Endocrine

Diabetes Mellitus

Inability to regulate blood sugar levels, requiring daily insulin injections and careful diet management.

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Expert guides

"Is This a Death Sentence?" The Honest Prognosis for a Diabetic Pet

It's the question really underneath all the others, even when no one says it out loud. An owner takes in the word diabetes, asks sensible things about insulin and diet, and behind their eyes is the thought they're too frightened to voice: is this it? Am I about to lose her? It's a fair thing...

Dr. Alastair Greenway10 min read

Diabetes in Dogs and Cats: The Same Word, Two Different Diseases

When a dog or a cat is diagnosed as diabetic, most owners' minds reach straight for what they know about diabetes in people: a relative who injects insulin, a colleague who manages theirs with tablets and diet. Let me gently take that off the table, because the most useful thing I can tell you on...

Claire Greenway9 min read

Feline Diabetes Explained: Why a Cat's Diabetes Is Its Own Disease

Most of what gets written about pet diabetes carries, quietly, a canine accent. So if you've just been told your cat is diabetic, here is the thing worth knowing first: your cat's diabetes is not a smaller version of a dog's. It looks far more like human type 2 diabetes, and because the insulin-making cells...

Dr. Alastair Greenway10 min read

Getting the Diagnosis: How Vets Confirm Diabetes

Most owners arrive at the diagnosis the same way. Something had been off for a few weeks: the water bowl emptying too fast, puddles where there had never been puddles, weight sliding off despite a hearty appetite. A sample went off, and now there's a word on the page. Let me walk you through how...

Claire Greenway10 min read

Can I Do This? The Honest Commitment of Caring for a Diabetic Pet

There's a particular silence that falls in the consult room after I say the word diabetes. The owner nods, asks a sensible question or two about insulin, and then, often while standing up to leave, comes the real one, the quiet one. "I work full time." "I'm not sure I'm the right person for this."...

Dr. Alastair Greenway10 min read

What Diabetes Actually Is in Dogs and Cats

When I tell an owner their dog or cat has diabetes, I can see the same thing happen behind their eyes. They half-remember something about human diabetes, sugar, injections, and they're trying to map all of it onto the animal in front of them. Some have already decided it sounds like a death sentence. It...

Claire Greenway10 min read

Hypos: The Emergency Every Diabetic Owner Must Be Ready For

Of all the things I tell a new diabetic owner, this is the one I'd ask you to hold onto hardest. Most of the daily routine you're learning is forgiving: get the timing a bit off, run a little high for an afternoon, and your pet is fine. The one exception, and the reason this...

Dr. Alastair Greenway11 min read

Your First Insulin Injection: How To Do It Without Fear

There's a moment I've come to recognise in the consult room. The owner has the diagnosis and the kit, they've nodded along to everything, and then I hand them a loaded syringe to try for the first time and their hand goes very still. They're not frightened for themselves. They're frightened of pushing a needle...

Claire Greenway11 min read

The First Two Weeks on Insulin: What To Expect

You're home from the vet with a little vial in the fridge, a box of tiny syringes, and a head full of half-remembered instructions. You've given the first injection, or you're about to, and the practical worry sits on top of a quieter question: how will I know if it's working? What if I'm getting...

Claire Greenway10 min read

Feeding a Diabetic Pet: Timing, Portions and Treats

Owners walk out of the diagnosis consult braced for the injections. Almost no one walks out worried about the bowl, and yet it's the bowl that trips most people up a fortnight later. What do I feed? How much? When, relative to the jab? Can he still have his bedtime biscuit? Feeding quietly does a...

Dr. Alastair Greenway10 min read

Storing, Drawing Up and Handling Insulin Properly

There's a sentence I hear in the consult room more often than almost any other once a pet is a few months into treatment. "The insulin's stopped working." The dog is drinking again, the cat is losing weight, the readings have crept back up, and the obvious conclusion is that the dose has failed or...

Claire Greenway11 min read

The Insulin Types Explained (and the New Oral Options for Cats)

Most owners meet their pet's insulin as a single box pushed across the desk, a name they've never heard, with no sense of why that one. Then they search it and fall into forum threads arguing about Lantus versus ProZinc versus something they can't even buy here. So let me do what the leaflets and...

