Max has earned his wings

[jaimeed]

Hi Everyone,
I'm new to the forum and having a rough morning after my dog Max's shot. He's had diabetes for 3 months now and the shots aren't getting any easier for me. I am being as gentle as I can be and I rub the area for a minute to try and desensitize it before the shot. This morning he really yiped and it made me cry afterwards. I hate hurting something that I love not once but twice a day. It's hard on me. It's not always bad but I it seems worse when my husband isn't here to help rub his ears while I do it. Ugh. Anyway, Max is around 47lbs and receiving 15 units twice a day. Does anyone else out there have a dog that weight and if so, how many units are they receiving? I realize that it depends on the dog but I was wondering if I'm way under the average. I am monitoring with both a monitor and urine strips but the insulin units seem to keep going up. He is on Blue Buffalo dry dog food mixed with my homemade wet food of boiled chicken thighs, carrots, celery, pumpkin, flaxseed. Then once that is cooked I mix it with raw green beans and carrots that I've chopped in the blender. For treats he gets homemade... beef baby food, wheat flour and eggs, baked in the oven.
Thanks for the input,
Jaimee

[peggy0]

Hi jaimee

What type of insulin is Max on? and do you monitor him at home? The experts here are really going to have to see results of a curve before they can determine what his results are given insulin and food. What time do you give them to them as compared to when you feed? Also are you letting the insulin warm up a bit from the fridge? It only takes about 15 minutes. Cold insulin stings. I feel my dog buffalo blue but moved to the weight control. It brought his BG down a bit, but I only modified his food once I had a pretty consistent curve to play with.

[k9diabetes]

Hi Jaimee,

Welcome to the forum!

I have LOTS of questions...

What insulin are you giving - NPH? Vetsulin?

Where are you injecting Max?

Do you rotate the injection site?

What gauge is the needle in the syringes you are using?

Do you warm in the insulin in the syringe before injecting?

What breed is Max?

Has he had a curve done on his current dose of insulin? If so, please post the results.

What kinds of results have you been getting with the monitor and what kind of blood glucose monitor is it?

In other words, is Max "regulated" now or still working on it?

Does he bounce back up every time he gets an insulin increase?
____________

Okay... enough questions! For now... :)

15 units is a pretty average dose in a 47 pound dog. The dose could go quite a bit higher and be considered normal.

As far as the comfort of the injections, some things that potentially could help include:

- Be sure to warm the insulin to room temperature before injecting

- Put the bevel of the syringe facing up when you inject

- If you are using a fairly large needle, get syringes with a finer needle

- If you are using a long needle, try a syringe with a short needle

- try injecting somewhere else - diagram of where you can inject: http://www.bddiabetes.com/us/main.aspx?cat=1&id=395

- skip the rubbing and see if this actually makes it easier - maybe just make it a quick experience without time for anticipation

- reward afterward with a treat Max likes

- inject while he's finishing his food so he's distracted

- work on your own mental approach to the injections - be as calm and nonchalant about it as you can be so that you convey that energy rather than fear and anxiety to Max.

With more information, we can offer some additional advice. Hang in there. It does get easier.

Natalie

[fatdog55]

Jaimee
I am going to assume that by your saying that the insulin keeps going up – you mean his numbers are high and you are trying to combat the increasing bgs with more insulin.
One thing you may want to back off on regarding his food is the carrots – both raw and cooked; they are high in sugar content… not sure about the wheat flour, but I am about the carrots.
Also, as Natalie suggests above – a thin needle works wonders.
Paul

[jaimeed]

Wow this is THE most supportive forum I've ever been involved with. I feel better already just knowing how many caring folks there are out there. I will try to answer all of the questions...Max is a 12 year old Lab/Dach. mix (the only Dachshund you see is in the face a little :>) I make sure that the insulin is warm first by holding it in my hand or under the arm pit which is know to have the most heat. Am I over heating it? He is on Vetsulin and we are using the 1/2cc 29 guage 1/2" Ulticare needles. I am ordering BD needles in the morning because I read that there are problems getting rid of the air bubble and that's just whats happening to me. I have tried all of the tricks but I tap the needle and it's there at the top, I eject some insulin out but it's still there. We feed at 8am and 8pm with the injection coming right after each meal. We inject him anywhere we can find fat but mostly the scruff on the top of the back and down, sides of the neck where there is a lot of loose skin and fat. We rotate the injection sites too. I always give him a treat afterwards and make a big deal..."good boy good boy" in our little language. Then he gets kisses to "take the boo boo away" I'm a little nutty about my doggies. They're our best friends. We didn' t have a curve done when Max was first diagnosed as my vet did not suggest it. I am just learning to use the monitor at home (One Touch Ultra) and it seems to work well on the upper lip. I try to do it at 2:00pm since my vet said that is the peak time. Once was 269 and the next was 346. He is not drinking a ton and peeing like before being on the insulin. He is always the one to pick play fights with our other dog so I know he feels good but what are the risks of not regulating your dog to be in the 100's?? Is it ABSOLUTELY necessary to use the monitor every day once we get the numbers a little lower? It's hard to give two injections plus stick him in the mouth every day. But if that's what you have to do then that's what you have to do. Thank you again for your help, I appreciate it so much!
Jaimee

[We Hope]

Hi Jaimee!

I don't believe BD sells U 40 syringes in the US, so if you were ordering those, you would need to convert the dosage of the insulin to the U 100 syringe by multiplying it by 2.5. The only other U 40 insulin syringes on the market here that I am aware of besides UltiCare are the Vetsulin ones.

If you're determined to use the U 100 BD syringes, since Max's current insulin dose is 15 units of U 40 insulin, you would need to fill a U 100 syringe to 37.5 units. It means that you would need 1/2 cc U 100 syringes which hold up to 50 units--the 3/10 U 100 syringes hold only up to 30 units. If you don't multiply the number of U 40 insulin units by 2.5 for use in a U 100 syringe, you would be underdosing with the insulin.

You won't do the insulin any harm if you re-inject it into the vial and re-draw it, if that might help. You're warming the insulin the right way--by putting the syringe unfer your arm or warming it with your hands. ;)

Am going to suggest that you try not to use the scruff of Max's neck because the absorption there is not so good:

http://web.archive.org/web/20070208103248/http://bettermedicine.intervetusa.com/june2006/managing_diabetes.html

Dr. Greco:

"Is the client injecting in the proper place? (Armpit or flank instead of in the scruff; the scruff is a poorly vascularized area with slow absorption.)"

