Goldi is on insulin - question about dose

[EileenRC]

Has anyone used a 'by mouth' med to treat canine diabetes? My vet prescribed glipizide/glucotrol for my 13 year old toy poodle because I couldn't make myself administer insulin via syringe. I give it to her twice a day by mouth using a dropper.

Are there any other methods to be used? I feel like such a failure because the couple of times I tried giving her a shot, my hands shook & she screamed so I said that I just can't do it. Surely, I can't be the only person who reacted this way. What do other pet owners do?

Any ideas or help would be appreciated.

[We Hope]

Dogs have type 1, or insulin-dependent diabetes. This means the beta cells of their pancreases are unable to produce either any or enough insulin for their bodily needs.

Glipizide is a drug which increases the action of the pancreatic beta cells:

http://www.veterinarypartner.com/Content.plx?P=A&C=&A=627&SourceID=

"Glipizide acts by increasing the pancreas' secretion of insulin and it is possible that a level of adequate control can be achieved by maximizing the pancreas' secretion in this way."

The beta cells in canine diabetes are beyond being able to be stimulated to produce insulin. This is why canine diabetes means insulin shots.

"Oral Agents in Dogs

"The canine diabetes mellitus experience is more readily compared to Type I (insulin dependent) diabetes in humans. Drugs that are often helpful for feline diabetics have been crashing failures in dogs when used alone; however, some agents can be used as adjuncts to assist the insulin in achieving normal blood sugar levels.

"ACARBOSE (GLUCOBAY®, PRECOSE®)

"This medication inhibits the digestive enzymes responsible for breaking down starches. It's use leads to a more gradual absorption of sugars after a meal which in turn leads to a more stable blood sugar level. This medication is expensive and has potential for side effects (flatulence, weight loss, and diarrhea) thus it is not used except in dogs that have been difficult to control with insulin alone."

The reason an oral drug might help feline diabetes is because their diabetes is much like type 2, or non-insulin-dependent diabetes in people. People with type 2 can keep theirs in control in a variety of ways: some with diet alone, some with diet and oral meds; some are now using meal time insulin (short or rapid acting insulin used before or at meals).

Someone with type 1, or insulin-dependent diabetes has a deficiency of insulin and the only way to correct that deficiency is by giving insulin injections. Using an oral med to try to get beta cells that are not able to be stimulated into producing insulin again is something like trying to get your car to run when there's no gas in the tank--the only answer is to get more gas and put it in.

If you can tell us what aspect of giving insulin shots frightens you, we can probably suggest a workaround. There are insulin pens like these; some are disposable and others are refillable, like an ink pen with cartridges:

http://images3.wikia.nocookie.net/diabetesindogs/images/thumb/0/08/Novo_refillable_insulin_pens.jpg/250px-Novo_refillable_insulin_pens.jpghttp://images1.wikia.nocookie.net/diabetesindogs/images/thumb/7/7e/800px-Insulin_pen.jpg/250px-800px-Insulin_pen.jpg

There's also a device called Inject-Ease which takes the anxiety out of giving a shot:

http://www.palcolabs.com/section_products/injectease.html

http://www.palcolabs.com/images/InjectEase_Cap.jpg

She's probably picking up on your anxiety the times you did try to give her shots. You can learn how to give a pain-free shot in confidence.

http://k9diabetes.com/forum/showthread.php?t=973

http://k9diabetes.com/forum/showthread.php?t=1002

http://k9diabetes.com/forum/showthread.php?t=532&highlight=princess

Above are links to threads about shot time problems we have here on the Forum. The thread about Princess would be of interest, I think, because Princess and Natalie had quite a time in the beginning. With work, both Natalie and Princess were able to get to the point where injection time wasn't time for trauma and tears for either of them.

Many people have difficulty with this in the beginning--none of us really wanted to give our dogs shots but we realized that we had to do this to control their diabetes.

Please tell us more so we can try to help!

Kathy

[Patty]

I remember reading about someone (can't remember who) that called a doggie daycare/boarding center and set up an arrangement to administer the shots. She paid a small fee at first but eventually became confident enough to do it herself. A pet sitter with experience might be another idea as they could come to the house at shot time.

Just thinking outside the box...it might allow you to observe someone enough to feel comfortable trying again.

Hopefully the tips from other threads will help!
Patty

[k9diabetes]

I know you're replying right now... it occurred to me that I know someone who had a diabetic dog who lives in the same city that you do and who might be able to help you. I don't know where exactly, of course... how close to you she might be to you geographically. But I suspect she'd be very willing to try to help you.

Natalie

[EileenRC]

I know you're replying right now... it occurred to me that I know someone who had a diabetic dog who lives in the same city that you do and who might be able to help you. I don't know where exactly, of course... how close to you she might be to you geographically. But I suspect she'd be very willing to try to help you.

