Angel Bruno

[Bruno'sMom]

Hello Everyone! My name is Kathy and Bruno is my baby boy. He is a Lhasa Apso and he will be 4 in August. He was diagnosed with diabetes on june 11, 2009 (approx. 1 month ago). I noticed he was drinking water constantly and needed to go out much more often and right away. Bruno was incredibly easy to potty train and to this day will get extremely upset if he cannot get outside before he has an accident in the house. He is a larger sized Lhasa averaging out at about 29 lbs. according to the vet he was not overweight, just on the larger side. He currently weighs 23 lbs. He lost over 6 lbs. in one month.He receives one injection daily of 5 units vetsulin. When I first found out he was diabetic the vet told me he was VERY ill and that there were ketones in his urine. She told me he may not survive, that he could slip into a coma or start having seizures and either way his outlook was grim. I have been handling this on my own on a day to day basis but I know I am out of my league and I need any advice I can get. I need to get my boy healthy again! I have always had trouble feeding him, he has had digestive problems since he was a puppy. He threw up yellow foam often as a pup but the vet could never give me an actual cause. He will not eat the hill's diabetic food and I cannot find the Royal canin anywhere so I have been cooking his food out of desperation just so I know he has something in his stomach. He doesn't have much of an appetite.I have lost more sleep worrying about what I will be able to get him to eat so I can give him his insulin. I am disabled so I am home with him all day and night. I have to take him out about every two hours all night long and recently he does not want to come back in, he goes potty then comes back to the porch and lays down.Bruno is a very happy dog by nature but I can tell he is miserable and depressed.I'm sorry this is so long but I wanted to give as much information as possible in the hope that someone may have encountered some of the same situations and found solutions.Due to my health problems I have some days that seem to just slip by so I may not be online every day but I will try to check in as often as I can!I am so scared that there is something I could be doing to make my little one more comfortable and that I will find out too late. I also wanted to mention I have noticed his right eye looks milky and seems to have very little vision I was told by the vet he will go blind. Any advice on how to teach him things to make the transaction easier before he is completely blind? Thank you for taking the time to read this.I look forward to hearing from you, Kathy

[Margaret Boyle]

Hello Everyone! My name is Kathy and Bruno is my baby boy. He is a Lhasa Apso and he will be 4 in August. He was diagnosed with diabetes on june 11, 2009 (approx. 1 month ago). I noticed he was drinking water constantly and needed to go out much more often and right away. Bruno was incredibly easy to potty train and to this day will get extremely upset if he cannot get outside before he has an accident in the house. He is a larger sized Lhasa averaging out at about 29 lbs. according to the vet he was not overweight, just on the larger side. He currently weighs 23 lbs. He lost over 6 lbs. in one month.He receives one injection daily of 5 units vetsulin. When I first found out he was diabetic the vet told me he was VERY ill and that there were ketones in his urine. She told me he may not survive, that he could slip into a coma or start having seizures and either way his outlook was grim. I have been handling this on my own on a day to day basis but I know I am out of my league and I need any advice I can get. I need to get my boy healthy again! I have always had trouble feeding him, he has had digestive problems since he was a puppy. He threw up yellow foam often as a pup but the vet could never give me an actual cause. He will not eat the hill's diabetic food and I cannot find the Royal canin anywhere so I have been cooking his food out of desperation just so I know he has something in his stomach. He doesn't have much of an appetite.I have lost more sleep worrying about what I will be able to get him to eat so I can give him his insulin. I am disabled so I am home with him all day and night. I have to take him out about every two hours all night long and recently he does not want to come back in, he goes potty then comes back to the porch and lays down.Bruno is a very happy dog by nature but I can tell he is miserable and depressed.I'm sorry this is so long but I wanted to give as much information as possible in the hope that someone may have encountered some of the same situations and found solutions.Due to my health problems I have some days that seem to just slip by so I may not be online every day but I will try to check in as often as I can!I am so scared that there is something I could be doing to make my little one more comfortable and that I will find out too late. I also wanted to mention I have noticed his right eye looks milky and seems to have very little vision I was told by the vet he will go blind. Any advice on how to teach him things to make the transaction easier before he is completely blind? Thank you for taking the time to read this.I look forward to hearing from you, Kathy

Welcome Kathy,
The experts will contact you shortly I am sorry Bruno is feeling miserable and depressed. Try not to worry my Lucy has very little sight but it is amazing how they adjust. Bruno will be fine once you get things sorted out I know it is very frightening to begin with I can assure you Kathy we all went through this and with the support of this forum you will learn a lot Please don't feel sad as in the next few weeks you will feel better and see things more clearly.

Hugs to you both:)

[Bruno'sMom]

Dear Margaret and Lucy,
Thank you for the encouraging words! It's nice to know there are others out there that understand and care. Was Lucy's loss of sight gradual? Does she seem to use her other senses more? It was so nice to hear from you, Take care :).
Kathy

[Margaret Boyle]

Dear Margaret and Lucy,
Thank you for the encouraging words! It's nice to know there are others out there that understand and care. Was Lucy's loss of sight gradual? Does she seem to use her other senses more? It was so nice to hear from you, Take care :).
Kathy

Kathy,
Lucy had such high blood sugars to begin with and the insulin she was on had done nothing for her.

Her sight loss was gradual Lucy has been diabetic for 17 Months she uses her sniffing scent a lot more and her hearing but she is a happy wee soul.

She is now on Caninsulin since Feb and a change of diet and it seems to be working well.

We are hoping to have her eyes done we have asked our vet to refer us after our holidays in August. So we are hoping it can be done if not we will love and guide her just the same.:D

Kind regards.

[We Hope]

Welcome!

I believe Bruno needs to get on two shots of insulin a day to start feeling better.

