Couple of Questions

[sg1231]

I'm new to this board.....Eddie was diagnosed with diabetes about 4 months ago. He is a 10 yr old jack russell. They just can't get him regulated. started out with 9cc's twice a day..and now we're up to 14cc's twice a day. The vet is frustrated, as we are because he just doesn't look or act any better.

A lot of his problem i think right now is maybe depression over not getting any treats. He was used to getting treats..and yes table scraps (we were bad at that)...and partly feel like we're to blame for his diabetes in the first place. Anyway....what treats can I give him that are diabetec-safe...can I get them in a pet store? I've seen some that you have to send away for, but if I could buy some at the local pet store, that would be great.

Also...he LOVED his rawhide bones....any of those that are safe for him either?

Thanks for any information you can give to us..our vet is also leaning towards possible Cushing's disease as he's just not getting any better. This is breaking our hearts...so any help would be appreciated.

Thanks much.

[k9diabetes]

Re: Couple of Questions

Hi!

Can you tell us more about Eddie?

--How much does he weigh?

--What insulin does he get - NPH or Vetsulin?

--What is his diet?

--How has his blood sugar been monitored and what are the blood sugar levels typically?

I have found over the years that it's somewhat common for terriers to need a higher than average dose of insulin. I've seen two terriers, for example, who weighed about 25 pounds and needed around 20 units of insulin. Which is definitely higher than average but it worked beautifully for them - their blood sugar was very well regulated on that amount.

So it's quite possible that, tragic as the loss of treats is , that Eddie just needs more insulin than he's been getting.

If you can tell us more about how his blood sugar has been tested and the results of those tests, we can see if maybe that is the main problem.

Does Eddie like vegetables?

Green beans are a popular treat for diabetic dogs.

My dog wouldn't touch them if you paid him! LOL But a lot of dogs really like them.

Natalie

[sg1231]

Re: Couple of Questions

Hi...thanks for replying to me so quickly. His blood sugar levels are currently being checked every 2 weeks. two weeks ago, it was 360, and two weeks before that it was over 400. Today his reading was too high for the vet to get a reading.

He is on NPH, and he weighs 23 lbs. He has lost weight...he was around 26 lbs. when he was first diagnosed. His diet is the Hills Prescription W/D food. I give him the dry...but add a little water and nuke it for about 15 seconds to make it warm. I did have him on the canned, but that got to be too expensive....

Are any kind of vegetables ok for him? And as far as green beans..can they be canned? Thanks again...I appreciate it, and am glad to have found this web site!

Sue

[k9diabetes]

Re: Couple of Questions

Hi Sue,

That very high reading at the vet concerns me that his blood sugar might actually be going too low and he rebounded to that high blood sugar level. That can generate a Somogyi rebound, causing high blood sugar.

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

Basically, the body's protective mechanisms sense the low blood sugar, which can be deadly, and release an emergency dump of sugar into the bloodstreatm. Which overwhelms the insulin you injected, causing high blood sugar.

Spot checks just don't tell you enough about the blood sugar throughout the day. A curve is needed to see if during other parts of the day his blood sugar is going much lower, possibly too low.

www.k9diabetes.com/insulinfood.html.

Have you ever considered home blood glucose testing?

Would your vet be willing to do a curve?

Natalie

[Patty]

Re: Couple of Questions

Hi Sue,
I just wanted to say welcome!

As far as the veggies go, I would use frozen green beans. Canned have other additives such as sodium. Peas can be a bit starchy for regular snacks. But other ideas are a thin slice of peeled cucumber or a grape tomato (not grapes but the little tomatoes).

Patty

[sg1231]

Re: Couple of Questions

He did have a curve done when he was first diagnosed. The reading this morning was before his shot....I forgot to mention that...but thought I would post it. Why wouldn't my vet have come up with that as a possible solution, or why wouldn't she suggest home glucose testing. What does that entail? Would I have to get blood every day from some kind of a prick in his paw or something?

Thanks again for welcoming me and giving me suggestions.

Sue

[k9diabetes]

Re: Couple of Questions

There is a huge variation in approaches by vets. Everything from vets who are basically livestocks doctors who wonder why anyone would even treat diabetes (obviously NOT the kind you want) to vets who are very assertive about getting the best regulation possible (the best kind of vet as far as I'm concerned).

Eddie will have the happiest, healthiest, longest life possible if you work to get the best diabetes regulation that is possible. To do that, you need more information than you can get from a spot check.

