Treatment, monitoring, and euthanasia in canine diabetes mellitus - a questionnaire-based survey among veterinarians in Norway

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Abstract Background Canine diabetes mellitus (DM) is a relatively common endocrinopathy, and it requires dedication and commitment from an owner to care for a diabetic pet. This study aimed to describe treatment and monitoring habits, perceived owner and veterinary concerns when treating and monitoring a diabetic dog, as well as triggers for and risk of euthanasia in diabetic dogs among Norwegian veterinarians. A questionnaire was designed and made available online. Results A total of 125 veterinarians completed the survey. According to the data collected, the cumulative incidence risk for treatment initiation was 71.6% (95% CI 63.2, 80.6), suggesting that the respondents started most of the diabetic dogs seen in their practice on treatment. The majority of the respondents reported that all female entire diabetic dogs were neutered near the time of diagnosis. Main veterinary treatment concerns identified were difficulties in achieving rapid and adequate control. Main respondent-perceived owner concerns were cost and injecting their diabetic dog. About 60% of respondents had never used a continuous glucose monitor. Of respondents having used such monitors, half had experienced owners changing the insulin dose themselves, without consulting a veterinarian. Nearly one third of the veterinarians recalled that issues related to monitoring contributed directly to euthanasia of a diabetic dog in their care. The estimated one month and one year cumulative risk of euthanasia in dogs started on insulin therapy found in our study were 11.5% (95% CI 8.3, 14.6) and 26.9% (95% CI 22.0, 31.8), respectively. In our study population, respondents working in large cities were more likely to report a high probability of starting treatment than respondents in small cities and rural areas. Respondents in small cities and rural areas were also more likely to report medium and high risk of euthanasia compared to respondents in large cities, respectively. Veterinary-perceived owner triggers for euthanasia were dogs’ quality of life, monitoring, and owners’ lifestyle changes. For the respondents themselves, comorbidities were the leading factor reported for recommending euthanasia. Conclusions This questionnaire-based study describes perceived treatment concerns, and reasons for and estimates of euthanasia risk in dogs with DM, based on the experiences of veterinary practitioners working in Norway. The results highlight important aspects of the treatment and monitoring of dogs with DM, as well as triggers for euthanasia. Further investigations into the aspects identified could be useful to improve the overall care for diabetic dogs.