Pete and Woody - how long to regulate?

[PeteandWoody]

Woody is a 10 y o female black lab / golden retriever mix.
Before the onset of diabetes (Dec. 2010) she weighed just around 100 lbs. She now weighs about 93. We feed her 2 cups of Purina One Adult Lamb/Rice with about 4 oz. of diced chicken breast X 2
Her insulin is Humulin N
Right now her dosage is 23.5U X 2
Her 14 day BG avg. is over 400
We use an AlphaTrak meter
Her BG is rarely under 300
I have raised her dosage to 23.5U I have just recorded only her second reading below 250 since onset.
Does it normally take this long to get regulated?
I have read about Somoygi and I am worried that I may be causing that by giving her that much insulin

contact me with your comments PeteandWoody

[CraigM]

Re: Your dog's diet, insulin, and meter used

Pete&Woody,
I hate to give recommendations for insulin dosages, for obvious reasons. I will tell you that Annie weighs 16 pounds and gets 7.5 - 8iu of NPH twice per day and is pretty well regulated with numbers in the low 100s (pre-meal fasting). Based on that, I would say you are still on the low side. Others will probably give you their impressions.

Welcome to the forum, and good luck.

Craig & Annie

[Taylor]

Re: Pete and Woody - how long to regulate?

I’m still too new at this to give advice but Taylor is similar in age, weight and breed, and three months into this diabetes adventure he is still not regulated and we are up to 32 units am and 31 units pm. I am, however, beginning to see a few readings in the target zone. Every dog is different and it sounds like you are moving up slowly which is the safest way. Welcome to the forum.
Pat

[CarolW]

Re: Pete and Woody - how long to regulate?

Hi Pete and Woody, and a BIG, fat welcome to you!

Is your vet working with you as a team-partner? What does your vet say about doses of insulin? Did your vet instruct you? In what way?

That AlphaTrak is a great meter to have! Said to be very dependable.

Are you running BG curves, and basing your dose-change decisions on those? My vet won't change a dose without at least a 12-hour, day-long curve, with readings every couple of hours, beginning just before feeding in the morning, and usually ending just before feeding in the evening, unless there appears reason to continue past the evening meal and injection.

By the way, my Kumbi drops up to 100 mg/dL (or 5.5 mmol/L, the measurement we use in Canada, where I live) on a walk, even if he's only getting light to moderate exercise.

If you have curve data, that should reassure you about Somogyi rebound, I'd THINK! What sorts of sequential readings are you getting that's suggesting rebound to you?

I THINK what you're feeding is lower in fiber than MY vet would approve for a diabetic dog. The reason for fiber is to slow absorption of the insulin - try to even out the timing of how it works with food, so the two (insulin and food) work together. There are many ways to feed diabetic dogs successfully, and each dog is different, so most of us need to do some experimenting.

Here are some useful links:

BG curve stuff:

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

And, of course, the excellent articles on the main site here:

http://k9diabetes.com/monitoring.html

And about the workings of food and insulin together, I really REALLY like this article:

http://k9diabetes.com/insulinfood.html

The article on regulation is excellent, too.

I notice you included your email address for contacts; I made a note of it. However, what I suggest you do is, come here to the forum to post and ask your questions. You'll likely have many replies from people with different experiences, many of whom have considerable knowledge about canine diabetes. Sharing knowledge here is particularly educational for everyone with a diabetic dog!

So, I hope you'll feel free to come here. It does, I admit, take wild horses for ME to post on an online forum, because I prefer to do everything by email - offline.

However, the excellence of this particular forum brings me here - working online, so to speak. I've been a member of several forums, lists and groups on canine diabetes, and this one outshines the others precisely because of its organization, along with the dedication of the site-owner and the membership.

About Woody's current dose - that looks just like a typical recommended starting dose for NPH insulin - that is, barely more than 0.25 units per pound of body weight. You could go a LOT higher than that (though presumably, you'd do it in increments of reasonable size) before you'd be likely to see rebound, unless there's some other factor involved.

It took me well over a year to catch on to the real excellences of this forum (I can be very slow!) And - regulation? Some dogs will regulate in a couple of months, but others can take well over a year. Kumbi and I were one of the latter - about 14 to 16 months, it took us.

