# Efficacy of a Standardized Low-Dose Insulin Infusion Protocol in the Emergency Stabilization of Diabetic Dogs

## TL;DR

A fixed-dose insulin infusion protocol safely and effectively lowers blood sugar in diabetic dogs during emergencies.

## Contribution

A standardized low-dose insulin infusion protocol is shown to be effective and safe for emergency diabetic dog treatment.

## Key findings

- A significant glucose reduction occurred within the first five hours of infusion.
- The protocol was safe with no hypoglycemic episodes observed.
- Sex or breed did not significantly affect the glycemic response.

## Abstract

Diabetes mellitus in dogs can progress to an acute decompensated state, characterized by severe hyperglycemia, dehydration, ketosis, and, in some cases, ketoacidosis hyperosmolar hyperglycemic syndrome (HHS). Continuous intravenous insulin infusion is commonly used in emergency management, yet dosing protocols vary between protocols. This study evaluated the effects of a fixed-dose insulin infusion protocol (0.05 IU/kg/h) over 12 h in decompensated diabetic dogs. Capillary blood glucose was monitored hourly, and the influence of sex and breed on glycemic response was analyzed. We observed a marked glucose reduction within the first five hours, followed by stabilization. The protocol was safe, with no hypoglycemic episodes, and sex or breed did not significantly affect glucose response. These findings support the use of a standardized, fixed-rate infusion protocol as a practical and effective option for managing diabetic emergencies in veterinary practice.

Background: Continuous insulin infusion protocols are essential for managing decompensated diabetic dogs, but comparative data between variable and fixed infusion rates are limited. Methods: This prospective observational study evaluated the glycemic response of 21 diabetic dogs treated with a fixed-dose continuous-rate infusion (CRI) of regular insulin at 0.05 IU/kg/h for 12 h. Capillary blood glucose was measured hourly. Statistical analyses included Wilcoxon signed-rank tests, Friedman test, Mann–Whitney U, and Kruskal–Wallis tests. Results: A significant reduction in glucose concentration occurred during the first five hours of infusion (p < 0.0001), followed by a stabilization phase with no further significant changes. No differences in glycemic response were found by sex or breed. The protocol was well tolerated, with no hypoglycemic events observed. Conclusions: A fixed-dose CRI of 0.05 IU/kg/h offers a safe and effective option for acute glycemic control in diabetic dogs, including those with early ketoacidosis. The standardized approach simplifies management without compromising efficacy and supports its inclusion in emergency treatment protocols.