How long for insulin to start working??

[snickmom]

I'm new to this site and very grateful for all the information. We have a 14 pound 9-year old female mini schnauzer that diagnosed with diabetes about a week ago. Ever since diagnosed, she's been on 2 units of HumulinN in the morning and 1 unit at night. Those low amounts were able to get her levels down while she was at the vet's office. The last couple of days we have noticed that she's become somewhat lethargic and she's still extremely thirsty. We haven't had another "curve" done yet but we were just wondering if it takes some dogs a while to get used to the insulin or..?? Also wondering if the extreme thirst ever goes away??? Thanks so much in advance for any suggestions or input you might have.

[k9diabetes]

Re: How long for insulin to start working??

I probably have more questions for you than answers!

- Did she eat for the vet while they were giving insulin and testing her blood sugar?

- How low did they get her blood sugar while there?

- Are you monitoring with urine tests? If so, what have the results been?

- Is she getting a meal and injection every 12 hours?

- Are you pretty confident in your insulin-mixing and injection technique?

This is something to consider especially if the vet didn't really show you how to do it and you haven't done it before.

Three possibilities come to my mind if there are no problems likely with technique, meals, etc....

1 - That amount of insulin is not enough at home.

Maybe she did not eat well for them at the vet's office? Also, stress can drop blood sugar.

2 - It's actually more than she needs and she is "rebounding."

http://www.caninediabetes.org/pdorg/somogyi.htm

The additional excitement/activity/exercise at home could be changing how she responds to the insulin relative to being stuck at the clinic all day.

3 - Her blood sugar is going through large swings from high to low and back to high.

Again, this could be meal or activity related or just her more settled long-term response to the insulin since it can take a week or so for a dog to show how they will respond as their body adjusts.

The only way to get some answers is to test. Ideally blood glucose.

But even some urine testing would help get a handle on whether her blood sugar is high all the time or going low and then high in a rebound cycle.

Fill us in a bit more and then we could talk about how to test to see what's going on with her.

Natalie

[CarolW]

Re: How long for insulin to start working??

Just want to welcome you here; I'll be watching for your replies to Natalie's questions, and cheering you on. Do yell for help, any time! and please keep us updated on how things are going!

Fri, 12 Feb 2010 02:33:20 (PST)

[snickmom]

Re: How long for insulin to start working??

Thank you so much for taking the time to read and reply to my questions. I'll try to answer them the best that I can.

1) The vet said she ate pretty well, threw up once but I'm sure that was because of stress.
2) They got it down into the 120's. They did this with 2 units in the am and 1 unit in the pm, we've been continuing with those same amounts.
3) We're not monitoring with urine tests, they didn't even mention us doing that.
4) Yes, she's getting a meal and injection every 12 hours
5) Yes, we think we're doing everything right as far as injections go

She seems to be doing a little bit better the last couple of days. As of Friday she's been on insulin for 1 week. We actually switched her dry food from Hills Science Diet W/D to Wellness Reduced Fat because we'd heard and read a lot of good about the Wellness brand. She seems to be taking in a little less water the last couple of days and she seems to be a little less lethargic also. The vet suggested we bring her back in because there's a test they can also run that would show a 3-week average of her sugar levels. It would only require one blood draw. She's been through so much lately that I'm thinking we'll do that right now instead of another curve test. We'll definitely do another curve but thought we'd try the "3 week average" test first since it would be less stressful for her.

Again, thank you SO much for your input. We're grateful for any suggestions, ideas, etc... because we love our little girl SO much and we want to do what's best for her.

[CarolW]

Re: How long for insulin to start working??

I expect your vet is talking about a fructosamine test; that gives you an average BG (blood glucose) level for the past two or three weeks.

But it tells you nothing about how low your dog's BGs go, and to make dose changes that respond to your dog's typical variation in BG levels through a day, you need the curve.

Lots of us do this curve-testing at home. It's not everybody's cup of tea, and some prefer to let the vets do it. I admit, it took me a week to get up the courage to try it!

Once I did, though, I was extremely glad I had, and I kept going, even though it wasn't always easy, and I learned as I went along.

You can see a bunch of charts, mostly my Kumbi, but also some other dogs, if you start here:

http://www.coherentdog.org/vek/bgcharts1.php

The one consideration about the food you might want to watch is the fiber content. WD has fiber that helps slow the absorption of the insulin, so it evens out a bit after injection; I don't think Wellness does that. But a lot of people here, I think, use the Wellness, and might comment on how they manage with the higher fiber that commonly is a great aid to diabetic dogs. Many, I think, feed canned pumpkin - not pie-filling, just canned stuff without spices. That seems to provide the fiber that helps "keep hold of" the insulin as it goes along!