Caninsulin is classed as an intermediate-acting insulin, as is NPH. There just is no way you can stretch an intermediate-acting insulin into a long-acting one without using the two shots a day.

I've known people whose dogs were started on the one-shot method; every one of them didn't get their dogs regulated until they switched to the two shots a day protocol. One person in particular tried working with it for 7 months and still her dog wasn't regulated. After changing to the two shots a day protocol, he regulated easily and quickly.

My Lucky regulated on a similar insulin; at the time Lilly made Iletin II Lente. It's identical to Caninsulin except for the strength. Caninsulin is a U 40 insulin, while the old Lilly insulin was U 100. Lucky received two shots a day of the old Lilly insulin.

We no sooner regulated him on that and Lilly decided to discontinue making it. At the time, they still made pork NPH. This was the only intermediate-acting pork insulin in the US then, so we had to switch him to that.

Lucky had extreme problems with the protamine suspension of the NPH and the two different preservatives in it as opposed to the one which can be used in Lente type insulins. He was doing so badly with problems he never had until it was necessary to use the pork NPH, we made application for permission to import Caninsulin for his personal use; there was no Vetsulin in the US yet.

When we got the insulin, we used it as two shots a day, the same as we'd done with the old Lilly insulin. Lucky regulated very quickly and easily--matter of fact, he liked Caninsulin ever better than the old Lilly one! :)

I believe Bruno really needs to have shots twice a day to get regulated. Think he will feel much better and have his appetite pick up also.

Kathy

[k9diabetes]

Hi Kathy,

Welcome to you and Bruno, which is a very serious name for such a cute little guy!

So he's been diabetic a month... as Kathy mentioned, he almost certainly needs two injections a day to regulate. I know of only one or two dogs out of a hundred or more that could get by on one injection a day.

How has his regulation been monitored so far? Has the vet done curves?

Are you doing any urine or blood testing at home?

Just reading between the lines, it seems like your vet has not pursued good regulation energetically. The best way to get Bruno feeling better is to get him the insulin he needs twice a day so he gets full coverage from it and then monitor how he does with the insulin to improve his regulation.

You may need a more dedicated veterinarian who is willing to work for good regulation and help you with this.

Most likely his appetite will improve when the diabetes is under better control.

No harm in sticking with home cooking for now. Once we see how it works with his insulin, it can be tweaked if need be. Lots of diabetic dogs do great on home cooked food.

If curves haven't been done, he needs a curve also.

When he goes to two injections (tomorrow I hope!), they may decrease the dose somewhat. I wouldn't go down more than 2 units, probably only 1 unless the urine or blood sugar level has been monitored and found that 5 units of Vetsulin is dropping it a long way.

Hope that makes sense!

So please talk to the vet as soon as you see these messages about putting Bruno on two injections a day and then please fill us in on how his blood sugar is being monitored and what the results of that testing have been.

We have all been at this spot - it's really hard when they don't feel well. But we can help you get Bruno feeling better! So I'm glad you're here.

Natalie

Lhasa averaging out at about 29 lbs., currently weighs 23 lbs.
One injection daily of 5 units vetsulin.
Ketones at diagnosis, not much appetite
Lifelong digestive problems
Currently home cooking, won't eat WD

I am disabled so I am home with him all day and night. I have to take him out about every two hours all night long and recently he does not want to come back in, he goes potty then comes back to the porch and lays down.

Bruno is a very happy dog by nature but I can tell he is miserable and depressed.

I also wanted to mention I have noticed his right eye looks milky and seems to have very little vision I was told by the vet he will go blind.

[Bruno'sMom]

Hi Kathy,
Thank's for the info about doing two injections instead of one. I am going to take Bruno to another vet later this week and I will suggest trying this. At this point I know something needs to be changed. My little guy just lays around all day and groans or growls when I try to pick him up. He is normally very happy and energetic and lives to guard me and our home:). I appreciate the help!
Take care,
Kathy

[Bruno'sMom]

Bruno had very small black freckles on his stomach now they have enlarged and are about the size of a pencil eraser. They are not swollen but the spots have changed just recently and he groans alot! I feel like there are so many things I could be doing to help him and/or make him more comfortable. If this is something I should be concerned with would someone please let me know? Also, I have his readings from his first glucose curve (done about 3 weeks ago) but didn't know where to post them? I really appreciate how helpful everybody is!
Thank you,
Kathy :)

I am adding Bruno's readings from his first glucose curve, they are as follows:
I was told they started the first reading at 9:00 am and completed at 5:00 pm at 2 hour intervals- 343, 228, 165, 114, 115.
I know Bruno was very upset during the entire day because everytime I phoned to check on him I could hear him barking his "desperate" bark and they told me he was being a brat. I don't think they let him out as often and/or as quickly has he needed to go potty as I had to clean him up when he came home and bathed him the next day! I don't know if this is common or not? All of this is so new and scary but I am trying to learn as fast as I can.

[ravenecw]

Bruno had very small black freckles on his stomach now they have enlarged and are about the size of a pencil eraser. They are not swollen but the spots have changed just recently and he groans alot! I feel like there are so many things I could be doing to help him and/or make him more comfortable. If this is something I should be concerned with would someone please let me know? Also, I have his readings from his first glucose curve (done about 3 weeks ago) but didn't know where to post them? I really appreciate how helpful everybody is!
Thank you,
Kathy :)

I have no idea about the spots- my guess is to get them checked out but hopefully someone else can let you know more than that.

You can post your numbers right here in your post- that's what I do (and most others)- you will get feed back for sure...

[Bruno'sMom]

Thanks! I'm going to take him to the vet tomorrow but I don't have alot of faith in the place I take him, I am hoping to switch to another vet as soon as I can. The doctor is very nice but I don't think they are as agressive/involved as I would hope for.
Take care,
Kathy :)

[We Hope]

Has Bruno ever been tested for Cushings? One of our members recently had something similar happen:

More troubles. I noticed Daisy has dark splotches on her tummy.
She is on hydrocrotisone for her IBD and although the liver enzymes look pretty good she is apparently Cushingoid from the cortisone. She does not have the disease.