Natalie
Hi again Natalie,

How do you put people in touch with each other? I have no problem giving you my contact info, if you want.

Eileen

[EileenRC]

I remember reading about someone (can't remember who) that called a doggie daycare/boarding center and set up an arrangement to administer the shots. She paid a small fee at first but eventually became confident enough to do it herself. A pet sitter with experience might be another idea as they could come to the house at shot time.

Just thinking outside the box...it might allow you to observe someone enough to feel comfortable trying again.

Hopefully the tips from other threads will help!
Patty
Hi Patty,
What a great idea. There is a kennel about a mile away in which I left Goldi last May while I went to Kansas for a nephew's graduation. And, of course, they had to administer the shot every day. I might be able to go there because it's closer than the vets. I could watch them do it a few times before I do. I know the needle is so tiny and that she doesn't feel it. She definitely was reacting to my shaking hands and tenseness and that's why she screamed..........but, boy! it upset me so.

Thanks very much for your help. Forums/chat rooms are new to me. Except for using a Microsoft one many months ago when I was having pc problems, this is my first venture of this kind and I like it, I like it!!

Eileen

[EileenRC]

Dogs have type 1, or insulin-dependent diabetes. This means the beta cells of their pancreases are unable to produce either any or enough insulin for their bodily needs.

Glipizide is a drug which increases the action of the pancreatic beta cells:

http://www.veterinarypartner.com/Content.plx?P=A&C=&A=627&SourceID=

"Glipizide acts by increasing the pancreas' secretion of insulin and it is possible that a level of adequate control can be achieved by maximizing the pancreas' secretion in this way."

The beta cells in canine diabetes are beyond being able to be stimulated to produce insulin. This is why canine diabetes means insulin shots.

"Oral Agents in Dogs

"The canine diabetes mellitus experience is more readily compared to Type I (insulin dependent) diabetes in humans. Drugs that are often helpful for feline diabetics have been crashing failures in dogs when used alone; however, some agents can be used as adjuncts to assist the insulin in achieving normal blood sugar levels.

"ACARBOSE (GLUCOBAY®, PRECOSE®)

"This medication inhibits the digestive enzymes responsible for breaking down starches. It's use leads to a more gradual absorption of sugars after a meal which in turn leads to a more stable blood sugar level. This medication is expensive and has potential for side effects (flatulence, weight loss, and diarrhea) thus it is not used except in dogs that have been difficult to control with insulin alone."

The reason an oral drug might help feline diabetes is because their diabetes is much like type 2, or non-insulin-dependent diabetes in people. People with type 2 can keep theirs in control in a variety of ways: some with diet alone, some with diet and oral meds; some are now using meal time insulin (short or rapid acting insulin used before or at meals).

Someone with type 1, or insulin-dependent diabetes has a deficiency of insulin and the only way to correct that deficiency is by giving insulin injections. Using an oral med to try to get beta cells that are not able to be stimulated into producing insulin again is something like trying to get your car to run when there's no gas in the tank--the only answer is to get more gas and put it in.

If you can tell us what aspect of giving insulin shots frightens you, we can probably suggest a workaround. There are insulin pens like these; some are disposable and others are refillable, like an ink pen with cartridges:

http://images3.wikia.nocookie.net/diabetesindogs/images/thumb/0/08/Novo_refillable_insulin_pens.jpg/250px-Novo_refillable_insulin_pens.jpghttp://images1.wikia.nocookie.net/diabetesindogs/images/thumb/7/7e/800px-Insulin_pen.jpg/250px-800px-Insulin_pen.jpg

There's also a device called Inject-Ease which takes the anxiety out of giving a shot:

http://www.palcolabs.com/section_products/injectease.html

http://www.palcolabs.com/images/InjectEase_Cap.jpg

She's probably picking up on your anxiety the times you did try to give her shots. You can learn how to give a pain-free shot in confidence.

http://k9diabetes.com/forum/showthread.php?t=973

http://k9diabetes.com/forum/showthread.php?t=1002

http://k9diabetes.com/forum/showthread.php?t=532&highlight=princess

Above are links to threads about shot time problems we have here on the Forum. The thread about Princess would be of interest, I think, because Princess and Natalie had quite a time in the beginning. With work, both Natalie and Princess were able to get to the point where injection time wasn't time for trauma and tears for either of them.

Many people have difficulty with this in the beginning--none of us really wanted to give our dogs shots but we realized that we had to do this to control their diabetes.

Please tell us more so we can try to help!

Kathy
Hi Kathy,
Thanks for your reply. You know so much! I'm going to print it out and start a folder to keep all the info close..........I have so much to learn. I won't have time tonight to visit the links you gave me about giving a pain-free shot.......it'll have to wait until tomorrow. I'm playing cards this evening with some 'girlfriends'. We are all in our 60's & 70's but we're still 'girlfriends'.........ha, ha!

