a test.

When your diabetic dog also has cancer or another serious illness, his plan has to fit the whole dog. Ask the vets who is in charge and which problem comes first, and put all the food, medicines and check-ups on one list so they can sort out where instructions clash. You can ask about comfort care and pet-loss support well before any final decision.

Other medicines, vaccines, flea treatments and surgery

Some medicines, steroids among them, can affect how well insulin works. That's the worry behind whether steroids or other medicines affect a dog's diabetes, but it doesn't mean you should stop a prescribed medicine yourself. Give your vet a full list, including creams, eye drops and supplements, and make sure every vet who prescribes for him knows he has diabetes. If he gets weak, vomits or won't eat, call your vet soon.

If he's stiff and sore, pain and arthritis medicines for a diabetic dog need your vet to check the exact medicine or supplement against everything else he takes. Never give human painkillers or leftover pet medicine. The same goes for an itchy dog: whether allergy medicines suit a diabetic dog depends on the exact medicine, why he needs it and what else he's on. Don't use another dog's prescription or stop a medicine without asking.

Diabetes isn't a reason to stop routine care on your own. Ask your vet which flea, tick and heartworm products are safe for a diabetic dog, taking the exact pack with you and mentioning any past reactions. Most diabetic dogs should still be vaccinated. Take his vaccine card and written plan, and tell the vet beforehand if he's unwell or his readings have been unsettled.

If he needs an operation, surgery, dental cleaning and anaesthesia for a diabetic dog need his own plan covering food, insulin, checks and recovery. Don't just follow the usual no-food-the-night-before advice. Get written instructions for dropping him off and bringing him home, including who to call if he won't eat afterwards. A painful tooth needs treating too, so try not to keep putting it off because you're scared. The questions for the vet sheet helps you remember what to ask.

Behaviour changes, weak back legs and signs that can't wait

It's unsettling when your dog suddenly acts differently. If your diabetic dog's behaviour has changed, it isn't always just the diabetes: strange behaviour, weakness or unusual sleepiness can be signs of low blood sugar, and pain or other illness can change behaviour too. Describe what he's actually doing rather than calling it naughty, and don't punish him. If he is confused, wobbly, has collapsed or is having a seizure, get urgent help now.

Weak back legs or neuropathy aren't always caused by diabetes. Neuropathy means nerve damage, and it's more common in diabetic cats than dogs. Sudden weakness can be an emergency, especially after an insulin injection. If he's wobbly, trembling, can't stand or has a seizure, call your vet or an emergency clinic now. Don't make a struggling dog walk just to film it.

If you're ever unsure whether to wait, go back to when a diabetic dog needs a vet the same day. A dog who just looks very tired can still be in trouble, and ketones on a urine strip, a sign his body is burning fat for fuel, mean a same-day call too. If you can't wake him properly, go now. Our guide When the day goes wrong: urgent help and the emergency page cover what to do next.

Senior dogs and quality of life

It's natural to wonder whether treatment is fair on an older dog. On whether it's worth treating diabetes in an older dog, age on its own doesn't decide it. Ask your vet what can be treated, whether he's likely to feel better and what daily care will involve for both of you. You can ask whether trying treatment for a while and then reviewing it is an option, and you don't have to decide everything while you're still in shock.

Can a diabetic dog still have a good quality of life? Yes, most can, and you'll judge that best by watching your own dog. Look at his comfort, appetite, sleep, how he moves and whether he still cares about his favourite things. Write down the small good things, like waiting at the door or getting excited about a walk, next to the hard days. A sugar reading on its own doesn't tell you how his day went.

If he seems more distressed, ask your vet for a review rather than accepting it as part of diabetes. You know your dog best, so trust what you see. If this is all weighing on you, feeling overwhelmed is common, and it does tend to get easier.

When care gets too hard, comfort care and saying goodbye

If you're exhausted and wondering how long you can keep this up, you're not a bad owner. Many people reach this point. Our page on what to do if you can no longer manage your dog's care suggests telling your vet honestly what you can't keep doing, whether it's the lost sleep, the fear or the physical work, and asking what help or simpler options there are. A good vet will think about both of you. You don't have to work it out alone.

When your dog is near the end, palliative or comfort care for a diabetic dog is about keeping him comfortable for the time he has left, and it should still be planned with your vet. It doesn't mean just stopping his insulin at home. Ask what can ease pain, sickness, thirst or distress, agree when you'll review the plan, and ask who to call in a crisis. These conversations are easier to have early than in an emergency.

Knowing when it's time to say goodbye is one of the hardest questions you'll face, and no single reading or age can answer it for you. Watch the ordinary parts of his day: resting comfortably, eating willingly, getting to his favourite spot and responding to you. Ask your vet whether he is suffering and what can still be eased. You can have this talk before there's a crisis, and talking about it doesn't mean you've decided anything.

Ask about comfort care, euthanasia if his suffering can't be eased, and support for afterwards. You shouldn't have to deal with the planning and the grief on your own.

After your diabetic dog has died

I'm so sorry if you're here because your dog has died. If you're asking whether you did something wrong after your diabetic dog died, going over the last meal, the last injection or the last decision again and again is very common when you're grieving, but it rarely tells you what happened.

If you want answers, ask your vet to go through the records with you, and to write down what they know and what they're not sure about. You deserve a clear explanation, and it can help to have someone sit with you through that conversation.

Pet-loss support can help with the guilt as well as the sadness. You don't have to decide anything yet, whether that's another dog, clearing away his things or how soon you should feel better.