My German Shepherd's Condition is worsening FAST!

[Lexy]

Hi, I am new.

My beloved family German Shepherd is really deteriorating fast. She was diagnosed in December with Diabetes after she started drinking tons of water and acting highly lethargic. This was odd for such a spirited canine.

Here are the FACTS:

She has been on a semi-regulated diet. I only say this because, I don't think my fam (whom I don't live with) regulates her as aggressively as I would in terms of diet. She has had a life time (9 years) of eating people food. They assure me she has been eating 3 meals, and getting HUMULIN shots 2x a day.

We recently switched from VETSULIN to HUMULIN. I am not sure if this is the reason. I can tell you that the insulin was NOT kept refrigerated. I am not sure if this matters that much.

She also does not get nearly enough exercise. She looks very skinny. I think she needs to gain some weight back. I am going to start taking her for more athletic walks. I tried to the other night, but she wore out coming home and dragged her feet thus hurting her paws. I may get a wagon so I can wheel her home should this happen again. =(

A few days ago her eyes got this smokey gray colored look to them, and she can barely walk up a curb, and she bumps into things. Her vision is going fast.

We have taken her to the vet, but I want a second opinion. I feel my fam's vet isn't on the ball. They are supposed to do blood work, but I was not there for the appts (work, and all), so I am hoping everything was executed correctly.

REMEDIES:

Switch her to higher fiber? Put some oats or some other complex carb in and reduce meat?

Change immediately from Humulin back to Vetsulin?

New vet? Better bloodwork.

Clearly something changed to make her condition worsen fast. =(

ANY HELP WOULD BE WONDERFUL! Thoughts? Advice?

[k9diabetes]

Re: My German Shepherd's Condition is worsening FAST!

Hi Lexy,

I'm sorry to hear your dog is having a hard time and know it's even harder to try to help and monitor from a distance.

Your dog needs to stay on NPH because Vetsulin is not being sold in the U.S. so supplies are rapidly running out (see information about this here: http://vetsulin.com/vet/Vet_ProductAlert.aspx )

Probably when the switch was made to Vetsulin the vet drastically reduced the dose. Unfortunately, that was the result of a professional recommendation that really applied more to cats than to dogs. Vets who followed it cut the insulin dose too much and sometimes they also have taken far too long to bring it back up.

I would hold off on exercising your dog right now. Later on, when things are more settled, that would be wonderful for her. But right now she either doesn't have nearly enough insulin to get energy into her cells or her blood sugar may be dropping sharply when you exercise her or both. Plus right now you don't want her to burn off what calories she is getting.

Please tell us more about her dose and how well regulated she was on Vetsulin.

- How many units of Vetsulin did she get?

- Did she get injections twice a day with Vetsulin?

- How many units of NPH is she now getting? And is it twice a day?

- What was her blood sugar like on Vetsulin - how was it tested, how often, and what were the results?

- What do her meals consist of now?

Three meals may not work as well with NPH as with Vetsulin but I don't want to worry about that until we find out more about what's been happening with her in terms of units of insulin and level of regulation.

- Also, how much does she weigh right now?

Her being skinny could be because she's been poorly regulated (the development of cataracts that you're seeing also suggests her blood sugar hasn't been well controlled) or because she's not getting enough to eat or both.

So please tell us more.

Natalie

[Lexy]

Re: My German Shepherd's Condition is worsening FAST!

Natalie:

Thank you so much for your response.

First, the vet just said on the phone we could switch back to Vetsulin. I don't understand this darn vet.

Here are facts to answer your questions:

Vetsulin: Lexy had 5 units given ONCE daily

She is on Humulin N receiving 8 UNITS TWICE DAILY

She was tested once when taking Vetsulin with blood sugar of 328

Her weight is now 65 lbs down from 85 lbs =(

Her meals since diagnosis have been:

7 AM Milk, 1 Egg RAW

930AM
Pedigree mixed with some Beneful and home-cooked Chicken (switched from Alpo)

2PM 4 Chicken Jerky Strips and Vegetable Soup with Noodles

Evening Snacks
Snacks may incl Dog Biscuits or 2 Chicken Strips

930PM
Pedigree mixed with some Beneful and home-cooked Chicken

PLEASE NOTE: She gets very hungry LATE NIGHT and wakes up and goes to the dog bowl where we leave a little Beneful and she takes some.

