Newly diagnosed diabetic dog: which insulin and how to start
9-year-old spayed female Poodle weighing 7 kg with polyuria, polydipsia, polyphagia and weight loss. Blood glucose 420 mg/dL with glucosuria and no ketonuria; she is eating well and alert.
Which initial protocol is most appropriate?
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A. Oral glipizide every 12 h and recheck in a month
Sulfonylureas need functional beta cells. Canine diabetes resembles human type 1 diabetes, with near-total beta-cell loss, so oral hypoglycaemic drugs do not work.
B. Lente insulin at 1 U/kg every 24 h to control blood glucose as soon as possible
The dose is excessive and increases the risk of hypoglycaemia. Also, in dogs lente insulin rarely lasts 24 h: a single daily dose leaves hours without cover.
C. Porcine lente or NPH insulin at about 0.25 U/kg every 12 h with food, and recheck in 1–2 weeks
Correct. These are the recommended starting insulins in dogs, given every 12 h with meals. Start with a conservative dose and adjust gradually: insulin takes days to reach a steady effect.
D. Insulin glargine once daily, as in cats
Glargine is a first-choice insulin in cats, but in dogs its effect is less predictable and it is not recommended first-line, let alone once daily.
lightbulb Key takeaway
The goal in a diabetic dog is to control clinical signs (polyuria, polydipsia, weight) without hypoglycaemia, not to normalise blood glucose. Do not raise the dose in the first week: let it stabilise and adjust in 10–20% steps.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.