[EileenRC]

It's me again, Kathy. I just reread the info in your note & see that the first part is a quote from We Hope[/I]............so, thank you We Hope!

And thank you again Kathy!

Eileen

[EileenRC]

This is to all you wonderful people who reached out to me this evening. I'm so grateful. Before hearing from you, I was feeling quite alone and worried. I'm going to sign off for now but I'll be back tomorrow or later tonight after my company leaves.

Eileen

[CarolW]

Eileen,

I'm glad you came here to investigate. Besides the links given to you already, quite a few people have reported this one really helpful.

http://www.coherentdog.org/vek/painlessinj.php

My diabetic dog Kumbi, along with my vets, were my teachers for this, and Natalie and Kathy contributed the tip about keeping the bevel of the needle up.. Looking forward to your further reports!

Sat, 19 Sep 2009 20:01:34 (PDT)

[k9diabetes]

I understand the dog is good with shots at the vet so I think it's mainly a matter of getting Eileen over her fear. Which is great as it would be much more difficult if the dog was scared of all shots.

When I think about my cat and that first insulin shot... if she had let out a scream in response, I probably would have screamed back and never tried again! Or just plain had a heart attack as I was such a wreck already.

I will email the folks I know and see if they are interested and have time to help.

Natalie

[Cornspot]

After you do it a couple times it will be a piece of cake. Try poking an orange a few times (use water not the expensive insulin) Just to get the feel of how a syringe works.

I don't know if any inulins that are appropriate for you dog can be used in one, but there is a needleless device for humans that can't handle injections. It uses high pressure to drive the insulin into the skin. It it pretty loud, but we give certain cat vaccines with one & they seem to do OK with it.

BUT really the injections don't hurt (I have to stick myself 4-6 times a day & most of the time I can't feel it!)

It will help to draw the insuling then hold the syringe in your hands a minute to take the chill off--cold insulin does sometimes sting a bit

Also, not sure how your vet taught you but I found this advice very easy to picture in my head when i was first taught how to do Sub Q injections: pull some skin up to make a "tent" with your non-dominant hand, poke the "door" to the tent with your fore finger of the other hand and that's where you are going to put the needle. Insert the needle into the "door" at a bit of an angle so it isn't directly sideways or directly up & down.

I hope you are able to find someone to help you out; maybe your vet will do it for you.

[EileenRC]

Posted November 13, 2009 and merged to EileenRC's thread November 14 by Natalie

Today my 14 year old toy poodle, Goldi, resumed insulin injections. I had been giving them to her daily until July 22nd when I decided that I didn't want to do it anymore (I just hated doing it.) and asked my vet to prescribe an oral medicine.......glipizide. I guess I never felt good about the switch because I never read anything positive about this medication. Also, every source I read or searched that prescribed insulin injections also commented that there were no good oral meds at this time for dogs. So, I've decided that I have no choice but to suck it up and do what's best for Goldi. My question........is it possible for the insulin need to lessen from 6 units to 3 units?

EileenRC

Here's the rest of Eileen's post. I may rearrange this so it shows up under her name but wanted to post this for now...

More on Goldi's situation/prescription.......she is to receive the 3 units once a day. The former dosage of 6 units was also once a day. I've read that many people have to give it twice a day, so I wonder about that too.

My next concern is with dismissive attitude of my vet when I asked him about not using Vetsulin because of an FDA report questioning its efficacy. He used Vetsulin today and that's what I have here at home to give Goldi tomorrow...........am I right to be concerned or am I over reacting? I think that's all for now.........hope it's not too much to post.

[Patty]

Hi Eileen,
I'm sure there are others that will come along to help but I wanted to say I'm glad you decided to "suck it up" as you say :D and go back to injections.

I do know that Glipizide or Glucotrol blocks the potassium channels in the beta cells of the pancreas, which in turns increases the amount of calcium and signals the release of more insulin from the beta cells. This is helpful for Type II diabetics that can produce their own insulin but have develop resistance. I know Kathy had sited some info like this.

But Type I diabetics, like dogs, don't produce insulin anymore. The beta cells are destroyed so the Glipizide can't help them produce what isn't there.

As far as the dose of insulin, that depends on the food you are feeding now and how the body is using the insulin.

I recently switched insulins and had to return to NPH. Ali is now using a full 1-2 units less so far than she had previously.

What dose did you start out with?
What type of insulin?
Are you feeding the same food as before July 22nd?
Is she still 9lbs?

Hang in there :)
Patty

[k9diabetes]

Are you monitoring her blood sugar - am wondering how the single injection per day has been containing her blood sugar. Anything you can tell us about that would be helpful.

My best guess about the Vetsulin is that the supply IS going to be depleted and it's only a question of when that occurs and how long it is not available.

So you may very well have to switch to NPH... but NPH absolutely must be given twice a day.