Sometimes I do think vets figure people wouldn't want to do more so they don't suggest it. Your asking for a curve may be all that is needed to have the vet do one.

Rebound is a very distinct possibility when you see the blood sugar going up with more insulin. There are a few others as well.

To home test, you need a blood glucose monitor - for Eddie I'd suggest a Freestyle monitor - with test strips. And a lancing device - I recommend the Accucheck Softclix - much quieter and gentler than others I have tried.

Then look at www.k9diabetes.com/bgtestvideos.html for the various ways you can test your dog's blood sugar. With Eddie, I'd start with the lip or the back at the base of the tail as testing sites. If you watch the video of Chris tested on the lip, it's a big file so give it time to download. And there is a picture tutorial for testing at the base of the tail.

Have you used urine strips to test for glucose?

You could start with those and see if his urine goes negative for glucose during the day. That would suggest that rebound is occurring.

It may be that another vet would manage Eddie better - is the vet someone you can talk to about managing Eddie's blood sugar better? It can make a big difference just to indicate that you are interested in more monitoring with a vet who is flexible.

Natalie

[MattiesDad]

Re: Couple of Questions

sg1231, I have a similar problem. Mattie, my 11 year old Miniature Schnauzer, is insulin resistant. She's 16#, and gets 13 units twice a day. Her glucose remains over 300, and she has since gone blind. In an attempt to lower her glucose level, I've switched to a grain free dry dog food. She hasn't been re-tested yet, so I don't know what, if any effect her diet has had. (No more pancakes, Mattie. It was like one per month, anyway.)

I guess I'm wrestling with a decision here. Obviously, her quality of life is diminished. When I'm gone, she doesn't have access to stairs, fortunately. I'm also concerned about my mother tripping over her when I visit, because she can't see people and get out of their way.

I've never had a dog expire quickly from a heart attack, it's always involved the trip to the vet, and I'm trying not to make any hasty decisions here.

[CraigM]

Re: Couple of Questions

sg1231,
Welcome to the board! Lots of good info,and people, here to help.

As a snack Annie likes, believe it or not, broccoli or cauliflower pieces! Doesn't seen to matter to her if it's cooked or raw. She rarely gets a very small piece of chicken, about the size of my thumb nail.

As others have said, home testing can really help get Eddie's numbers into a better range.

I've got to run, but will try to post more a little later.

Craig & Annie

[ozzi]

Re: Couple of Questions

Hi Sue,

I just read your message about Eddie. I'm not the most experienced person regarding dealing with canine diabetes, but I can tell you a couple of things that I have learned or am doing with Ozzi. First, and most important, I very loudly hear that you are taking some blame/responsibility for causing Eddie's diabetes. This is SOOOOOOOO NOT TRUE. I felt exactly the same way when Ozzi was diagnosed because I had also been feeding him table scraps for 13 years. I felt as though I had caused it, or at least had some part of the responsibility. My vet assured me this was not the case. It really has to do with insulin production and the pancreas, and the table scraps along the way did not CAUSE diabetes. It's sort akin to thinking that eating a lot of sugar causes diabetes...it does not. It's a physiological process and a breakdown in the normal functioning of an organ. Honestly, it's that simple, and that complex! I really identified with your feelings, and wanted to share with you that you did not create this monster called diabetes.

I also identify completely with Eddie's behavior and your desire to try to substitute treats and discontinue table scraps. I didn't know what to do myself. Ozzi was used to treats after going to the bathroom and he was used to table scraps, for better or worse. I felt that it wasn't fair to stop either, BUT I made some major adjustments which are working for me. I can't advocate if they will work for you, but here goes. I felt that I wanted to keep Ozzi's life as normal as it had been, without sacrificing his health. I continued to give him treats after going to the bathroom, but I cut them in half. He didn't seem to notice, he was still getting something. I also did not stop giving him table scraps. He honestly expected it. But I did become educated on what would be problematic and what would not. Protein (e.g. meats) will not adversely affect his sugar. Vegetables like green beans, cauliflower and broccoli are okay. Clearly sugar is a problem, so doughnuts are out...lol. And if you aren't aware, carbs are a real problem. Carbohydrates are complex sugars, that break down in the body to simple sugars, and will cause a rise in blood glucose. If I have macaroni, he gets one piece instead of a tablespoon. For me, this has worked. Ozzi does not feel that he's getting gypped and he has accepted this well. You might want to give it a try.

