My mother's dog Duke

[janet]

About a month ago we found out my mother's dog is diabetic! My mother is 80 years old and has Alzheimer's and Macular degeneration. Duke is her life and I was scared to think what effect it would have on her to put him down, so I decided to try and manage the disease. The first couple weeks I was a wreck giving him his shots, he would jerk and several times I misses. I learned now that the bevel up and warming is essential to a less traumatic injection. The vet never mentioned it and I will mention to them next visit. They did however suggest putting him on a counter or table for the injection. Oh by the way Duke is a schnauzer (15.4 at his last weight). We started on 4 units and have now increased to 5. On his first curve the morning tests were good by afternoon sort of off the chart 550 is as high as the vets chart went, so who knows.
He had been licking (his cookie) lol as the vet tech refers to it so he is now on antibiotics as well.
He is a different dog on his new diet and insulin. I get a bit freaked out about the 2 times a day thing. I live with my mother at the moment but hope that isn't a permanent arrangement. I have a husband and 3 dogs of my own.
Mom also is on a fixed income so we'll see how this all goes, her meds come first and she's already in the donut hole with her meds and we all know what that means, (no insurance help on some very expensive drugs). So far we have over 500 in vet bills for the last month, which included a grooming and the food. I drop a vile of insulin in the first week! I'm more careful now.
Have I left anything out. I'm trying to stay positive about it all but I get no help. The rest of the family want no part in his care, but they also don't want me to put him down, nor do I want to but it keeps me trapped so to speak.
I also need to watch my mom like a hawk so that she doesn't slip him a forbidden treat. So far carrots have been the only treat suggested. He's on W/d wet and dry about a little over two cups combined, more dry then wet.

[ozzi]

Re: My mother's dog Duke

Janet,

You surely have your hands full! Kudos to you for taking on Duke's diabetes management!! It sounds like you're doing well with it, although it's frustrating when you're the only one participating!

A couple of thoughts I wanted to share. You really are to be congratulated for what you are doing. It may at times feel like a thankless job but I promise you it is not. Not only is Duke benefiting from your kindness, so is your Mom. I think one of the worst things one can do to an elderly person is take away their animal! It's really difficult for elderly people who start to see a number of losses in their lives...friends, family, income, driver's license, and independence in general, so taking away their dog can be devastating. I can't quote the studies that have been done, but I can paraphrase the content, which is that animals have a positive effect on one's health. With your Mom's issues around Alzheimers, she will need a great deal of consistency, and honestly, it would be very upsetting to take her dog from her at this time. Additionally, as her vision continues to deteriorate with macular degeneration, it will be more important than ever to stimulate her other senses, including touch. I bet she is never happier than when she is talking to and petting Duke. And I think you will see that Duke will play an even more important role in making her happy despite her chronic problems.

Unfortunately Alzheimer's progresses and I don't know what stage your Mom is in, but at a certain point she probably won't be able to take care of Duke at all. It sounds like you have your hands full with your three dogs, and I was thinking that if you weren't able to take Duke yourself, you might start to try looking at the possibility of a future adoption when your Mom can no longer care for Duke herself. For example, there is a local shelter near me where people are foster families until a permanent home is found. And they even take a picture of the dog with their history (while you continue to care for them) to try to find a permanent future home in cases like yours. I don't know if such a place exists where you live, but the point I'm trying to make is that there may be resources out there to help you place Duke in the future. There are people who would consider adopting a diabetic dog. Even your vet might be able to help.

For now, you're doing a wonderful thing! Regarding putting Duke on a counter, I think if that works for you, then continue doing that. I have Ozzi sit on the floor and give it to him there...mostly because I don't think I could lift him to a counter twice/day everyday!! It's really whatever is comfortable for you when giving the injection. As far as treats, I give Ozzi green beans, cubes of boneless, skinless chicken that I boil and then simmer for about 10 minutes, and small pieces of reduced fat cheese (which has minimal carb), and cheese was always something he loved. If you can post all of the numbers for Duke's curve, that would be helpful. There are some great people here who can help interpret them and give you advice (e.g., it would be helpful to know the number before his BG was 550).

I wish you the best and hope things work out for you.
Kevin

[Noodle]

Re: My mother's dog Duke

Hi Janet & Welcome!

I really commend you for taking on the responsibility for Duke's care so your mom can continue to benefit from their bond. Alzheimer's & Macular Degeneration is a tough combo. Does she have the wet or dry kind? My dad's currently in the dang donut hole too, so you both have my sympathies. Medications can be incredibly expensive!

