
www.caninsulin.co.uk
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 
Vet’s name:
Practice name:
Tel No:   
Fax No:
Clinical signs evident in 
the animal at the time  
of BG curve?
 (please tick)
Time glucose curve started:    Time insulin administered:
2 46810 12 14 16 18 20 22 24
1
5
10
15
20
25
30
35
23456
Hours from start of monitoring
Blood glucose mmol/l
789101
2
For more information or to download a printable version 
of this form, visit www.caninsulin.co.uk
 
Blood Glucose Monitoring Chart
71755.47_Diabetes_Interpretation_Callback_GMChart-3.indd   1 30/01/2015   13:57