Am going to suggest that you have a curve done for Max because this is the only way you can tell how he's using the insulin at various times of the day; unless you've done that, you don't know when Max's insulin peaks. The peak time is when the insulin is working hardest, so that would correspond to the time when bg's are at their lowest, or nadir point.

When you see the time activity profiles for any insulin, they are an average. They're compiled by giving insulin to healthy people or pets and taking blood samples every hour and testing them for the presence of insulin. Some people and pets use insulin faster, and some use it slower--it depends on the person or pet.

Getting a curve done will also show you how Max's food and insulin work with each other. With the information a curve provides, you can learn how to make diet changes which will have a positive effect on the insulin--it's very hard to do that without the knowledge you gain from a curve.

You can do a curve at home or you can have your vet do one, but I think you do need this information to be able to get Max's bg's regulated.

http://petdiabetes.wikia.com/wiki/Blood_sugar_levels

There are risks to having bg's that stay too high. Dogs in particular are prone to losing their sight from high glucose levels, as diabetic cataracts form faster from them. Some vets want their patients to be under 200 at all times.

When you get to the 180 and above area and stay there for a while, the renal threshold has been crossed and this means the glucose spills into the urine; you can't measure it with a urine glucose test stick if it's 180 or below. Poor regulation can mean more prone to infections, especially urinary tract ones, since bacteria thrives in the sugary urine; it can also make for more serious renal problems too.

A lot to think about, I know, but I think the key to doing better for Max is to have a curve done--either by you at home or at the vet's.

Kathy

[k9diabetes]

It sounds like you are doing lots of things right!! That's great!!

Thinner needles might be more comfortable for him. And to get thinner needles, you do have to go to the U100 syringes and make the conversion that Kathy described, filling the U100 syringe to the 37.5 mark with Vetsulin in order to deliver 15 units of insulin.

In U40 syinges the thinnest needle is the 29 gauge. In U100 syringes you can get 30 gauge and 31 gauge, with 31 gauge being the finest needle.

What is your sense of why Max is reacting?

Do you think it actually hurts him or is he reacting to being held / restrained, anxiety, etc.?

You might try faking an injection using a syringe with the cap on and touching it to his skin the same way you would if you were actually injecting him. If he still reacts, then you know it's anticipatory / emotional rather than necessarily that the injections are actually uncomfortable and you could work on some training with the cap on to get him used to being restrained, tented, injected, etc.

I'm guessing he might not like the neck area so I'd avoid that...

We injected Chris along the rib cage just behind his front leg about midway vertically. (Looks like BD reoganized their website... will have to update the links)

From BD slide show how to inject your dog (http://www.bd.com/us/diabetes/content/pets/dogs/popup_injectdog11.asp)


http://www.bd.com/us/diabetes/images/pets/dog_injection_site_selection_graph_wider.jpg

We injected where this diagram labels it as "Side of Chest."

We had started with the scruff but he got thick skin there very quickly. The side worked much better for us.

We didn't look for a fatty area - just used the area that worked best for Chris.

If they really are uncomfortable - he reacts only when the needle is put in, you can experiment with different positions to have him in, different places to inject, and different angles or approaches to the injection.

For example, some dogs don't like having the tent of skin pulled up and if you skip that they do better.

Some dogs don't like a particular spot or they prefer one side of their body to the other.

Some do better if you put the syring straight down into a tent instead of coming in from the side. Of they prefer a 45 degree angle.

No one can tell you what might work for Max so you just have to experiment and see if you can find something that works better.

This is getting long so I'll respond to other questions in another thread.

I know you'll get there! We have had a couple of people for whom injections were a major challenge. I'll pull up one of the threads so you can see it. They got it sorted out and I know you will too! :)

Natalie

[k9diabetes]

What are the risks of not regulating your dog to be in the 100's??

Is it ABSOLUTELY necessary to use the monitor every day once we get the numbers a little lower?


The primary problem that comes from not getting blood sugar into the 100s is cataracts, which are very very common in diabetic dogs.

Not every dog can be regulated that tightly anyway - you want to regulate Max as best he safely can be to avoid hypoglycemia. The thing with the cataracts, too, is that once they start to form that cannot necessarily be stopped.

There's time yet to see what Max will be capable of. For now, it's okay to concentrate on trying to make injections a dull, uneventful process for everyone!

As far as home testing goes, some people never home test. Some test quarterly or monthly. Some test weekly or daily. It all depends on how well Max responds to food and insulin and how tightly you want to regulate him.

I tested Chris routinely before 3 of his 4 meals a day and then other times when I wanted to know what it was or was doing a curve. His insulin needs varied from week to week on kind of an undulating wave up and down through a unit or a unit and a half's difference and a single dose every day would not have worked well for him. Plus he couldn't care less about being tested or injected. He was Mr. Mellow that way. Not try to clip a nail...

You will work all of this out over time after you know more about Max's idea of diabetes regulation.

Natalie

[eyelostit]

Hi jamieed,

Niki didn't like her shots at first but after awhile somehow she knew she needed the shot and would come to me after food for her shot, I think in awhile your dog may start coming to you (tho I know it seems not posssible right now ;) )

I would ease off the carrots and use green beans or a piece of brocolli for a treat. I have found the timing of the treat makes a big difference also with bg. I like to give Niki her treat right before she goes into her peak insulin time.

Hang in there, it'll get better.:)

[jaimeed]

What is your sense of why Max is reacting?

Do you think it actually hurts him or is he reacting to being held / restrained, anxiety, etc.?

Probably through my own fault...Max is a bit of a "mommas boy". I got him from a local shelter as a pup so he didn't have much time to become frightened of things but he gets upset quite easily. Loud noises, thunder, etc. He will want to sit on my lap until he feels better. Even if our other dog makes a gagging noise, you know, when they have a hair in their throat or whatever, Max gets up and leaves the room. He doesn't like when the cat throws up either..hahaha which is a pleasant noise in itself. So I guess I'd have to say that he is extra sensitive, he doesn't give the vet trouble with yipes when he gets his shots there and he seems that way too when my husband gives the shot. Maybe he tends to be more of a baby when I'm there. This morning's shot went well. I made sure the bevel was up too.

When you get the bg's that low eventually....and the insulin peak, my vet tells me, hits at 2:00pm...6 hours from the shot.....if you are at work during the day...how can you be sure your dog isn't at home having an episode of hypoglycemia??

[jaimeed]

Ok just checking back in to tell you Max's bg results. I used the monitor at 2:00pm which is when my vet told me his nadir would be with the Vetsulin. He is at 306 and the urine strips show 1/2% and no ketones. Should I increase to 16 units? He's been at 15 now for a while. Also, what types of foods can I add that help counter the glucose?