Kevin gave some great information and you will find lots of useful tips all over the board. The more information you can provide, the more we can help you make Duke's care as easy as possible for you. If you are open to home testing Duke it can save a lot of money over time. No more expensive trips to the vet for curves. You don't need an expensive dog monitor - a people monitor works just fine and you can pick them up for free or nearly free. Strips are another story, but you can find them less expensive than retail online. I order mine through Amazon and a few people here use eBay.

Also, what insulin is Duke on? If he is on NPH, Walmart sells a version called ReliOn/Novolin which is the same insulin as the Humulin you get at Walgreen's and other pharmacies, but for half the price. I will say that a few members have had issues with the ReliOn insulin (my own dog didn't do as well on it as the Humulin), but many others have not had a problem. So it might be worth a shot to give it a try.

There are plenty of healthy, low glycemic treat options you can try. Many members use veggies, so you can buy whatever is least expensive that week or on sale. My dog loves cucumber chunks. Many members use green beans - even frozen. Some like broccoli or cauliflower pieces. Small pieces of lean meats (you want to avoid marinated, seasoned, etc) like chicken or turkey work. There is a brand of hot dog that escapes my memory at the moment, that is a favorite of our member Forbin. Hard boiled eggs are great too, but some of us have found that adding protein can increase their blood glucose and make it hang there too long. You obviously want to avoid adding more carbs and also fatty foods since diabetic dogs can be susceptible to pancreatitis. It becomes a bit of a science experiment since all diabetic dogs react a differently to things.

I'm very happy you found your way to the forum. Hopefully you won't feel so alone on this journey when you come here for support.


Noodle & Daisy

[janet]

Re: My mother's dog Duke

Thanks all for your words of encouragement. You folks seem more knowledgeable than the vet or at least better at sharing what you know.
Don't get me wrong I like Dukes vet and I'm sure she would answer all questions, I just hate to bug her all the time. She did give me her private number, heck people doctors don't do that!

Duke is on Humulin N, his curve, which I don't have a copy of it started well, (below 200 for two tests) but ended on the high side (above 550 for two or three) in late afternoon. From what I've read stress can raise the level and he was captive with a loose cat in the clinic. lol I would guess he was a little stressed. Vet still increase from 4 to 5 units. Oh and he also got groomed the same day, so testing may have been off for several reasons. Did I mention his age? He's 10, birthday in October.

If I were to do blood curve at home would I be adjusting his dose everyday based on whether it is high or low. Confused about that part. If so, do you take into consideration stress factors to make that determination? Is there a site where I can read about how to adjust insulin if I do try to do my own testing. What symptoms should I watch for, he seems just fine since he's been on the insulin.

We live very close to Bel-Rea institute, so help may be close at hand. Mom's house is sure big enough to take a roommate and what better roommate than someone training to become a vet tech. Duke would get lots and lots of loving..... Meeting with a young girl this week that is looking for room and board. Wish me luck!

[Patty]

Re: My mother's dog Duke

Hi Janet,
Welcome! You've gotten some great information from the others. What a great opportunity to have a vet student possibly help in Duke's care.

Is there any way you could get a copy of Duke's curve - bg (blood glucose) values and times? I'm a bit concerned with raising the insulin dose 1 whole unit if some of Duke's numbers were below 200. Is he scheduled for another curve soon?

It's true that stress can increase bgs but another possibility is rebound or Somogyi effect. This is when bg drops too quickly, around 100 points in 1 hour, or the blood sugar gets too low and the dog's counter regulatory hormones kick in to protect itself. The result is typically very high blood sugar for a period of time. Here's a link that explains this http://www.caninediabetes.org/pdorg/somogyi.htm

I would separate any stressful activity from days he gets a curve done in the future, such as the grooming, as it will skew your results and you won't see a true picture of how his food/insulin are working together.

He's on W/d wet and dry about a little over two cups combined, more dry then wet.

Do you measure the wet and dry separately so they are consistently the same amount each time? That will help with regulation.

Also are his shots/food currently 12 hours apart?

As the others said, learning to home test is very beneficial if you are up for it. It helps you to see patterns in your dogs blood sugar and will help determine when the best time for exercise would be or if his blood sugar has large swings between high and low points. I like the OneTouch Ultra2 meter personally. Here are some links for home testing http://www.k9diabetes.com/bgtestvideos.html

Again, glad you are here!
Patty

[ozzi]

Re: My mother's dog Duke

Janet,

That is AWESOME news! I really hope the roommate situation works out for all of you!! It really sounds like a nice solution!

