Multiple Medical Issues and Food - Help!

[Jaye]

Hi, Folks...

I'm new here, although not new to canine diabetes (or feline diabetes either). My Robbie will be 15 this month. He's a mix of poodle and ?, approximate 21 lbs, which is his normal weight, although he's always been slim. He's been on 9.5 units of Vetsulin since April of 2009. I thought he was doing fairly well, although, after initial BG curves at the vet, we've been using the Keto-Diastix for general...and I realize it's VERY general...glucose readings.

For food we do a bowl of Royal Canin OS canned 2x daily. He's had bouts with urinary crystals in the past and the vet decided not to take him off the prescription food. He gets several supplements a day (arthroflex, forti-flora, vetasyl).

As many of you have been doing, we've switched to NPH over the last week or so. Started at 7.5 units and I tried, for the first time with him, to do actual BG readings. I've been doing them with my cat for months, but Robbie is a bit of a...shall we say, "drama queen." The poor boy screams when the vet even shows him a needle. He fights, wimpers, yelps..the whole nine yards. It took months to get him used to his 2X daily shots.

His first readings weren't bad. 177 at 4.5 hours and then 128 at 5 hours post injection. Then the other day they dipped to 94 at approx. 4.5 hours. I know that's not that low, but I freaked a bit and gave him some of his normal food. Later the BG was quite high...rebound from the low BG or the result of the food I don't know.

Vet had me drop to 7 units, although on the U100 syringes the difference between the two is really difficult for this old gal with bifocals to see. Here's the "I'm feeling guilty" part. Today I was told to test him at 4 hours and at 8. It was a disaster. Not only would he NOT bleed, even with a warm compress, but he got very tense (seems his recent blindness exacerbates his nerves as well). Then my sweet little boy started showing his teeth and biting at me! Didn't matter where I tried...ears, base of tale (I can't do his mouth...he's always been very sensitive there). I was almost in tears when I called the vet, because I've fought very hard to be able to handle this diabetes stuff (first with Robbie, then with my cat, Chester). Forgot to mention that I'm highly needlephobic.

Vet (who I trust completely) said not to stress him out any more and to bring him in Monday for a full BG curve. I know it's a good idea when switching the insulin...and it's been a decent amount of time since the switch, but DRAT! I've failed and I'm not happy about it.

I've noticed more peeing in the house, which I assumed was a separation anxiety issue (which we sometimes struggle with) but now I'm thinking it's because he wasn't as regulated as we thought. Not sure, though, because the peeing is only when we're not home or when we, for lack of a good reason, ignore his barking. Caught him lifting his leg today for that reason. He easily makes it through the night with no problems.

Behaviorally, he seems to be doing okay. Doesn't like steps (up is worse than down) and flinches when things move too close to him, but on our 2X daily walks with his "sister," Callie, he usually doesn't walk, but jogs, and I have to step it up to keep up with him. I keep reminding him that he's 15, blind and diabetic, but he doesn't seem to notice my huffing and puffing in my attempt to follow.

Sorry for the long post. I'm just venting but it's nice to have found a place to vent!

Here he is...my sweetheart.

http://i33.photobucket.com/albums/d88/Pinkponderosa/RobbieDog.jpg

[k9diabetes]

What a cute boy! Sorry to hear that everyone feels so upset right now...

I agree with the vet that there's no point of continuing trying to test blood glucose when it's just upsetting everyone and everything. So I too would have said just to stop for now.

Have you continued to urine test?

If so, what kind of readings have you been getting?

Do you use syringes with half-unit marks?

With the readings you had and the drop in dose, he should be in pretty good shape. So it seems to me that there's no panic in needing to test. You could try once or twice in a day and then set it aside.

Tell us about your testing materials... what gauge are the lancets and do you use a clicker or lance by hand?

Natalie

[CarolW]

Hi! - and a big, fat welcome to you and Robbie!

Glad you joined us. I can't be too coherent at this hour - up in the wee hours, but will be watching your reports, and cheering you on, and maybe have some comments and suggestions later.

Just wanted to welcome you and Robbie.

What a gorgeous guy Robbie is! Thanks for the picture!

Sun, 11 Jul 2010 02:23:17 (PDT)

[BestBuddy]

Robbie is definitley a sweetheart.

Some things take time and I wouldn't be getting upset about BG testing just yet. If you are all getting stressed it is time to take a step back and leave the testing for a bit. Maybe when things settle down you can try again because it really is a valuable tool. Although the urine sticks are not very accurate you can still keep an eye on things so I would continue those.

Dogs can pick up on our stress and it makes them nervous and upset so it is important for you to take a few deep breaths and relax. I know it is hard but you can learn to pretend and hopefully soon you won't have to pretend because it will be easy for both you and Robbie.

Good luck.

Jenny

[Tikobird]

Welcome Jaye & Robbie! What a cutie he is - never would have guessed him to be 15 from that picture! Don't beat yourself up too bad - everything takes time to accomplish and the fact that you are willing to try & learn is 1/2 the battle! Good luck with the home testing - post his curve results when you can so everyone here who can help with advise has the info. This is also the best place to "vent" as we all understand what it is you're going through and many have great suggestions to beat just about anything you run across.;)

[Jaye]

What a cute boy! Sorry to hear that everyone feels so upset right now...

Thanks! It's a pretty constant theme in my house. I have cats with feluk, FIV, kidney failure, diabetes, pancreatitus..you name it, we have it!


Have you continued to urine test?

Yes, we (hubby and I) were always pretty diligent about the urine tests and they were never hugely consistent. We'd get tons of negatives, then, for no apparent reason, he would zoom over 1000. My vet keeps reminding me that urine test strips are only able to give us a general view of his blood sugar since the last time we tested and that (this surprised me) they will show negative until the blood sugar reached around 200, when the blood spills into the urine. (My fault totally if this isn't accurate...I was a bit stressed when she told me and might not have gotten it right).


If so, what kind of readings have you been getting?

Last night: 7.0 units. Checked at 3.25 hrs post injection. He was over 1000
This morning: Checked before breakfast (5:15 a.m.) Again, he was over 1000 so I upped him to 7.5 units.

Checked again at 3.75 hrs post injection...still over 1000.

Although vet said to put him at 7.0, she predicted that we would end up higher and I think tonight and tomorrow morning (before his BG curve starts at 7:30 a.m.) I'm going to do 7.5 if his urine numbers are still high.


Do you use syringes with half-unit marks?

Yes, which are REALLY challenging when my cat needs 1.75 units!


Tell us about your testing materials... what gauge are the lancets and do you use a clicker or lance by hand?

I alternate between Keto-Diastix and Diastix. We've never had an issue with ketoacidocis yet. I used the Freestyle Lite meter that I use for my cat and the accompanying lancets set on 4 (highest level). If he would have bled the first prick I think we would have been okay. It was the subsequent unsuccessful attempts that freaked him out. Not to mention the sound of the plunger and the beep (Robbie hates beeps...Drama Queen!)

As far as using a regular lancet, frankly, I'd have a hard time. I mentioned being a needlephobe...I still have heart flutters when I give his shots and I've been doing that for well over a year! It's a very situational thing. I give his shots yet need to look away when the vet gives his vaccines. My husband has to administer the cat's B12 shot...and he's not around during the week to help with Robbie.

Thanks again for your fast responses, everyone!

[k9diabetes]

You got the information from the vet about blood versus urine glucose right. There is a "threshold" above which high glucose in the blood starts to spill into the urine and that threshold is around 180.

So any time the blood sugar stays below that threshold, no glucose goes into the urine.

As you know, then, urine tests don't tell you anything about low blood sugar.

Since you had some low readings, I would not want to up his insulin until a curve can be done.

I know what you mean about the lancing by hand! I was very lucky that Chris was a champ with the lip so I could always use the clicker. I did NOT want to have to stick my directly! I also liked that he had enough fur that I did not have to actually see the injection go into his skin either. I have a tendency to pass out at the sight of needles going into skin, especially my own! So I was glad he wasn't a hairless breed!

Natalie

[Patty]

I'm a bit late in getting to this thread but just wanted to say welcome to you! What a great picture of your guy ;)
Patty

[BestBuddy]

Guilt and failure were something I dealt with for a long time with my Buddy. I cried for 2 weeks when he was dx with diabetes blaming myself and feeling like I was going to vomit when it was time for the injections. My hubby did them until I discovered the BD inject ease. I have recommended it many times but not sure that anyone ever used it. Once adjusted to my needles it was magic and I used it for 4 years before it finally wore out from the dropping and use but I loved it so much I got another and continued to use it for another couple of years until Buddy passed away. I didn't have to worry about how hard to push the needle because the inject ease did it for me.

I also didn't home BG test for the first 4 (yes four) years and I wish I had started earlier. Buddy was also a drama king and squealed like a girl whenever we tried to BG test so I just didn't. We used the ketodiastix which worked ok until other health issues popped up and we really had to start the BG testing. I would never have believed that I could use Buddy's lip because he hated his mouth being touched but it was the easiest place to get blood and he was a real trooper about it. It was actually much easier than I thought. We used the softclix because it didn't make much of a noise and I really wish I had persevered at the start.

So I suppose this is my confession but we got through it all and so will you.

Jenny

[Jaye]

Thanks, Jenny and everyone else...

I had high hopes for testing Robbie in the lip, but those were crushed the first (and only) time I tried. Had I not removed my hand in time, there would have been holes in it, no doubt in my mind. And, even though I know that it would have been my fault, if they would have had to be treated by a doctor (who are required to report dog bites) Robbie would have been put in quarantine.

That happened to a friend of mine who had an injured dog that bit her daughter who hugged her on the wound when the dog was sleeping. The police came, the dog wasn't allowed to leave the yard (even for walks) and had to be kept on a chain while outside for 10 days.

I would never have thought that Robbie would bite, but as my father always told me "All dogs bite, all horses kick."