Her hair is falling out real bad. Her tail looks almost bare now and I recently noticed a dark tummy. I thought it was the hair growing back from the ultrasound but the hair there is white so I finally figured it iyt was discolored skin.

What the heck will we do now?

Can she take a medicine to reverse drug-induced Cushings?

As you may have read Daisy's vet is on vacation and I need to know
what is going on here.

I do not think she can come off the hydrocortisone ir the IBD will be
too bad.

This is really getting crazy.

In Daisy's case, the hydrocortisone she needs to take for IBD is the reason for the Cushing's.

There are times when it's really difficult to tell if Cushing's is involved or not:

http://www.vet.uga.edu/VPP/clerk/Zwicker/

Canine Hyperadrenocorticism, Diabetes Mellitus, or Both?

We've had a few members who were initially told their dogs had both diabetes and Cushing's but as they continued with working at controlling the diabetes, it became apparent that they had only diabetes. As you can see from the article, yet to be regulated diabetes can interfere with some of the diagnostic tests for Cushing's.

Personally don't know anyone whose dog had diabetes who came up with the kind of spots you're describing with Bruno. I would ask some questions about the possibility of Cushing's as well as about diabetes when you take Bruno into the new vet tomorrow. Hope this means things will be looking up for you both! :)

Kathy

[Bruno'sMom]

Hi Kathy,
I appreciate the quick response! I will ask the vet about cushing's among my MANY other questions.Bruno's hair is falling out (lots and lots). I was checking back through my notes from the first visit when I was told that my baby was diabetic and I remembered the doctor telling me Bruno had a lump/mass on his liver but that we should focus on the diabetes due to the severity of his condition (he had ketones in his urine?) and that the liver lump would be secondary and perhaps was even "a red herring" ? This was the same visit that she gently suggested I may want to consider having him put down. I am disabled and she is aware of my current financial difficulties so I think she was trying to give me a way out. She kept stressing that he would go blind, that he was suffering and could expire at any time. I mentioned that I would sell my car if I had to so I could cover his expenses and she told me not to do anything so drastic at this point and sent me home with instructions to monitor him and give him the one injection daily. Since then I have had him back for his BG curve and she said she was pleased with his numbers "perhaps due in part to his being so young". Bottom line is my little guy is obviously miserable and I want to fix that for him ASAP!
I am sorry this is so long but I don't have anyone else that understands and has the ability to answer my questions. Thank you so very much!
Kathy

[k9diabetes]

Cushings can cause skins problems, as can thyroid disorders and auto-immune problems. From the looks of the curve, though, Cushings doesn't seem very likely.

9:00am - 343
11:00am - 228
1:00pm - 165
3:00pm - 114
5:00pm - 115

Given Bruno's seeming desperation about being at the vet, the readings could be much lower there from all his barking and anxiety than they would be at home. This is where home testing would tell you whether vet stress altered his curve.

Still, with one injection a day only, looking at that curve, I think Cushings is not very likely.

With the digestive sensitivity, could be something more along the lines of an autoimmune disorder that's affecting the skin.

See what the vet says and we can try to sort things out from there.

You may already be there... if not, I'd ask her to give it to you straight about your options and then let you choose what you can and cannot do financially.

She sure is a downer though... I'd rather work with someone who can see the upside, you know! ;)

Natalie

[eyelostit]

Hi Kathy and Bruno Welcome :)

Sorry for the late welcome, I've been behind with everything.

Welcome to the board

Dolly and Niki

[Bruno'sMom]

When my little guy was diagnosed last month he had ketones in his urine. He has not been doing very well so I am trying to monitor him as much as I can. I started using the Keto-Diastix yesterday and he is showing the darkest burgandy (most ketones) each time. Should I be testing at any specific time, such as before meals and/or insulin or does it not matter?
Thanks :)

[k9diabetes]

He needs to go to the vet tonight... what are your emergency vet resources.

Anything beyond moderate to mild ketones is an emergency.

Natalie

[k9diabetes]

I talked to Kathy last night and as of around 11pm my time Bruno was doing okay. He had been switched a couple of days ago from 5 units once a day to 3 units twice a day so probably just not enough insulin. He is scheduled to see a new vet today. I hope, since I didn't hear back from her last night, that he did okay through the night.

Natalie

[snow]

I talked to Kathy last night and as of around 11pm my time Bruno was doing okay. He had been switched a couple of days ago from 5 units once a day to 3 units twice a day so probably just not enough insulin. He is scheduled to see a new vet today. I hope, since I didn't hear back from her last night, that he did okay through the night.

Natalie

Ketones are so scary - hope Bruno is OK

[k9diabetes]

Bruno got through the night with a little extra insulin and it sounds like the new vet is much more positive and encouraging - thank goodness! :o He has a UTI and they started antibiotics so I hope his glucose levels will come down as that kicks in.

I think Kathy will come by an post tonight or tomorrow.

I'm so relieved!!

Natalie

[Bruno'sMom]

Thank's to Natalie, Bruno and I survived the night! I took him to the new vet today and things are looking up :) He has a UTI and is now on antibotics. As for the high ketones they are hopeful that with close monitoring and a gradual increase of his insulin we may be able to get my little guy back to feeling more like his usual self! I actually have already noticed an improvement in the little things such as his appetite improving, he's not as lethargic and I actually got kisses for taking him for a ride :) I want to thank you all for your concern and your willingness to share your time, knowledge and kindness with the people like me that are stumbling through this, not sure what to do next but wanting to learn. I will be taking Bruno in next week for a new glucose curve with the new vet so I'll keep you posted!
XOXOX,
Bruno and his mom :)

[k9diabetes]

It's great to get a fresh start with a vet who will work with you. Hopefully the antibiotics will bring the blood sugar down and the ketones with it.