In the meantime, the purpose of doing a glucose curve is to determine how Duke's body processes the insulin he receives. It will help to show you how quickly the insulin brings down his sugar (and sometimes it can be too quickly, causing "rebound" or the body's way of protecting itself by producing more glucose which you do not want!), when the insulin peaks, how low his "low" is during the day, and how his numbers are throughout the day.

You definitely do not want to adjust his insulin daily. That will make you crazy! I did that myself, not knowing that I should not, and it causes problems. From what I have read, it takes about 3 days at the same dose to adjust because there is "overlap" between the doses where there may be a little bit left prior to injecting again, so the insulin is a bit higher than what you are injecting due to the "leftover."

It is best to maintain him on his current dose of 5 units Humulin N as you are doing. When he is on that dose for about 3-5 days, you can do the curve. This will give you an accurate reflection of how he processes the insulin. You should feed him as you normally do and do everything the same as you normally do, to obtain accurate results. It is crucial to get a fasting sugar (before feeding him and giving insulin in the morning) and then take a test every two hours for 12 hours ideally. This shows you what is happening during that 12 hour period. The other thing I want to mention is that antibiotics can temporarily increase BG, so it would be wise to do the curve several days after completing the prescription. In the meantime, you can do spot checks to check his sugar and to give you experience for the big day!

When you get the curve, feel free to post the results. People here can help you interpret them, as will your vet. Adjustments can be made based on the results. For example, if he is having rebound during the day, the answer would be to lower his dosage. If he has good sugars, but goes too low at a certain time, the answer could be to provide him with a snack just before that time. Every dog is different, and the idea is to match the insulin needs with the way he processes the insulin.

In terms of symptoms to watch for, they would be no different from what you would watch for any day. Nothing different should be expected since you actually won't be changing anything during the curve, and will be keeping everything exactly as you have been doing.

Signs of hyperglycemia can include excessive panting, becoming antsy, anxiety, lethargy, increased thirst, increased appetite, frequent urination, sleepiness, vomiting and abdominal pain (where they 'tuck' their bellies up toward them). These signs could mean his sugar is too high. When this happens to Ozzi, I take his BG and also test his urine for ketones. If ketones are present, it can be an emergency because it can be the beginning of DKA, diabetic ketoacidosis. In that case you would definitely want to call the vet immediately.

Signs of hypoglycemia can include acting "drunk," stumbling, shakiness, anxiety, confusion, lethargy, weakness, seizures or coma. If any of these things occur, you would want to take Duke's BG and if it is low (below about 60), you would want to rub a teaspoon of Karo on his gums and then feed him (even a biscuit), and monitor his sugars. It's a good idea to have Karo in your house just in case!

You're doing good!!
Kevin

[eyelostit]

Re: My mother's dog Duke

If I were to do blood curve at home would I be adjusting his dose everyday based on whether it is high or low. Confused about that part. If so, do you take into consideration stress factors to make that determination? Is there a site where I can read about how to adjust insulin if I do try to do my own testing. What symptoms should I watch for, he seems just fine since he's been on the insulin.

Hi there,

The dose does not get adjusted based on daily reading, how its done is to stick with the dose you are giving, then you can test the blood glucose, the curves from your vet would be great if you could post that.

From there the insulin can be adjusted up or down by 1/4 to 1/2 unit on a weekly basis (not everyday) depending on the reading you are getting.

You start out going low with any insulin increases to see how that will affect the bg readings. Any adjustments with insulin usually take 3-4 days to see results, insulin just works that way and we humans find it hard to be patient, but we must.

Keep in mind insulin does not work like an asprin, and giving more can do more harm than good. You keep the injections 12 hrs apart as you are learning this now.

Welcome to our forum!

Dolly & Niki

[janet]

Re: My mother's dog Duke

Janet,

You surely have your hands full! Kudos to you for taking on Duke's diabetes management!! It sounds like you're doing well with it, although it's frustrating when you're the only one participating!

A couple of thoughts I wanted to share. You really are to be congratulated for what you are doing. It may at times feel like a thankless job but I promise you it is not. Not only is Duke benefiting from your kindness, so is your Mom. I think one of the worst things one can do to an elderly person is take away their animal! It's really difficult for elderly people who start to see a number of losses in their lives...friends, family, income, driver's license, and independence in general, so taking away their dog can be devastating. I can't quote the studies that have been done, but I can paraphrase the content, which is that animals have a positive effect on one's health. With your Mom's issues around Alzheimers, she will need a great deal of consistency, and honestly, it would be very upsetting to take her dog from her at this time. Additionally, as her vision continues to deteriorate with macular degeneration, it will be more important than ever to stimulate her other senses, including touch. I bet she is never happier than when she is talking to and petting Duke. And I think you will see that Duke will play an even more important role in making her happy despite her chronic problems.