And we're now in another period, three-plus years down the road, of changing doses (Novolin-NPH insulin). Most dogs will require occasional changes of dose. In fact, I'm doing a curve on Kumbi today, and will report in our thread, after it's done.

Glad you're here! Looking forward to your next report!

Sun, 21 Feb 2010 16:44:26 (PST)

[Patty]

Re: Your dog's diet, insulin, and meter used

Woody is a 10 y o female black lab / golden retriever mix.

Before the onset of diabetes (Dec. 2010) she weighed just around 100 lbs. She now weighs about 93. We feed her 2 cups of Purina One Adult Lamb/Rice with about 4 oz. of diced chicken breast X 2
Her insulin is Humulin N
Right now her dosage is 23.5U X 2
Her 14 day BG avg. is over 400
We use an AlphaTrak meter
Her BG is rarely under 300
I have raised her dosage to 23.5U I have just recorded only her second reading below 250 since onset.
Does it normally take this long to get regulated?
I have read about Somoygi and I am worried that I may be causing that by giving her that much insulin

contact me with your comments PeteandWoody

Hi Pete and Welcome!

I would also say you are probably on the low side of where Woody may end up with regard for dosage. Have you done any curves on her (where a blood sugar reading is done every 2 hours starting before her food/insulin then throughout the day until next meal)?

Many of the newer generation vets especially like to do the fructosamine test to get an average look at bg. Honestly, I don't think they tell you as much as a curve does. The fructosamine can't tell you what the highest or lowest bg was within that time period. Knowing the high/low points allow you to see how the food is working with the insulin, whether rebound is an issue, and if the dose can be safely increased.

That's great you have a meter. Where do you test Woody? I would run a comparison test if you haven't already next time you're at the vet's office. Even the Alphatrak can vary with the lab equipment. Have the vet draw blood and run Woody's bg on his lab machine. You can test Woody as you normally would at home and compare the difference. My Alphatrak is off by 30 some points, others have been within just a few points of the vet. There are also several people here using the Freestyle Lite test strips in their alphatrak meter to save money without any problems.

As far as food goes, the Purina Lamb and Rice is a bit higher in fat and lower in fiber. But if Woody has been doing well on it, I would try to do a curve to see how it's working with the insulin before trying to fix what might not be broken

Each dog is different with regard for how quickly they regulate. How often have you been evaluating for insulin increases?

We'd love to see a picture of your girl when you get a chance! You can go to the user cp and add an avatar.

Again, welcome!
Patty

[Noodle]

Re: Pete and Woody - how long to regulate?

I just wanted to add that Noodle seemed difficult to regulate for months. But the vet started very conservatively (around 8 units per shot I think) and it wasn't until we hit the mid 20's that we started seeing any results. He ended up needing 30 units and he is under 60 pounds. You still have a lot of dosage wiggle room to go based on Woody's current weight.

[eyelostit]

Re: Pete and Woody - how long to regulate?

Hi there,

It took us a long time to get Niki regulated, I didn't know forums existed for canine diabetes, so I had to rely on the vet who caused more trouble, so we switched vets.

Can you do a curve when you have some time and post the figures here.

Niki weighs 45 lbs and is on 10.5 to 11 units NPH, she eats Orijen dry food, green beans and ground turkey

Dolly

[k9diabetes]

Re: Pete and Woody - how long to regulate?

Welcome!

I'm glad you are home testing. As others have said, what you need to settle the somogyi rebound question is a curve. Then you will know if Woody is going through large swings in blood sugar from high to low or is actually pretty stable in the 300s or so and just needs more insulin.

Let us know if you are not familiar with curves - some vets don't use them, which I think is a shame. Curves are what made it possible for us to regulate our diabetic dog. Never could have done it without them.

If you have done them before, it would be great to do another one as soon as possible. You can post the results here for input if you like.

I'm anxious to hear more about Woody (and see a picture if possible!)

Natalie

[PeteandWoody]

Re: Pete and Woody - how long to regulate?

I've read all replies and will start a BG curve in the morning. My vet has been working with me every step but never said anything about doing a 24 hr. curve. We started her at 15U in Dec. and now we're at 24U.
I did get an occasional good or even great when she was at 23.5U but it never did level out. I had sever readings between 150 and 250. These numbers were after meals.
I had been testing after meals and my vet suggested testing before meals. The latest test have shown high bg levels on the b4 meal testing. Low number is about 350 and high end was 711. I will post the curve results Saturday morning. I've kept her at 24U for the past week.
I tried feeding her Purina DCO and she refused it. Also tried one from Hills W/D that was high fiber. Here are some pics.
These are on Facebook

Magnum was her best friend. We lost him to bone cancer 1/28/10.
I will relate more about the medical history of Woody at another time.

