Blood Glucose Monitoring Chart Page 2
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1
2Diabetic Interpretation Callback
Request Form
Vet / Nurse Name:
Veterinary Practice:
Contact No:
Preferred contact time: a.m.
p.m.
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.
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.
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
71755.47_Diabetes_Interpretation_Callback_GMChart-3.indd 2
30/01/2015 13:57
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Parent category: Medical