[k9diabetes]

Max is SOOOOOO handsome!!

Has he ever had a curve done?

There's no guarantee without a curve that his nadir is at 6 hours. We have a handful of dogs here on the forum whose lowest blood sugar is at meal time and the highest is at about six hours.

I would want more information before making any changes in dose.

How about a mini-curve?

Check the BG...

before food and insulin
3 hours later
6 hours later
9 hours later
just before next food and insulin

That would give you enough information to have a basic idea of the "shape" of his curve so you would know when he actually has the lowest blood sugar between injections.

Natalie

[jaimeed]

He IS handsome! My little sweetie pie he is....always such a good boy. I haven't done a curve but I like the sounds of your mini curve. I can handle that. I'd sure hate to drop him off at the vets for 24hours. He had TPLO surgery last May and I cried every day until he came home. I'm waaaaayyyyy too emotional about my animals. Anyway I seem to have an easier time doing the prick on his upper lip for the monitor than I do giving the shot. I am so glad you guys are here for help!!!

[k9diabetes]

So is he built like a miniature labrador - long legs in lab proportions?

[jaimeed]

Yep, he's got real long legs. I saw his mom at the shelter and she was more Dachsund so I guess he took after dad.

[k9diabetes]

Don't mean to be rude... but have you ever wondered how exactly that particular "coupling" works just physically in terms of height?!?!?!?!?!? :o

[Cara's Mom]

Natalie.......now I have this picture in my head:o:o!!!!

LOL

[jaimeed]

Yeah really....I guess nature finds a way!

[jaimeed]

Hey one other question about glucosamine....I was feeding Max Synflex which you may of heard of....a glucosamine and chondroitin supplement for his arthritis. After I found out about his diabetes I stopped because I kept reading that it was really bad for diabetic dogs(not really from any reputable sites though) and my vet said it was fine. I have gone back to giving it to him since he has some arthritis. Has anyone heard of the effects of this being bad on diabetic dogs?

[Fishslayer]

Welcome to the site! That picture of Max is adorable!:D As you've already seen, there is a wealth of knowlege & moral support here.

Sounds like you are well on your way to regulation. I also home test with the One Touch Ultra II & also use the Keto-Diastix to keep an eye out for Ketones and to give me an idea of how long Lucy has been over 180. She varies a lot during the day & I doubt I'll ever have her in the low 100's throughout the day & night.

But we keep tweekin'.;)

I have found the food distraction to work well with Lucy. I hand feed her meals and hold out a bit of kibble. When it's time for her injection & give her a couple handfuls & then sneak in the injection. Lucy is VERY food motivated. I've also trained her to "Still" while I hold her scruff.


Don't mean to be rude... but have you ever wondered how exactly that particular "coupling" works just physically in terms of height?!?!?!?!?!? :o

Natalie.......now I have this picture in my head:o:o!!!!
LOL

Our departed mutt Shovelhead's mother was a Corgi/Rott mix...:eek:



Rick

[k9diabetes]

There was a lot of talk for a while about glucosamine being bad for diabetic dogs - there was a warning for human diabetics about it.

My dog was on a glucosamine supplement for quite a while when he was diabetic.

The first one we tried was an off-the-shelf brand from Petco and it did seem to cause some problems with Chris' blood sugar. But I believe that was not from the glucosamine but from some other ingredients in it.

Because we switched to Cosequin, which is a vet-approved glucosamine supplement without any other added ingredidents, and that one did not cause any problems at all with Chris' blood sugar.

In the end, I wasn't convinced it was helping him either so eventually we discontinued it as he had a lot of other medications on board. It turned out that stiffness he was experienceing was mainly from allergic reactions, not arthritis.

In the end, it probably will vary with the dog, like most things do!

Natalie

[jaimeed]

Yes that picture of Max shows him with his hedgehog...his very first Christmas present. He still has it after 11 years! Of course I have to keep restuffing him after Max tears it all out. Corgi-Rott mix sounds crazy!

[jaimeed]

Natalie, there are several kinds of Cosequin...is this the stuff that you used for Chris?
http://www.petco.com/product/13422/Cosequin-Capsules.aspx?CoreCat=OnSiteSearch

[k9diabetes]

Chris was 60+ pounds so I think we used the Cosequin DS. And I know we used the capsules. As I recall, he didn't like the flavored chews. We put the capsules into his wet food or wrapped soft cheese around them.

http://www.petco.com/product/13423/Cosequin-Double-Strength-Capsules.aspx?CoreCat=OnSiteSearch

So the same thing as you posted but for larger dogs.

We never used the ones that had additional supplements in them. Chris was allergic or sensitive to a lot of stuff so we tried to use the simplest products possible.

[k9diabetes]

Our vet at the time endorsed only two glucosamine sources - veterinary Cosequin and I believe it was the Costco brand for people.

She said at the time, and this was a few years ago, that these were the only products that had been analyzed and verified as actually containing the amount of glucosamine they advertised.

She was concerned about pretty much anything else as maybe having real glucosamine in it and maybe not or not having very much glucosamine in it, mostly fillers.

[jaimeed]

Ok great, thank you again!

[jaimeed]

Ok one last question I promise! I don't want to drive you guys crazy but I just want to make sure I am getting the right thing....are these the correct needles?
http://www.americandiabeteswholesale.com/-strse-122/BD-Ultra-dsh-Fine-Insulin-Syringes/Detail.bok

Did someone say that there are problems using the shorter needles?

[Fishslayer]

I believe most of the people here use 1/2" needles. The 5/16" work but some have had problems getting consistent insulin absorption. As I understand it you need to be a bit more precise with the 5/16" needles.

I use .3cc syringes with 1/2" 29GA needle for Lucy's 6.5 IU injections. Your 15 IU would only be 50% of the .3cc syringe's 30 IU max capacity. For my big hands (;)) 15 IU in the .3cc would work fine and I believe I would get a more precise measurement. The .3cc syringes are also marked in 1/2 IU increments.

Lucy does fine with 29GA needles but others have reported much improved comfort for their dogs using the finer 31GA needles. Lucy's a Cattle Dog, tho. They're pretty tough.:cool:

So I guess it's what works for you. I would not expect you'd have much problem with the .3cc syringes. When Lucy was on Vetsulin (U40) I was using almost the whole capacity of the syringe and sometimes it got awkward, but we did it.

Rick

[We Hope]

Everyone doesn't have problems using the shorter needles. Most don't, but there is the possibility that one can have bg control problems when going from a standard length needle to a shorter one.