Keep us posted! :)

Natalie

[k9diabetes]

How is Bruno doing? I've been worried about him.

Natalie

[Bruno'sMom]

Thanks for checking in! Bruno is doing okay.I'm staying hopeful and doing alot of praying! His ketones have come down but are still in the moderate range.The best news is he seems to have his appetite back (he was wasting away before my eyes) and in turn seems to have a bit more energy . He is definately more alert and acting more like his old self! We have an appointment with the new vet Tuesday for a blood draw and I am very anxious about the results. I noticed when checking his urine that even though there are consistantly ketones there are NOT always signs of glucose (I use the strips that show both) and even the vet seemed a little puzzled by this. Is this common? We will let you know how the vet appointment goes.
Take care,
Kathy and Bruno :)

[We Hope]

We may have an answer for this, thanks to Google Books and Dr. Hanas, whom you may have seen quoted a lot around here. :)

http://books.google.com/books?id=2lyIu4_5r4IC&lpg=PA101&ots=k1AJ6-L5UE&dq=positive%20ketones%20negative%20glucose&pg=PA101

Type 1 Diabetes in Children, Adolescents and Young Adults By Ragnar Hanas

Page 101

"Acetone will also show on urine strips. Acetone may be present in the blood for many hours although no new ketones are formed after extra insulin is taken. Because of this, urine strips may continue to be positive for ketones although blood ketones strips are normal."

So what she's saying is that if you test blood for ketones, you would find normal readings but because of the "lag" between the blood and urine readings (just like with checking then for glucose), you could be seeing the "leftover" results.

It's also possible to get false readings on glucose or ketones (false negatives or false positives) if you're taking certain meds:

http://petdiabetes.wikia.com/wiki/Medication_warnings#False_Testing_Results

Here you see that an antibiotic, cefixime/Suprax, can cause false urine ketone readings.

http://www.rxlist.com/suprax-drug.htm#ad

The drugs related to this one are shown at the left.

So it could be what Bruno needs to take to get rid of his UTI that's playing tricks with the ketone portion of the urine strips.

HTH!

Kathy

[k9diabetes]

How'd the vet visit go? I'm hoping Bruno's ketones have gone...

Natalie

[Bruno'sMom]

COPIED FROM VISITOR MESSAGES FROM BRUNO'sMOM

http://www.k9diabetes.com/forum/member.php?u=1070

Hello eveybody! I am DESPERATELY looking for VETSULIN that someone may have left that.I am aware that they're no longer producing this product but it is the only thing that has helped bruno.He was a severe case when diagnosed but has shown great improvement on vetsulin.I have been using any I could get my hands on,even if the product date has expired.I ran out a few days ago (I had stockpiled all I could find!)Bruno is not responding to the other types of insulin.He is down to 20lbs.from his normal weight of 29lbs.He is given 6 units twice daily so a bottle does last us for a decent amount of time.I'm writing this hoping that someone will be able to help.I realize many are in my same position but I am desperate to keep my little guy alive!Please notify me if you know where I may locate any vetsulin(expired or not!) Please keep us in your prayers!Time is of the essence,he has been on novolin r for 4 days and each day has worsened. Humulin also does not work for him. Thank you!


Hi everybody, I am hoping someone will be able to help!

Bruno, my 5 year old lhasa apso is very ill. He was diagnosed approx. 2 years ago and after a long struggle we finally managed to get his diabetes under control. The only thing that works for him is vetsulin which I'm sure many of you know is no longer being produced.

Bruno was switched to novolin R 5 days ago and he is now near death. I had a small amount of expired vetsulin left so I switched him back last night and he is struggling to come back.

My little guy is a fighter so I am holding onto the hope that I will have enough vetsulin left and he will be able to hang in there until I can locate someone that has some vetsulin that they would be willing to part with. I am desperate and will purchase any amount including expired vetsulin as long as it has been refrigerated. Please let me know if you have some or know of anyone that does.

My vet has said that he could pass away at anytime so obviously time is of the essence. I thank you all for taking the time to read this! Please keep my baby in your prayers and pass the word if you can!

[Soaphie & Sydney's Mom]

did she try ordering overnight from canada?

[Joan]

Exactly right, vetsulin is the same as caninsulin available from many online orders from Canada, they all ship to U.S.

http://www.77canadianpharmacy.com/buy-Caninsulin.php

[Soaphie & Sydney's Mom]

I was previously having an issue ordering from Canada - but perhaps they have since straightened out their inventory. Also, ordering from the UK is another option.

[k9diabetes]

Hi!

You hopefully can order some from Canada... there were problems a while back because there was so much demand that they weren' shipping it and I don't know if that's still true or not but it's worth a try. That may have been related to the potential bacterial contamination problem and perhaps they have resolved that by now.

Could you post or send me the blood sugar readings Bruno is getting on NPH?

Sometimes we can figure out a way to make the insulin work better if the dog's body is responding to the insulin itself.


Natalie

[Bruno'sMom]

Hi everybody, I am hoping someone will be able to help! Bruno, my 5 year old lhasa apso is very ill. He was diagnosed approx. 2 years ago and after a long struggle we finally managed to get his diabetes under control. The only thing that works for him is vetsulin which I'm sure many of you know is no longer being produced. Bruno was switched to novolin R 5 days ago and he is now near death. I had a small amount of expired vetsulin left so I switched him back last night and he is struggling to come back. My little guy is a fighter so I am holding onto the hope that I will have enough vetsulin left and he will be able to hang in there until I can locate someone that has some vetsulin that they would be willing to part with. I am desperate and will purchase any amount including expired vetsulin as long as it has been refrigerated. Please let me know if you have some or know of anyone that does. My vet has said that he could pass away at anytime so obviously time is of the essence. I thank you all for taking the time to read this! Please keep my baby in your prayers and pass the word if you can!