Additionally, when he was first diagnosed, after his leg weakness improved, I tried to increase his exercise as tolerated and this will help to decrease his blood sugar. Exercise is really, really helpful if you can do that without causing any other injury.

You have to be careful though because you really do need to know where his sugars are to be able to adjust him. This is the importance of a glucose curve. I also used the curve to see where he was "lower" during the day, to try and work in the 1/2 treats. I think if you can get a handle on where his sugars are during the day, you will be able to better hone in on his insulin requirements and will be able to use food, and exercise to maintain better control.

I originally thought that after a glucose curve, we were done! I realize now that it's super important to repeat periodically to maintain control. You really can't make effective insulin adjustments without knowing how his body is responding, and that changes. To that end, the best way to do this is via home glucose monitoring, which I absolutely have to do myself, and I sympathize with you if are as nervous about it as I am. I can only say that you and I absolutely must get over ourselves and learn to do it. It's for the benefit of our pets, and is the best way to know how to manage their insulin, diet and exercise.

My best wishes to you. I completely identify with your story, and I know you will get there, as will I. From reading this forum, I have come to the conclusion that there is no global "correct" answer to treating diabetes (except glucose monitoring!), and that the treatment really has to be individualized to the dog. It takes time and willingness, and you wouldn't be here if you weren't willing to do the best you can for Eddie, so BRAVO!

[ozzi]

Re: Couple of Questions

Hi,
I just read your message about Eddie. I'm not the most experienced person regarding dealing with canine diabetes, but I can tell you a couple of things that I have learned or am doing with Ozzi. First, and most important, I very loudly hear that you are taking some blame/responsibility for causing Eddie's diabetes. This is SOOOOOOOO NOT TRUE. I felt exactly the same way when Ozzi was diagnosed because I had also been feeding him table scraps for 13 years. I felt as though I had caused it, or at least had some part of the responsibility. My vet assured me this was not the case. It really has to do with insulin production and the pancreas, and the table scraps along the way did not CAUSE diabetes. It's sort akin to thinking that eating a lot of sugar causes diabetes...it does not. It's a physiological process and a breakdown in the normal functioning of an organ. Honestly, it's that simple, and that complex! I really identified with your feelings, and wanted to share with you that you did not create this monster called diabetes.

I also identify completely with Eddie's behavior and your desire to try to substitute treats and discontinue table scraps. I didn't know what to do myself. Ozzi was used to treats after going to the bathroom and he was used to table scraps, for better or worse. I felt that it wasn't fair to stop either, BUT I made some major adjustments which are working for me. I can't advocate if they will work for you, but here goes. I felt that I wanted to keep Ozzi's life as normal as it had been, without sacrificing his health. I continued to give him treats after going to the bathroom, but I cut them in half. He didn't seem to notice, he was still getting something. I also did not stop giving him table scraps. He honestly expected it. But I did become educated on what would be problematic and what would not. Protein (e.g. meats) will not adversely affect his sugar. Vegetables like green beans, cauliflower and broccoli are okay. Clearly sugar is a problem, so doughnuts are out...lol. And if you aren't aware, carbs are a real problem. Carbohydrates are complex sugars, that break down in the body to simple sugars, and will cause a rise in blood glucose. If I have macaroni, he gets one piece instead of a tablespoon. For me, this has worked. Ozzi does not feel that he's getting gypped and he has accepted this well. You might want to give it a try.

Additionally, when he was first diagnosed, after his leg weakness improved, I tried to increase his exercise as tolerated and this will help to decrease his blood sugar. Exercise is really, really helpful if you can do that without causing any other injury.

You have to be careful though because you really do need to know where his sugars are to be able to adjust him. This is the importance of a glucose curve. I also used the curve to see where he was "lower" during the day, to try and work in the 1/2 treats. I think if you can get a handle on where his sugars are during the day, you will be able to better hone in on his insulin requirements and will be able to use food, and exercise to maintain better control.

I originally thought that after a glucose curve, we were done! I realize now that it's super important to repeat periodically to maintain control. You really can't make effective insulin adjustments without knowing how his body is responding, and that changes. To that end, the best way to do this is via home glucose monitoring, which I absolutely have to do myself, and I sympathize with you if are as nervous about it as I am. I can only say that you and I absolutely must get over ourselves and learn to do it. It's for the benefit of our pets, and is the best way to know how to manage their insulin, diet and exercise.

