Initial management of canine diabetes mellitus emphasizes solving dehydration and electrolyte abnormalities through what first step?

• A. Aggressive IV fluid therapy to correct dehydration and electrolyte abnormalities, followed by insulin therapy.
• B. Immediate insulin therapy without fluids.
• C. Diet-only management.
• D. Oral hypoglycemic agents.

Answer: (A)

The main idea is that addressing dehydration and electrolyte disturbances takes precedence before addressing high blood sugar. In a diabetic dog that is dehydrated, the first step is aggressive intravenous fluid therapy with isotonic crystalloids. Restoring circulating volume improves tissue perfusion and kidney function, which helps the body correct electrolyte imbalances (and any associated acid–base issues). This fluid resuscitation also provides a safe foundation for subsequent insulin therapy. Starting insulin before fluids can worsen dehydration and electrolyte shifts, so fluids come first. Diet-only management or using oral hypoglycemic agents does not rapidly correct the acute dehydration and electrolyte abnormalities seen in these patients.