Tomorrow is the BG curve. I'm going to give him 7 units even though he was high tonight on the test strips. At about 2:30 today he just stopped and stared very strangly...almost thought he was having a small seizure (although there's NO history of that with him). Hubby couldn't tell, but I knew he wasn't feeling right. I thought about the Karo syrup, but opted for a piece of bread instead. His test strip not long before this happened showed negative and I was concerned that he got low since I had given him 7.5 in the morning.

This diabetes is all encompassing, isn't it? With Robbie, and my cat who is FAR from regulated, I'm pretty doggone stressed out!

[k9diabetes]

I'm really anxious to see the curve as it sounds like he may be going through some wide swings in blood sugar. Tweaking the diet can often help if that's the case.

You have a lot on your plate so I can imagine how stressed you are!

Robbie's diabetes should eventually get settled into a routine and won't require thinking about it too much. In some ways, I think I'd rather deal with canine than feline diabetes, both because I've never had a cat that would allow me to test blood sugar and because with dogs they just lose their ability to produce insulin and you move forward with injections whereas cats can go into remission.

I had a cat with diabetes but it was before they knew much about how feline and canine are different. She didn't respond to the insulins available at the time so lived about 18 months with very poor blood sugar... I know she would have done a lot better if she had developed it a few years later when more was known.

Natalie

[Jaye]

Ugh! What a horrible and stressful day.

I took Robbie in for his BG curve (and stayed with him the entire time. We need softer seats at the vet for the humans!)

He got 7 units of NPH at 5:30 a.m. I didn't have a BG (because of his testing issues discussed above) but his urine glucose was NEG.

I took along my Freestyle Lite meter to compare with their Accu-check. We didn't get both on the first reading, but did on all subsequent readings. Part of the surprise was that the numbers were SO different. The next part of the surprise you can see in this basically non-existent curve...more like a sliding board!

5:30 - Breakfast and 7 units NPH

Accu-Check / Freestyle
7:50 - 430 / No Reading
9:40 - 417 / 307
11:30 - 367 / 267
1:30 - 316 / 227
3:30 - 229 / 171
5:00 - 229 / 159

He never came back up!

We had to leave at 5:00 to get home and feed and give insulin to the cat. Robbie normally eats at 5:30 and gets his shot but we were kind of at a loss what to do. My vet is VERY good and even she was scratching her head.

She put in a call to the vet internist who, of course, had left for the day to see if he had suggestions. We didn't want to not give him any insulin after eating for fear of ketoacidosis, but don't want him too low, either.

She told me to give him 3 units with dinner, and tomorrow morning up his units to 8 since he obviously was too high in the morning (He was previously on 9.5 with Vetsulin). I'm beginning to wonder if we really had him regulated on that or not...this is beginning to make me think probably not.

I just got a urine glucose on him at 8:00 p.m. and made sure to check the keytones as well. Both were NEG, which means, if I'm not mistaken, that his BG is probably below 180. Of course, how far below who knows?

Vet says that it seems like the higher numbers show a greater discrepancy between meters than lower ones and that proved to be true. Even if I could get him to allow me to test, right now I wouldn't trust the results.

We may have to switch insulins again. She's thinking maybe PZI, although my cat dropped low quickly on that, so I'm a little tense.

Anyone have any suggestions?

[Patty]

I don't have a lot of time right now to go back and look, but are you home during the afternoon? An afternoon snack maybe around 1pm could be a solution to evening out the curve.

I wouldn't look at switching insulins. I think you should be able to "tweak" the food to change the shape of his curve.

If you aren't home in the afternoon, another option might be adding a food to his current meal that is slower to digest and will be converted to glucose later in the day, such as brown rice.

It would be interesting to know what is happening with his numbers at night.

One other question, has the vet run a comparison test with her meter against the lab machine to know how far it's off?

Patty

[Jaye]

Thanks for responding!

I'm only home during the day for the summer, I'm a teacher. I do have someone who comes daily to let Robbie (and Callie) out, but he can only come around 11:30.

The brown rice sounds like an interesting idea. I'll run it past my vet. Would that, I wonder, interfere with his prescription diet for urinary crystals?

I'm pretty frightened of his numbers, both day and night!

She said that their meter reads very close to the lab's meter...within 10 I believe she said.

I'm just going out to see if he'll pee for me again...we're all pretty exhausted after the day we just had (only to come home to tornado warnings!)

[k9diabetes]

I wouldn't rush to change insulins either. He is getting a considerable effect from the NPH. It's just taking some time for him to unlock the insulin and put it to work while his food is being digested very quickly.

So the food and insulin are not balanced.

One thing you should rule out is whether he goes low in that first hour or two after a meal and so is actually getting a little rebound.

I suspect he's not and that it's just his meal kicking in fast and early.

With a negative urine test this morning, presumably his blood sugar then was and had been under 180 for a while. So perhaps very similar to his dinnertime blood sugar.

Which would make his curve a mountain instead of a valley.

Which isn't bad in and of itself. Some dogs have mountains for curves and I'm actually a big fan of them because however low the blood sugar is at meal time is as low as it's going to go.

What I would want to change about his curve is the difference between highest and lowest blood sugar.

There are several ways to do that.

-- You could give some Regular or Novolog faster acting insulin with his injection, either by mixing two insulins in one syringe or, given his steep mountain curve, by trying 70/30, which is a preprepared miixture of 70% NPH and 30% Regular.

To do this, I would cut his dose a couple of units when starting him on some faster acting insulin. See if it levels out his curve and then increase the dose to get good numbers. If you premix it yourself, you could start with a small percentage and slowly increase if needed.

-- You could arrange for him to have a lunchtime meal, either from the person who visits him or through a timed feeder.

-- You could add protein and fiber to his diet and see if that slows digestion down enough to hold some glucose from his food until later in the day.

The dip in the curve is late enough that I don't know if a tweaking of the diet will be enough to delay the food conversion that long. If you can do a mid-day meal, I'd try that first and try the faster acting insulin if you can't do a mid-day meal.

I'd trying "adding" the mid-day meal first, not taking it from his other meals. Then whether you keep in the extra or adjust portions would depend on whether he needs to gain some weight.

In both cases, the aim would be to flatten the curve. Not to worry about how high or low the blood sugar is, only on how much difference there is between highest and lowest. If you manage to flatten the curve, then you can adjust the insulin to bring all levels down into a good range.

Does that make sense?

Natalie

[Noodle]

I just wanted to say welcome to you and Robbie. He is just adorable! He looks so "puppy-ish" for 15. :D

I'm sorry you're having so much trouble with the BG testing. The lip usually works out well for many, so I'm sorry he won't let you test there. But there are others on the board who use alternate sites, so hopefully you will find a site he will tolerate.

Natalie posted a lot of good ideas to try, so hopefully one of those will work well for Robbie. My dog Noodle had a mountain curve for a long time (he is much flatter now) and it bothered me a lot until I understood the benefits. Like Natalie mentioned, when the lowest number is always at meal time, it can be easier to manage. You rarely have to worry about an unexpected low at an unpredictable time while you're away and you know he will probably be increasing after that since it's meal time.

I'm glad you found your way to the forum. The support, information, and problem solving you'll find are tremendous. :)

[Jaye]

Hi, Folks...

The saga continues...

After his 3 units last night I checked his urine at 2 hours and it was NEG, then again at 4.5 hours and it was up to 300. We were under tornado warnings, though, and he was shaking like a leaf for most of that time, which always messes with his numbers.

He was understandably high (1000+) this morning with the urine strips after having only 3 units last night but, thankfully, no ketones.

Gave him 8 units this morning, checked his urine again at 4 hours and it was still 1000.

My vet talked to the internist and he also had never had a dog with these kind of numbers on NPH. We're going to stick with it, however, for awhile and not go to PZI (which she was thinking might be a one shot per day thing since he was already so slow to come up with the NPH).

I told her about the brown rice and she agreed that to add protein/fiber was a good idea. We don't feed him the diabetic diet because of his urinary crystals so I'm going to get brown rice (maybe pumpkin if I can find it) and add more Vetasyl (2x daily instead of 1x daily) to his food.

She also said to continue through Friday with 8 units in the morning and then try going to 5 units at night. On Friday, I'm going to borrow one of their Accu-check meters for the weekend (rather than my unreliable Freestyle Lite) and, because my hubby is home on the weekends, we're going to do a 24 hour curve on poor Robbie. It won't be pleasant for any involved, particularly my husband who is VERY soft hearted when it comes to animals, and I have a muzzle prepared if necessary. When I consider that the alternative is to leave my gentle little soul at the animal emergency center in a cage for 24 hours I think hubby will toughen up a bit.

I also discussed your idea of the two different insulins. She concurred with everything you suggested, however apparently the NPH would have been the faster acting one and it doesn't seem to work that way with Robbie. She said something about Lente insulin, which isn't available?

Anyway, he's lying on the floor in quiet sleepy bliss while I'm totally stressing out. Wish this site was also for cats...my Chester and his glargine saga is equally frustrating!

[k9diabetes]

There is some confusion somewhere on the insulins... NPH is not a faster acting insulin. It is intermediate. The faster acting choices are Regular (same insulin molecules as NPH but nothing added to slow down absorption), Humalog, or Novolog.

Eileen uses Novolog with her dog Mildred in the way that I was describing. She gets a base dose of NPH plus a few units of Novolog fast acting insulin to deal with a post-meal spike in blood sugar.

Eileen's thread (http://www.k9diabetes.com/forum/showthread.php?t=374)

The lente insulin she's talking about is Vetsulin. Lente insulins are 30% somewhat faster acting insulin and 70% longer acting crystalline insulin.

We actually used only Regular faster acting insulin with our dog Chris. He tended to be slow to put insulins to work so didn't get a sharp drop from it and we were able to use that without any longer acting insulin for him. The main drawback is that it has to be given more often. With nothing to slow down the absorption, it's out of the system in around 6-8 hours. Six in Chris' case.