My best wishes to you. I completely identify with your story, and I know you will get there, as will I. From reading this forum, I have come to the conclusion that there is no global "correct" answer to treating diabetes (except glucose monitoring!), and that the treatment really has to be individualized to the dog. It takes time and willingness, and you wouldn't be here if you weren't willing to do the best you can for Eddie, so BRAVO!

[CarolW]

Re: Couple of Questions

Hi Sue, and a big, fat welcome to you and Eddie!

I am a fan of terriers; have had them for many years now, and I used many, many treats in training! I learned to use tiny, tiny treats.

All the same, when my Kumbi was diagnosed with diabetes, my vet said, "no treats."

And I stuck with that, for four months. The purpose of that is to avoid giving any food between meals, to allow testing for blood glucose levels to reflect how the race between insulin and food is going, at the current insulin dose.

But - unless your vet or you is doing blood glucose CURVES - that is, repeated readings of blood glucose levels over at least a 12-hour period, the giving of a few treats won't make much difference to the results you get during a curve test. Why? (pardon my stupidity in the wee hours in my usual brief wee-hour stint) - because, you are not DOING the tests (nor is the vet, of course).

You sound like a truly great Human DogMum; Eddie is a very lucky dog. I have another treat suggestion for you. I agree with those posted for you so far. But so far, I don't think anybody has mentioned a common useful treat for diabetic dogs - tiny bits of canned food for diabetic dogs!

I feed Kumbi on a veterinary diet - dry and canned. Like you, I couldn't afford to feed the canned - exclusively. But if I use the canned ONLY for treats, I can make a can last about a week. (I wouldn't want to have an open can longer than that.)

I simply take a tiny bit of the canned in my fingers, and let Kumbi lick it off. Many dogs love canned dog food.

Lately, since my Kwali died - she was Kumbi's constant companion - Kumbi's life has changed quite a bit. He's coping well with the loss, determined to go on with his own life. But while Kwali was still alive, ill, I started feeding BOTH dogs somewhat differently; the result was that now, after his insulin shot, Kumbi is getting about three tablespoons of his canned food. That's a LOT more than treat-size - it's a substantial part of his meal.

Before that, though, just a bit of the canned stuff served really well as a treat.

Of course, it's not very portable that way! That is, I wouldn't leave the can out of the fridge (carry it around).

Some people "cut" a can-ful into slices, and bake the slices. I think they use microwaves; I don't have one, and don't know how to use them, but food might last longer if baked or "nuked" - and again, you can make tiny treats out of those slices. You could even freeze a bunch of these "treats" in little bags, and remove a bag a day from the freezer, or something like that.

About blood glucose curves, do go to the links Natalie provided; I often suggest that. Besides those, here are some more.

A detailed description of using the "lip" for testing (this is how I do it with Kumbi, and it closely resembles what Natalie does, with one big difference: instead of using a device, I hold the lancet in my hand, and prick manually).

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

Curve tests are described here:

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

There are lots of charts showing the results in that section.

Just a few days ago, I added a new section with charts, to help see variations in BG (blood glucose) levels, and what those variations might signify, in one way or another. I'll be adding to this section, because the other day, Kumbi ran high numbers. He went back to normal the following day; that's a common thing with diabetic dogs - run high for a day, and then go back to normal - it all depends on various events in the dog's life, including, maybe, them getting into something they shouldn't!

So, these charts give a kind of visual, graphic, indication of how food, insulin - and exercise (at least in Kumbi's charts) affect blood glucose levels.

You'll find those here:

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

I think if Eddie were mine, I'd begin by looking into how you'll track his glucose levels - maybe your vet will help; if not, maybe another vet would. Doing blood glucose curves gives your vet and you solid information on which to base changes in insulin dose. I believe curve results, along with any clinical signs (such as how much the dog drinks and pees, as well as energy levels, weight loss) - give you information accurate enough to be confident when changing insulin doses.

And I'd also try using at least a FEW- tiny! - treats - after injections, at least. And if you decide to work with testing glucose with a glucometer, then I'd also add a tiny treat after each reading.

I'm glad you joined us here; this is my favorite forum on canine diabetes, largely, because it's very responsibly managed, and very effective.

Kumbi sends greetings to Eddie.

Thu, 4 Mar 2010 02:51:12 (PST)