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When the day goes wrong: urgent help

How to spot an emergency or a low, what to do first, what to tell the vet, and which answers only your own vet can give.

Sunny, owner“I wish my dog lived as long as I do.”Updated

I'm an owner, not a vet. This is not veterinary advice, so check anything medical with your own vet.

Key facts

  • Collapse, a seizure, not responding or struggling to breathe: go to an emergency vet now. Call ahead on the way if you can.
  • Weak, wobbly, trembling, dazed, vomiting, not eating around insulin time or ketones on a urine strip: call your vet straight away. Even one sign is enough.
  • Never pour food or liquid into the mouth of a dog who can't swallow properly, and keep your hands away from his mouth during a seizure.
  • Don't wait for a meter reading, a message reply or your notes before getting help.
  • Insulin amounts, how much sugar to give in a low and any change to the plan come only from your own vet.

I never give insulin amounts here. Yours comes from your vet's written plan.

Diabetic dog emergency: go to a vet now

If your diabetic dog collapses, has a seizure, won't respond or is struggling to breathe, this is an emergency. Go to an emergency vet now and ring ahead on the way if you can. Don't stop to take a reading, search or wait for anyone to reply. The emergency page has the same steps in one place, ready for your phone.

If your dog has a seizure, contact a vet or emergency clinic straight away, even if the seizure stops. Low blood sugar is one possible cause, but there are others. Keep your hands away from his mouth, and don't force food, water or medicine into a dog who can't swallow properly. If you can, note when it started and the last meal and injection times, but don't let that slow you down.

For the signs that need a call today rather than a dash to the clinic, see when a diabetic dog needs a vet the same day. If you can't wake him properly, go now. You know your dog best, so if you're worried, call your vet, even if what you're seeing isn't on any list.

Signs of low blood sugar in a diabetic dog

Low blood sugar (called hypoglycaemia) can happen to any dog on insulin. Signs include weakness, walking strangely or wobbling, trembling, seeming dazed or vacant, a seizure, collapse, vomiting, or not eating around insulin time. Your dog doesn't need to show all of them. One is enough to call.

If your dog is weak, shaky, wobbly or won't eat, call your vet or an emergency clinic now. If your clinic gave you a plan for lows, follow it while you call. A low can show up after exercise, so if he's weak or wobbly after a walk, stop, call your vet, and follow your written plan for a low if you have one.

Only check his sugar if it won't delay the call, and only with the meter your vet is happy with. If he looks unwell, trust that over the number. Even if he seems better after you've acted, follow your vet's plan and get him seen.

How much sugar to give a diabetic dog who goes low

I won't give teaspoons, sachets or 'a little on the gums' as an amount to use, because that depends on your dog and only your vet can work it out. I also can't tell you a low is mild enough to handle at home. That call belongs to your vet. More on how much sugar to give if your diabetic dog goes low.

Call your vet or an emergency clinic now if he is weak, wobbly, trembling, vacant or worse, and follow the low plan already in your house if they gave you one. If he can't swallow properly, never pour anything into his mouth, because he could choke. Get him to a vet now.

If you already gave honey or sugar in a panic, tell the vet exactly what you gave and when, and keep the packet handy in case they ask. Don't take a quick improvement as a sign it's all over, and don't give more insulin later to bring down a high reading. Call for the next step.

Getting ready for a low before it happens

It's much easier to stay calm in a low if you've planned it on a good day. Ask your vet to show you what to give, how to give it, and where to go after. Most vets suggest keeping something sugary your vet has approved in the house and in your walking bag. There's a fuller checklist on what to keep ready in case your dog goes low.

Write down the vet's low-sugar plan in their words, the vet and emergency clinic numbers, the route at night, and his insulin name, food and last injection time, ready to read out. Make one card for the fridge and one for your bag, and show everyone who looks after him.

Check the plan at each check-up. Once he's safe after any low, ask the clinic to write down what to do if it happens again, so next time you're not searching in a panic. You can take questions for the vet to that appointment.

Low blood sugar at night

A low can happen at any hour, and daytime readings can miss what happens overnight. That's one reason vets sometimes suggest a sensor or a longer curve. Ask your vet when his insulin works hardest and whether any night checks make sense. There's more on lows at night in a diabetic dog.