It may be that, given that you have struggled with giving injections, the vet is wanting to stick with an insulin that "sometimes" works once a day. In truth, it almost never works properly when given once a day...

So if you can tell us more about how her blood sugar has been on 6 units and on 3 once a day, we can talk more about what is and isn't working.

Natalie

[EileenRC]

Hi Patty,

Thanks for your response. Today was the first time since 7/22 that I gave Goldi an insulin injection and I've been pleased with myself all day!!

In early June when Goldi was first diagnosed with diabetes the vet prescribed 6 units of Vetsulin once a day. The first few days were rough but bit by bit I got better at it until I could do it without my stomach doing flip flops. Then on 7/22 my other dog Tasha had to be put to sleep and when I tried to give Goldi her shot that day she screamed and I guess I freaked out. I know she picked up vibes from me..........I couldn't stop crying & my hands were shaking so I probably put the needle in wrong. But whatever, I told the vet I just couldn't do it anymore and so he told me about Glipizide. I gave her a dropperful twice a day but I really never felt good about it.........in the back of my mind, I knew she should be getting insulin instead.

So, the other day I dropped her off early (8 am) so that the vet & staff would have her the whole day to do whatever it is they do to see where she is regarding her diabetes. When I picked her up at 6 pm, I was told that she only needed 3 units once a day. The insulin is Vetsulin. I'm feeding her different food which she likes better. I'll have to look up the name. It comes in rolls and is kept refrigerated in the market. She now weighs 8 lbs. She used to be over nine lbs.

My other concern is the use of Vetsulin. I mentioned the FDA warning to the vet and he seemed dismissive, I thought. I printed out the FDA warning from the government website and also the one from the Vetsulin site and left them with the nurse to put on his desk. His attitude bothered me but maybe I'm overreacting.

Anyway Patty, thanks for listening. I hope I haven't included too much information for the forum. Perhaps I should have sent you a private message instead. Please let me know if I need to do something differently. I know eventually that I'll find my way around the site.

I last visited this site in September but then kept using the Glipizide. Happiliy, for Goldi's sake, I've smartened up and I'm so pleased that you all are here to help.

[EileenRC]

Hi Natalie,

Thanks for your input. No, I'm not monitoring her blood sugar. Looks like I'm going to have to learn how to do it. So many people on your forum seem to do it that I'm wondering why my vet never brought up the subject either time regarding Goldi. Perhaps you're right and the vet didn't want me to be overwhelmed so is holding off suggesting it.

But, wouldn't you think that he'd have me bring her back in so he could check it? He never did the first go 'round in June. And it wasn't mentioned when I picked her up this past Friday evening. It's only through your forum that I'm beginning to realize how much is involved in controlling blood sugar.

I like my vet but am beginning to think that he's not being as attentive as he should be.

[Patty]

Eileen,
Congrats on your first shot since July!

You'll find a lot of great support here. And really there's no such thing as too much information ;) Makes it easier to help people. Looks like Natalie's given you some good insight on the Vetsulin issue. I too wonder how Goldi's doing on a single injection.

I'm very sorry to hear about Tasha.

Take care,
Patty

[k9diabetes]

Since he had her all day recently, he may have done a curve where he would check the blood sugar multiple times throughout the day.

Please ask the office staff if a curve was done and, if so, to give you the results - either read you the times and readings or give you a copy by hand or fax.

Then post the results of the curve here if one was done so we can take a look.

Given that Goldi went so long without insulin, she may still be producing some insulin of her own and that's why the dose was reduced and is remaining at once a day.

Even if a curve wasn't done, ask them for a copy of the results of all blood glucose testing they have done. That way, we can help you sort out how she has been doing with and without insulin.

I'm so proud of you for fighting back your fears and giving Goldi insulin. :)

And my condolences on the loss of Tasha... I know how hard that is.

Natalie

[k9diabetes]

One more thing... no post is "too long." The more details the better. I personally have written some major novels. So don't worry about trying to be brief! :)

Natalie

[EileenRC]

Hi Natalie & Patty,

Under the windows on the right side there are 3 icons: 'QUOTE', 'Multi-Quote This Message' & 'Quick reply to this message'...........I clicked on QUOTE & this window popped up.......so I'll reply here. Hope you get this. I haven't looked yet but is there a directory or whatever to define different icons, etc....? Occasionally, in a new situation I'll start investigating 'stuff' and then can't find my way back to where I started..........where I need to be. Hopefully, I haven't done that here.
-------------------------------------------------------------------------
Anyway, regarding Goldi's results.........I'll call the vet tomorrow morning to get some answers. Many thanks for suggesting that, Natalie.

I'm happy to report that today's injection went smoothly. I used the tip I read somewhere on this awesome site/forum about rotating the syringe so that the bevel side faced away from her body. But, I gotta tell you that I had to use a magnifying glass to find the right spot........on the syringe that is. Then I marked it in red........think I'll do this with all the syringes.