[k9diabetes]

Hi,

Can you call me ASAP so we can sort exactly what is happening with Bruno's blood sugar?

I am going to email you my phone number.

Natalie

[k9diabetes]

I'm very concerned about whether the vet is handling this problem properly.

Your dog should be receiving some faster acting insulin to avoid ketoacidosis and to see if he responds to the human insulin when nothing has been added to it.

Please get in contact with me this afternoon if you can so I can find out the details of what happens with your dog on NPH and whether he's receiving critical care for his high blood sugar.

Unless he absolutely refuses to use the human insulin molecule, which is very rare, it should be possible to get his blood sugar down to a safer level.

Natalie

[CarolW]

I hope you're in touch with Natalie by phone - I'm watching your thread and rooting for you and Bruno!

Fri, 17 Jun 2011 17:25:14 (PDT)

[peggy0]

How is Bruno doing? Have you gotten in touch with Natalie?

[MaryLea]

Praying 4 u & watching 4 news.

Mary

[HarrysMom]

You are in my thoughts and prayers.

[k9diabetes]

I didn't hear from Bruno's mom... I just hope he's getting proper veterinary care.

Natalie

[k9diabetes]

Just talked to Bruno's mom. She is checking on what it would take to have him seen at the emergency vet clinic today and I'm going to donate to the cost if it's at all affordable to do, like if they will see him for a couple of hundred. If they quote her a thousand, it won't work but I'm hoping they wouldn't charge too much to get him on IV fluids.

He hasn't been tried on a full dose of NPH so it may be that the NPH will work for him if enough of it is given.

Natalie

[k9diabetes]

Yay! Bruno is on his way to the hospital.

Natalie

[CarolW]

Bless your huge heart, Natalie - keep us posted when you have any news!

Sat, 18 Jun 2011 17:30:20 (PDT)

[k9diabetes]

He's a very sick boy... four days with high ketones, throwing up, probably in ketoacidosis. I don't know if he will pull through but finally he is hopefully going to get the help he needs to have a chance.

Natalie

[jesse girl]

I believe nph doesn't work that well for jesse and she may have a reaction to it but finding an alternate routine and a way to reduce her insulin needs through diet she was able to be regulated on it so with all those problems anything is possible and hope his numbers can be stabilized with nph we are definitely cheering him on

[Patty]

keep us posted as you know more Natalie. Is he tolerating fast acting insulin?

[k9diabetes]

Patty, the sad thing is that until tonight he hasn't been given any fast acting insulin... I talked to Bruno's mom about 9pm my time and he's staying in the hospital overnight. His blood sugar was 875. I assume they will give him some fast acting insulin and I sure hope he responds to that.

When she ran out of Vetsulin, the other vet, not this one, switched him from 6 units of Vetsulin to 3.5 units of NPH per injection. Then recently, Bruno's mom gave him Vetsulin that's about 4 months out of date... not sure if that's an open bottle or an unopened bottle. But his blood sugar was so high and his ketones so heavy by that time that I don't know that it would have made much of a difference.

No one she has talked to seems to be aware that there is such a thing as Caninsulin just across the border.

She is going to call me tomorrow and said she would also try to post here at the forum. So I think I will track down some resources that explain Caninsulin / Vetsulin - probably just the writeup on Kathy's Canine Diabetes Wiki would be enough to do it.

This vet seems much much better. She will be there with him tonight.

Natalie

[k9diabetes]

For Bruno's Mom,

You can print out the pages at the following links to give to the vet to see if you can obtain some Caninsulin from Canada. I've also included a link about ketoacidosis.

Caninsulin page (notes that it is called Vetsulin in the U.S.)

http://diabetesindogs.wikia.com/wiki/Caninsulin

The next link is an FAQ page by the maker of Vetsulin stating throughout that Caninsulin and Vetsulin are the same thing. Just different names in different countries. Caninsulin has been used for some time in Europe, the UK, and Canada. It was approved in the U.S. five or six years ago and is called Vetsulin in the U.S.

http://www.vetsulin.com/vet/faq.aspx#2

Is this a brand new insulin?
No, Vetsulin is registered in over 30 other countries as Caninsulin®. It was first registered in Australia in 1990, so there is over a decade of safety and efficacy history with this product.

On Ketoacidosis:

http://diabetesindogs.wikia.com/wiki/Ketoacidosis

[CarolW]

I'm glad Bruno seems to have a better vet this time, because he surely needs that. Hope they can bring his BG levels down - and that the links you showed for Bruno's Mom will help her. They should!

Praying for Bruno.
Sun, 19 Jun 2011 01:21:16 (PDT)

[Patty]

Oh my! 875. I'm glad this vet seems to have a handle on it. Sending love and prayers for Bruno.
Patty

[buddingartist]

Bless your heart Natalie.

It is horryfing to read this. Amazingly, it appears that R insulin is not commonly use by many vets here. I only learned about R insulin from this board.

When Buddy was rushed in for acute ketoacidosis and pancreatis, he was in the 600's and he was put on intraveinous, was fed treats in order to be able to give him insulin and injected NPH for 2 days. Need I say how sick he was when he came home?

My prayers go to little Bruno and his mom.

Louise

[Soaphie & Sydney's Mom]

FYI - if Bruno's mom places and order for Vetsulin in Canada, some online companies require a prescription....the prescription HAS to say Caninsulin or expect further delays.

Are we certain that Bruno won't respond to NPH? Or was he just give too low of an amount.

I'll be watching for further updates.

