Why is my diabetic dog shaking? Low sugar, seizures, dreams and when to call the vet

My diabetic dog is shaking. What do I do?

First, look at whether he's awake or asleep, and say his name.

If he's asleep and twitching, and he stops and wakes up as himself when you call him, it's most likely a dream. Make a note of the time and carry on watching him.

If he's awake and trembling, wobbly, weak, slow to respond, confused or not himself, treat it as a low. Soak a few cotton buds in a syrup your vet has approved and rub them between his cheek and gums, not with your fingers, and never pour liquid into his mouth. Then call your vet now. A small high-carbohydrate meal is only for a dog who is awake, only mildly off and not shaking. Low blood sugar in dogs has every step.

If he's stiff or jerking and doesn't respond to you, it may be a seizure. Keep him away from stairs and furniture edges, keep your hands away from his mouth, and call your vet or an emergency clinic straight away. The emergency page has what to tell them.

If you treated it as a low, he had a seizure, or he still isn't himself, don't give any insulin, extra or usual, until your vet says so. If he woke up as himself, or he stopped once he was warm or the fright had passed, his usual meal and insulin can go ahead. Never give more insulin because he shook.

Shaking can be a sign of low blood sugar

Insulin is there to bring his sugar down. If it goes too far, he may go quiet, walk oddly, or start to shake. Shaking is reason enough to treat it as a low.

Watch for him being suddenly tired or sleepy, odd, wobbly, weak or shaky, and at the worst, collapsing or having a seizure. Some owners also notice their dog looking spaced out, very hungry or twitchy.

A low is more likely in the hours after his insulin, on a day he ate less than usual or brought his food back up, after more exercise than usual, or if he may have had his insulin twice. What if we might have given the insulin twice? covers that last one. A sudden shake is a reason to think of a low, not of high sugar, so never give more insulin because he's shaking.

Get ready before you ever need it: keep the syrup your vet recommends, cotton buds and the vet's number in one place. Be ready for a low has a simple checklist.

Shaking in his sleep: dreaming or something else?

Dogs dream, and dreaming dogs twitch. You might see his paws paddle, his lips or eyelids flutter, or hear little yips and woofs. These movements come and go, and his body stays loose rather than stiff.

Gently say his name rather than touching him, because a dog woken suddenly can startle. A dreaming dog wakes, looks at you and is himself.

A diabetic dog can also go low while he's asleep, so the test is how he is when he wakes. If he wakes wobbly, dull, confused or still trembling, treat it as a low and call your vet now. If he doesn't respond to you at all and his body is stiff or jerking, it's a seizure: some dogs have them in their sleep or just as they wake.

Lows at night are easy to miss, because everyone is asleep. If you've seen twitching more than once, or always at the same time after his insulin, tell your vet. They may want to check his sugar at that time of day. Lows at night and panting or restless at night have more.

What does a seizure look like in a diabetic dog?

A seizure is different from a dream. His legs may go stiff or jerk hard, he may fall onto his side, his eyes may be open but he doesn't respond to you, and you can't wake him by calling his name. He may drool or foam, chomp his jaw, or pee or poo where he lies. Seizures usually happen while a dog is awake, though some start in sleep or as he wakes.

Afterwards he may be confused, wobbly, restless, drooling or panting for a while.

In a diabetic dog on insulin, a seizure can be caused by a very low sugar, so it's an emergency. Call your vet or an emergency clinic now, even if he seems to recover. Keep calm, move furniture away and keep your hands away from his mouth. If someone else is with you, they can time it and film it on a phone.

No food, no poured liquid and no fingers in his mouth. If you can rub your vet's syrup on the inside of his cheek with cotton buds without a struggle, do it while you phone. If you can't, don't fight his mouth. No emergency vet nearby helps if your clinic is closed.

Other reasons a diabetic dog shakes

Diabetes doesn't stop a dog shaking for ordinary reasons, so think about what else is going on.

Cold. A thin coat, a wet walk or a cold floor at night can set a dog shivering. If he stops once he's warm and is otherwise himself, that was probably it.

Fear or stress. Some dogs tremble at injection time, at the vet's or during fireworks. Making injections easier helps with the first one.

Pain. Shaking can be a sign of pain, including a sore belly from pancreatitis, a bad back or sore joints. Food after pancreatitis and weak back legs have more, and pain medicines and diabetes explains why you shouldn't give him your own.

Feeling sick. A dog with a bad stomach upset can shake too. In a diabetic dog, vomiting with shaking, weakness, fast breathing or sweet breath can be ketoacidosis: call your vet now. Diabetic dog vomiting and diabetic ketoacidosis in dogs explain why.

Older age. Some dogs shake more as they get older. A slow weakening of the back legs over weeks is a different problem from a sudden shake, and worth a vet visit. Wobbly after a walk helps you tell tiredness from a low.

Poisoning. Some poisons cause shaking too. If he may have eaten something he shouldn't, call your vet now.

What to tell your vet

Your vet will want to know: was he awake or asleep, how long it lasted, whether he stopped when you called him, how he was afterwards, when he last had insulin and how much he'd eaten, and whether anything else was going on, like vomiting, not eating or a long walk.

A short video on your phone is worth more than any description, so if it happens again and he's safe, film it.

If the shaking keeps happening around the same time after his insulin, ask whether he needs his sugar checked at that time, or a glucose curve. Home testing, glucose curves and notes for your vet has a simple way to keep notes.