We had a dog on another board who suddenly came out of regulation. Everything was looked at and there were no answers. When we started talking about what changes had been made, big or small, it came out that they had switched from a standard length needle to a shorter one. Changing back to a standard length needle made things right again for that particular dog--people sometimes have the same problem and they need the same "fix". :)

Kathy

[jaimeed]

So I guess they don't make a 31 gauge needle that 1/2" length?

[We Hope]

All of the 31 gauge needles I have seen are short ones--the 5/16" length as opposed to the 1/2" standard length.

http://www.childrenwithdiabetes.com/gifs/products/BDUFS1cc.jpg

Here you see a close up of the difference in needle lengths. The BD Ultra-Fine and Micro-Fine are standard 1/2" length needles, while the Ultra-Fine Short is 5/16".

Some information about needle lengths and gauges from ReliOn:

http://www.relion.com/information/faq-insulin_delivery.htm#2

"What does the gauge number (and other size numbers) mean?

"The higher the gauge number, the thinner the needle. Gauge numbers for insulin syringes are 27 to 31. We have 29, 30 and 31 gauge in our line. The length of the 29 gauge needle is ½ inch. The 30 gauge and 31 gauge needles are shorter, measuring 5/16 inch. Use 3/10cc syringes for up to 30 units of insulin, 1/2 cc syringes for up to 50 units and 1cc syringes for up to 100 units."

http://www.relion.com/information/faq-insulin_delivery.htm#3

"I currently use ½ inch needles, can I switch to a short 5/16 inch needle?

"Short needles are not for everyone. Check with your doctor before switching from a standard to a short needle, as insulin absorption rate could differ."

[jaimeed]

Ok thank you again

[Patty]

Hi Jaimee,
Just to add another dog to the mix with regard to needles. My Ali is 48 lbs and I use the BD Ultra-Fine 3/10cc 31G 5/16" needles with the 1/2 unit markings. I've always used the shorter needle with her but we started at 29G and switched to the 31G for comfort. She's on 8 to 8 1/2 u of N insulin.

BD does make a 30G needle in the 1/2" length: http://www.americandiabeteswholesale.com/-strse-120/BD-Ultra-dsh-Fine-Insulin-Syringes/Detail.bok

Like Kathy said, I'd check with your vet. If insulin absorption rate could change I'd want to be able to monitor closely.

Take care,
Patty

[k9diabetes]

I think we had half inch length 31 gauge needles at one point but I'm not sure...

Most of the time we used the BD 31 gauge short needles and they worked great with Chris.

I preferred the short needles with him as he did not have a thick layer of fat under his skin and the short needles seemed to deliver the insulin to the right spot better. I worried with the longer ones that we were hitting the skin on the other side of the tent.

Natalie

[k9diabetes]

Looks like the 31 gaugers are all short needles...

http://hocks.com/hocks-healthcare/hocks-category/syringes.html

We used the ones with half unit marks as a 3/10 cc syringe was plenty big for Chris' dose.

http://hocks.com/hocks-healthcare/hocks-product/A910291.html

Even if you only go from 29 to 30, it makes a huge difference. Chris was on 30s when the pharmacy accidentally gave us a box of 29s and Chris absolutely felt the increased size of the needle and didn't care for it.

Natalie

[jaimeed]

Ok so my vet called me and said he didn't think it was a good idea to swich to the U100's. He said the math gets really tricky and I could overdose Max in a heartbeat converting from the U40's. Does anyone have tricks to get these needles to release the air bubble?? This happens EVERY time....I push air into the vial...tried taking out the plunger and putting it back in several times...push and pull the insulin out and in until I think there aren't any bubbles but when I pull it all the way out and flick it I can see the bubble up top quivering around. So I push up to a unit of insulin out but then still see the bubble up there. How can insulin come out but not the bubble???

[Margaret Boyle]

Ok so my vet called me and said he didn't think it was a good idea to swich to the U100's. He said the math gets really tricky and I could overdose Max in a heartbeat converting from the U40's. Does anyone have tricks to get these needles to release the air bubble?? This happens EVERY time....I push air into the vial...tried taking out the plunger and putting it back in several times...push and pull the insulin out and in until I think there aren't any bubbles but when I pull it all the way out and flick it I can see the bubble up top quivering around. So I push up to a unit of insulin out but then still see the bubble up there. How can insulin come out but not the bubble???

Jaimeed,
I use U40 syringes sometimes there is a little circular rough bit right at the top of the syringe it looks for all the world like an air bubble but if you put your finger near where it is you will find it is not a bubble. I hope this helps.
The thing is if you draw the amount of units up in the empty syringe then inject this air back into the syringe then draw up the insulin a bit past the
correct dose then you have some leeway to inject back into the vial to clear any small air bubbles without losing your insulin.
The other option is draw the insulin straight from the vial very slowly so that you always have insulin at the top of your syringe and always go past the correct dose so that you can put the insulin back in the vial.
Sorry if this is long winded but Natalie or Kathy will give you some good links to go to, hope I have been of some help! :):)

[We Hope]

http://petdiabetes.wikia.com/wiki/Injecting_insulin#Injection_tips

See if anything here might help you.

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7258

Also try working with the BD demonstration--select that you want to draw and inject one insulin and pick the right size of the syringe. The injecting section would not apply here, since this is a demonstration on how to do it for people, but the tutorial is very good.

BTW--you do not, as the demonstration shows, need to wipe the needle and vial with alcohol--this is for humans only.

I always did as Margaret says, to draw up slightly more insulin than I planned to use and then re-injected that portion back into the vial. We used the same UltiCare syringes you're using now and I never had a bit of trouble with any of them. You can re-inject the insulin in the vial and re-draw it without damaging the insulin.

Kathy

[jaimeed]

Oh my gosh I bet that's what I am seeing....that's awesome then, I don't have to worry about that. You guys are sooooo helpful thanks!

[k9diabetes]

The math isn't tricky. It's just important to understand what you are doing so you know the difference between units of insulin and the mark on the syringe you are using to deliver those units.

There is a whole conversion table here - this is something that's often done with cats as it's easier to measure small amounts of insulin this way:

http://www.medi-vet.com/Insulin-Syringe-Conversion-Chart.htm

http://felinediabetes.com/insulin-conversions.htm

Yes, you do have to be careful.

It's a pretty straightforward formula...

(U)40 x 2.5 = (U)100

So if Max is on 15 units of Vetsulin...

(U40 units of insulin) 15 units x 2.5 = (U100 syringe) fill to 37.5 mark on syringe.

