Pragmatic approach to diabetes mellitus in dogs

Background : Diabetes mellitus (DM) is common in dogs. Management is potentially expensive, time‐consuming and stressful. Effective use of a pragmatic, evidence‐based protocol can create excellent clinical outcomes, control costs and reduce stress for pets, vets and owners. This article is based on a talk given by the authors at BVA Live in 2023. It details the experience of the authors in using a standard management PDSA national protocol for DM for over 10 years, and is not intended to be a ‘gold standard’ which is applicable to more complex cases and in different settings; instead, it focuses on a contextualised approach. Contextualised care is defined by the RCVS as a ‘way of delivering veterinary care that acknowledges that there are different ways to approach the diagnosis and treatment of an animal, depending on the circumstances of the individual animal and their caregivers, and the context in which the care is delivered.’ This article describes management of canine diabetes within the context of PDSA, a veterinary charity which funds veterinary treatment for pets with lower income owners. The charity environment means that use of financial and people resources must be optimised without compromising patient care. Aim of the article : This article details how diabetes mellitus can be diagnosed and treated successfully in a contextualised way using a protocol developed in a charity environment, but which is applicable to all circumstances. Evidence for the efficacy of this approach is given. Management of diabetic ketoacidosis (DKA) is not discussed.