So if, just for example, Robbie was getting 8 units of NPH and some faster acting insulin might be helpful, I would start with just 1 unit of Regular insulin and 7 units of NPH, mixed in a single syringe - so still 8 units of insulin total. See how that went and slowly replace NPH with Regular, unit for unit, until the curve was as flat as possible.

All of which we can talk more about after the curve. Testing is very important when trying to tailor a regiment to a dog's exact needs. We switched Chris at one point from all Regular insulin three times a day to all NPH three times a day, every few days we replaced 1 unit of the old insulin with 1 unit of the new insulin until we had completely reversed it.

Natalie

[Jaye]

Thanks for your responses, Natalie...

Today was weird. We started with the 8 units and he stayed high (urine) over 1000. At about 3:30 I swear I saw a TINY little pinkish tinge in the ketones, and I called the vet (regular vet was gone...this is one of the junior vets). She told me not to freak yet, to get another sample right before feeding (5:30) and call her.

Regular vet said to give him 5 units tonight. I was afraid that, with the high numbers and the possible trace of ketones, I might be asking for trouble with such a low dose.

At 5:15 I checked his urine and it was coming down...approximately 500 and the I didn't see any trace of ketones. That dog is an enigma! So he's finally getting lower just at the time we need to feed/inject. I called her and she said stick with the 5 units, so I did.

Hubby found canned pumpkin in a store where he works but he has to buy it, as he calls it, "Lumberjack" style (6 lb can). I can freeze it though, yes?

I'll talk to my vet again when she gets back on Friday about the two insulins. It scares me to do that, but nothing about this process doesn't scare me, so if that's what needs to happen, I'll adjust.

Tomorrow morning should be interesting. Will he be 1000+ or NEG? It's always a surprise. She told me to give him 8 units either way because yesterday, when his morning urine was Neg at 5:30 he was well over 400 by 7:30.

I plan on doing the curve starting Saturday morning through Sunday morning (and maybe a bit beyond). The poor boy...poor me! No sleep at all this weekend, I guess!
Sorry for talking your ear off...it really helps calm me down, though.

[Patty]

Hubby found canned pumpkin in a store where he works but he has to buy it, as he calls it, "Lumberjack" style (6 lb can). I can freeze it though, yes?



Definitely :)

When Robbie had urinary crystals, do you know if they were struvite from higher pH?

Patty

[Jaye]

Hmmm... No, I don't know what kind they were. Who am I kidding? I didn't know there were different kinds. :)

I do know that it was probably around 5 years ago. Both dogs had them and we put them both on Urinary SO although I think the brands have changed (Walthams / Royal Canin). Neither have had crystals since, so I'm reluctant to fiddle with that.

I made up a batch of brown rice. I'm wondering, though, if I should wait until after the curve to change his diet. He's over 1000 again (urine) at 2.5 hours after his shot. Of course, he only got 5 units, so maybe I shouldn't be surprised.

I feel as if I'm wading through a mine field and I don't have a map!

[Patty]

Whether you decide to change the food or not, I would be sure there's about 4 days where no changes occur in food/insulin to get an accurate picture of how they are working together.

[Patty]

With regard to the urinary crystals. A lower pH (more acidic) can cause calcium oxalates. Higher pH (more alkaline) can cause struvite crystals. These are the most commons types. http://en.wikipedia.org/wiki/Bladder_stone_(animal)

Here's a good article on food and struvite crystals in the urine. http://www.dailypuppy.com/articles/what-foods-to-avoid-for-pets-with-struvite-crystals-in-their-urine/08ff2e12-c4c7-8e00-bfc3-cb3a88054b71

My dog tends toward more alkaline urine. I occasionally track her pH with pH stix by pHion.

[Jaye]

Whether you decide to change the food or not, I would be sure there's about 4 days where no changes occur in food/insulin to get an accurate picture of how they are working together.

I think I'll wait until after his BG curve to change it then. Frankly, I borrowed some brown rice from my neighbor and all she had was Minute Rice. After I cooked it, it looked less than appetizing. Found myself saying "I wouldn't feed that to my dog!" then realized that's what I had planned to do! :)

Question: Is the purpose of the brown rice (if I understand correctly) to have something in him that will digest more slowly and introduce glucose in his system later than his normal food, hoping to bring his curve back up? And then we could raise his dosage so that his highs weren't so high because we know (hope) that the rice will keep him from getting low later in the day?

So....if I'm not all screwed up with the above...days like today, when he was high all day long (too low of an a.m. dose still?) wouldn't be such a good idea with the rice?

Also, if Robbie is still dropping late in the day (like today, when his 5:15 urine read 500 instead of the 1000s we had all day), wouldn't his meal, at 5:30, stop that trend and basically "reset" things. That's where I'm getting confused, I guess. I've heard of overlap, and I definitely need to avoid that, yes?

Oh, dear....I'm sure you have better things to do with your time!

[Patty]

I'm going to type within your post as it's easier to respond to questions...

I think I'll wait until after his BG curve to change it then. Frankly, I borrowed some brown rice from my neighbor and all she had was Minute Rice. After I cooked it, it looked less than appetizing. Found myself saying "I wouldn't feed that to my dog!" then realized that's what I had planned to do! :) LOL...yes I would avoid Minute rice. It's enhanced with things your dog doesn't need. I would look into an old fashioned unenriched brown rice. I think when I tried it with Ali mine was a medium grain.

Question: Is the purpose of the brown rice (if I understand correctly) to have something in him that will digest more slowly and introduce glucose in his system later than his normal food, hoping to bring his curve back up? Exactly. Ideally a meal midday would be better as Natalie suggested. But I know you would only be able to do that if you had someone who could come into the home daily or an automatic feeder. And then we could raise his dosage so that his highs weren't so high because we know (hope) that the rice will keep him from getting low later in the day? Right. The idea is to level out the curve. I believe the late day drop is occuring because there isn't enough food in the system during that time of day to match the insulin which is still active.

So....if I'm not all screwed up with the above...days like today, when he was high all day long (too low of an a.m. dose still?) wouldn't be such a good idea with the rice? We'll see what your next curve reveals and go from there.

Also, if Robbie is still dropping late in the day (like today, when his 5:15 urine read 500 instead of the 1000s we had all day), wouldn't his meal, at 5:30, stop that trend and basically "reset" things. That's where I'm getting confused, I guess. I've heard of overlap, and I definitely need to avoid that, yes? If Robbie is dropping into his next shot time, it is possible for overlap to occur. So, there may be some residual insulin from the previous shot working in addition to the evening shot. The additional insulin may be stronger than the food, so things would not actually "reset" but may start stair stepping downward. Does that make sense?

The goal is to try to match the food and insulin so you have a more even response. It takes a bit of work sometimes to find the right balance. Whether that includes adding a slower digesting carb to bring up the afternoon numbers. Or looking into adding a faster acting insulin as Natalie described to bring down the morning numbers (with a lower baseline NPH dose).

Oh, dear....I'm sure you have better things to do with your time! Don't feel bad asking questions. Many of us have had struggles ourselves and learned from each other here. ;)

Let's see what your curve brings and go from there.
Patty

[Jaye]

Thanks, Patty....

Even though I'm only using urine test strips until I do the curve on Saturday, I'm starting to see a trend here.

Last night, as stated above, he was finally starting to drop around mealtime. The vet suggested giving him a lower dosage in the evening (from 8 units to 5 units). Once again, after eating he had a sharp climb and tested 1000 at three hours, then at 5.25 hours he was down to 200.

I'm thinking the 5 units were enough because, this morning, he was only 100 pre-injection. Then again, after 2.5 hours he had another sharp climb to 1000. I'm curious to see if this keeps repeating itself. It would, indeed, look like he needs two different kinds of insulin...or that the larger dose/smaller dose might be the way to go with him.

[Jaye]

Arrrggghhh! Just when I think that I'm seeing a pattern - sharp rise the first two hours after breakfast, then a slow decline until right before dinner time, Robbie throws me a curve ball (maybe he knows it's his birthday tomorrow and he can have his own way).

I've been testing every 3 hours (urine) since, well, yesterday, but today he's been consistently at 1000. So I'm thinking, okay, at least a pattern is clear and we can start to deal with it. NOT!

Just tested him at 12:45 (7.25 hours post shot) and he's Negative! What gives with that, I wonder? And, of course, is that negative just a little negative or a huge negative I have no clue. I might try to BG test him now, although I know it won't be pretty and my meter isn't very accurate.

I just bought a OneTouch which is supposed to be much closer than the one I have but I refused to buy the $70 test strips from Walgreens. I'll get them on-line. I had intended for them to go hand in hand with his curve on Saturday, not that I'd need them today.

Editing in: He actually let me test him and was relatively calm about it! Here's the strange thing...urine is Negative but BG meter says 221. The curve we did the other day shows that my meter actually reads lower than the vet's meter, more so in the higher range. At the range it's reading now, it was 89 lower than the vet's number...so I'm quickly becoming fed up with urine testing. Apparently a negative doesn't always even mean he's approximately 180 or below...in this case he could conceivably be over 300!

Plus now he's got a rather disgusting sore on his 'hinder' that he is exacerbating by scooting. I just had his anals expressed and we checked his stool, so she is guessing allergies. It's not like I can bandage his behind! So, into the tub he goes to clean it, then anti-biotic cream and I watch him like a hawk. An e-collar won't help because he's not chewing it, he's scooting it raw.

Did I say 'Aarrrrrggghhh' already?

[k9diabetes]

It takes a while for the glucose to spill into the urine. Plus the 180 is a "guideline" and some dogs spill glucose at somewhat higher or lower levels. I think Chris did not spill glucose into the urine until around 200 or so.

