The more we can keep your dog’s insulin injections, food intake, and exercise consistent from day to day, the more likely we are to be successful in managing the diabetes long-term. This usually means following a 12-hour schedule for insulin and meals with limited snacks in between.
Diabetes management often has three phases. The first is initial stabilisation to get your dog back to baseline if they were diagnosed during a diabetic ketoacidosis (DKA) crisis, including treating any underlying medical conditions that may be making their diabetes worse. The second is making a management plan for insulin, nutrition, exercise, and monitoring to keep the clinical signs of diabetes under control in a safe and sustainable way. Finding the right routine usually takes about 6–12 weeks and can feel labour-intensive at first, but it becomes more manageable once things settle into place. The third phase is maintenance mode where we keep track of how everything is going over time and make adjustments as needed if your dog’s condition changes.
If your dog was diagnosed with diabetes through an episode of diabetic ketoacidosis (DKA), the first priority is to stabilise them with emergency treatment. This usually involves hospital care with intravenous fluids, insulin, electrolyte supplementation, and close monitoring to fix the dehydration, high blood sugar, and the acid imbalance in the blood.
Depending on any other health conditions your dog may have, it can take anywhere from 3 to 10 days to bring their condition back to baseline and stabilise their blood glucose levels. You can expect to spend anywhere from NZD $500 to $1,200 per day for treatment depending on where your dog is being treated and how much care they need each day. If your regular veterinary clinic doesn’t have staff on-site overnight or if your dog’s condition is particularly serious, your veterinarian may recommend transferring your dog to an after-hours or specialist clinic for more intensive care.
The good news is that if DKA is caught and treated quickly, most dogs will recover very well with around 70% surviving and being discharged from the hospital. For the 30% of dogs with DKA that end up being euthanised, this is usually because of costs rather than treatment failure.
We understand that deciding to euthanise a dog with DKA for financial reasons is a difficult and deeply personal decision. It’s important to recognise that this choice often comes from a place of love and wanting to prevent suffering. Many families face the heartbreaking reality of balancing medical options with what’s realistically possible. If ongoing treatment isn’t feasible, euthanasia can be a compassionate decision made in your dog’s best interest, ensuring they don’t continue to experience pain or distress.
If your female dog hasn’t already been desexed at the time of diagnosis, your vet may recommend spaying her as soon as possible. This is because hormones produced during parts of her heat cycle — especially progesterone — can interfere with how insulin works in the body. In some cases, if spaying is done early enough, it may even lead to the diabetes going away completely.
Even if the diabetes doesn’t go away, spaying usually makes it much easier to manage. Without desexing, the amount of insulin she needs can fluctuate significantly depending on where she is in her cycle. During phases with high progesterone, she may need large doses of insulin — but as hormone levels drop, those same doses can become too much and dangerously lower her blood sugar. It’s not always easy to tell where a dog is in her heat cycle without regular testing.
The cost of a spay for a female dog can range from NZD $300 to $800 depending on your dog’s size and the level of care they need.
Our main goal in managing diabetic dogs long-term is to keep their symptoms under control in a way that allows both you and your dog to have a good quality of life.
Since the main problem in Type 1 (insulin-dependent) diabetes is that your dog is no longer producing enough insulin, the most important part of managing the condition is giving them regular insulin injections. We also need to pay close attention to how much glucose is coming into the body through their diet and how much glucose is being used up or burned through exercise or other stressors to make sure the insulin dose we’re giving will match their needs on most days. We also keep track of how well everything is working over time with a monitoring plan that can be as simple as watching for changes in your dog’s symptoms or much more involved, such as regularly checking their blood glucose levels at home.
In most cases, your dog can keep eating the same diet they are currently on unless they have other medical conditions like pancreatitis, food allergies, or kidney disease that require a special diet. The main changes you might need to make are:
The most important thing is finding a complete and nutritionally balanced diet that they will consistently eat within 10 to 15 minutes of being offered their meal.
Most dogs will need two insulin injections per day for the rest of their lives, and it’s best to give them as close to 12 hours apart as possible — for example, at 7am and 7pm every day. There’s a little bit of wiggle room — about 1 hour either side — so the injections can sometimes be given between 11 and 13 hours apart if needed.
This is probably one of the most challenging parts of managing a diabetic dog as it often means adjusting your lifestyle and daily routine to make sure someone is always available to give your dog their insulin injections on time.
It’s completely normal to feel nervous about giving injections, especially if you’re uneasy with needles. But giving an injection to your dog feels very different from getting one yourself, and most people find it quickly becomes second nature. Insulin needles are tiny and usually painless, so discomfort is minimal. Some dogs may fuss more about the handling than the injection itself, but with patience and consistency, most adapt well.