Prior to her sickness she was a VERY picky eater so she has never been easy to feed.

[k9diabetes]

Re: My German Shepherd's Condition is worsening FAST!

Holy Cow Lexy! She went from 5 units once a day to 8 units twice a day? That's three times as much insulin.

When did this change take place? Was it gradual?

Why the huge increase in insulin?

And the diet...

There's a lot about this picture that's troubling.

Natalie

[Lexy]

Re: My German Shepherd's Condition is worsening FAST!

Well, I am on this forum for a reason.

I think my family needs better advice, and I don't like the doctors.

You have already been helpful in that my fam has been more responsive because I hit them with specific questions, and told them that I am in touch with a "Pet Diabetes Group". Otherwise, they get defensive like I am calling them bad parents or something. I am very frustrated and worried at the same time. Not good.

The Vetsulin to Humulin change was after 1 month in. Apparently Lexy started panting a lot, and sitting outside in the cold (she is always warm) since she went to this 8 unit dose, twice daily. We are wondering if this is wayyyy too much.

We called the vet and the vet said go ahead switch back to Vetsulin ASAP. Then I read the link you posted. I am seriously wondering what the heck is going on with this vet.

Any diet tips would be valuable as well.

As a human, I have had bad doctors in my life. Hell, one tried to put me on Vioxx long term when I had some athletic pain, and if you look up Vioxx it was causing liver failure in patients.

Trust me, I LOVE FORUMS as I have gotten so much valuable info from them.

We need to save this gorgeous, loving, vibrant member of my family!

[k9diabetes]

Re: My German Shepherd's Condition is worsening FAST!

I can't decide what to say about the insulin doses because I'm concerned about being confusing.

The Vetsulin dose is minute for her size, particularly when given once a day. But if she responded to that tiny amount of insulin with blood sugar in the 300s, then I wouldn't triple the dose in one short step even if it's a minute one.

So if she responded pretty well to 5 units once a day, then 8 units twice a day could be too much insulin for her.

8 units is still a small dose for her size. Our dog weighed 62 pounds and used about 11 units of NPH. I think the average dose for 65 pounds would be somewhere in the neighborhood of 15 units or more.

But some dogs are very sensitive and don't need a lot of insulin.

The only way to know for sure what's going on with her is to do a curve - a premeal blood sugar test and then a blood sugar test every 2 hours for at least 12 hours.

Some vets are just not aware of the FDA alert. If they don't keep up with professional email services, etc. they may not know. It would be good to give them a copy of the information on that page.

NPH is usually a really great insulin for dogs and costs far less than Vetsulin...

Which reminds me - did your parents get new syringes with the NPH so they have the syringes that are matched to that insulin?

Natalie

[Lexy]

Re: My German Shepherd's Condition is worsening FAST!

Natalie:

We are going back to Vetsulin for the time being as per the doctor, and using 8 unit doses Twice Daily - though I cannot explain why the change in dosage from the original recommendation.

I am also seeking a new vet or second opinion. I am in Sherman Oaks in Los Angeles, so any suggestions would be appreciated.

Also, I would like to buy some Diabetic Dog Food, and I heard there are good online stores. I only buy online by recommendation. Would you recommend any?

I am becoming quite certain there is an insulin issue at hand here, and my family agrees. I wish I had caught this trend sooner, than to have to write on a forum in a hectic emergency.

Eventually we will obviously have to do Humulin.

Also, can you recommend a place to get a testing kit or machine to measure blood glucose?

Your help is of great value!

[k9diabetes]

Re: My German Shepherd's Condition is worsening FAST!

