To Feed or not to feed?

Re: To Feed or not to feed?

Sandra Taylor RVN, MBVNA — Fri, 30 Jul 2010 13:44:22 GMT

Feed then inject.... but if a dog is not eating, you can inject as normal as insulin is an appetite stimulant, I was taught this on a diabetes course with Grant petrie, he recommends that if the dog does not eat, then you inject anyway... if the dont eat by the next feeding time then you get them check. So I guess there is some logic in injecting and then feediong an hour later... you may well get animals eating who otherwise may not have eaten earlier....if you get what I mean!

oh and cats always feed ad lib

Re: To Feed or not to feed?

Lolita — Fri, 30 Jul 2010 11:03:26 GMT

I was taught to feed then inject, then you know you are not putting them at risk of hypo if you inject and then try to feed and they dont want to eat

Re: To Feed or not to feed?

Sal the 1st — Fri, 30 Jul 2010 09:32:30 GMT

same here - feed then inject. I tend not to inject while the animal is eating or you could run the risk that if the owner doing the injection is a bit rough the animal can associate meal times with pain and you may find it starts to make itself scarce at meal times, but I suppose its down to the individual and I know plenty of doggy diabetics that are injected while they are eating and dont notice

Re: To Feed or not to feed?

Claire Cameron — Fri, 30 Jul 2010 09:23:05 GMT

[quote user="Nick Shackleton DipAVN(Surgical)VN MBVNA"]

I would agree with Laura. I have been taught, feed then insulin

[/quote]

Snap

Also what if you inject them then they won't eat?

Re: To Feed or not to feed?

Phrin Vernon RVN — Thu, 29 Jul 2010 22:30:16 GMT

We did a fairly recent GA on a diabetic dog, and the VS took his advice from Anaesthesia for Veterinary Nurses (another big up for this book!)

We did half dose insulin, glucose saline drip, BG every 10-15mins, and adjusted the drip according to the BG readings.

The dog recovered fantasically!

Oh, and I too was taught feed then insulin - too high a risk of a hypo otherwise!

Fabulous portfolio case LOL

Re: To Feed or not to feed?

S-J — Thu, 29 Jul 2010 22:06:25 GMT

correct me if iam wrong but i was under the impression that using a glucose saline doesnt actually affect the overall blood glucose but that the glucose aids in increasing the the fluid uptake by the cells because of the large osmotic difference. saying that we also use it to stabilise diabetics especially the ketoacidotics

blimey thats a bit technical for this time of night

Re: To Feed or not to feed?

Steph Worsley — Thu, 29 Jul 2010 22:00:39 GMT

yup agree with getting back to normal routine asap.

however we dont routinely use glucose saline through ga's unless there is a serious drop in blood glucose or if the patient has fairly low glucose anyway. mind you that might be because most of the diabetics i deal with have pretty much high readings anyway

Re: To Feed or not to feed?

Nick Shackleton — Thu, 29 Jul 2010 21:45:19 GMT

I was told half dose of insulin in the morning, then glucose saline during GA, half hourly blood glucose, IV glucose if required.

I think the key is get back to normal routine as soon as possible

Re: To Feed or not to feed?

Steph Worsley — Thu, 29 Jul 2010 21:41:47 GMT

Just out of curiosity what protocol do you all use when you starve an animal for GA

we always recommend 1/2 dose insulin on the morning

Re: To Feed or not to feed?

Steph Worsley — Thu, 29 Jul 2010 21:39:51 GMT

feed then inject

We don't teach our students to inject then feed later and we get referred a lot of diabetics, (generally unstable or even in diabetic ketoacidosis) and we then have to stabalise them.

I can kinda see the logic but the insulin shoulod be working by the time the glucose is being absorbed by the animal anyway even feeding then injecting.

what if the animal doesnt eat after being given the insulin????? surely you dont want animals coming in hypoglycaemic or even worse the owner injecting then throwing the food down and rushing out for the day and coming home to an animal in a coma or even worse dead!!!!

we warn owners about the risks of hypoglycaemia so surely we shouldnt be potentially inducing it!!!

Re: To Feed or not to feed?

S-J — Thu, 29 Jul 2010 21:35:00 GMT

we always feed first then insulin, its hard enough to get them to eat anyway without having to worry if they are going to have a hypo

Re: To Feed or not to feed?

Vickipr — Thu, 29 Jul 2010 21:31:57 GMT

ahhhhhhhhhhh that makes sense and I'm pretty sure that's what the vet said as well. Something along those lines anyway!

Re: To Feed or not to feed?

Sam Leeks — Thu, 29 Jul 2010 21:25:42 GMT

If i remember rightly from what a vet told me, its something about having the insulin actually working when u feed, rather than feeding when blood glucose is high and making it even higher with food. by feeding an hr after injection the insulin is already working and so the glucose levels shouldnt get much higher. we still however feed and then inject as this works well with clients life style and you dont have the worry of an animal not eating.

Re: To Feed or not to feed?

Nick Shackleton — Thu, 29 Jul 2010 21:18:01 GMT

I would agree with Laura. I have been taught, feed then insulin

Re: To Feed or not to feed?

Cat Woman — Thu, 29 Jul 2010 21:17:29 GMT

During or after feeding for us too.

Re: To Feed or not to feed?

Vickipr — Thu, 29 Jul 2010 21:16:52 GMT

no, I hadn't heard to feed after either! Apparently thats what new grads are being taught! One of the vets did explain the reasoning to me, but I can't remember exactly what it was!

He did say that if the patient went a bit hypoglycaemic then that would make it eat?? Not sure about that tho....

Re: To Feed or not to feed?

Laura Ringsell — Thu, 29 Jul 2010 21:09:16 GMT

always say inject after eating or during. Would be very worried about feeding an hour later (especially cats) and how on earth does that fit in with peoples life styles - as it is so many people think euthansia is the tx of choice never heard that one - course will be interesting and hopefully clear up your conflicting thoughts.