It’s still really important for diabetic dogs to get daily exercise — we just need to be a little more mindful about how long and how hard they exercise.
In a healthy dog, the body naturally reduces insulin production during activity to switch from storing glucose to burning it for energy. But in diabetic dogs, we can’t ‘turn off’ the insulin we’ve injected, which means their blood glucose can drop too low during or after exercise.
Gentle walks under 30 minutes are usually no problem. But if your dog is doing more intense activities — like running, swimming, playing fetch, or agility training — we may need to keep a closer eye on things for the first few weeks to see how they respond and adjust the plan if needed. This may include adjusting the timing of exercise, decreasing the insulin dose, or providing your dogs with snacks around exercise times to keep their blood glucose levels up.
Monitoring is most important (and most intensive) in the first few weeks after diagnosis while we figure out the right insulin dose for your dog. Every dog’s response to insulin is a little different and can change day to day depending on diet, activity, and even how the insulin is given. That’s why we start with a low dose, adjust gradually, and use monitoring to make sure treatment is working safely without pushing blood sugar too low.
Whenever we change a dog’s insulin dose, we usually give them 7 days to adjust and then perform a blood glucose curve to check the response. This involves taking blood glucose measurements every 1-2 hours over an 8-12 hour period to see how long the insulin injection lasts and whether its keeping your dog’s blood glucose in a safe range.
There are several different ways to monitor diabetes. Some dogs have blood glucose curves done at the vet clinic while others are monitored at home with a handheld glucometer or a continuous glucose monitor (CGM) sensor. Each option has pros and cons in terms of cost, convenience, accuracy, and stress for your dog. Your veterinarian can help you choose the method that fits your household best.
Diabetes can lead to complications and emergencies, some common and others sudden and serious. Th risk of these can be reduced by following your management plan.
Hypoglycaemia (low blood sugar) is one of the most serious complications of diabetes treatment. It happens when insulin lowers blood glucose too much, often due to a missed meal, over-exercise, or an error with insulin dosing. Signs include weakness, trembling, disorientation, seizures, or collapse, and it can be life-threatening if not treated quickly.
Immediate care usually involves giving a fast source of sugar (such as honey or glucose syrup rubbed on the gums) if the dog is conscious and able to swallow. If the dog is unconscious, this is a true emergency requiring immediate veterinary attention.
The cost of treating a hypoglycaemic crisis depends on severity. Mild cases may only need a vet check and monitoring (around NZD $150–$300), while more serious episodes requiring intravenous glucose and hospital care can range from NZD $500–$2,000+.
Diabetic ketoacidosis (DKA) is a life-threatening emergency that can develop when diabetes is uncontrolled, usually due to very high blood sugar combined with dehydration and imbalances in electrolytes. It often happens if diabetes has not yet been diagnosed, if insulin doses are missed, or if another illness (such as infection or pancreatitis) pushes the body out of balance.
Signs include severe lethargy, vomiting, loss of appetite, dehydration, and sometimes collapse. Dogs with suspected DKA need urgent hospitalisation for intensive care, including intravenous fluids, electrolytes, insulin therapy, and close monitoring.
Treatment is costly and intensive, with hospitalisation typically ranging from NZD $2,000–$5,000 depending on the length of stay and complications. Even with treatment, DKA carries significant risk. Preventing crises through regular monitoring, consistent insulin, and prompt attention to illness is the best way to keep your dog safe.
Cataracts are one of the most common complications of diabetes in dogs, with around 75% developing them within the first year after diagnosis. A cataract is a clouding of the lens inside the eye that blocks light from reaching the retina, leading to partial or complete blindness. Cataracts can also cause painful inflammation (uveitis) and sometimes glaucoma if left untreated.
The most effective treatment is cataract surgery, where the cloudy lens is removed and replaced with an artificial one. This has a very high success rate (around 95% if the eyes are otherwise healthy) but requires referral to a veterinary eye specialist and typically costs NZD $4,000–$7,000.
If surgery is not an option, dogs can still enjoy a good quality of life with medical management, which usually involves daily anti-inflammatory eye drops and regular check-ups to keep the eyes comfortable and prevent complications.
Your veterinary team can help you navigate the menu of options to create a management plan that best suits you and your dog’s situation. For more detailed information on how to create a customised care plan with your veterinarian, check out the Diabetes Management section.
It usually takes 6–12 weeks after the initial diagnosis to settle into a routine that works for you and your dog. Once the right insulin dose is found, things tend to stabilise as long as routines stay consistent and no new health issues develop. Long-term monitoring often relies on watching clinical signs — changes in thirst, urination, appetite, weight, and energy — with extra testing if problems arise. The key is consistency and knowing what changes should prompt a check-in with your vet.
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