Hi Lexy,

Home testing would really help this situation out. For your dog, I'd recommend starting with a OneTouch Ultra meter. It has a good reputation for medium to large dogs and is what we used for all of Chris' years as a diabetic.

You can see video and picture tutorials of how to get a blood sample for the meter at www.k9diabetes.com/bgtestvideos.html. If you look at Chris' lip test, it's a big file so give it time to download.

I'd recommend the lip or an elbow callous if she has one.

If you do the lip, get an Accucheck Softclix lancing device - the best I've seen in my six years on forums for diabetic dogs. If you do the elbow callous, you will need to use the lancet by hand as the clicker device usually won't go deep enough in the thick skin of a callous.

As far as food, since she's really hungry now, maybe she will not be such a picky eater. Many folks here have switched to Blue Buffalo Wildnerness food and had very good results with it.

But... food changes change everything! So I'd hold off on any food change until you can sort out what's happening with her blood sugar on her current diet and get settled into NPH. She will have to come off of the Vetsulin in the near future as they simply won't be able to get any.

Food changes are complex with diabetics even when they're regulated.

First step is to assess what her blood sugar is actually doing right now and find a vet to work with. I will see if I know anyone in that area.

And if you take a look at the main website supporting this forum, www.k9diabetes.com, there are general information pages that can help fill in the details about diabetes.

Natalie

[CarolW]

Re: My German Shepherd's Condition is worsening FAST!

Hi Lexy,

Glad you found this forum; I've been on quite a few, and this one is the one I strongly recommend.

I just want to welcome you, and also, say that I'm guessing your family isn't purposely having difficulties (I'm sure you know that), but that rather, maybe the vet is, for whatever reason, behind the times (maybe overworking - but failing to keep up with current veterinary information can really be a problem) - AND - your family is probably used to just doing what the vet says, and not comprehending what a very active part we Human Dog-Parents need to take really to see to it our dogs do well.

This is particularly a difficulty with diabetes, where we need to be having our eye on things daily - and nightly. And we need our vets to be very well-informed team-mates for us - they need to instruct us, and also, to listen to our reports.

Both choice of food and choice of insulin are pretty crucial when treating diabetes. It becomes important to be consistent, in order to track how the dog is doing. This also means that keeping records is important. I keep mine in a spiral notebook, AND in a master text file (plain text) on my computer.

By the way, I use a OneTouch Ultra2 meter to track my Kumbi's glucose levels, and he's a small dog; it works really well for us. We use the Lip - no device; I prick by hand. We can do a test now in less than one minute, and Kumbi gets a tiny treat after the test.

Perhaps if your family were to read on the forum, that would give them a better idea of what this is all about.

I'll be following you and your dog closely!

So, welcome!

Tue, 4 May 2010 14:48:43 (PDT)

[Lexy]

Re: My German Shepherd's Condition is worsening FAST!

Follow up for Cinco De Mayo:

My poor Lexy has worsened. We got her bloodwork back and she has sugar of 280. We moved her to Vetsulin (8 units, Twice Daily) as of yesterday. We are also seeking a new vet and a second opinion.

Here is an update:

Lexy has a white "dot" over her pupils, that sounds like its similar to the smokey layer she had brewing before. Cataracts?
I have not seen Lexy since Monday because I do not live at home.
She has weakened more, and seems kinda blind. =(
Her blood sugar came back from the vet as 280
The vet recommended returning to Vetsulin and left it at that, no other advice. He continues to give the same tired advice as Lexy's condition has worsened. ARGH! =(

Clearly, we have found a lot of vet's are not on the ball, but I feel we can be more effective if we ask specific questions. Any suggestions?

My list is:

1) Does she need to be hospitalized to stabilize her condition?
2) Is she possibly rejecting Humulin? What are our options?
3) Are there doggy diets we can purchase?
4) Let the vet know we are buying the recommended blood glucose meters as mentioned on this forum
5) What exercise regimen do they recommend?
6) Are there surgeries for her cataracts/eye issues?
7) What are her chances of recovery?
8) Should we adjust her diet such that she gains some weight? ie higher in fiber etc

I WISH I HAD FOUND THIS FORUM SOONER!