[Noodle]

Re: Pete and Woody - how long to regulate?

Oh, my - they're just beautiful!

I'm very sorry to hear about Magnum passing.

Our vet tried Noodle on DCO and it never worked. He would eat it (he is definitely NOT a picky eater, lol) but it gave him gigantic BG swings. You may want to explore foods that do not have corn and or wheat as one of the main ingredients in the future. While many diabetic dogs do just fine on almost any type of food, some seem more sensitive to certain carbs. My own does much better on foods with chicken, oats and barley as the main ingredients.

We're using Newsman's Own Organics (Advanced dry) right now. He loves it and his swings aren't as dramatic as on other foods we have tried. It's really pricey in the store (they only have it consistently at Whole Foods around here), but I have it auto shipped on Amazon for around $21 for a 12.5lb bag. I wouldn't mess around with the food right now until you start to see some better numbers with Woody, but it's something to consider once you are getting closer to fine tuning and flattening Woody's curve.

It will be very interesting to see the results of the 24-hour curve and should provide some very useful information. Good luck to you both tomorrow!

[PeteandWoody]

Re: Pete and Woody - how long to regulate?

More about Woody. She had a TPLO at Cornell U. when she was about 3. She has had several UTI's. She had one when she was diagnosed with diabetes. We nearly lost her. She was in the ICU for 2 days. Our vet didn't think she was going to make it but didn't tell us that till she was out of the woods. She was on Clavamox 250 mg to clear up the infection for 4 weeks. Her hips are normal but she has arthritis and is taking glucosamine. When she was in the ICU they did a sonogram and found spots on her liver. Our vet prescribed Denamarin which helps the liver heal itself. She is still on it. The vet wants us to have a biopsy done in a couple of weeks. My wife and I have discussed it and decided not to do the biopsy. If she does have cancer, we do not want to put her through chemotherapy at this age. She is weak in her hindquarters because of the arthritis. Her quality of life would really be on the low end of the scale. This is Magnum, doing his movie star act.

[peggy0]

Re: Pete and Woody - how long to regulate?

Adorable pictures!! Looking forward to see the curve. Once we have that info, we will be able to help you out. My dog is on blue buffalo weight control. switched foods several times trying to get him regulated. I'd work on the insulin dosage right now and worry about the food later

[Patty]

Re: Pete and Woody - how long to regulate?

Pete,
Those pictures are great!! You mentioned Cornell. Are you in NY then? We have several people from various parts of NY here. Looking forward to your curve.
After things settle down with her diabetes, there are some things you could look into adding to help with the arthritis and for preventing UTIs. But I'd get her food/insulin settled first.
Patty

[k9diabetes]

Re: Pete and Woody - how long to regulate?

What beautiful pictures!!

I'm so very sorry to hear that you so recently lost your friend Magnum... it is so hard. He was a beautiful boy with such a sweet face.

So far, I think everyone here who has tried DCO has given up on it. I'm not sure why it has not seemed to work well for many diabetic dogs while Science Diet WD has a pretty good track record. But we have dogs here eating just about every diet imaginable and doing well so prescription diets definitely aren't required.

I'm looking forward to seeing the curve.

Natalie

[PeteandWoody]

Re: Pete and Woody - how long to regulate?

Pete,
Those pictures are great!! You mentioned Cornell. Are you in NY then? We have several people from various parts of NY here. Looking forward to your curve.
After things settle down with her diabetes, there are some things you could look into adding to help with the arthritis and for preventing UTIs. But I'd get her food/insulin settled first.
Patty

We live in Baldwinsville. It's about 10 mi. NW of Syracuse. I went to Tractor Supply and the highest fiber content of their selection was 5%. What should I aim for? So far Woody's numbers look terrible. I had 2 appointments early today so I started the curve at 1100 At which time she ate and got her (24U) shot. 1st reading b4 meal was 540 then @1500 it was 436,1700 -492, 1900 - 449, 2100 - 455.