Dr. Alastair Greenway12 min read

Continuous Glucose Monitors (FreeStyle Libre) on Pets: The Game-Changer

A few years ago, knowing what your diabetic pet's glucose did across a day meant grim choices: a row of finger or ear pricks at home, or a long, stressful day at the clinic having blood drawn every couple of hours. Then a small white disc designed for people with diabetes quietly changed everything. I...

Dr. Alastair Greenway12 min read

Home Blood Glucose Monitoring: Curves and Spot-Checks, Done Properly

The first time most owners hear the words "blood glucose curve", the real question follows fast: you want me to take my pet's blood, at home, with a needle, every couple of hours? It sounds like something that should happen in a hospital.

Claire Greenway11 min read

Diet as a Lever: Low-Carb Cats, Consistent Dogs

Most owners arrive at the food question expecting me to hand over the name of a prescription diet and send them on their way. It's a fair expectation, but it sells the subject short. For a diabetic pet, food isn't only fuel. It's one of the levers we actually pull to change the disease, sitting...

Dr. Alastair Greenway10 min read

Fructosamine and the Vet Rechecks: The Bigger Picture of Control

A few weeks into life with a diabetic pet, the rechecks start to feel like a ritual. You bring your dog or cat in, often with a phone full of home readings, the vet draws a little blood, weighs them, has a feel, and then talks about a number you may never have heard of:...

Claire Greenway9 min read

Reading a Glucose Curve: The Nadir, the Duration and Stress Hyperglycaemia

For most owners, a first glucose curve arrives as a column of numbers on a scrap of paper, or a wavy line on a phone app, and it can leave you feeling shut out of your own pet's care. Six readings, a squiggle, and the nagging sense that everyone but you knows which number matters....

Dr. Alastair Greenway11 min read

How Insulin Dose Titration Works (and Why It Takes Weeks)

There's a question I can almost set my watch by. About two or three weeks after a pet starts insulin, the owner rings, and somewhere in the first minute it comes out: "I don't think the dose is right yet." Often there's a flicker of failure underneath it, as though they were meant to have...

Claire Greenway9 min read

The Lifetime Cost of a Diabetic Pet, and How Insurance Really Works

There's a moment, usually a day or two after the diagnosis, when the worry turns from your pet to your bank account. The leaflet says "diabetes is manageable," the forum says "it cost me a fortune," and nobody has given you the actual numbers. So let me lay them out plainly, because in twenty years...

Dr. Alastair Greenway12 min read

Travel, Boarding and Sick-Day Rules for a Diabetic Pet

Diabetes settles, in the end, into a pleasant kind of dull. Two meals, two injections, a quick note in the app, twice a day, until it's muscle memory. And then one of three things happens. Your pet wakes up off their food. You've a holiday booked and a cool bag you're not sure how to...

Claire Greenway13 min read

Weight, Dental Disease and the Other Things That Quietly Wreck Control

There's a particular call I take more than any other from a settled diabetic family. The pet was doing well, the numbers had stopped sliding around, the dose hadn't changed in months. Then it all drifts: more water in the bowl, a litter tray needing doing twice as often, a morning glucose that creeps up...

Dr. Alastair Greenway12 min read

Diabetic Cataracts in Dogs: Spotting and Managing the Blindness Risk

There's a phone call I take more than almost any other from owners of newly diagnosed diabetic dogs. The dog was fine. Then, over a weekend, the eyes went cloudy and the dog started bumping into the coffee table. The owner is frightened, and underneath the fright there's usually a flicker of guilt: did I...

Claire Greenway12 min read

What To Watch at Home: The Signs That Tell You How Control Is Going

In the early weeks, owners ask me a version of the same anxious question: "How do I know if it's working?" Behind it sits the assumption that the answer lives in a meter, that without a row of glucose numbers they're flying blind. The truth is more reassuring: the best monitoring tool you have is...

Dr. Alastair Greenway10 min read

Settling Into the Daily Routine That Works

There's a moment, usually around the third or fourth week, when an owner rings the practice and I can hear that something has shifted. The panic has gone, the needle they were certain they could never manage has become a non-event done while the kettle boils, and the question is no longer "can I do...