I'm glad you're going to do a blood glucose curve. That will help with more specific information. Some dogs are "wobblers" and do not provide a very consistent response. Very frustrating at first but you can get used to it once you realize that's how it's gonna be!

Chris did a "wave" - his insulin dose rolled through about 7.0 to 8.5 units, slowing rising, topping out, dropping, bottoming out, etc. etc. Not a huge wobble but enough that he would have had a lot of high blood sugar if I hadn't adjusted his dose to accommodate it.

It can take a while to sort out wobblers. You have to test over a period of time so you can see trends over an extended period. But home testing blood sugar can get you there. Lots of aaarrggghhhs along the way though! ;)

Natalie

[Jaye]

I'm not surprised that Robbie is a wobbler! It was a relief to see that he really wasn't that low (or low at all, actually) so now, at 3:45 when I did another urine test, and he's again negative, I'll not worry so much. Perhaps his body is starting to get adjusted to the NPH a little?

I still plan to give him 5 units tonight as per the vet's instructions. He was at 100 this morning on the pee strip, which I was comfortable with.

Now this new problem...the sore on his rump. I cleaned it and put antibiotic cream, but it's impossible to keep rump meds from wearing off or getting licked.

Tomorrow we're going to the vet and he'll get a Convenia 2 week antibiotic shot. He's had them before with no adverse reactions. Plus, they're doing his toenails (which he's a MAJOR drama queen about). The groomer won't do them anymore and I worry about diabetes and the toes. I'm hoping that, with the vet techs doing it, plus the antibiotic shot for the butt wound already there as well, we'll be alright.

So here's the question of the day...will the antibiotic screw up the BG? Can't have the infection take hold, though, so little choice, I guess.

Tomorrow is his Golden Birthday...15 on the 15th...and the poor dog spends it at the vet!

[Patty]

Just wanted to say
Happy Birthday to Robbie!!! :cool:
15 years is definitely something to celebrate!
Patty

[Jaye]

Thanks! I agree!

[CarolW]

Oh, Jaye - 15 is a really grand achievement! Good for Robbie, and good for you, for helping him get there!

The antibiotic COULD raise Robbie's insulin requirements a bit, but I expect you'll be on top of that with testing of some kind.

So much easier with a meter - but of course there's the slight matter of getting there!

I don't know if my series on engaging a dog's cooperation would help, but it might. Also, learning about canine calming signals MIGHT help some.

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

Particularly, this might be of assistance:

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

And on calming signals:

http://www.coherentdog.org/arc2006/calmsig.htm

with elaborations and anecdotes:

http://www.coherentdog.org/arc2006/dogconnect.htm

It's amazing when you use a canine calming signal with your dog, and your dog responds to it. Most dogs will!

I used these signals constantly with Kumbi at tricky times such as shot times and BG-testing. Dogs do indeed seem to find the signals reassuring - once the signal has been given, they can begin to relax, and usually do.

Wed, 14 Jul 2010 18:37:01 (PDT)

[Tikobird]

Happy birthday robbie!!!

[Jaye]

Happy birthday robbie!!!


Robbie says "Thanks!"

We had a HUGE storm last night and no one got any sleep because Robbie is storm-phobic. I give him alprazolam for this and it usually works. Lately, however, I've noticed that it's not so much the thunder, but the lightning that sets him off, even on the medication. I'm wondering if, with his near blindness, it's more of an issue. Wonder if anyone else has experienced that...

The big testing weekend is almost upon us. I have my Freestyle Lite Meter (which isn't very accurate for dogs, apparently) and I've borrowed my Vet's Alpha-Trak. We plan on doing side by side comparisons throughout. I also purchased a OneTouch Ultra Mini (but haven't gotten the strips in yet). Hopefully they might come in sometime Saturday and we can also compare them for part of the curve.

Should be interesting!

[Tikobird]

Good luck with the testing! Dozer is also a stormaphobic - always has been. Not only does the thunder & lightening make him a nervous wreck, we usually have power outages along with our big storms and even during the day if he "hears" the power go out he starts pacing and then to make matters worse all our rooms have hard wired smoke detectors that "beep" at intervals to alert you that the power is out which pushes him over the edge. We had a good thunderstorm a couple nights ago (they fortunately have been few & far between lately) but the power went out about 10:30pm & Dozer cried at the foot of the bed until we helped him up...he then proceeded to get right in the middle of the bed and pant for the next 3 hours! Needless to say nobody slept well that night LOL

[Jaye]

Dogs do indeed seem to find the signals reassuring - once the signal has been given, they can begin to relax, and usually do.

Wed, 14 Jul 2010 18:37:01 (PDT)


Wow...since reading this post, I realize that I've been using some calming signals without even realizing it. Robbie has always been very tender/protective of his tummy area, particularly since his first bout with pancreatitis. We always say "Ready, Set....Go!" when we pick him up and he gives a little hop to our arms on "Go." When someone else picks him up, however, he usually gets all tense and squeals...unless they use the chant (we've taught our neighbor to do it).

When he gets his shot our ritual is a tiny bit of melted fat free cheese in a bowl after he eats his supper. I found treats didn't distract him enough but working to get melted cheese from a bowl is an intense distraction for him (and not so easy for me to clean afterwards, either!) However, once he realized that it came with a shot, he didn't fight the shot but always stopped, paused and seemed to wait for the injection. Kind of defeated my purpose of the cheese for distraction. I started saying, very calmly "put your head down" and guiding his head back to the cheese. Now, when I say it, he just goes back to the cheese with no question...no struggles...and I give the shot. This is a FAR cry from the dog that used to be hysterical at shot time. My husband watches it and thinks it's magic (he's never quite so successful with the injections).

Robbie's urine numbers seems to be back into the pattern of negative at feeding time and then an immediate spike so that by 1.5 hours it's at 1000, then a slow descent through the day. Maybe he will be a mountain and not a valley...we'll see what the BG curve tells us this weekend.

[Jaye]

Well, today the at home BG curve began! My husband is home (he works out of town during the week) but I'm only having him "on-standby" because I know I'll need to be able to do this myself.

I was SO afraid of testing his 'under lip' because he snapped at me that one time. I think the problem was that I startled him from a heavy sleep. I've been doing the lip all morning and it's worked well. He doesn't care for it, but I've only had to have Hubby's help 2 of the 5 times so far.

From the earlier discussions, it was suggested that Robbie was having a sharp increase immediately following breakfast followed by a VERY slow decline. The BG curve at the vet showed that so we've been giving 8 units a.m. and 5 units p.m.

Today's curve, however, is actually showing (so far...knock on wood) a real curve!

5:12 a.m. Pre-breakfast testing 423
5:15 a.m. Breakfast
5:20 a.m. First injection (8 units NPH)
7:20 a.m. 387
9:20 a.m. 339
11:20 a.m. 310
1:20 p.m. 343
3:20 p.m. 440

I wasn't surprised that he started high, after only 5 units in the evening. My regular vet is out until Monday, but the jr. vet (for lack of a better term) wants me to call before the evening shot. She said we will probably up it.

Is that a good idea when doing a curve? Shouldn't I keep things the same through the 24 as he's had for the last several days...then up it when the test is over and spot check him then?

I'm so glad I'm doing this...even if Robbie isn't. He's 15 and who knows how many summer days he has left. I don't want them spent with him feeling crappy.

[Patty]

You're right. I'd keep things the same today to see a clear picture of what's been happening. Then make the increase tomorrow.

It's always possible the sharp increase seen at the vet's was due to stress before the insulin had kicked in yet. Just a theory.

Glad testing is going well :)

[Jaye]

Now I'm wondering if we even need to do a 24 hour curve. The reason in the first place is that his BG never bottomed out on Monday when we did it at the vet. I, too, am beginning to think that the stress was what kept it high (I know I was certainly stressed!)

I'm kind of worried about ketoacidocis here. His test at 3:20 is getting pretty high...440

Is there any reason, with a daytime curve that we're getting, to think that the night would be that vastly different?

Before we did the curve at the vet we were giving him 7.5 2X daily (his vetsulin dose was 9.5 2x daily).

It' pretty obvious (from this curve and the urine strips for the past week) that even the 8 he gets in the morning isn't enough, so certainly 5 at night won't cut it either.

How much can I safely raise the night from the 5 he's at now. Am I risking it to go to 8? That scares me, but I'd be willing to bump it up to, say...6.5?

Sounds like I'm bidding on a house.

[Jaye]

The saga continues...

Both vets (I called the senior vet at home...she gave me per personal cell number...I love my vet) said to up Robbie to 8 units tonight. They feel he is much too high (I concur) and we need to get him down. I was worried about such a large change, but she reminded me that we were on 7.5 2x before the curve on Monday and his vetsulin was 9.5 2x. Tomorrow morning, if he starts high I'm to go to 9 (GULP!)

Wish this site covered cats as well. My little Chester just tested 515! I thought it might be rebound, but he didn't get below 258 today (which is low for him lately...new insulin and multiple health issues). Oh, well....we'll just test them BOTH all night!

[eileen]

The saga continues...

Both vets (I called the senior vet at home...she gave me per personal cell number...I love my vet) said to up Robbie to 8 units tonight. They feel he is much too high (I concur) and we need to get him down. I was worried about such a large change, but she reminded me that we were on 7.5 2x before the curve on Monday and his vetsulin was 9.5 2x. Tomorrow morning, if he starts high I'm to go to 9 (GULP!)

Wish this site covered cats as well. My little Chester just tested 515! I thought it might be rebound, but he didn't get below 258 today (which is low for him lately...new insulin and multiple health issues). Oh, well....we'll just test them BOTH all night!

So nice to have a vet that will work that closely with you.

Night time curves are important as they can vary, no exercize or snacking going on.

For 3 years I also had a diabetic cat, Bobby, part of that time spent in remission. He has since died from congestive heart failure.
My vet also teased me, asking me what was in my water ;-)

I suggest that you join a feline specific diabetic group. I belonged to this one, actually still do.