The thing you have to do is know whenever you speak to any medical person about how much insulin Max is on is that Max is on 15 units of insulin.

The fact that you fill a U100 syringe to the 37.5 mark is inconsequential to anyone else dealing with Max. It's only what you do to deliver those 15 units.

Basically, Vetsulin as a U40 insulin is a dilute solution. In one milliliter of Vetsulin there are 40 units of insulin.

U100 insulin solutions are more concentrated. In one milliliter of a U100 insulin solution there are 100 units of insulin.

So in every drop of a U100 insulin there is "more" insulin than there is in a drop of a U40 insulin.

Syringes deal with liquid volumes and the marks on them are calibrated to match the insulin they are designed for.

Hope that helps a bit as far as how it's done and why it's done. I say it's up to you to decide whether you feel comfortable making the conversion or not. If you understand it, you will be fine. Plus you can always just plain write it down in great big numbers and tack it to the refrigerator!!

Natalie

[jaimeed]

I think I'll give it a little longer. We have switched to my husband giving Max his shot in the evening and I do it in the morning. Once a day is a lot less hard on me. His bg was 196 yesterday so I am getting better numbers. We'll do the mini-curve this weekend when we're both here together.

[Fishslayer]

Ok so my vet called me and said he didn't think it was a good idea to swich to the U100's. He said the math gets really tricky and I could overdose Max in a heartbeat converting from the U40's. Does anyone have tricks to get these needles to release the air bubble?? This happens EVERY time....I push air into the vial...tried taking out the plunger and putting it back in several times...push and pull the insulin out and in until I think there aren't any bubbles but when I pull it all the way out and flick it I can see the bubble up top quivering around. So I push up to a unit of insulin out but then still see the bubble up there. How can insulin come out but not the bubble???

My vial had been getting tricky as it's getting close to empty. I actually tossed out a couple of syringes & started over.

I had vacuum in the vial. The rubber top was dished inward.

First, I removed the plunger from a syringe & inserted with the vial upright. This released the vacuum.

Then, I followed the procedure of injecting a dose worth of air into the vial.

When I draw out the insulin, I go very slowly & can actually watch the insulin dribble in & fill the void at the top. Then I complete the draw very slowly & watch for any bubbles to form. So far it's been working pretty well. Occasionaly I might have to fiddle a bit.

As for flicking the syringe to get a bubble out... it's never worked for me. Not once.

Rick

[jaimeed]

Jaimeed,
I use U40 syringes sometimes there is a little circular rough bit right at the top of the syringe it looks for all the world like an air bubble but if you put your finger near where it is you will find it is not a bubble.

I think this is what I've been seeing but I'm still double checking...I'm just happy Max is down from the mid 300's to 196....it means I'm doing something right for him.

[jaimeed]

Thanks Patty...I am going to stay with the 1/2" for now and see how we go.

[jaimeed]

Ok I lied about the last question being the last one....does anyone give their dogs plain rawhide chewies? I have the pencil thin ones that only have rawhide in the ingredients. Would this have any effect on bgs?

[Margaret Boyle]

:DI think this is what I've been seeing but I'm still double checking...I'm just happy Max is down from the mid 300's to 196....it means I'm doing something right for him.


Well done yes you are doing something right. :D

[Fishslayer]

Ok I lied about the last question being the last one....does anyone give their dogs plain rawhide chewies? I have the pencil thin ones that only have rawhide in the ingredients. Would this have any effect on bgs?

My dogs (Lucy included) get rawhides from time to time. Not really sure if it has much effect on BG, but...

I try to supervise all my dogs when they have rawhide chews. I give mine the big ones from Costco. The problem (especially with my Cattle Dogs) is they try to eat the darn thing. Large chunks can block the intestine & then ya got a nice surgery to pay for.:(

When I see a chunk or flap developing that they can tear off & swallow I cut it off & toss it.

Rick

[jaimeed]

I know what you mean. That's why I switched to the ones that are pencil thin and they don't really unravel. See usually dinner time for us means treats for them because we had a bad habit of sharing a tidbit here and there. I know.....BAD. So now to keep them from begging, when we sit down for dinner I give them a rawhide to keep them busy.

[k9diabetes]

I would guess it gets digested slowly and so might inject some glucose several hours later. Only way to know is to test and see what happens. Maybe break off a small piece.

[jaimeed]

Hi everyone,
My Max has had diabetes for 2.5 years now and it's been well managed until recently. For the last few weeks now, his drinking/urinating has increased a lot. I increased his insulin by 1 unit...to 19 but I haven't seen a change at all. He's 13 now and I understand he is "up there" but he is sleeping so deeply now as well. Sometimes I have to touch him a little to wake him up. Is it possible that he is resisting the insulin?
Thank you for any help you can give, this is so hard to go through, he's such a good boy.
Jaimee

[HarrysMom]

I can't comment on the amount of insulin, but have you checked your dog's hearing? My Harry has gone deaf, and it takes a while to wake him up.
When is the last time you've done a curve? Also have you ruled out any urinary tract infection or other possible inflammatory conditions?

[jesse girl]

are you home testing ?

if not you might want to do a curve at the vet to test the blood sugar and just get him checked out raising the dose on just symptoms is something i wouldn't recommend

welcome to both of you

[jaimeed]

Thank you for the quick replies! Yes, I did test his blood last week and he was in the high 200's so that is why I had increased the insulin. I test his blood from his upper lip and I do it right at 2pm since he get's his shot at 8am and 8pm. I was wondering about his hearing also but when we do our own little tests, he seems to be fine. I am hesitant to do a curve because he is so frail in this past year. I hate to put him through the stress of not being able to see where he is for a whole day...I know that sounds stupid. What sort of inflammatory conditions??

[HarrysMom]

I would do a home curve and see where his BGs are all day.
With my dog, I notice that any inflammation - allergies, skin infections - can cause high BGs - along with urinary tract infection. Heat wave would also cause his BGs to elevate.

[SandyL]

Welcome!! Since you test you can do the full curve at home... No need to go to the vets for that and have her out of your site :)

I had a Shepard boarder collie mix some years and she too would sleep so hard she wouldn't wake if the house was falling down!! She was about the same age also, and she wasn't even a diabetic!!

Sandy

[k9diabetes]

Your dog's blood sugar is not much higher so it doesn't seem like it's the diabetes that's a serious issue for him. A pretty common source of inflammation in a guy his age would be arthritis. And there could be some other health problem causing him to suddenly slow down so much. Either one or both could increase his insulin requirement.