Good luck!

Tami, Soaphie and Sydney

[k9diabetes]

I received this as a visitor message about 5:30pm California time.


Just a quick update. Bruno is still hospitalized.They rehydrated him and brought his numbers down from high 800s (when first hospitalized) to 256 by early this morning. No ketones in his urine, but they had to express his bladder for him. He has not eaten and he is still extremely lethargic! They tested his pancreas and it is fine. He is still on an IV and other than lifting his head up and licking the air (I think he was aiming for me but could be wishful thinking) when I first got there today, he is barely moving. I put a little baby food on his lips and he licked it off, he also lifted his head up whenever I put the open jar of baby food under his nose but made no move to eat. His eyes are mostly closed and I'm not sure he really knew I was there. Any thoughts on what could be causing his unresponsive demeanor? I'm so worried.

[CarolW]

No idea, but prayers are flowing for you and Bruno. He's made it this far; I hope he'll improve - and then recover!

Hang in there; we'll hang in there with you!

Mon, 20 Jun 2011 01:54:20 (PDT)

[peggy0]

Poor thing. Prayers for Bruno to pull through this quickly

[MaryLea]

Best wishes, hugs and wags from here, too. Watching and praying for a good report about Bruno! :)

Mary

[Bruno'sMom]

Hi Everyone! I'm still trying to learn my way around the forum so hopefully this will find it's way to where it needs to go! I spoke with Natalie earlier today and gave her an update on bruno. I just found all of the posts attached to this thread or I would have responded sooner! It means so much to not feel like I'm in this alone and second guessing myself about every move I make regarding bruno's care. Thank you ALL so much for your concern and prayers for bruno!! Natalie has been so great!! Bruno came home from the hospital monday evening. He is improving but is still sleeping most of the time.Today he was up a little more and has eaten everything I offered him. Until this morning I was still syringe feeding him baby food. He is down to 17.6 lbs from 29 before being diagnosed, so the dr. said give him whatever he wants to eat. We have an appt. at 4 tomorrow for a glucose test. I will keep you posted !! kathy :)

[jesse girl]

that is wonderful news my jesse came back from the brink and she is doing well it can take some time to heal its great your baby is eating that is so important

[k9diabetes]

Great to see you here Kathy! :)

I merged your old thread with the new a couple of days ago so we have Bruno's history.

Natalie

[Patty]

So great to see an update Kathy! And glad he has his appetite back :)
Do keep us posted,
Patty

[jjefferjo]

YEA! Please keep us updated

[HarrysMom]

I am so relieved Bruno is OK. Hope he continues to heal.

[Bruno'sMom]

Hi Everyone!
Bruno had his bloodwork done today and his reading was 153 =D He is still sleeping ALOT Although he is behaving a little bit more like his demanding little self! lol He actually walked out to the car and into the vet's office on his own. Even yesterday I don't think he would have had the stamina. We are scheduled to revisit the vet in about 8 days for another meter read/check up as long as bruno continues to improve. They have him on clavamox for his UTI and he will be finished with it the day before his next appt. Thank you all for being here for Bruno and me! I will keep you updated, hopefully bruno will continue to get stronger over the next few days. <3 kathy

[Patty]

That's great news! So glad he's gaining his strength back :)

[CarolW]

Super good news about Bruno! I'm SO glad to read this!

Keep up the great work! Hang in there, Bruno; I think you have the whole forum cheering for you! (You too, Kathy!) That doesn't mean we stop the prayers [grin]

Thu, 23 Jun 2011 22:23:55 (PDT)

[Bruno'sMom]

Hi everyone, Bruno is continuing to act a little more like himself everyday! Yay!!:D He is still weak and he definately needs to gain a little weight (currently 16 lbs) I am taking him in for blood work and a follow up by the end of the week. I'll keep you posted on his results. I need to order caninsulin and I was hoping some of you could tell me if the site I was planning to order from is a "good" site? If not, any recommendations would be appreciated. Has anyone ordered from "77CanadaPharmacy" they say I don't need a prescription and I can have it express shipped. I worry that it won't be properly refridgerated in transit. I have been told that Canada's mail carriers are on strike so I planned to have it shipped through fed ex or some similar courier. If anyone has another pharmacy that they are comfortable with I would appreciate their info. Thank's for all the help! Kathy :)

[CraigM]

I haven't ordered anything from Canada, but be sure they will ship overnight express in a chill pack. When we were using Vetsulin I'd order from several different sellers and they would only ship Monday - Wednesday to be sure the package arrived before a weekend. Expensive shipping so I'd buy 3 or 4 vials at a time for the same shipping cost. Good luck.

[Soaphie & Sydney's Mom]

Even though it is from 77canadapharmacy - their suppliers are in the UK - it is shipped from the UK to you.

[k9diabetes]

I'm so glad to hear about Bruno! :)

Natalie

[CarolW]

i noticed your post in Natalie's "Jack the project" thread (Everything Else) - and besides cracking up at your description of how Bruno insists on having his needs met NOW, I was thrilled to learn how well he is doing!

Hope that Vetsulin (rather, it will be Caninsulin - same stuff) comes in okay for you and Bruno. How very tough to have to order from the UK (even if the order is placed through Canada). (Thanks to Tami, Soaphie and Sydney for that information!)

Camellia and I send Bruno our regards. Kwali and Kumbi do, also, but from the Bridge.

Mon, 4 Jul 2011 22:56:09 (PDT)

[CarolW]

Just had another belated thought. Is Bruno on NPH insulin at the moment? And he's doing okay? Can't remember if you've learned to test his BG levels yourself (around here, that's called "home testing"). If he IS on NPH now, and doing well on it, maybe you wouldn't need the Caninsulin? I think you said before NPH didn't work for Bruno.

