23/05/2026
Meet Bella🐶 - all the way from Botswana! 🇧🇼
Bella was admitted to Onderstepoort Veterinary Academic Hospital in critical condition, suffering from Hyperosmolar Hyperglycaemic Syndrome (HHS), a rare but life-threatening complication of diabetes mellitus.
What is HHS?
When blood glucose and sodium levels rise to dangerously high levels, the blood becomes extremely concentrated, drawing water out of cells - including brain cells. After witnessing muscle tremors, vacant staring, loss of coordination, vomiting, and diarrhoea at home, Bella’s owner made the urgent decision to travel to Pretoria. On presentation Bella was very lethargic and we noticed her pupils were unequal in size, suggesting significant neurological involvement. Without urgent intervention, HHS is fatal, and even with intensive treatment the mortality rate in dogs remains high.
Why is ICU care so critical?
Correcting the high glucose and sodium levels too quickly can cause the brain to swell, making slow, controlled treatment and 24-hour monitoring absolutely crucial. We used a FreeStyle Libre 2 continuous glucose monitor to track Bella’s levels in real time during her stay, and the best part? Now that she’s home, our team in Pretoria can still monitor her glucose levels remotely. Technology making specialist care truly borderless! 🌍
Bella is now getting once-daily Tresiba (degludec) insulin injections and we can continue adjusting her dose as needed. 🌟