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

[CarolW]

Hi Jaye,

I was just reading in Tali's (tomswife's) thread how you tested Robbie on the lip - and it worked! And you were shocked by your success.

So, I'm offering you my heartiest congratulations on achieving this success! I think a lot of people BELIEVE their dogs would never accept having their mouths fiddled with. Possibly that's sometimes true, but you never know till you try. Positioning has a lot to do with success; that is, if you stand alongside your dog, not directly facting the head, it can be a big help (you work from the side, so to speak).

I do love the inner, upper lip as a prick-site for blood samples. You mentioned your vet said it heals fast, and I found that to be true with Kumbi. Also, because the nerve-endings are so few in that area, causing pain is extremely rare. A very few times Kumbi felt it, and he would tell me so, but most of the time, he never felt any pain at all.

Also, I'm delighted that your vet was thrilled with your success! You must, indeed, have a good vet. It does make life easier for our vets when we can provide glucose curve information.

Hope you'll report here to your thread, too!

BIG congratulations to you and Robbie!

Sun, 18 Jul 2010 21:05:23 (PDT)

[Jaye]

Hi, CarolW...

Thanks for the encouragement! I am exhausted from a soon to be 48 BG curve, but feeling more empowered, that's for sure. Robbie still isn't anywhere near what I would call regulated, but now I feel we'll get there.

My poor cat, Chester, had a BG spike of 600 last night! Needless to say I freaked out, called the vet at 9:30 p.m. and, luckily, she and my main vet conferred and suggested I give him 2 units NPH (which I had for Robbie) over the 3.0 of Lantus that he was on. It did the trick, probably saved his life and he's feeling much better today.

My vet told me to call her at 1:30 in the morning to see how Chester and Robbie were doing! I asked her if she was sure and her response, "Yes, otherwise I'll just be up all night worrying!" And this wasn't his normal vet, but the jr. vet (normal vet was at a conference). Today (Sunday) his normal vet called and began with "I'm dying to know how the BG testing went..."

I really think I have the best vets in the world and I'm forever grateful to them. She really stressed how pleased she was that I was doing this because it gave us so much more information to work with.

I'll post Robbie's numbers tomorrow when I've had a chance to recover from the curve, plus the comparison charts between the AlphaTrak and the OneTouch (we've been doing two curves...dog and cat...and comparing two and sometimes three different meters...for almost 48 hours. I'm a zombie!)

[Jaye]

Yay! Robbie is doing much better now that I'm home testing! An interesting time the last few days for sure...

1) It never became a curve! He has a sharp bump after eating followed by a long, gradual slope.

2) The 24 hour curve is still going, much like the Energizer Bunny. It's been messed up by a couple of things...we added 1 unit of NPH yesterday around noon because he was just staying so high and feeling miserable. Now that I'm home testing, I'm feeling safe doing this. Before I would have been a nervous wreck.

3) We've bumped up the insulin...and back down, so a scientific curve it's not.

We got up to 9u of NPH last night, (he was doing horribly on the lower doses...this more closely matches his vetsulin dose).

A brief history of the past 24 hours (a backwards curve...started at dinner, ended at dinner the following day). It's actually much longer, but this is where it started looking like he was doing pretty well. I didn't do it every two hours, I needed sleep and I had been testing every two hours for two days straight already! It started every four hours, then I found my cat was having blood sugar difficulties so, since I was up, I tested Robbie more often later in the night.

5:00 p.m. 191
5:15 p.m. Dinner
5:30 p.m. PM Injection - 9 units NPH
9:30 p.m. 182
12:30 a.m. 120
3:00 a.m. 105
4:00 a.m. 116
5:00 a.m. 118
5:15 a.m. Breakfast
5:30 a.m. AM Injection - 8.5 (because he was way under 200)
8:30 a.m. 215
11:30 a.m. 122
2:30 p.m. 109
5:00 p.m 105
5:00 p.m. Dinner
5:30 p.m. PM Injection (again went with 8.5)

I'll keep testing tonight (I'll be up anyway) but it's nice to see his after meal spike not hitting the high 400s.

My vet and I have decided, for now, that if he's over 200 at mealtime, then we go with 9 units. If under, we go with 8.5 and see how it goes.

Luckily, I'm on summer vacation for another month, but I'm starting to (cautiously) feel much better about him (wish the cat would come around as well).

I asked her about the danger of overlap because he rarely rises by mealtime and, if I understood her correctly, she didn't think it was a large problem in his case, because he digests pretty darn fast and always has had (well, since I've been testing and noticed it) a pretty quick spike after eating.

She thinks that any overlap we have between insulin doses might help to lessen this spike. Thoughts?

[Jaye]

Now that I'm home testing, I've discovered a new dilemma. Having two dogs (one diabetic and one not) creates its own set of challenges...and here's mine.

Callie, my non-diabetic dog, came to me with pretty severe separation anxiety (this was several years ago). After MUCH behavior modification and lots of hard work (as much as with Robbie's diabetes, actually) we've gotten her over it. (Robbie has some minimal issues with it as well). Our solution, the one we've been using for years now, is not conducive to good diabetic numbers, however.

Everytime I leave the dogs alone we have a ritual. They go in their room and I give them each a Kong (smaller...about 2.5 inches) then I leave without a word. They are much more excited about the Kongs then they are about me leaving and it occupies their little minds long enough that they've forgotten about me.

We have a neighbor that comes over around 11:3O or noon to let them out to pee and spends a little time with them. He continues the ritual by giving them each a pre-made Kong before he leaves.

Usually they are stuffed (not tightly) with either boiled chicken breast or some deli turkey breast, or sometimes just some of their canned dog food (Royal Canin Urinary SO) topped with a seal of fat-free cream cheese. Exciting for them, but not for the numbers I want to see.

Today I left at 10:30, gave them each a Kong only 1/2 filled with dog food topped with the cream cheese. Lo and behold, when I tested him at 11:30 his sugar had spiked into the mid-200s. Tested him again at 1:30 (when he's been below 100 lately) and it was 270!

So either that tiny bit of food (and it really was tiny) wreaked havoc on his sugar or perhaps he didn't absorb his shot well this morning?

I need some sort of food that they will look forward to eating that I can stuff in a Kong without spiking him. The morning one (about 6:30 a.m. - he gets his shot at 5:30 a.m.) is the worst because he usually has a post-meal climb anyway.

Compound the problem because we won't be getting up in the middle of the night to give him two Kongs so either I find a diabetic "free" treat, or adjust the daytime dosage to accommodate the Kongs.

I don't mind his sugar going up a tad in the afternoon because that's when it's been showing a tad low. At least I wouldn't be at work worried that he's becoming hypoglycemic.

I was thinking perhaps of getting some cans of WD (if they have it in smaller cans, which I don't know) and trying that as the Kong stuffer. He doesn't normally eat that because he's on the prescription food for crystals (they both are). But how much of a treat is that?

I'm stumped!

[Ladybug]

Hi Jaye,

I'm not too familiar with the kongs, but the treats I give to Ladybug are green beans (not canned) or broccoli - frozen, cooked then chilled. Sometimes she gets a slice of cucumber or zucchini. She gets a small puppy Milk Bone around 4-5PM only because she normally drops at that time of the day. I've also given her a small of piece fat-free cheese, which doesn't make her spike. There's also someone here who gives their dog Hebrew National Beef Hotdogs with no problem.

I was giving Ladybug a few pieces of dry food or puppy Milk Bone after our walk in the AM, but that was causing her to spike into the 300's around noon every day, so we don't do that anymore! LOL!

The experts should be along soon to give better advice.

Linda/Ladybug :)

[Jaye]

I've heard about the green bean snack and I wonder how Robbie would like that. I know my husband munches on them raw (we are talking raw, right?) I'll get some tomorrow and see how it goes.

How about carrots? I know that he enjoys them every now and again.

[Patty]

Hmm...I assume you have an easy to clean up area they are eating their Kongs in. I was thinking of the container I've seen that allows you to freeze water/treats for the dog to lick/melt gradually.

Frozen green beans can spike Ali pretty easily. Each dog is different so you'll have to experiment. Depending on the time of day a raw baby carrot is sometimes ok for her (cooked are too high in sugar). A cucumber slice is often a freebie for us. But most often she gets ice chips frequently throughout the day. She's thinks this is a big treat, lol :D

What if you took your Kong and stuffed it with a few of these veggies then filled it with some water (you could flavor it with a bit of water from a can of tuna - packed in water or a tiny bit of canned food or chicken breast).

I know it's not the same hard work as something that sticks to the inside of the kong, but it's a thought...

Patty

[Ladybug]

I don't give Ladybug raw green beans. I buy a bag of frozen, steam them in the microwave, then chill. Same thing with the broccoli. Even if everything is fresh from my garden, like it is right now, I still steam it. But, the zucchini and cucumber are raw.

Ladybug only gets a small amount of raw, not cooked, carrot every once in a while - they make her spike.

Every dog is different - what affects Ladybug may not even bother Robbie. You'll just have to try different things then monitor the bg's.

[Jaye]

Tried the raw green bean tonight...Robbie look at me like I was nuts. He did eat the raw baby carrot and liked that but, knowing my luck, that will make him spike. I gave it to him right after his meal so it probably won't be a fair judge to see what his numbers are later.

Cucumber? That will be next...I think I have one in the fridge.

[CraigM]

Annie comes running whenever she hears us getting ice from the ice maker in the refrigerator. Trouble is that she doesn't always finish it and we have a puddle (tile / Pergo floors, so not too bad).

She also likes a bit of broccoli and cauliflower.

[Patty]

We have Pergo too Craig...so ice puddles if she misses a piece. A surprise if walking around in socks, LOL ;)

[Jaye]

We tried the cucumber tonight. He refused to recognize it as food! He's never been a fan of ice, unfortunately. This is going to be a challenge. So far it's just the carrots, and that's only a tolerance, not a true affection for them.