Claire Greenway10 min read

Feline Diabetic Remission: Real, and the Window Is Now

When I tell an owner that their newly diagnosed cat might one day come off insulin altogether, I often watch the same thing happen on their face: hope, then a flicker of suspicion, because it sounds too good to be true. It isn't. Feline diabetic remission is real, common enough to be a genuine goal...

Claire Greenway11 min read

What "Good Control" Actually Looks Like (and Why It Isn't Perfect Numbers)

There's a particular worry I see in diabetic pet owners a few months in. The injections are happening, the pet seems well, and yet the owner is anxious, because they've been checking glucose at home, or reading a forum, and the numbers aren't "normal." Their own blood sugar would sit around 5 mmol/L. Their dog's...

Claire Greenway11 min read

What Good Control Buys: Heading Off the Complications

There comes a point, usually a few weeks in, when the injections and the meals and the logging stop being terrifying and turn into a chore. The fear fades, and what's left is the grind: two needles a day, every day, seemingly forever, for a pet who looks, frankly, fine. And a quiet question surfaces....

Dr. Alastair Greenway12 min read

Staying in Remission, and Spotting a Relapse Early

There's a particular happiness I see in owners whose cat has just come off insulin. Relief, mostly, after weeks of injections and finger-pricks and worry. And then, usually in the same breath, a flicker of something else: but is it really gone? Will it come back?

Claire Greenway11 min read

Giving Your Cat the Best Shot at Remission: The Playbook

When an owner first hears that a cat, unlike a dog, can sometimes stop being diabetic, the next question is almost always the practical one. Not "is it true," but "what do I actually do?" The why and the biology live in feline diabetic remission, and I'd read that first if you haven't. This page...

Dr. Alastair Greenway11 min read

Quality of Life and the Honest, Hard Decisions

The numbers won't settle no matter what you try. Or the cost has crept beyond what you planned. Or your pet is simply old, and you're starting to wonder whether you're holding on for them or for yourself. Whichever of those it is, let me start with what I'd say if you were sitting across...

Claire Greenway10 min read

Somogyi and Dose-Chasing: When More Insulin Is the Wrong Answer

There's a logic that feels unarguable when you're holding the meter. The number is high. Insulin brings numbers down. So surely the answer is more insulin. I've watched careful, loving owners follow that thread into trouble, nudging the dose up week after week because the morning reading stays stubbornly high. It's the most intuitive move...

Dr. Alastair Greenway10 min read

When the Insulin Just Won't Work: The Resistance Work-Up

There's a sentence I hear when an owner has reached the end of their patience, and it always carries the same flat exhaustion. "We keep putting the dose up and it makes no difference." By then they've usually been climbing the dose for weeks, the numbers are still stubbornly high, and the fear underneath is...

Claire Greenway12 min read

Diabetic Ketoacidosis (DKA): The Emergency and Its Warning Signs

Diabetes can throw up two emergencies, and they run in opposite directions. One is the hypo: too much insulin, a blood sugar that crashes in minutes, the wobbly, trembling pet I write about in the hypoglycaemia guide. This page is about the other one, and it worries me more, because it's quieter at the start...

Dr. Alastair Greenway10 min read

The Concurrent Diseases That Fight Your Insulin

The dose has crept up again. We're at numbers that would have sounded alarming three months ago, the glucose curve is still a flat high line that barely dips, and you're doing everything right. And yet the insulin just isn't working. The natural instinct, yours and sometimes mine, is to reach for the dial and...

Claire Greenway12 min read

The Unstable, Brittle Diabetic: Why Control Slips, and What To Do

There's a particular kind of tiredness I've learned to recognise across the consulting table, and it doesn't belong to the pet. It belongs to the person opposite: the one who's been up in the night checking the cat, who's turned down a weekend because nobody else can manage the injections, whose meter read 4 one...

Dr. Alastair Greenway10 min read

Breeds prone to Diabetes Mellitus

Diabetes Mellitus is seen more often in some breeds than others. If you have one of these, its breed guide covers what to watch for and where to get help.

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