Keeping hope alive! =)

[k9diabetes]

Re: My German Shepherd's Condition is worsening FAST!

Blood sugar of 280 is not all that high so it's okay to relax about that a bit.

Which makes me wonder whether Lexy has some other problem going on if she truly seems unwell. Her diabetes does not seem to be raging out of control.

Or perhaps you're more worried than you need to be?

Obviously I can't answer that question from here. But with blood sugar in the 200s to 300s perhaps, the diabetes is not a threat to Lexy's well-being.

Is the 280 blood sugar from an injection of NPH or from Vetsulin?

It is possible to be allergic to NPH. Rare but it does happen. Our dog was allergic to it. He used an entirely different insulin.

The white dot could be a cataract but it doesn't sound like it... they are usually hazy and cover a larger area. The lens, which is where cataracts form, is inside the eye. What you're describing sounds like a cornea problem.

First and foremost, you need a vet you can trust.

You are not too far from VCA West Los Angeles. I don't know of direct experience with the vets there but one of the medical directors, Dr. Bruyette, is an endocrinology guy and he is definitely aware of the value of home testing blood sugar and presumably some of that has filtered down to the vets who work there. It is a large hospital with specialty staff. So that is one possibility.

The lack of trust is really at the root of this... we can suggest possibilities but a good vet needs to see Lexy and determine what is and isn't working.

I would aim for someone who supports good regulation and home blood glucose testing, who understands that Vetsulin will not be available, and who is supportive of including you and your family as important in making decisions and as an important part of treatment.

If Lexy is truly struggling, she needs to see a vet as soon as possible. Problems like pancreatitis, for example, can become critical if left untreated for very long. So in your shoes, I would find a vet in a larger hospital with specialty care available and have her seen ASAP (preferably today), not even so much regarding the diabetes but for what else might be happening that's causing her to feel so poorly.

Natalie

[O'Riley]

Re: My German Shepherd's Condition is worsening FAST!

Hi Lexy,

Ditto on getting to a vet pronto. One thing you can do right now is buy some Ketodiastix (over-the-counter at the drugstore) and catch some urine and test for ketones.

The day that my Riley was diagnosed, the vet drew blood and the lab glucose showed 280, just as your dog's did. I bought the ketodiastix and tested his urine the next day and he was seriously positive for ketones and also registered at the highest (bad) end of the glucose color chart. I started home testing right away and quickly discovered that his blood glucose readings were all over the place, including in the high 400's. My point is, the lab glucose reading of 280 wasn't a good indicator for how wildly fluctuating and out of control Riley's blood glucose levels truly were. The 328 on your other lab test gives you a hint of this. By the way, was the blood sent out to be analyzed, or were the two readings you've gotten from the vet done on a little handheld meter? I was assuming it was a lab value, but now I'm wondering if the vet did a blood panel?

With the Ketodiastix, within 30 seconds of dipping a test stick in a fresh urine sample, you'll be able to rule in or out ketones and get a general idea of his blood glucose level. If his blood glucose is in the high range for a good part of the day, he could be dehydrated which I've just read will dramatically decrease the effectiveness of the insulin.

You're lucky to be near Dr. Bruyette's office. That's where I'd go.

~Rosey

PS I have decided that I will never rely on a vet's ketodiastix results. I'm convinced that the test "stix" my vet was using were old. They're only good for six months after the bottle is opened. After that you throw them away and get a new bottle. I may be wrong, but I really don't think it is possible to go from zero ketones in the afternoon using the vet's "stix", to registering full fledged serious ketones the next day on my brand new stix.

[tardischan]

Re: My German Shepherd's Condition is worsening FAST!

Hi Lexy.

If your poochie is deteriorating, then yes, see a vet asap.

[connieandgypsy]

Re: My German Shepherd's Condition is worsening FAST!

Is she spayed or intact...i am not much help unless it concerns hormones and diabetes...i really hope she picks up and you find a good vet.