Mon, 4 Jul 2011 22:59:01 (PDT) yes, Camellia, I'm COMING (to bed).

[Bruno'sMom]

I so very much appreciate all the input from everyone. Carol, glad to make you laugh with bruno's bossy little ways. :-) I have to admit that even though I should correct him I'm usually laughing while I do it! I was truly blessed when I was given my little boy to love. To answer your question, I am not home testing yet but I plan to start very soon! :-) I am so grateful for all of the resources the forum offers, I have been reading all I can trying to learn anything that may help bruno. I placed an order for caninsulin only to be contacted several hours later by the pharmacy (77canada) to be told they are unable to get any more caninsulin. I would be extremely grateful if anyone has any information and/or ideas on where I might locate any vetsulin/caninsulin. Bruno is still weak but he is doing sooo much better than he was, I'm afraid he's still too weak to try switching his medication. We have an appt. With the vet on monday and I am going to discuss switching bruno to another insulin but we have tried this twice before and each time I almost lost my baby! He has been difficult to regulate and only the vetsulin seems to help him. I'll keep everyone updated after our appt. on monday. Thank you all for your help and good thoughts!

[CarolW]

I wish it wern't so confoundedly difficult to get Vetsulin/Caninsulin for the dogs who need it! Looks as though you've already been through trying to work with NPH insulin - looks as though Bruno, like Soaphie, DOES need Vetsulin (Caninsulin). So I surely hope you can locate a reliable source of supply.

If ONLY I had a REAL magic wand! Camellia says, she'll use hers on Bruno's behalf.

Thu, 7 Jul 2011 21:30:42 (PDT)

[Bruno'sMom]

Carol, please give Camellia a hug from Bruno and me! And yes, please have her send some magic our way! I think it's going to take some divine intervention to get my baby straightened out but I believe in the power of prayer (along with a little magic here and there, lol) I'm so unbelievably grateful that Bruno is doing as well as he is!! Now I just need to locate some vetsulin. I had hoped to have more time to let him get his strength back before he had another shock to his system. He's so skinny and frail looking but inside beats the heart of a lion! Thank you for your kind thoughts! Hugs...Kathy and Bruno :-)

[CarolW]

Kumbi was that frail for a time, but we kept working at it. I asked my vet, Is he going to die? And my vet said, no.

I had been ready to help him take his flight rather than let him suffer. He lasted several years after that, REALLY enjoying his life, in good health - but then cancer, not diabetes, took him.

Camellia says, yes, she will put all her power into her magic wand for Bruno.

Hugs back to you and Bruno! Camellia contributes licks and wags.
Thu, 7 Jul 2011 22:58:28 (PDT)

[kitrose08]

Just went online.. which I usually do for my meds and saw that you can purchase Caninsulin online the product number is A10514..Telephone number is 1 800 545-1106.It is a Canadian Pharmacy which ships to the U.s without prescription,,,Hope that helps...

[k9diabetes]

Hi Kathy,

Just a quick note while you are on. I owe you a text message but have been having a very very bad day here today... :(

I want to send along some guidance that you can talk with the vet about for a switch to NPH. She seems very up on things so may have the situation well in hand. But I think it would be helpful to have the background on how dogs here in less distress than Bruno did it and how I would do it if Bruno was my dog.

And then I think it's worth discussing the possibility of the vet herself obtaining some Caninsulin. I do not know whether she is restricted from purchasing it from someplace like the UK. We have had at least one vet recently who has claimed to be doing that.

We do know that he responds to human insulin - that's what was given to him while he was in the hospital. So the question is whether he responds to human insulin packaged up as NPH. There are also several other insulins types that use human insulin that could be tried - Lantus and Levemir.

I will try to get as much information to you as I can before your Monday vet appointment.

Natalie

[farrwf]

Just went online.. which I usually do for my meds and saw that you can purchase Caninsulin online the product number is A10514..Telephone number is 1 800 545-1106.It is a Canadian Pharmacy which ships to the U.s without prescription,,,Hope that helps...

http://www.77canadapharmacy.com/Caninsulin.php

https://chat.livechatinc.net/server/images/logo.png


77 Live Helper11:33:31 AM
Hello Bill. How may I help you?

Bill11:34:06 AM
Yes ... you have the Caninsulin in stock & ready to ship?

77 Live Helper11:34:45 AM
it takes 2 to 3 weeks to receive it and it expires in Sept 15

11:34:57 AM
we are trying to find some new stock but it is very difficult

Bill11:35:44 AM
Thanks ... you mean you don't have it in inventory and you have to order it?

77 Live Helper11:36:12 AM
meaning, yes we have it. It takes 2 to 3 weeks to receive and the expiry is Sept 15

Bill11:36:58 AM
Let me try again. If you have it in stock why does it take two weeks to ship?

77 Live Helper11:37:00 AM
because it ships from the UK.

Bill11:37:46 AM
OK

[farrwf]

And then I think it's worth discussing the possibility of the vet herself obtaining some Caninsulin. I do not know whether she is restricted from purchasing it from someplace like the UK. We have had at least one vet recently who has claimed to be doing that.

Natalie

Caninsulin / Vetsulin Now Available to Veterinarians Across the USA Through 77Canadapharmacy.com

Dog & Cat insulin Caninsulin / Vetsulin now available for USA citizens and Veterinary clinics from 77 Canada Pharmacy.



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(PRWEB) April 19, 2011
On February 4, 2011 The Food and Drug Administration (FDA) announced an anticipated shortage of Vetsulin (porcine insulin zinc suspension), a product used to treat diabetes mellitus in dogs and cats. Due to a manufacturing shortage in the US market Caninsulin / Vetsulin has been removed from the US marketplace with no date of future availability.
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For further information or to place an order telephone toll free 1-800-545-1106, email customerservice(at)77canadapharmacy(dot)com or purchase directly from our website:
http://www.77canadapharmacy.com/Caninsulin.php

[Soaphie & Sydney's Mom]

77pharmacy is only allowing you to order 1 bottle at a time

[k9diabetes]

Hi Kathy,

I think I passed on to you most of what I was thinking about Vetsulin and NPH but wanted to write a bit about how I would transition Bruno to NPH if that's what you have to do.

