1 Blood Glucose Monitoring Chart Pet Details Pet's name: Owner's name: Breed: Sex: Neutered: Yes No Age: Weight: Feeding time (am/pm or ad libitum): Body condition (please indicate): Overweight Correct weight Underweight Treatment Number of units of Caninsulin : Frequency of administration (SID/BID): Date: Please record time of injection(s) on the graph Tick relevant box for timescale used 2 4 6 8 10 12 14 16 18 20 22 24. 35. 30. 25. Blood Glucose mmol/l 20. 15. 10. 5. 1 2 3 4 5 6 7 8 9 10 11 12. Hours from start of Monitoring Time Glucose curve started: Time insulin administered: Vet's name: Clinical signs evident in the animal at the time Practice name: of BG curve?
2 (please tick). Tel No: Fax No: For more information or to download a printable version of this form, visit 1 30/01/2015 13:57. Diabetic Interpretation Callback Request Form Vet / Nurse Name: Veterinary Practice: Contact No: Preferred contact time: other Client name/animal's name: Species: Breed: Age and weight: Sex: Neutered: Body condition (please indicate): Overweight Correct weight Underweight Diet: History Please attach the animal's full history with all relevant information including: date of diabetes diagnosis, diagnostic tests performed, doses of Caninsulin administered, dates and details of insulin changes, any concurrent medications, concurrent diseases, relevant Blood Glucose curves and fructosamine results where applicable.
3 SA-F01884 63125/AUG14/NB/4K. Please also email or fax any Blood Glucose curve charts, urinalysis reports or other laboratory results. Please email or alternatively fax to 01908 685606. A Technical Adviser will endeavour to contact you within 24 hours (Mon-Fri), at the specified time where possible. If you have an urgent query, please contact the Technical Product Support Team on 01908 685685 or email For more information or to download a printable version of this form, visit Rewriting pet diabetes management Use medicines responsibly. For more information visit Caninsulin is indicated for the treatment of diabetes mellitus in cats and dogs.
4 Caninsulin is an intermediate acting insulin product containing porcine insulin, which is structurally identical to canine insulin. Legal category POM-V. Further information is available from: MSD Animal Health, Walton Manor, Walton, Milton Keynes MK7 7AJ. Please contact our Technical Product Support Team. Tel: 01908 685685 Fax: 01908 685606 Item Code: SA-000468. 2 30/01/2015 13:57.