For much of Chris' last year and especially his last six months, he was frail and he slept much much more than he used to. He would spend entire evenings back in the bedroom sound asleep and it would take a lot to wake him up and especially to motivate him to get up and go out and see what was happening.

It can be hard to know if it's "just" old age or if there is something you can manage that will improve their quality of life. So in that respect, I think some investigation (especially noninvasive ones, like bloodwork, x-rays, and ultrasounds) is worthwhile. I know that our working with a good cardiologist gave us another year with Chris that we wouldn't have had if we had just left his heart conditions untreated. It made a huge difference in his energy and stamina.

For a long time, people were surprised at how old Chris was because he didn't look it. But that last year, no one was surprised any more. We weren't really as aware as people who saw him less frequently just how much he changed, how old age and his health started to impact him. It can be gradual and only becomes obvious to us when it crosses a threshold and makes a big difference in their behavior.

So on the chance that something can be done to help Max, it would be great to get him a thorough checkup. Even something like treating pain from arthritis can make a big difference.

I hope in Max's case that's it's *just old age and nothing more serious.

Natalie

[janspack]

I have a 15 yr old (non-diabetic) and he too sleeps like a log. A couple of times I've been convinced he has died. It's frightening isn't it? I tend to wonder if any new symptom could be the beginning of the end. It's always there in the back of my mind although I try not to worry too much.;)

There are quite a few things that could cause excess thirst in an older dog, including but not exclusively, kidney changes. My old boy Toppa has early stage kidney failure but it only causes the high thirst so far with no other obvious symptoms.

In your shoes, as others have said, I might increase the blood glucose testing so that you can keep a close eye on things to see if there is a pattern. I'm not sure if numbers in the 200s would be a big problem.

I think I would ask your vet to do a "senior dog" blood panel to check on possible other causes of this symptom. My diabetic dog Dazzle is having this problem too. Despite having now got good BG numbers (after a long battle) she is still drinking far more than is normal and now she has a good curve, my vet is hopefully going to try to sort this out and see if there is another problem that is causing the thirst.

btw, Toppa says that 13 is just a spring chicken!

[AZPitasmom]

Natalie.......now I have this picture in my head:o:o!!!!

LOL

LOL!!!! WAAYYY too much information!!!!:D

[AZPitasmom]

[QUOTE
Our departed mutt Shovelhead's mother was a Corgi/Rott mix...:eek:
Rick[/QUOTE]

I bet that was ONE awesome looking dog!!!

[jaimeed]

Hi all, I have a very important question.
The last few weeks have gone like this:
6 weeks ago my Max's numbers spiked 350's
Vet instructed move up units of insulin from 18 to 22
Numbers still at mid 250's
Vet increased and increased to 26
4 weeks ago numbers were good - around 150
3 weeks ago he became lethargic and started periodically throwing up
Took him to vet - checked blood - glucose 59 - beginning signs of renal failure and given fluids to give once a week subcutaneously
We are continuously checking his glucose but a week ago it showed 23
We've been feeding more carby foods and karo and his units are back down to 18 so as not to drop it too fast, as per the vet, but yesterday his number was 24.
What is going on? Is it possible for a dog to become non-diabetic?
It would be a blessing, maybe Max could live out his final times with one less ailment. Our hearts are breaking..just don't know what to do.
Thank you for any feedback,
Jaimee

[Judi]

Hi Jaimee: I'm not one of the pros around here but wanted to bump your post up and offer you some sympathy.

Depending on how long your dog has had diabetes, some dogs do still produce some insulin during the "honeymoon" period. Look at Jim's thread about Spirit for that.

My Jenny was diagnosed in May and needed 7 units to be regulated till September then suddenly she got scary low like your dog and currently only needs 3 to 3.25 units to maintain. She does have Cushings disease but I don't think that has a lot to do with it.

Have you changed your dogs diet at all?

I know my vets had no problem stopping Jenny's insulin cold turkey until we saw where she was at then slowly starting her at low amounts again until we figured out her new dose so I'm curious as to why your vet thinks you need to keep giving some insulin and if you are why so much?

Jenny went for 36 hours with no insulin. In that time frame her BG varied from 46 up to 350 or something. High is better than low.

I hope you can get your doggy regulated but when in doubt, I'd go for less or no insulin. Just my opinion

hugs to you and your dog. Judi


edited to add a link to Jim's thread: http://k9diabetes.com/forum/showthread.php?t=3215&page=22

[jesse girl]

oh my that is not any fun been there done that

are you home testing i presume you are

first things first you must remove the lows from the equation and reducing the dose is needed

i would take it down to 15 or lower the body has its storage reserves of sugar to counteract an overdose of insulin this reserve is not limitless and can be depleted as you can see with those scary lows .

you want to find a dose where you dont go to low and once you find that dose stay there for a week and then reevaluate at that time on dosing

it is always possible that insulin can be produced by the body especially at the beginning but usually fades over time so you may see some fluctuations . its rare for a dog to be diabetic and then return to normal as judy said you could take your baby off insulin for a few days to determine .

you are going in the wright direction but you might want to decrease the dose more substantial to get entirely out of any possibility of going hypo

welcme to both of you and you should see an improvement

[Patty]

From what I've read renal insufficiency can cause lower blood sugar.

"Kidney failure (http://k9diabetes.com/script/main/art.asp?articlekey=58724) causes hypoglycemia in three separate ways. The kidneys help to generate new glucose from amino acids (called gluconeogenesis). Gluconeogenesis is impaired in kidney failure. Also, insulin circulates for a longer period of time and is cleared slowly when kidney function is poor. The third important reason is that kidney failure reduces the appetite and consequently, oral intake of food." http://www.emedicinehealth.com/low_b...a/page2_em.htm

I'm glad your vet has him on fluids. I agree with Jesse girl in that the insulin dose needs to be reduced further until you have no lows.

[jaimeed]

Yes I am thinking that kidney failure is causing the drop in blood sugar.

We plan on reducing the units again tonight and today when we pick up more K/D food at the vets, I am going to ask if we HAVE to do it by 2 units at a time. Can't we just drop him from 16 to say....5 since his numbers are so low? I just tested him again at 12:30pm and he us at 44. I quickly gave him food and a TBS of Karo. So decreasing 10U over time has only increased his glucose from 23-44.

His bloodwork from 2 weeks ago suggested beginning signs of renal failure. High BUN/CREA LIPA. Is he in pain or discomfort? I know what the prognosis is. I guess I just want to know how much time we have with our little sweetheart.