This might be my hopeful imagination, but Goldi seems perkier. Is that possible so soon? She's only had two shots.........yesterday & today.

[EileenRC]

Hi Natalie & Patty,

Under the windows on the right side there are 3 icons: 'QUOTE', 'Multi-Quote This Message' & 'Quick reply to this message'...........I clicked on QUOTE & this window popped up.......so I'll reply here. Hope you get this. I haven't looked yet but is there a directory or whatever to define different icons, etc....? Occasionally, in a new situation I'll start investigating 'stuff' and then can't find my way back to where I started..........where I need to be. Hopefully, I haven't done that here.
-------------------------------------------------------------------------
Anyway, regarding Goldi's results.........I'll call the vet tomorrow morning to get some answers. Many thanks for suggesting that, Natalie.

I'm happy to report that today's injection went smoothly. I used the tip I read somewhere on this awesome site/forum about rotating the syringe so that the bevel side faced away from her body. But, I gotta tell you that I had to use a magnifying glass to find the right spot........on the syringe that is. Then I marked it in red........think I'll do this with all the syringes.

This might be my hopeful imagination, but Goldi seems perkier. Is that possible so soon? She's only had two shots.........yesterday & today.

It's me again trying to see what things mean. I'm trying to put in a smiley face but no luck.

[EileenRC]

It's me again trying to see what things mean. I'm trying to put in a smiley face but no luck.

Now I know what 'QUOTE' is used for.

[Patty]

Eileen,
I think you clicked on the smileys at the bottom. Look at your last post. The title has a cool smiley next to it. :cool:

The smileys to the right of where you're typing will insert in your text. Or there's a smiley you can click on up next to the "A" that changes the text color if it looks the same as mine.

Patty ;)

[EileenRC]

Eileen,
I think you clicked on the smileys at the bottom. Look at your last post. The title has a cool smiley next to it. :cool:

The smileys to the right of where you're typing will insert in your text. Or there's a smiley you can click on up next to the "A" that changes the text color if it looks the same as mine.

Patty ;)

Oh yeah!! :D Thanks Patty!!

[k9diabetes]

You can also practice in our practice forum: http://www.k9diabetes.com/forum/forumdisplay.php?f=7

Its sole purpose is for junk posts - you can start a new thread, post a reply to one of the existing ones, and try out anything else you want to try there.

Natalie

[EileenRC]

Since he had her all day recently, he may have done a curve where he would check the blood sugar multiple times throughout the day.

Please ask the office staff if a curve was done and, if so, to give you the results - either read you the times and readings or give you a copy by hand or fax.

Then post the results of the curve here if one was done so we can take a look.

Given that Goldi went so long without insulin, she may still be producing some insulin of her own and that's why the dose was reduced and is remaining at once a day.

Even if a curve wasn't done, ask them for a copy of the results of all blood glucose testing they have done. That way, we can help you sort out how she has been doing with and without insulin.

I'm so proud of you for fighting back your fears and giving Goldi insulin. :)

And my condolences on the loss of Tasha... I know how hard that is.

Natalie

Hi Natalie,

As you suggested, I called the vet's office and asked that they print out the results of the testing done on Goldi last Friday.

I'll pick up the printout today, I hope.

The person I spoke to kind of discouraged me from testing at home. She said that most owners rely on the vet to do it periodically. Perhaps I should point her to this website so that she can see the information and directions available to those who want to do it?

Eileen :confused:

[k9diabetes]

It's not unusual for vet offices to discourage home testing... I have a lot of theories on why that is! :) Some are not familiar with how easy it can be to do at home. Some fear the humans will start making uninformed decisions with potentially very dangerous results. Some don't like the variance with regular meters for people...

We were fortunate that our vet when Chris was diagnosed suggested testing to us as we were not aware it was done. He didn't suggest it right away but did after Chris started throwing such confusing curves.

If nothing else, I think it's worthwhile for checking for low blood sugar, something urine testing doesn't help with. At its best, it allows you to manage your dog's blood sugar and maintain much better blood sugar management, plus tweak things if needed and see the results of the tweaking on the insulin/food balance.

Natalie

[EileenRC]

It's not unusual for vet offices to discourage home testing... I have a lot of theories on why that is! :) Some are not familiar with how easy it can be to do at home. Some fear the humans will start making uninformed decisions with potentially very dangerous results. Some don't like the variance with regular meters for people...

We were fortunate that our vet when Chris was diagnosed suggested testing to us as we were not aware it was done. He didn't suggest it right away but did after Chris started throwing such confusing curves.

If nothing else, I think it's worthwhile for checking for low blood sugar, something urine testing doesn't help with. At its best, it allows you to manage your dog's blood sugar and maintain much better blood sugar management, plus tweak things if needed and see the results of the tweaking on the insulin/food balance.

