In managing canine diabetes mellitus, what is a typical starting insulin dose and an outline for monitoring?

• A. Start 0.1 U/kg subcutaneously every 24 hours; monitor weekly
• B. Start 0.2–0.4 U/kg subcutaneously every 12 hours; monitor with urine glucose curves and occasional blood glucose checks, adjust as needed
• C. Start 2 U/kg IV every 4 hours
• D. Start 1 U/kg subcutaneously every 24 hours

Answer: (B)

Starting insulin therapy in dogs with diabetes is about establishing a safe, steady basal dose that can be titrated based on how the dog responds. A typical starting plan uses a modest dose given under the skin twice daily, at 0.2–0.4 U/kg every 12 hours. This range provides enough insulin to begin controlling fasting glucose without a high risk of dangerous lows, and splitting it into two injections helps cover the daily fluctuations in glucose and feeding.

For monitoring, rely on practical data you can obtain in clinic or at home: urine glucose curves to track how well glucose is being cleared over the day and occasional blood glucose checks to corroborate the trend and catch hypoglycemia. Reassess the dose every 1–2 weeks and adjust gradually—usually by 10–20%—based on signs of diabetes control (reduced drinking and urination, weight gain, appetite) and the glucose curve results. If hyperglycemia persists, increase the dose; if hypoglycemia or low readings occur, decrease. Maintaining consistent feeding schedules and owner education about signs of hypoglycemia are also important components of successful management.