Since he was tried on half his Vetsulin dose when switched to NPH last time, I would switch him at or very close to his current dose of Vetsulin.

I'm not sure what dose he's on now. Let's say for sake of example that it's 5 units.

Normally, I'd suggest starting him on the new insulin at 4 units - that's a 20% reduction in the dose. In Bruno's case, if I was going to switch him to NPH, I'd start at that 5 units and then just monitor him very carefully.

The vet's records about how much Regular insulin it took to control his blood sugar while in the hospital would also be very useful in determining a dose.

If his blood sugar was well controlled, for example, on 6 units of Regular every six hours, then I'd probably start him on 7-8 units of NPH twice a day. NPH is a like a time-released version of Regular. So you need more units of NPH to get the same blood sugar lowering effect because less of it is released at any particular time.

I will be very anxious to hear how the vet visit goes.

Natalie

[k9diabetes]

One more thing about possibly switching insulins.

Since we know Bruno responds to Regular insulin, he can also be given that only as his insulin.

Our dog, Chris, wound up on Regular insulin only after proving to be allergic to NPH. Because it's faster acting, it's also shorter acting. He was first tried on Regular three times a day but it was lasting only about 6 hours so we put him on it four times a day and that's what worked for him. And in actuality, I found the four-times-a-day schedule less painful than three. On insulin every 8 hours, one injection was always at a horrendous time of day.

We did 4am, 10am, 4pm, and 10pm.

I have always been very good at going back to sleep so I often got up at 4am and did his meal and injection and then went back to bed for a while.

This is not something I would expect many vets to have ever tried or even considered.

It was thrown out as one possible solution when we had a second consult at a veterinary teaching hospital and because I was concerned about Chris' absorption of another insulin, we decided to try the Regular because nothing was added to it.

You can read and print out Chris' case study, which talks about the long road we had in arriving at Regular insulin four times a day. Perhaps Bruno's vet would find it interesting.

www.k9diabetes.com/k9diabetes.pdf (http://www.k9diabetes.com/k9diabetes.pdf)

I would want any dog trying it to have blood glucose testing at home because you have to see how quickly the Regular drops the blood sugar. And it probably requires something other than the prescription diet - that usually doesn't break anybody's heart! But it can be done. I also worked with someone else later who put her Rottweiler on the same thing and she did well with it also.

So there is an insulin that works for Bruno - Regular. We know because that's what brought his blood sugar down while he was in the hospital.

I would be more than happy to relay our experiences with it to the vet if she is interested in knowing how and why we did that, something that might be needed only if NPH doesn't work for him.

And if she has any questions about NPH, she might think you're crazy but I would be more than happy to talk to her about all of the dogs I've seen on NPH in the past seven years. Some vets aren't all that familiar with NPH if they went straight from using Humulin L to Vetsulin.

Natalie

[Bruno'sMom]

Hi everyone!
Just a quick update. Bruno went to his doctors appointment and as of now she wants to keep him on vetsulin/caninsulin as it seems to work the best for him. He had been throwing up for two days prior to his appointment so he was on a half dose of his insulin when tested, his glucose was 451. We are scheduled to recheck next week with the vet. I did manage to order a vial of caninsulin (they had no explanation for the call I received cancelling my previous order). Thank you for sending the info regarding 77canada pharmacy!! I will post more soon, will be starting to home test soon! Take care everyone, hope all is well with you and your babies! :)

[k9diabetes]

Sadly, I received word this week from Kathy that Bruno passed away. It seems that something much more serious than his diabetes was going on with him.

Godspeed to Kathy's beloved Bruno,

Natalie

[Soaphie & Sydney's Mom]

Oh my goodness! So sorry to hear this.

We are here for you Kathy!!!

[Judi]

I'm so sorry about Bruno's passing. hugs, Judi

[CarolW]

Kathy - I am so very, very sorry you lost your Bruno. Holding you tight in my heart and arms. You certainly did all you possibly could for him.

My deepest sympathy.
Fri, 28 Oct 2011 04:44:26 (PDT)

[Abby's Mom]

I am so sorry to hear of Bruno's passing. God speed till you meet again. Sending hugs your way.

[buddingartist]

So sorry to hear of Bruno's passing.

Take good care Kathy

Louise

[beachnut55]

Saddened to hear of Bruno's passing. May he cross the Rainbow bridge and enjoy his wonderful new life on the other side with all of our departed furbabies.

[Patty]

Oh Kathy, I'm so sorry to hear this. Godspeed to Bruno. Much love and hugs,
Patty

[eileen]

Very sad news indeed, my heart goes out to you for your loss.

[SandyL]

I'm so sorry about little Bruno. Many healing hugs for you Kathy!

Sandy

[MaryLea]

So sorry to hear of your loss. We felt with Ruffles that much more was going on besides the diabetes, too. It was just too much for their little bodies to handle. May the good memories heal your hurting heart.

Mary

[Bruno'sMom]

Hi everyone! I am so thankful for all of the kind words and caring thoughts! When Bruno was diagnosed with diabetes I was devastated, this forum helped me to understand that we were not alone and whenever I felt overwhelmed or confused there was always someone that would reach out with advice and comfort. You are very special and I will always be grateful to you all for helping me to be a better "mom" to my baby! I will keep you and your babies in my thoughts and prayers! Sending you lots of hugs...kathy

[Aeron's Mom]

Sending love and condolences to you and Bruno.

Jessica