I just found a list of "free" foods for human diabetics. It seems that fat free cream cheese, which I use to top off his Kong and keep the meat inside of it, is considered a free food up to 3X per day (for a human, of course) at 1 tblsp per time. Maybe if I leave out the meat and just smear the inside of the Kong with the fat free cream cheese (which he loves) it might work. He'll know he's getting a Kong and he'll be occupied for a short while. Might try that tomorrow.

Another site said all meat and fin fish are free?? Seems strange to me, but I usually use chicken breast (boiled) in the kong. Today I was lazy and used his regular dog food...maybe that's where the problem came from. If so, that would make life much easier...because he loves his chicken breast.

[Noodle]

Sounds like Robbie is not a big veggie lover. That's a tough one. Noodle loves any crunchy veggies and cucumbers and the ribs of romaine don't cause a bump in his BG, so I stick with those.

Extra protein above what he already gets in his meals tends to cause Noodle to stay at whatever his highest number is after meals. Only thing you can do it try out the chicken and cream cheese and test. If it doesn't cause a big spike but keeps him at a bit higher number than usual while you're gone, then like you mentioned, that could actually be a good thing. At least you won't have to worry about him going too low while you're not home. :)

Scrambled egg is another possibility. Noodle had better numbers with egg than he did with chicken, but it still kept him at the higher end longer so I don't use it as a treat anymore, unless he's having a low end week.

[Jaye]

Sounds like Robbie is not a big veggie lover. That's a tough one.

He takes after me!

Only thing you can do it try out the chicken and cream cheese and test.

I think I'll try them separately. Cream cheese along might be best for the 6:30 Kong, then perhaps a little chicken in it for the 11:30 one. Although his numbers yesterday were all over the board.

I gave him a few baby carrots last night immediately following his meal, just to see if he would eat them. We had a 1:00 bg of 255! That's when he's typically been a little low. But, as I said, they were all over the board yesterday.

I'm wondering if the small dried liver treats I give him immediately after testing (which I do several times a day) are a cause of this. True, they're dried meat, but maybe the way they're processed makes them not great for him?

[Noodle]

My brother has bought Noodle several different type of treats since the diabetes diagnosis - all protein based, like liver or fish. Every single one of them has made Noodle's BG nutso.

I would try giving Robbie one of the liver treats just once on a particular day and testing right before the treat and then at half an hour after, 1 hour, 1.5 hours, and 2 hours without any other treats given for those tests. That should give you a clear picture of how they may or may not be influencing his BG. I would also make sure to do it at a time of day that you know he's not already climbing following a meal - some point in the day when he tends to hold relatively steady (if he has one of those, lol) for a few hours. If one of the treats increases him by, let's say 20 points, then a secession of those could really add up during a curve. The flip side is that it could prove to be a great treat for times of day when he tends to go lower.

How did the cream cheese alone and chicken alone experiments work out? :)

[eileen]

Another great summer treat is frozen dollops of canned PURE pumpkin. All of my dogs go nuts over these treats.

I put a tablespoon on a cookie sheet and stick into the freezer. You can also use an ice cube tray.
They then store nicely in a plastic container or a baggie.

I form them in different sizes so my larger dogs get bigger ones right down to tiny bite size treats for my tiny terrier.

Just be sure to give to them outdoors as they can leave a bit of a mess behind.

[Jaye]

Robbie is truly an enigma. Curve? Hardly!

He seems (as a VERY general trend, nothing is nailed down yet) to start lower, climb in the next couple of hours, then decline to his lowest before his evening meal.

Of course, that's if there's no storm, or treats, or the wind blows from a different direction or it's a weekday ending in the letter "y."

He had a couple of scary lows the other day at 6.5 hours (got down to a 43 on my meter...@30pts lower than the AlphaTrak would read, but still scary for me).

Since yesterday, I've been adding brown rice to both the morning and evening meals. Maybe too much because he got up to about 203 in the middle of the night. I kept the brown rice in, but decreased amount for today's morning meal and it did keep his afternoon levels from going too low, but kept them a bit higher than I liked (200 + @30) so tonight we upped his insulin which had been at 8.75 (really hard to do accurately, btw) to nine units, and kept the brown rice at 2 tbsps.

Treats have been little bits of boiled chicken breast and raw carrots. He won't eat any other veggie. We'll see how it goes.

[k9diabetes]

Chris was personally offended by vegetables! I tried green beans and he flipped them across the room.

Natalie

[CarolW]

Gosh, Jaye - I wouldn't be worrying about numbers in the 200s.

Maybe a trip through some of these charts would give you ideas.

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

I'm not trying to suggest you should endorse large fluctuations, nor sit around on your butt on days whose names end in "y" (hehe; that was a clever one!).

But, say, 200 or even close to 300 shouldn't, I think, be a cause for worry.

If you go look at those charts, notice their varying shapes.

Hugs to you and Robbie, and your cat, too.

Tue, 27 Jul 2010 23:01:47 (PDT)

[Jaye]

Gosh, Jaye - I wouldn't be worrying about numbers in the 200s.

Maybe a trip through some of these charts would give you ideas.

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

I'm not trying to suggest you should endorse large fluctuations, nor sit around on your butt on days whose names end in "y" (hehe; that was a clever one!).

But, say, 200 or even close to 300 shouldn't, I think, be a cause for worry.

If you go look at those charts, notice their varying shapes.

Hugs to you and Robbie, and your cat, too.

Tue, 27 Jul 2010 23:01:47 (PDT)


Thanks! Those charts are great. I'm having trouble getting two different meter readings to show up as colored lines on any charts I create (getting frustrated...but today it's supposed to rain so a nice day to number crunch again). I do believe I've become a number chaser and a bit obsessed. But I'm starting back to school soon (and have to deal with middle schoolers rather than dogs and cats....I'll take the dogs and cats) and feel the pressure to get things "straightened out" so that I'll not be so worried when I'm gone.

The 200s weren't the problem last night...rather he started to get low. I'm not saying he was really low (because with my OT meter, I'm not confident of that...can't wait to retest this weekend with the borrowed Alphatrak again). He just got to 104 at about 12:30 p.m. Not knowing if he would get lower (like he did a few days ago...meter read 43...I worried. Gave him three thumbnail sized cubes of chicken breast and three carrots, then tried to sleep.

This morning, pre-shot, he read 84 (which is probably actually higher) so, instead of giving him 9 units (which is our new number as of last night) I gave him a "skinny" 9 and three heaping tbsp of brown rice in his food instead of the two I gave him last night.

Of course, to complicate things, a big storm is expected so I gave him a dose of his alprazolam at 12:30 a.m. Robbie is EXTREMELY thunderphobic and shakes pathetically. I found last time that, instead of increasing numbers with stress like I expected, his went down (can shaking be considered exercise?) So that's why I was afraid he'd get too low as I slept. Of course, the storm isn't here yet (by 6:00 a.m.) so numbers could be interesting today.

He's really starting to show a "mountain" instead of a valley in his curve and if I were confident it would stay that way I could relax more knowing his lows would be when I'm home to feed and watch him.

Here are the most recent #s:

Tuesday: 8.75 units NPH

5:00 a.m. 139 (fed him at 5:15, shot at 5:30)
9:30 a.m. 215
11:30 a.m. 203
1:30 p.m. 200

5:00 p.m. 111 (increased to 9 units NPH, fed at 5:15, shot at 5:30)
9:30 p.m. 126
10:30 p.m. 145
12:30 p.m. 104 (3 cubes chicken/3 carrots/ no sleep for me)

Wed: "Skinny" 9 units (upped brown rice to 3 tbsp)
5:00 a.m. 84 (fed at 5:15, shot at 5:30)

[k9diabetes]

I love mountain curves exactly for the reason you mentioned - you do a premeal test and know that's about as low as the blood sugar is going to go.

And ultimately the shape is not terribly important. As long as the range of blood sugars is good, it can be a double humped camel for all I care! :)

Our dog was one whose blood sugar dropped due to stress. Vet visits in particular. I had to take my meter and a syrup source with us when he went to the vet.

Natalie

[Jaye]

As long as the range of blood sugars is good, it can be a double humped camel for all I care! :)

Natalie


:) I agree! Thanks to this site, I know that it's nothing to worry about if he's a bit upside down...typical of my pets anyway.

He started this morning at 84, then spiked to 256 at 9:30. I wonder if the alprazolam could be messing with his BG...but his stool was a tad loose as well. Then again, it's been VERY hot and humid lately. He's already on 1/4 metronidazole 1x daily for issues, so I'll not worry...I will not worry...(maybe if I say it like a mantra it will work?)

I think I'll give his poor lip a bit of a break and not test him until 12:30 today (when he's gotten a tad low before). And me a break as well.

[Jaye]

Chris was personally offended by vegetables! I tried green beans and he flipped them across the room.

Natalie

That shows talent!

[Noodle]

Noodle has always been a mountain as well, though he wobbles a bit and throws me a low day here and there. His mountain has flattened out substantially since switching to BB though - more like a gently rolling hill now, lol. I agree a mountain can be easier to manage and more predictable. It's especially wonderful at night when you know you can sleep for X number of hours before it may start to drop. ;)

It's easy to get caught up chasing numbers - I did it too for quite a while. I think it's par for the course in the beginning. You need lots of testing/curve information for comparison and then you eventually find that magic combo if food/insulin/testing/activity/snacks that works for your dog and allows you piece of mind. :)

[jennjenn7777]

Jake likes the pre-packaged thin sliced turkey breast as a treat. It has less than 1 carb in it and he loves getting a slice! Every now and then I'll give him a piece of a light hot dog. He likes that too.

[Jaye]

Doggone that Robbie! Just when I think I see a pattern...post meal spike to the mid 200s, then a slow decline to dinner time, he throws me a curve.