If you find him weak, wobbly, confused, unusually hard to wake or having a seizure, call your vet or emergency clinic now. Don't give extra food or insulin at night on a guess. Follow your vet's low-sugar plan and call them.

Write down anything unusual you saw at night and the time, along with the evening meal, insulin time and the evening walk. Ask what to do if he hasn't finished his evening meal. Sleeping near him for a while can ease your mind.

Diabetic dog panting or restless at night

Panting, pacing or not being able to settle at night has lots of causes, so don't just put it down to a warm room. Call your vet, especially if he also seems weak, confused, in pain or unwell. If he's struggling to breathe, collapses or has a fit, this is an emergency. Go to an emergency vet now. Read more on a diabetic dog panting or restless at night.

The vet will want to know whether he can settle, whether he responds to you normally, whether his breathing is easy, and when he last ate and had insulin. Write down when the episode began. Don't walk him or give him a snack to see if it helps.

If your clinic is closed, call an out-of-hours or emergency vet. Only check his sugar if you've been shown how and it won't slow you down.

No emergency vet nearby at night

Many areas don't have a clinic open all night close by, so a plan made in advance matters more than searching on the night. See what to do when there's no emergency vet nearby.

While your dog is well, ask your vet who to call after hours and find the nearest clinic that is open late. Save the numbers and the route. Note who can drive, how long the journey takes and how you'll lift a big dog, plus a short summary of his diabetes and insulin to read out on the phone. Keep it with his low-sugar card.

Ask your vet what you should do at home on the way, and when it's safe to wait for morning. If he is weak, collapsed or fitting, don't wait for a reply to a message. Call and go.

Diabetic dog not eating, vomiting or dehydrated

If your diabetic dog won't eat, is vomiting, is unusually weak or is shaking, call your vet right away, before his next insulin time. Tell them whether insulin was already given, when he last ate and how he's acting now. Stick to the written plan they already gave you. See my diabetic dog won't eat, and if he ate only part of the meal after insulin, call your vet.

Diabetic dogs lose a lot of water through peeing, so dehydration can creep up, especially with heat, vomiting or diarrhoea. Signs can include dry or sticky gums, sunken eyes, tiredness and not wanting to eat. If a dog who drank a lot suddenly stops drinking, tell your vet, because it doesn't mean he's better. More on signs of dehydration in a diabetic dog.

Keep fresh water out all the time and don't take it away. If he's vomiting, not drinking, weak or very sleepy, call your vet now, because this can be serious. Don't try giving fluids under the skin at home unless your vet has trained you and asked you to. If he collapses or is breathing strangely, go to an emergency clinic now.

Ketones and diabetic ketoacidosis (DKA)

Ketones can build up when the body can't use sugar properly and starts burning fat for fuel. This can lead to diabetic ketoacidosis (DKA), which is life-threatening. It needs a vet, often a stay in hospital, and there's no home remedy for it. Dehydration can go along with it.

On a urine strip, any colour other than negative for ketones means call your vet the same day, even if he seems fine. If he's also vomiting, weak, flat, dehydrated or breathing fast or hard, call now. See what to do if a urine strip shows ketones.

Don't wait to see if the next strip looks better, and if your dog is ill, don't wait to buy strips or test again. Have the result, when he last ate and how he's doing ready when you call.

Insulin mistakes: given twice or the wrong syringe

If your dog may have had his insulin twice, treat it as an emergency. Call your vet or an emergency clinic now, even if he looks fine, because a double dose can push his blood sugar dangerously low. Tell them the times you know and the ones you're unsure about. Don't try to balance it out with the next shot yourself. Read what to do if the insulin might have been given twice.

The syringe has to match the strength of the insulin your vet prescribed, for example a U-40 syringe for 40 units per ml insulin and a U-100 syringe for 100 units per ml insulin. The lines on a syringe only mean something for that type of syringe. Never work out a conversion or guess which line to use, and don't copy a calculation from another owner. See matching the syringe to the insulin.

Show the bottle and syringe box to your vet or pharmacist before you inject, and keep anything that doesn't match aside until they tell you what goes together. If you think you've used the wrong combination, or your dog is weak or trembling, call a vet urgently. Don't give more insulin, or a guessed amount of sugar, to try to undo a possible mistake.

