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VN: Home Care and Nursing Clinics for Diabetic Dogs

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Betty is a Miniature Schnauzer who has been in the hospital recently for stabilisation following a diagnosis of diabetes mellitus. Today is the day she will be going home. The veterinary surgeon has asked you to join her in the discharge consultation to talk with the owners about injecting Betty with Caninsulin and feeding schedules.

 

What sort of things would you include in this discussion with the owner and how could you demonstrate injection techniques/check their technique?

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Posted by: @laura-georgeimproveinternational-com

Betty is a Miniature Schnauzer who has been in the hospital recently for stabilisation following a diagnosis of diabetes mellitus. Today is the day she will be going home. The veterinary surgeon has asked you to join her in the discharge consultation to talk with the owners about injecting Betty with Caninsulin and feeding schedules.

 

What sort of things would you include in this discussion with the owner and how could you demonstrate injection techniques/check their technique?

 

During the discharge appointment, it is important to include discussion of:

  • Insulin storage and handling
  • What clinical signs to monitor for at home which may indicate hypoglycaemia, along with the first aid measures they can take - include instructions on how to contact the clinic both in and out of hours
  • Feeding plans - including diet type, feeding times and discussion of weight loss requirements (if applicable)
  • Plan for follow-up appointments and nursing clinics

It can be helpful to discharge owners with a diabetic diary (apps are available) where they can record the daily management for Betty. These diaries can provide a really good overview of how Betty has been in the time between appointments and remove the need for the owner to try and remember what has happened during this time.

A good way to demonstrate injection techniques is to use water and a soft toy. Correct handling (and disposal) of sharps can be discussed and owners should demonstrate the injection technique back to us. This will not only give owners more confidence with injecting but will also allow us to help and reassure them.

It is important to allocate a good amount of time for the discharge appointment to allow the owner time to ask any questions they may have as undertaking care of a diabetic pet is a big thing and they may have concerns. It is really helpful to work closely with the owners on things and to try and create a management plan that works with their, and their pet's normal routine, to reduce obstacles to treatment.

Before saying goodbye to owners, it is important to emphasise to the owners that no concern they may have is too small. They should feel comfortable to contact the practice at any point with any questions and this owner support is an area where VNs can excel.

 

 

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Next task:

Betty will be seen by you at a nurse diabetic clinic one-month after discharge. What support or advice should be included in outpatient diabetic clinics? How can we ensure these outpatient clinics are beneficial for owners?

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Posted by: @laura-georgeimproveinternational-com

Next task:

Betty will be seen by you at a nurse diabetic clinic one-month after discharge. What support or advice should be included in outpatient diabetic clinics? How can we ensure these outpatient clinics are beneficial for owners?

 

Diabetic outpatient clinics/appointments with RVNs are key support resources for owners of diabetic patients. They help us to utilise several of our nursing skills and take some pressure of the veterinary surgeons while helping to build owner trust.

During the clinic, an up to date history can be gathered - this includes eating, drinking and toileting habits, medication regimes and activity levels, we can also check if they have demonstrated any signs of hypoglycaemia (if not already reported). This is where diabetic diaries can be helpful as they may be more accurate than the owner's memory over a longer period. The pet should be weighed to ensure they are not gaining or losing weight (or to check they are losing weight but at a steady rate if a weight loss plan has been put into place). 

Particularly, with newer diagnosed patients, we can check the owner is happy with insulin storage and administration. Similarly to the discharge appointment we can get them to demonstrate on a soft toy and they should be feeling more confident with injections at this point. 

When necessary, and under the instruction of a veterinary surgeon, blood and urine samples can be collected to check things such as glucose and ketone levels but, if the animal has been unwell further testing may be required.

Remember - any concerning findings from the nurse clinic should be relayed to the veterinary surgeon.

 

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