C09991756 / invoice 10000

13 units sid 7pm

O called as concerned that glucose reading HIGH, even after insulin dose. 
Ate dinner but seems lethargic and not wanting to get up much
Spoke to NB who recco monitoring overnight. If still all readings high tomorrow call clinic and we may increase dose 

https://www.animaldiabetesaustralia.com.au/media/General%20information%20for%20diabetic%20dogs.pdf handout given
Demonstrated how to administer toujeo insulin and scan freestyle libre at discharge. Os feel comfortable administering. Also adv he has had a sedative to help remove IVC so may be extra sleepy at home for next 2-3 hours. 

Discharge notes: 

Zeus has been a lovely patient while in hospital with us at Bundoora Vet Clinic.
Zeus was hospitalised for management of diabetic ketoacidosis (DKA), a serious complication of diabetes mellitus involving high blood glucose, ketone production, and dehydration.
He has also been on antibiotics for his UTI, his next dose is due when you get home this evening. 

During hospitalisation he received:
- Intravenous fluids
- Continuous insulin therapy
- Electrolyte monitoring and correction
- Close blood glucose and ketone monitoring

He is now much brighter, eating, hydrated, and clinically stable. His blood glucose improved and blood ketones now within normal range. We have transitioned him from IV insulin to long-acting insulin.

Insulin Therapy: 
- Toujeo (insulin glargine U300)
- Give once every 24 hours
- Administer subcutaneously (under the skin)
- Give at the same time each day
- Ensure Zeus eats prior to insulin administration

NOTE: Do not change the dose unless directed. f Zeus does not eat, contact the clinic before giving insulin.

Glucose Monitoring: 
Zeus has a Freestyle Libre continuous glucose monitor in place. Scan as directed to monitor glucose trends and keep the sensor clean and dry. Please contact the clinic if it becomes dislodged or stops working. We will use these readings to guide future dose adjustments.

Diet: 
- Feed a consistent diet. Consistency is key to diabetic regulation.

Monitor at Home For: 
- Reduced appetite
- Vomiting or diarrhoea
- Lethargy or weakness
- Shaking/tremors
- Disorientation or collapse
- Excessive thirst or urination
- Signs of hypoglycaemia (wobbliness, dullness, seizures)

If concerned about low blood sugar:
- Offer food immediately if conscious
- Rub honey or glucose syrup on gums if unable to eat
- Seek urgent veterinary care

We would like to see Zeus back in 5-7 days for a recheck and to assess his blood glucose curve (via his freestyle libre readings on your phone). 

It has been our pleasure to care for Zeus. Please do not hesitate to contact us if you have any concerns, we wish them a speedy recovery.

Kind regards,
Dr Divya and the BVC team