Why I won't tell you an insulin amount

Your dog's insulin amount has to come from your own vet, who has examined him. I won't give a starting amount, an amount per kilo, a 'usual' range or a different insulin to switch to. That's prescribing, and only your vet can do it. I also won't confirm a number you heard somewhere else, because saying 'that sounds right' is the same as giving you one. More on what insulin amount to give a diabetic dog.

A number from another owner is only a guess for a different dog. If you've lost the plan, call the clinic and ask them to tell you again. If he seems unwell, call before the next shot.

You can still write down the times, what he ate and how he seems. Use the blank insulin schedule and leave the amount line empty until you copy it from your vet. If the hard part is giving the injection, ask the vet to watch you do it once.

Can I change my dog's insulin plan at home?

When a reading worries you, it's tempting to change the insulin yourself. Please don't. A high number, a late meal or a long walk is a reason to call your vet with your notes. Changing the plan at home can push his sugar dangerously low. Leave any change to your vet. See changing a diabetic dog's insulin plan at home.

I won't tell you to give less, give more, give it later, or leave it out 'just for today' because of a chart. The same goes for switching brands: keep using the insulin they gave you until they tell you to change. If a meal is late, see what to do if the morning meal ran late. If your plan doesn't already cover it, call your vet.

Write the clock time, the food, the reading if you have one, and how he seems, then call the clinic and read them what you wrote. Give the next dose as your written plan says unless they tell you something different. If they do change the plan, ask them to repeat it so you can write it down correctly.

My meter shows a number. What does it mean?

When you get a reading, write one line: the time, the reading, his last meal and how he seems. If he is weak, wobbly, vomiting or very flat, stop writing and call your vet now. If he seems his normal self, stick to your plan and send the number to the clinic. More on what a glucose reading means.

I won't give a colour chart, a target range or a rule like 'at this number, change the insulin', and a photo of a meter isn't a vet visit. Your vet's goals are about avoiding lows, easing symptoms and keeping weight and daily life steady. One reading on its own isn't a reason to change his insulin, and if your dog worries you, get help even if one reading looks normal.

One number can't show how his whole day went. That's why vets often ask for a glucose curve, a set of readings taken across one day. The lowest point on the curve is called the nadir, and when it happens varies from dog to dog. If your vet asked for a curve, use the home curve sheet, and see notes and curves to show your vet.

Does this mean my dog has diabetes?

If your dog suddenly drinks and pees much more, book a vet visit soon. My Labrador Cooper did exactly that before his diagnosis, but only a vet can tell you if it's diabetes. Other illnesses, including Cushing's, kidney problems and diabetes insipidus, can cause the same signs. I can't say yes, no or 'probably', and I won't give a number that means diabetes. See does this mean my dog has diabetes.

While you wait, keep things normal: water available, the food he already eats, and no new medicines. Don't start insulin or any human medicine, and don't cut back water to see what happens. If he is weak, vomiting or not eating, don't wait for the appointment: call the vet today.

For two days, write down how much he drinks, how he eats, his weight and his energy, and take his medicine list and any old results. If it is diabetes, most dogs do well with treatment, and starting out with a diabetic dog covers the first weeks at home.

What to tell the vet on the phone

The clinic will want to know what he's doing right now and when it started. Tell them when he last ate, whether he's had his insulin and whether it might have been given twice. Mention any recent illness, any glucose reading with the time you took it, and ketone results if your vet has shown you how to check. If you're not sure about something, say so instead of guessing.

Bring the written plan, the insulin box if the clinic asks for it, and whatever notes you keep in a notebook for your diabetic dog. If someone else can make the call or grab things, let them, so you can leave sooner. Don't hold up getting to the vet to fill in a form.

After an emergency visit, ask your vet what has changed and when to come back. Update every copy of the plan so the old one isn't still stuck on the fridge, and make sure whoever helps you knows the same plan. Once things are calm, your everyday routine is in the daily routine guide.

Emergency signs come first, before notes, searching or AI. If your dog collapses, has a seizure, won't respond or has trouble breathing, go to an emergency vet now.

Open the blank scheduleLog today

Sources

Every outside source I used is listed on the Sources page.

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The warning signs that mean you call your vet now.