Why, I wonder, for seemingly no reason at all, did his post meal spike not happen tonight?

I've been checking him pre-injection (113) and then four hours post meal. Tonight he was only 98! Of course, I'm not totally sure what that would be with the Alphatrak at this lower range, but, as his tendency is to go lower through the night, I guess it will be another sleepless night. At least until he starts to rise again.

[Patty]

Was he a bit more active before meal/shot time? Sometimes a surge of activity, stressor, etc. can drop them a bit further if the insulin is still active. Then you can see some overlap occur with the next shot.

This happens with Ali from time to time.

Hope things are back on track today.
Patty

[Jaye]

Was he a bit more active before meal/shot time?
Patty


No, he's not very active at any time (enjoying his retirement at 15 I guess...not that he ever was that active before).

I wondered if maybe he did peak, but it was earlier than before, so after another long night when he got down to 88 (or whatever it really is on my meter) and I stayed up until he started up again (gave him a few chicken breast cubes) I decided to check him at 3 hours instead of 4.

He was 154 at 5:00 a.m., ate at 5:15 and shot at 5:30
At 8:30 he was 203 (there's my little spike)
I'll check him again at 11:30 and edit in with the results.

I need some sleep!

[Jaye]

Hi, All....

Just when I thought things were going in the right direction for Robbie...

We've been testing pretty heavily since Friday evening when I borrowed my vets AlphaTrak. I'm no longer using my OneTouch Mini...those numbers were consistently 30-70 off!

Friday he was at 9 units NPH 2x daily. Numbers were looking pretty good...not perfect, but pretty good. Ranging from the absolute highest (271 - 3 hours post shot when he normally spikes) to 133 the same day (three hours later).

Saturday night the numbers started creeping up...260, with a Sunday am number of 238. We (vet and I) upped it to 9.5 which is exactly what he was on for over a year with Vetsulin.

Sunday...(on 9.5 units)

5:00 a.m. = 238
10:30 a.m. = 179
12:30 p.m. = 217
5:00 p.m. = 276
10:30 p.m. = 192

Monday (today) Imagine my surprise with an am pre-shot of...
5:00 a.m. = 320
8:30 a.m. = 486

I checked for ketones and he didn't even have as much as a trace. *whew*

Called the vet and she told me to give him 3 additional units, which I did at 8:40 a.m. I'll be testing the poor boy all day in a panic.

Can't figure it out. He's been indoors mostly in the heat (but it's been hot for weeks so I'm factoring that out...he's in the air conditioning 95% of the time).

Yesterday I gave him his Tri-Heart pill for monthly heartworm preventative.

Food has been the same...no excess treats...he didn't get into the cat poop (no tell-tale litter around his mouth). His poop looks normal (although it contains wonderful bits of carrot and brown rice...ugh).

I did give him insulin from a new bottle this morning (Walmart Relion NPH...first time I've used it) but I have to discount that as well because last night's show was from the old bottle (which was new on 7/7/10 and still has at least 1/3 left.

Doesn't seem to be acting symptomatic (no excess thirst that I can see). He's lethargic, but that's kind of his normal 15 year old lethargy. He did join us on the walk which I cut short because I wanted to get back to check the ketones.

YIKES! My cat (who is normally sky-high) is actually lower than Robbie!

editing in.... I just talked to my vet and she suspects that it may have been an insulin absorption issue. Robbie is VERY picky about where he allows his shots and I might need to change locations. He's got football player shoulders from lipomas and I may have injected into some scar tissue. I thought about that as well, but it really doesn't explain that this morning's numbers were off as well as the 8:00 bg check. I'm not buying that explanation unless and until I see his numbers getting straightened out later. It's going to be another long day/night.

[eileen]

Personally I have issues with giving NPH at unscheduled times.

Giving additional units will throw into the mix another peaking action possibly overlapping and being affected by the previous dose.

Any number of things could have increased the bgs over the weekend.

Sunday's numbers are not at all bad.

There have been countless times Mildred will be fine then suddenly, without a visable cause go haywire for a day or two then on her own settle right back into where she was.

I've heard others in the past report of heart worm meds temporarily affecting the glucose ranges.

[Jaye]

Personally I have issues with giving NPH at unscheduled times.

Giving additional units will throw into the mix another peaking action possibly overlapping and being affected by the previous dose.

Any number of things could have increased the bgs over the weekend.

Sunday's numbers are not at all bad.

There have been countless times Mildred will be fine then suddenly, without a visable cause go haywire for a day or two then on her own settle right back into where she was.

I've heard others in the past report of heart worm meds temporarily affecting the glucose ranges.

YIPES... Now I'm a little scared! Hope I didn't screw up my poor little boy. I'll be testing him within an inch of his life today, of course, just to make sure he doesn't drop or rise too high.

I just retested him at 10:30 (2 hours after the additional 3 units) and he tested 279, so he's going down. Do you think every 2 hours is enough, or should I do it more frequently until dinnertime? The vet will call again this afternoon to see his progress.

Although I wasn't BG testing the last time he got his heartworm meds, that's the first thing that came to my mind, all other things being equal. It's good to know that others have reported this as well, so if it happens next month I will be looking for it.

[eileen]

Don't be scared...you are testing so have that to your advantage.

Every 2 hours is probably alright unless of course you see a reading that is of concern such as a rapid decrease in glucose levels as some dogs can rebound when there is a drop of 100 points within an hour.

With this extra insulin given 3 1/2 hours later it could also still be peaking when it comes time to give the p/m insulin dose.....just something to keep in mind when making a decision about the NPH dose and consider that with the fasting reading.

Be cautious and just don't try to chase the numbers with this right now.
Let it play out.

Life with a diabetic doggy (and I remember my days with my diabetic cat), always seems like something.

It will all be fine ;-)

[Jaye]

Thanks so much!

I found the thread that mentioned other people's issues with the heartworm meds. I'll admit, this had come to mind. I left a voicemail with my vet telling her my suspicions. It may not be the actual reason, but it makes sense, given the timing of everything.

Meanwhile, he's happy that I'm sitting next to him having a quiet day (and I'm using it as an excuse not to leave the house to do errands).

I'll watch him like a hawk before his evening dose and talk to the vet before I inject him.

I have to say (again) that I love my vet. I don't think a day goes by that she doesn't call (including weekends and her days off) to see how everybody is doing.

[eileen]

You may want to read a bit here too before talking with your vet.

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

[Noodle]

My vet has some treats that are supplied by one of the heart worm companies. They are the exact same formulation of ingredients, minus the medication itself. I've allowed Noodle to have them on 2 vet visits and both times his blood sugar shot up throughout the evening and he was still higher than normal the next morning. I didn't give it much thought the first time since he wobbles every couple of weeks for a day or two. But when it happened the second time, it was just too coincidental. Needless to say, he doesn't get them anymore. At the last vet visit, I brought his own treats - no problem with his BG that night. I don't remember what brand the heart worm treats were, but I'll ask at his next appt tomorrow.

I do remember the discussions on the board about some dogs increasing BG's each time they receive their heart worm meds. I hope that's what caused the bump in Robbie and that it's a brief blip. Another reason to love home testing - as least you know you have the information needed to keep him safe. :)

[Jaye]

I'm guessing that, if this is indeed the cause, that it's the medication in the heartworm preventative and not just the meaty part that contains it. Robbie doesn't use the meaty one, Heartguard, but rather the pill form, Tri-Heart.

I just tested him again (poor pin cushion pup). He's now 221.

Wondering what number I should look at tonight pre-shot to decide what to give him. If he's >200 should I give him his regular 9.5 units I wonder. Because I'm still on summer vacation I can stay up all night to test him if I need to. I'm almost doing that anyway to keep tabs on my unregulated cat, Chester.

[Jaye]

Well, we started today with wonky numbers again, but I'm not as worried now. I can't imagine that it is anything other than the heartworm meds and will be temporary. Thanks to the links given here, I see that other dogs experience this and that it can take a couple of days to iron out.

I was really nervous yesterday after giving him the extra 3 units. Tested him within an inch of his life. In fact, at dinnertime he was 111 but still dropping. I was concerned about giving him his full 9.5. Vet said to give him 9 because he was likely to get high again, but even with testing him in the night, that scared me. I wimped out and gave him 8.75.

I really needed sleep for a change so I gave him a couple of puppy bisquits around his low time and went to sleep.

I'm not surprised that this morning he was 286 (5:00) and at 9:30 he was 353 (his normal spike time). Poor boy...I'll keep him in the air conditioned house today and hopefully tomorrow things will start to iron out. I don't think I'll give him mid-day extra units though. Very stressful on me!

My BIG concern is that I'm going to be a couple of days without a meter! I'm borrowing the vet's AlphaTrak and it needs to be returned tomorrow. Mine isn't due for a couple of days and the OneTouch is basically useless. Then I remind myself that I went 1.5 years without home testing (just urine strips). Robbie will survive it, right?

[CarolW]

Jaye,

I'm a believer in allowing a dog to escape testing for a time, when it's not crucial. So are my vets. Several times they suggested to me I lay off from a lot of testing for Kumbi.

Kumbi, of course, always hated Procedures, so the testing was stressful for him. But even for laid-back dogs, it's a stress.

Because you will be there with Robbie, I'm quite sure he will be safe. But I hope, another time, you won't fall for the notion of giving extra, off-hour injections! I REALLY don't like that idea!

Well, you both survived it. Whew!

Love and hugs to you, Robbie, and your cat!

Wed, 4 Aug 2010 13:24:38 (PDT)

[eileen]

aw Jaye, honestly my heart dropped down into my stomach when you said that you'd be a few days without a meter....only because I am an avid tester, firmly believe in testing at every fasting as well as at peak time every single day and can not even imagine a day without a meter.