Natalie


Hi Natalie,

I just wanted to tell you that I got the curve info from the vets the other day but I've not had the time to enter it here. Tomorrow will be calmer. Also, I want to thank you again for your help..........'see' ya tomorrow.

Eileen:o

[k9diabetes]

Looking forward to it! :)

[EileenRC]

Looking forward to it! :)


Hi Natalie,

I'm copying this exactly from the report:

11/12/09

8am glu=466
Tx 3U vetsulin sq @ 12pm
3pm glu=352
5pm glu=142
Owner to give 3 units vetsulin Sq once daily

Don't know if this helps.

Eileen :)

[Patty]

I'm copying this exactly from the report:

11/12/09

8am glu=466
Tx 3U vetsulin sq @ 12pm
3pm glu=352
5pm glu=142

Eileen,
I'm curious, what time(s) do you feed Goldie?

352 to 142 in 2 hours is a pretty steep drop, a little over 100 points an hour. Was food given at 12pm too?

Patty

[EileenRC]

Eileen,
I'm curious, what time(s) do you feed Goldie?

352 to 142 in 2 hours is a pretty steep drop, a little over 100 points an hour. Was food given at 12pm too?

Patty


Hi Patty,

I just called the office and was told that she was fed Iams dry food @ 12pm.

Here at home, I feed her right before the injection which she get at noon once a day. She's been eating better I'm happy to say. I give her Fresh Pet Select which comes refrigerated in the super market. She loves the stuff. I give her 1/2 cup 2 or 3 times a day.......whenever she's looking for food, I feed her that. She also loves carrots. Since she's lost weight, I'm happy to feed her as often as she wants.

Eileen

[k9diabetes]

Unfortunately that curve suggests that the Vetsulin is not lasting 24 hours. The blood sugar is rising quite a bit sometime prior to 8am and because they are trying to give her all of her insulin at once, she's going through a pretty sharp difference between high and low - her blood sugar could be going quite a bit lower than the 142 because it's likely that her blood sugar got lower still sometime that evening after the curve was done. Vetsulin usually is still going pretty strong at 6-7 hours.

It sounds like at home you would have given her more food in the evening.

I thoroughly understand putting off two injections a day when you were so worried about giving one. Giving insulin once a day is a lot better than not at all. :)

But Goldie won't ever be able to be really well regulated on one injection a day because her insulin just doesn't last that long.

So if you can find the courage, now or in the near future, to give her two injections a day, she would be much healthier and undoubtedly happier too.

And she would need to be fed at the same time and not allowed to eat throughout the day - the food would need to go with the insulin so they can work together.

How are you feeling about the prospect of two injections a day?

Natalie

[EileenRC]

Unfortunately that curve suggests that the Vetsulin is not lasting 24 hours. The blood sugar is rising quite a bit sometime prior to 8am and because they are trying to give her all of her insulin at once, she's going through a pretty sharp difference between high and low - her blood sugar could be going quite a bit lower than the 142 because it's likely that her blood sugar got lower still sometime that evening after the curve was done. Vetsulin usually is still going pretty strong at 6-7 hours.

It sounds like at home you would have given her more food in the evening.

I thoroughly understand putting off two injections a day when you were so worried about giving one. Giving insulin once a day is a lot better than not at all. :)

But Goldie won't ever be able to be really well regulated on one injection a day because her insulin just doesn't last that long.

So if you can find the courage, now or in the near future, to give her two injections a day, she would be much healthier and undoubtedly happier too.

And she would need to be fed at the same time and not allowed to eat throughout the day - the food would need to go with the insulin so they can work together.

How are you feeling about the prospect of two injections a day?

Natalie


Well, of course, part of me doesn't like it but the other part realizes that it's probably best for Goldi and I'll get better faster at doing the injections.

Do you think I can do this without the docs say so?

I'm thinking that I need to find a new vet. I don't suppose that there is a directory for vets that specialize in particular diseases. I'd love to find one who would be willing to work with me in my attempt to really learn about this disease and not try to dissuade me from having too many questions or from testing Goldi's sugar myself.

Eileen

Eileen

[EileenRC]

I do feed her more at in the evening because she seems hungrier then. I've even thought about asking the doc about administering her shot at this time of the day because she'll easily eat enough to take the insulin. Sometimes in the morning I have to coax her to finish what I've put out for her.

Eileen

[EileenRC]

It's me again, Natalie,

I'm sitting here giggling at the last post. Hope you can make sense of it. I wrote something and clicked submit. Then I realized that I forgot to tell you about her hunger in the evening so went back to add that bit of info hoping it would all flow smoothly but alas, it didn't.

Eileen :o

[k9diabetes]

I think the vet will go along with two injections a day if you indicate that you are willing. My guess is that they were holding to one because they didn't want to overwhelm you.