It's just not fair that dogs get so little time only to suffer some slow ordeal. I hate this.
Thank you every one for your responses and help.
Jaimee

[bowens2]

Jaimee I don't have answers for you. But Monkey (my dog) after boarding at the vet for 10 days dropped really low and had seizures. Now Monkey has dropped from 15.75 units morning and 15.25 units evening to 10 units morning and 8.5 units evening. Monkey is only a 22lb. dog now. So to me this was a big decrease. More than 33%. But he seems to being doing well. I just keep waiting for the other shoe to drop. Monkey has been a diabetic for over 5 years.

[bowens2]

Hopefully they can give him something to extend his time if he is not in pain.

[Patty]

No, you certainly don't have to drop by 2u at a time. You could drop him to 1/2 or 3/4 of his current dose to try to eliminate the extreme lows.

[jaimeed]

Awww Monkey..I love his name

[jaimeed]

Ugh...why didn't my vet tell me that?? I think since Max is @ 16u and glucose of 44 I will drop him to 5u tonight

[Patty]

The advice when dogs were rebounding used to be to drop their dose by 1/2 for at least a few injections to rid the body of the excess insulin and work back upward.

1/2 of 16u would be 8u.

[k9diabetes]

Since he's had diabetes for almost three years, a restart of insulin production is not likely. In addition to the renal problems, other ways the blood sugar can drop include Addison's disease (lack of cortisol production) and perhaps liver problems that prevent the liver from releasing stored glucose to maintain the basal insulin level when there's no food being digested. Almost any condition that affects hormones can affect blood sugar levels.

You might consider checking his cortisol level to make sure it's not Addison's disease, which can be fatal if not treated and has a huge effect on blood sugar levels, dropping them quite sharply.

You might not need to have the ACTH stimulation test - could start with just checking his basal cortisol level - a single blood draw sent to the lab. The stimulation test determines how much cortisol he can produce in response to a stimulating chemical but it can be hard on a dog who has Addison's disease. So it would be cheaper and easier to first just get a base cortisol level to see if there is likely any problem there.

I think slashing the insulin dose significantly is a good idea. Always better to work up to the right dose rather than keep giving too much and having lots of low blood sugar.

Natalie

[jaimeed]

I think the time to make a decision is here. Max has been throwing up all day and can't hold down any food nor is he interested. He is drinking though. We are beside ourselves with the decision and it pains me terribly to type this but does anyone have any reassurance to offer about this cremation as an option? I can't stand the thought of my baby in the ground nor the thought of something I heard recently on the news….a crematorium not disposing of people's pets and just giving them mock ashes. Please, any thoughts are appreciated.
Thank you
Jaimee

[Judi]

oh Jaimee I'm so sorry. Can you just ask your vet about it? Odds are they have worked with this crematorium for years.

I hadn't seen Max's picture before, what a cutie with his toy. I'm so sorry he is feeling miserable and you are having to choose what is best for him. If he is not enjoying his life then you know you are doing the right thing.

big hugs from me and an ear scratch for Max. I am so sorry. Judi

[Shellie]

Oh Jamiee...I am so sorry you are having to face this decision! Never gets easier but you are a good mom and Max is lucky to have you!

I've always used cremation since I feel the same way about burial. I would ask your vet about the crematorium they use but I cannot imagine that something like you have heard is common at all! You should ask for an individual cremation, which will cost more, but you will have only Max's ashes. The other way is that they put several animals together and you get back a portion.

I know how you are feeling...sounds horribly cold to discuss this before you have even taken Max in but it's a good thing to know what you want before you go...it's terribly upsetting and trying to make decisions at that time is difficult at best.

My thoughts are with you and I hope you know that we are ALL with you in this! Hugs!

[jaimeed]

Thank you guys so much. Yes my vet does handle that. I just wish I didn't have such trust issues. The only reason I would consider burial is for the fact that I would KNOW his body is here and I could plant some of my flowers there that he could help to grow. Sorry to be so depressing...we didn't have kids...we have our pets and it's so hard ..as you all know. Thank you thank you all for caring.
Jaimee

[HarrysMom]

I got all my three babies cremated - and I chose individual cremation so I could get their remains back. Our vet has a contract with a reputable crematorium /pet cemetary. Their remains came back in very tasteful cedar boxes - and we gave them individual inscriptions for rememberance. I keep the boxes with me by my bed. The vet also did paw prints - on paper with ink for my cats and on clay for my Harry. Harry's pawprint made me cry yesterday - but I will cherish it for the rest of my life.

My heart goes out to you. The days leading up to their final moments were far worse in many ways than the days following them. It was incredibly painful to see them suffer and decline. After their passing, the suffering just became mine, not theirs. That was a huge relief.

[CarolW]

Jaimee - I can't really tell from your posts if in fact it's approaching Max's time. It COULD be, or it might not be. Can you get a reliable second opinion?

You are a fine Human Dog-Mum, as great as Max could possibly ask for. I've always had my dogs cremated.

Holding your hand through the ether, Jaimee, and giving Max gentle strokes.

Love and hugs,
Sun, 18 Dec 2011 18:25:29 (PST)

[peggy0]

I've had all mine cremated. When you take your pet they show you a tag with a number on it. You get that tag back with the ashes. It's put around one of their paws. I've always gone through my vet and found the folks they deal with to be very reliable and respectful. I'm so sorry you are going through this. maybe he will turn around for you. Prayers and hugs coming your way

[Patty]

Jaimee,
I'm so sorry Max is feeling so poorly. Has the vet given any anti-nausea medication you can use to help him?
Patty

[jesse girl]

my jesse was in bad shape for a while stools that looked like tar throwing up bile and she did come back from that

i think carols thought of a second opinion might be worth a try

i think i went 6 months with jesse thinking every day on how we were going to approach the end because i thought it was going to happen shortly

then after awhile her stools looked better she had a bit more energy then I thought I think she may live and decided to put the end thing on the back burner it did take some time and i am not sure how long she has but she did improve.

we did switch to one meal a day i am not sure if that was the diffidence but my thought at the time was to give her digestive system a break just a thought

[jaimeed]

You are all so sweet and at least while I'm talking with you all, my husband and I are not hugging and crying. Being that today is Sunday, I was only able to talk with my vet over the phone. I'm to call again in the morning..possible re-test of the blood. I did call another vet and she told me that the 100ml of subcutaneous fluids prescribed once a week for a 43lb dog was basically doing nothing and that she suggests 3 days a week of 150ml to 200ml.