I feed my Kumbi on one of these vet diets that contains fiber; much like the WD, but a different formula. He absolutely thrives on it, thank goodness.

If you haven't read this article yet, you might find it helpful:

http://www.k9diabetes.com/insulinfood.html

Sun, 14 Feb 2010 07:43:05 (PST)

[snickmom]

Re: How long for insulin to start working??

Good point about the Wellness food. We only had her on it for one day, think I'll go back to the Science Diet because her "poop" did look healthier and there was a lot more of it while she was eating that. Man, this is such a learning experience!!

[CarolW]

Re: How long for insulin to start working??

No kidding, about the learning experience! Ha!

I often don't even talk about Kumbi's food; his DRY food has a lot of corn in it, and typical dog-food label-readers frown on corn.

When my vet switched his food, she did it all at once, but to the canned exclusively. I couldn't afford to feed him exclusively on canned, and one of the techs said the dry was exactly the same. I should have known better than to believe that. But I purposely didn't read labels for several months after we changed Kumbi's food. I was afraid of what I might see! (haha!)

Well, sure enough; I just about freaked out when FINALLY I read the labels. Yet both Kumbi, and his elder companion, Kwali (RIP), absolutely THRIVED on the food!

You just can't beat that! It's the dogs who tell us if the food is right or not. But it takes about six weeks minimum to assess that.

If the Science Diet turns out to work well for your dog, I'd be tempted to stay with it unless something suggests changing it.

As always, I'll be here watching, and rooting for you!

Sun, 14 Feb 2010 12:10:54 (PST)

[snickmom]

Re: How long for insulin to start working??

That's exactly why I thought Wellness food would be better because the first ingredient showing in the Hills is CORN and like you, I'd heard that corn is a no-no for diabetic dogs. I think we'll stay on the Hills for now though. One more thing I forgot to ask....Is there a safe "chew" treat to give Snickers? She used to love "MOO" brand bully sticks but we stopped giving them to her once she was diagnosed. Is there any kind of safe "rawhide" type treat that we can give her that you know of? We give her freeze dried chicken and liver treats but she really needs something she can chew on for a long time.

Also, I clicked on the link for the food list under the FOOD/DIET heading on the website and it's a "bad" ---link.http://www.k9diabetes.com/foodlist.html.

[k9diabetes]

Re: How long for insulin to start working??

I am not sure what link you were looking at - it wasn't at k9diabetes.com. I never label a food as Good or Bad. I've seen a lot of diabetic dogs do well on WD.

Given that you are just getting started regulating Snickers, I suggest leaving the food alone for now.

Changing foods can make a huge difference not only in how the insulin gets used but in how much food you need for a particular amount of insulin. Some people who have switched their dogs from other foods TO the WD have found that they needed less insulin for their dogs. So a dose that might be working well for one food can be totally wrong for another.

Or one food may produce nice flat even blood sugar values while another food causes big swings in blood sugar.

I'm not crazy about corn as the first ingredient in a food but I have also seen a lot of diabetic dogs do extremely well on WD and I personally tend to think that good blood sugar regulation is more important to a dog's long-term health after a diabetes diagnosis than is eliminating corn from the diet. If WD makes that happen, WD is okay with me.

Once you get Snickers regulated and you have a good idea of what dose of insulin works for him, you could, especially if you learn to home test, try introducing some other food like Wellness to replace all or part of the WD and see what effect it has on his blood sugar, making the change in small increments.

Sounds like Snickers did okay with Wellness. Some of my pets (felline and canine) found Wellness to be a bit rich for them. There are a lot of high quality foods out there that you can consider when things are more settled. My nondiabetic dog Jack is now eating a combination of Prairie canned, Castor & Pollux Organix kibble, and Orijen kibble! My diabetic dog ate California Natural and Canidae canned food mixed with cottage cheese and chicken. He was on a faster acting insulin so his insulin use was a bit different.

If you read Noodle's thread, you can see that changing foods or even quantities can be challenging. So for now, with Snickers so early in the process, I would keep the diet steady - same food, same quantities.

Natalie

[snickmom]

Re: How long for insulin to start working??

I'm sorry for the confusion...by "bad" link I meant it doesn't go anywhere when you click on it. I was interested in seeing the different diets listed but when I clicked on the diet list it came up as a "bad link"....doesn't go anywhere. This is the one I'm talking about:

http://www.k9diabetes.com/foodlist.html