You can get a consult with an internal medicine specialist. They spend most of their time with more difficult diseases and see diabetics when the regular vet is unable to regulate the dog.

While on once a day insulin, it probably doesn't matter what time you feed and inject so you could move it to a time when she's more hungry.

If you go to twice a day the vet will most likely reduce the insulin dose some and allow the injections to overlap. And then see if the dose needs to be increased.

Try talking to them about twice a day and letting them know that you are willing to do it - when you are! ;) - and see what they say.

Natalie

[EileenRC]

I think the vet will go along with two injections a day if you indicate that you are willing. My guess is that they were holding to one because they didn't want to overwhelm you.

You can get a consult with an internal medicine specialist. They spend most of their time with more difficult diseases and see diabetics when the regular vet is unable to regulate the dog.

While on once a day insulin, it probably doesn't matter what time you feed and inject so you could move it to a time when she's more hungry.

If you go to twice a day the vet will most likely reduce the insulin dose some and allow the injections to overlap. And then see if the dose needs to be increased.

Try talking to them about twice a day and letting them know that you are willing to do it - when you are! ;) - and see what they say.

Natalie

For the first time since returning to the injections, Goldi is not interested in eating now..........11:30 am here in Austin. So, I'll wait awhile and try later. It's my fault, I guess, I gave her carrots and milk bone earlier. She's lost weight so anytime she wants to eat, I feed her...........carrots and biscuits are her favorites.

Do you think it matters what food is fed before the injection? I'm assuming that a 'proper' meal is needed.........not snacks such as carrots & milk bone biscuits.

I'll check into an internal medicine specialist.

Thanks, Natalie

Eileen

[k9diabetes]

Yes, you need a meal to go with the insulin. Otherwise you could have a rush of insulin and no food to go with it, with potential for low blood sugar as a result.

Natalie

[Bagel's Mom]

Hi all...Like I am an expert? Was reading here...I was told to stay away from feeding Bagel any carrots, potatoes, or corn since they are HIGH sugar carbs...
and go for protein.....
Also, lots of people have written that to me on our posting page..
Sande

[k9diabetes]

Sande is correct that carrots and potatoes are pretty high on the glycemic index so generally as snacks or part of the food they wouldn't be great for a diabetic dog.

Goldi just got started on insulin and we have been working toward her getting two injections a day. At the moment she is pretty much free feeding.

If we can get her onto two injections a day, I would advocate for tigher control of her diet - food and insulin together and snacks or mid-day meals only if her curve shows that she needs it.

Natalie

[EileenRC]

Sande is correct that carrots and potatoes are pretty high on the glycemic index so generally as snacks or part of the food they wouldn't be great for a diabetic dog.

Goldi just got started on insulin and we have been working toward her getting two injections a day. At the moment she is pretty much free feeding.

If we can get her onto two injections a day, I would advocate for tigher control of her diet - food and insulin together and snacks or mid-day meals only if her curve shows that she needs it.

Natalie


Hi Sande & Natalie,

Thanks for your input. My sister-in-law has been here for a week from Philadelphia and other than giving Goldi her once a day shot, I've not done much more w/advancing my cause of getting her regulated. But, today my she returns to the east coast; yesterday I made an appointment with an internal medicine veterinarian for this Thursday. They suggested I bring her medical history from my current vet as a way to limit costs........no sense rerunning the same blood tests, if both offices use the same lab. I'm thinking that it would be best to start anew. Any opinions?

I hate to admit this but I feel a little guilty going for a second opinion........I really like my current vet and don't want to hurt their feelings. I know, I'm the paying customer (any such thing as a non-paying customer?) but...........

Gotta go show Nell (sister-in-law) how to work the washing machine. I'll be in touch.

Eileen :confused:

[k9diabetes]

You should never feel guilty for getting a second opinion. That's just good conscientious parenting and your vet should encourage you to seek the advice of an IM too.

If you had a serious illness, your doctor would want you to have the best care available, right?

The sign of a vet confident that her treatment of your dog is sound is her willingness to have it reviewed by a specialist.

I'm anxious to hear how the second opinion goes! :)

Natalie

[EileenRC]

You should never feel guilty for getting a second opinion. That's just good conscientious parenting and your vet should encourage you to seek the advice of an IM too.

If you had a serious illness, your doctor would want you to have the best care available, right?

The sign of a vet confident that her treatment of your dog is sound is her willingness to have it reviewed by a specialist.

I'm anxious to hear how the second opinion goes! :)

Natalie

Hi Natalie,

I'm still here but don't have time for any details now except to tell you all that I'm now giving Goldi two shots a day...........I still hate it! Hope this changes but I'm thinking that I gotta work on changing my approach/attitude.

I'll try to write tomorrow.

G'nite, Eileen :)

P. S. Hope you are all happy and healthy........this includes both the two legged and four legged ForumFolks.

[Patty]

Cheering you on Eileen ;)

[k9diabetes]

Good for you!!!! :) :) :)

I knew you could do it. Remember when you refused to give even one?