The only thing we could get him to eat at dinner was tunafish ...protein...which is not good for renal failure but it's the only thing he even sniffed at. He threw that up so I went and got SPAM...horrible I know but the protein percentage is closer to the K/D prescribed food...that he no longer wants. He ate a few TBS of the SPAM and has kept it down for a few hours now. He is fast asleep and comfortable.

I would love for this to just be pancreatitis which can be fixed but even then, his blindness will still be there. He's been completely blind for a few months now...he has a lot to deal with, bless his little heart.

[HarrysMom]

I highly recommend Yahoo K9Kidney group. The moderators there know kidney failure and treatments better than most vets. There is also a very experienced and knowledgeable vet who contributes all the time.

http://pets.groups.yahoo.com/group/K9KIDNEYS/

[HarrysMom]

I did call another vet and she told me that the 100ml of subcutaneous fluids prescribed once a week for a 43lb dog was basically doing nothing and that she suggests 3 days a week of 150ml to 200ml.

She is right. My 9lbs cat was getting 75ml a day.

[MaryLea]

Oh, I'm so sorry you are having to go through this. I know you want to do what's best for Max. Is there anything the vet can do to settle his stomach? It's hard to know if he will come through this or not. I would get a second opinion if that is feasible.

Bottom line: go with your instincts. You know your fur baby best. we're hear to "listen" and offer support.

(((hugs))),

Mary

Agree about the fluids: they had Ruffles on 100 ml/day and she weighed only 15 lbs. Max can handle his blindness better than you can, most likely.

[HarrysMom]

Are you giving Pepcid? with kidney faillure, dogs often get acid stomach or ulcer. Many kidney pups and cats get Pepcid and Carafate.
Are you also using any phosphate binder?

[jaimeed]

Max did eat this morning and he has kept it down since 6:30am. He ate an egg and of course the spam. I tried to have the K/D food there next to it nice and warm but he was not interested. I am just glad he ate.

I am using Pepcid yes, they are 10mg and I give once a day. Where do I find a phosphate binder??

[HarrysMom]

I bought aluminum hydroxide at thrivingpets.com.
KD food is designed with low phosphorous. You may be able to switch food to something more palatable with phosphate binder.
I strongly urge you to join Yahoo K9Kidneys. The moderators there know how to get the dog to eat and deal with the crisis better than anyone. There is also a great vet who participates all the time. You can ask them about phosphate binder.
If your dog's phosphorous level is under control, you can try something like calcitrol to further treat kidneys.
You need to also track albumin and red cell values with the kidney disease. Anemia is a common side effect, so is hypoalbumia.
I strongly urge you to join the group and also consider taking your dog to an internal medicine specialist who would know all about binders, calcitrol, etc.

[jaimeed]

Ok I joined the other forum and will wait for a reply. Thank you so much:)

[MaryLea]

Watching and hoping for better news about Max. Have no experience in this area, but cheering you on. Glad you joined the other forum. Hope you get some good support there too.

(((hugs))),

Mary ;)

[Shellie]

Any news on Max? Am worried for the little guy!

[HarrysMom]

I saw Max's mom posting on K9Kidney group this morning. She is trying to start aluminum hydroxide and more fluids.

[MaryLea]

Thanks, Yunhee, for the update. Based on what they had us giving Ruffles, the volume they had her using was very low. Watching for a better report on Max.

Mary

[jjefferjo]

Thanks for the update

[Shellie]

Thanks for letting us know! It's so hard when you hear about them and then the moms get busy (or dads) and we hear nothing. Good thoughts and warm furry hugs out to Max!

[HarrysMom]

Max peacefully passed last night - according to Jaimee's posting on K9kidney. She did the most loving thing she could - Max has joined our angels at the bridge. I think Harry is showing him the ropes up there.

[Patty]

Jaimee,
I'm so very sorry to hear about Max. Holding you and your husband in my thoughts and prayers.
God bless,
Patty

[hiwaygal]

Jaimee

I am so sorry for you and the loss of Max.

Allow yourself whatever you need to grieve...don't let anyone tell you your feelings are not worthy! Don't be ashamed of your hurt, don't feel guilty, and know that we all know what you are going through!

There will be good and bad days. Stay strong and brave and know that Max loved you and he knew you loved him.

~hg

[MaryLea]

So sorry to hear about your loss of Max. My heart goes out to you especially during this difficult time. You and your husband fought a good fight for him. He was lucky to have you, and you him.

Mary

[Judi]

Thank you for letting us know Yunhee. Jaimee I am so very very sorry. hugs, Judi

[farrwf]

So very sorry to hear about Max, Jaimee. The only thing wrong with our wonderful pups is they aren't here with us long enough. God speed for Max.

[k9diabetes]

Oh no... I'm so very very sorry to learn of Max's passing.

I went back through his thread...


Max (in April 2009) is a 12 year old Lab/Dach. mix (the only Dachshund you see is in the face a little :>)

I always give him a treat after [his injection] and make a big deal..."good boy good boy" in our little language. Then he gets kisses to "take the boo boo away" I'm a little nutty about my doggies. They're our best friends.

Max is a bit of a "mommas boy". I got him from a local shelter as a pup so he didn't have much time to become frightened of things but he gets upset quite easily. Loud noises, thunder, etc. He will want to sit on my lap until he feels better.

He IS handsome! My little sweetie pie he is....always such a good boy.

That picture of Max shows him with his hedgehog...his very first Christmas present. He still has it after 11 years! Of course I have to keep restuffing him after Max tears it all out.

Max was the luckiest of dogs to have gone from a shelter to a beloved place in your home and hearts.

Natalie

[CarolW]

Dear Jaimee,

I am so very, very sorry to learn of Max's passing. You and your husband certainly did all possible you could for him, and then - you gave him that greatest gift of all, to assist him in his Flight to the Bridge.

I KNOW Yunhee's Harry is greeting Max there, and so are my Kwali and Kumbi.

Any time you feel like posting your memories of Max here and/or pictures, too, I would read them with great delight. He was obviously a wonderful dog, and, as the others have said, extremely fortunate to have found you to be his Human-Parents.

With deepest sympathy,
Thu, 22 Dec 2011 16:00:44

[Ladybug]

I'm so sorry to hear of Max passing....I know my Coco and Shadow are part of the Welcoming Committee at the Bridge....sending doggie kisses from Ladybug and virtual hugs from me....

Linda and Ladybug

[buddingartist]

So very sorry for your loss.

Louise

[Shellie]

So, so sorry to hear about Max's passing, Jaimee! I know he was a lucky boy to have you for a mom and I know YOU felt lucky to have him, too! Good thoughts and lots of hugs your way!