Unfortunately Alzheimer's progresses and I don't know what stage your Mom is in, but at a certain point she probably won't be able to take care of Duke at all. It sounds like you have your hands full with your three dogs, and I was thinking that if you weren't able to take Duke yourself, you might start to try looking at the possibility of a future adoption when your Mom can no longer care for Duke herself. For example, there is a local shelter near me where people are foster families until a permanent home is found. And they even take a picture of the dog with their history (while you continue to care for them) to try to find a permanent future home in cases like yours. I don't know if such a place exists where you live, but the point I'm trying to make is that there may be resources out there to help you place Duke in the future. There are people who would consider adopting a diabetic dog. Even your vet might be able to help.

For now, you're doing a wonderful thing! Regarding putting Duke on a counter, I think if that works for you, then continue doing that. I have Ozzi sit on the floor and give it to him there...mostly because I don't think I could lift him to a counter twice/day everyday!! It's really whatever is comfortable for you when giving the injection. As far as treats, I give Ozzi green beans, cubes of boneless, skinless chicken that I boil and then simmer for about 10 minutes, and small pieces of reduced fat cheese (which has minimal carb), and cheese was always something he loved. If you can post all of the numbers for Duke's curve, that would be helpful. There are some great people here who can help interpret them and give you advice (e.g., it would be helpful to know the number before his BG was 550).

I wish you the best and hope things work out for you.
Kevin

If Duke weighed any more than he does I wouldn't be lifting him either. I do hope he gains some weight back, he's gotten rather thin.
My mom already is to the point where she can't help with feeding etc. in fact we really need to keep an eye on her that she doesn't forget and feed him sweets. She gave him one or two choc chip cookies which brought all this to a head. Thought we were going to lose him and a darn wonder we didn't. He was so sick!!!

[janet]

Re: My mother's dog Duke

Thanks Dolly and Nikki for that information. We have 3 more day of antibiotics before we could do another curve. Because of cost hoping I can find the nerve to do myself.

[janet]

Re: My mother's dog Duke

Patty,

Yes feeding at 12 hour intervals and measuring along with keeping records for vet. Although I haven't introduced any additional treats other than small bits of carrots after his shot. It seems like I might be a bit anal about all this and could relax a smidge, but I just don't feel comfortable yet in changing much of anything until I get more information which you all have been great about sharing.

[janet]

Re: My mother's dog Duke

Noodle and Daisy,
This is great news and Duke will love you for it. How much of these treats can I introduce at this point without having him regulated yet?

[Noodle]

Re: My mother's dog Duke

Noodle and Daisy,
This is great news and Duke will love you for it. How much of these treats can I introduce at this point without having him regulated yet?

I would err on the conservative side until he is better regulated. Since you don't know how protein effects Duke's numbers yet, I would want to add as few extra calories as possible. I stuck with veggies in the beginning. Noodle was a free feeder before the diabetes and I felt really sorry for him during the transition to meals twice a day, 2 hours apart. He was in and out of the kitchen a million times a day looking for the food bowl that had been sitting there for years. So mid day I used to cut a small chunk of cucumber (probably about 2 inches of an average cucumber) and then cut that into smaller pieces. I'd toss those to him one at a time to drag it out a bit. He loves the big crunch of cucumbers and the game of catching them.

I would probably introduce the veggies slowly for the first week (if he hasn't already been a regular veggie eater up to this point) and keep on eye on his stool. Too much too soon may have an, um...loosening effect and we don't want to add that additional headache to your day, lol.

As far as the protein goes, that's not to say if you're cooking dinner and want to toss him a small piece of poached chicken or something that it would make a big difference. You just want to develop the habit of being more conscious of the cumulative amount and how it's prepared.

I don't know if this would work, but if you had a small dish of cut up veggies in the front of the refrigerator each day would your mom be more likely to reach for those to toss Duke? Maybe a picture of him with the dish could spark a connection? My grandmother had dementia and couldn't remember anything for longer than a few minutes. I really feel for your situation since you must constantly worry about what she might inadvertently feed Duke.

I love salads and Noodle loves the crunchy ribs of romaine. Doesn't get much cheaper and easier then that.

[k9diabetes]

Re: My mother's dog Duke

Hi Janet,

Saw you here and thought I'd bring up your thread.

Natalie