Natalie

[EileenRC]

Good for you!!!! :) :) :)

I knew you could do it. Remember when you refused to give even one?

Natalie

Hi Natalie & Patty,

Here I am again with another quick note. I've been giving 2 units (Vetsulin) twice a day since 12/10. Tomorrow I take Goldi to the vets (the new internal medicine doctor) for another glucose curve. I'm thinking that they need to prescribe an increase in dosage because her thirst and frequent urination haven't slowed down. I left her at the vets on 12/9 & the curve is as follows:
Readings:
8 am = HI (no numbers, just HI)
12 pm = 459
3 pm = 189
5:30 pm = 160

We talked about using another insulin down the road but for now I can keep using Vetsulin. Since I still have half a bottle, I'm pleased with this decision.

I'm getting better (the stomach butterflies are starting to fade) with the injections although if they found an oral treatment tomorrow, I'd be the first in line to buy it.

I want to thank you both for building my confidence and cheering me on. You'll never know just how much your input kept me from giving in to my cowardly side.

Goldi and I are off to bed now..........gotta be up early tomorrow. I'll be in touch.

Good night, Eileen :D

[k9diabetes]

Hmmm... I wonder if she ate for them there or if vet stress could be involved. Did she eat like she normally does at home during the curve.

With this curve, she really can't have any more insulin because her blood sugar is dropping down into the mid-100s on the what she's getting now. Even another half a unit could send her into hypoglycemica.

If this curve seems to be typical of her, I'd be switching right away to NPH to see if she gets a flatter blood sugar profile because while this does bring her blood sugar down, it's far from perfect. There's too much difference between her highest and lowest blood sugar.

It would be really helpful to know what happened after 5:30pm...

Depending on what her diet was during the curve, there may be ways to supplement her food during the day and flatten out the curve but I can't remember what her food schedule is and I can't look right now.

Got to run but would like to hear more about this,

Natalie

[EileenRC]

Hmmm... I wonder if she ate for them there or if vet stress could be involved. Did she eat like she normally does at home during the curve.

With this curve, she really can't have any more insulin because her blood sugar is dropping down into the mid-100s on the what she's getting now. Even another half a unit would like send her into hypoglycemica.

If this curve seems to be typical of her, I'd be switching right away to NPH to see if she gets a flatter blood sugar profile because while this does bring her blood sugar down, it's far from perfect. There's too much difference between her highest and lowest blood sugar.

It would be really helpful to know what happened after 5:30pm...

Depending on what her diet was during the curve, there may be ways to supplement her food during the day and flatten out the curve but I can't remember what her food schedule is and I can't look right now.

Got to run but would like to hear more about this,

Natalie

Hi Natalie,

Well Goldi is not at the vets because I awoke in the middle of the night feeling crappy. I'm still feeling that way so I rescheduled her for tomorrow morning.

Your note tells me that I really don't understand the relationship between blood glucose, diabetes, insulin, food and how it all works. I need to spend some time today finding out. I'm feeling a bit stupid right now. What brought it home to me was your comment about not being able to give her more insulin because the 3 units she got on 12/9 brought her down to 160 and to bring her lower would induce(?) hypoglycemica. And here I am thinking that she needs more because of continued thirst and frequent urination.........duh!

Thanks again!!

Eileen :o

[k9diabetes]

Dogs can really vary in how sensitive they are to high blood sugar. Some dogs will drink more anytime they go over 280 and then there are dogs like mine who never really drank much extra water until his blood sugar stayed at 450 or higher all day.

So the time Goldi spends with blood sugar in 300s and 400s is possibly enough to be causing her to drink a lot of extra water.

Do you notice the thirst being better in the afternoon and wee (sorry about the pun!) morning hours when her blood sugar, per the curve, is lower and that she's more thirsty in the early to mid-morning and evening when her blood sugar is much higher?

If she's very thirsty 24 hours a day, I would be concerned that something other than just high blood sugar might be involved.

Is she definitely drinking a lot too or is she just urinating a lot or often?

Frequent small amounts of urine, for example, could suggest that a UTI is the problem.

Very dilute urine can be related to the kidneys functioning poorly and not concentrating the urine.

I have to go back... I keep thinking Goldi was free feeding but I will look for sure. If she is, I doubt that's what they did at the vet, which would change the curve there versus how she is at home.

Natalie

[k9diabetes]

Yup, she has been free feeding... Does she still free feed?

If so, what did the vet do while running the curve? If they didn't let her eat all day or if she refused to eat while there, the curve at the vet would have a much sharper drop in blood sugar because at times of day when she normally would graze she didn't have any food.

So how much this curve tells us about how Goldi does during her normal day depends on how much the curve day was like her normal day...

Natalie