I can not even imagine giving an insulin injection without first knowing where Mildred's bg is.

But, many survive fine without this vigilant testing and I'm sure that as long as you are conservative with the insulin dose Robbie will be just fine until your meter arrives.

I certainly wouldn't make giving an extra midday insulin dose a habit, really not a good idea as was mentioned before...messes with the timing of the 2 scheduled injections with possible overlap.

[BestBuddy]

I often went a week or so without testing Buddy. In the beginning I tested all the time and I felt I was becoming a bit manic and I'm sure he hated being poked all the time. I still did a curve about once a month and some spot test if I was worried about how he was acting. We survived.

Jenny

[Jaye]

I'm hoping the meter comes tomorrow and, thank goodness, my vet didn't need hers back yet, so I still have it. He's had not so hot numbers (still wonky, in fact). This is day three after the heartworm meds and I'm hoping they straighten out. He was up in the 340s today for a couple of hours.

Normally he gets 9.5 units NPH. Vet said that if he's above 250 at supper time to up it to 10 tonight. I didn't give him any additional insulin yesterday or today so it sounds like a plan. Of course, that means I'll be testing in the middle of the night....again.

[Jaye]

Question for you folks:

Robbie gets his BG test at 5:00 (am/pm), eats immediately following (5:15) and gets his injection at 5:30.

When you're keeping track of the hours for your curve chart, do you consider 5:00 as 0/12 or would it be 5:30 (when he gets the actual shot).

It's driving me crazy because I'm sort of a stickler for things like that. I count the hours since the shot when I test him again but always wobble...is it from the shot or the pre-shot BG that counts?

[CarolW]

Hi Jaye,

How you count the test-times depends on what you're testing for (haha!)

My vet would take a curve beginning at the time JUST before giving insulin; then every two hours, till the mealtime. That's how things worked out for tests done in the vet's office.

But then I might test at fasting, which would be about half an hour before the shot (right before feeding), and, thereafter every couple of hours. I ended up usually doing what's shown on the first chart on this page:

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

So, I'd test at fasting, right before feeding - usually within five minutes. Then I'd test again right before giving insulin, and thereafter every two hours, except when I wanted more frequent readings, where I might test every hour for the first couple of hours after the morning shot.

There are other charts in this series:

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

And some more detailed ones for Kumbi, beginning here:

http://www.coherentdog.org/vek/bgcharts1.php

You can use the NEXT buttons above the main picture on each page to look at the next chart (or PREV to go back) or UP to get to the index page for the chart series.

Quite a variety of charts there.

I guess if you're measuring BGs related to insulin - and food - any convenient arrangement would do. I usually put in the actual times, though sometimes the hour-count is nice to have, as in, 0, as you do, then +1, +2, +4, and so forth.

Have fun! (ha!)

Wed, 4 Aug 2010 20:36:58 (PDT)

[k9diabetes]

Thirty minutes one way or the other won't make a significant difference in what the curve tells you about his food and insulin so I'd just pick one way of doing it and stick with that. The important information is the overall shape of the curve and how high and low the blood sugar goes.

You want over time to look at trends, not individual numbers.

Natalie

[Jaye]

I'm curious to know if anyone has trouble with their dog's BG soaring because of thunderstorm anxiety (or even dropping). We had a big one last night and when I tested him this morning he was through the roof.

I do give him alprazolam for bad storms and he does well with it...calmer but not sedated. I also have a Thundershirt that I suspect does very little (but he looks awfully dapper in it).

My vet thinks the high numbers are storm related and says it's okay to keep him a little calmer with the alprazolam. We've got at least three days of storms in the forecast. I predict I won't need it as much because once he starts getting used to a stretch of storms, he gets better.

It's the lightning that seems to set him off the most now that he's got cataracts. I wonder if it somehow is enhanced in his limited vision. Lighting was only a part of his previous anxiety...but now, holy cow! It's NOT fun dealing with the poor boy when he's trying to literally crawl through the floor. The reason I suspect the lighting is that he's always been deathly afraid of both storms and fireworks (typical). This July 4th we gave him his preventative dose of alprazolam (we live practically right by the darn city fireworks display). Pulled all the curtains, turned on all the lights, turned up the TV, and he was totally calm (1st time) even though the booms were shaking the house.

Now, when we have a lightning storm, if I turn on the lights so it's not so obvious, he does much better. So much dog...so little sleep!

[eileen]

Jaye,

Just yesterday a dear friend of mine with 2 diabetics told me that the one that is afraid of the thunder and lighting was in a comfortable 100 range but as soon as the storm hit soared to over 500, he is also blind from cataracts.

The other diabetic that is not afraid was not affected.

[Jaye]

Jaye,

Just yesterday a dear friend of mine with 2 diabetics told me that the one that is afraid of the thunder and lighting was in a comfortable 100 range but as soon as the storm hit soared to over 500, he is also blind from cataracts.

The other diabetic that is not afraid was not affected.

Thanks, Eileen... It's good to have some corroborating evidence to support my theory. Poor Robbie just came down from the heartworm meds, now we have storm season!

[peggy0]

Forbin was petrified of storms. He tried to climb the wall when they were bad and his BGs soared, his eyes turned blood red. Yes I am familiar with this issue!!

[Cornspot]

You could feed the exact same thing at the exact same time with the exat same amount of activity. The reality is that our metabolisms don't run like a machine. There are a lot of different chemicals working in there & they all affect our BGs and insulin receptiveness.

The goal of treating diabetes is to keep the numbers in range as much as possible. You'll never keep them there all the time.

And yes stress does usually make numbers climb (ie your dog who is scared of T storms or me who had to endure 3 out of 4 "main" people missing from work last week; I was the 4th & worked many busy hours & had to take extra insulin b/c of it)

[Jaye]

Robbie has been doing extremely well with his numbers lately. Staying from about 110 - 180 consistently. However, last night I decided to check him during his normal spike, around 9:30 and he surprised me with a 115. A lovely number to be sure, but he's usually more toward the 180 at this point and I wanted to go to sleep so I gave him a couple of chicken cubes, just to have some food in him and a rather large "baby" carrot...more of a toddler size, I'd say.

Checked in an hour and he was 143. This morning he shocked me with a whopping 352! What the heck? Could it still be from the carrot? Thoughts? I found an old post of mine...guess I should have checked here first.


I gave him a few baby carrots last night immediately following his meal, just to see if he would eat them. We had a 1:00 bg of 255! That's when he's typically been a little low.

Anyone else have big spikes with raw carrots?

[Jaye]

Question for you folks...

Robbie's numbers have really ironed out since those spikes early in August (which I'm convinced were because of the heartworm meds). I guess with September coming up, we'll know for sure when he gets them again.

Although I've not done a full curve, I've been testing him at least three to four times a day (school teacher on summer vacation...whew!). Since early August he's only spiked into the 300s twice and both times were somewhat predictable. One was a BIG storm and the other was carrots, which I'm finding spike his sugar.

Robbie is approximately 22 lbs. We've been on 10 units NPH since August 6th. He had originally been on 9.5 units of Vetsulin but that was before I started testing him with anything other than Ketodiastix so I can't verify how regulated he really was. He would, more than occasionally, read a 600 -1000 on the stick. When we switched him over to NPH we started at 7 units. That was early July. I shudder to remember the numbers he was showing at that dose (we had a 530).

Generally he's spends about 90% of the time comfortably in the 100's. His lowest was 105. The other 5% or so is in the low to mid 200s. I can't really say when his low is because he's not been predictable that way. Sometimes he's a mountain, other times a valley.

Here's a sample day when I did six tests:

5:00 a.m. 152
5:15 a.m. Breakfast
5:30 a.m. 10 units NPH
9:00 a.m. 207
12:30 p.m. 172
5:00 p.m. 114
5:15 p.m. Dinner
5:30 p.m. 10 units NPH
9:30 p.m. 115
10:30 p.m. 143

I start back to work on Tuesday and today my vet told me to give him a break from testing for awhile. The inside of his lip is getting a little abused looking, frankly. She considers him regulated and unless something changes I should let the both of us rest.

I'm not sure how I feel about that. I truly have been obsessing over it this summer...with him AND my cat, who is far from regulated. It's been very expensive and, although he seems okay with it, I don't want to do it to him if not necessary. Today's vet bill was over $1000 for a dental on one of our "healthier" cats.

What are your thoughts? I just don't know if I can go to work not knowing where he is, BG-wise. Is that just a control issue with me or sound diabetic maintaince? :confused:

[BestBuddy]

There is no right or wrong answer. Just what is right for you.

Buddy was regulated and I only tested when anything changed or there were outside stresses. It was great knowing I could test at anytime but I felt that the testing was more for me than him sometimes.

You will get many answers and they will be all different.

Jenny

[Jaye]

I'm just always so worried about doing the wrong thing for the guy. He's been such a trooper through this, as all our diabetic dogs are.

Looking at the numbers that I edited in, would you consider him regulated?

[eileen]

Wanting to know where their fastings are is definitely 'sound diabetic maintaince', not at all obssesive or controlling.

Knowing that at the drop of a hat and for any or no apparent reason their bgs can go amiss doing at least these 2 tests every day as a part of your routine will not only give you peace of mind, but will, without a doubt, keep Robbie (as well as your cat) safe.

There is no way in the world that I would ever, nor have I ever, in 6 years given Mildred an insulin injection without knowing where her glucose level is.

Also tested my Bob Cat daily as well when he was out of remission.

JMHO ;-)

[BestBuddy]

Those numbers are great. If that is what you have been getting then Robbie is definitely regulated.

I worried about not doing enough for Buddy too but sometimes I also felt that I had to back off and let him be a dog. We managed for over 6 years and had other health problems thrown in so I think we did it right with him.

I still miss Bud but I now look back and know it was his time and thank god for those extra few years.

Jenny

[Jaye]

Those numbers are great. If that is what you have been getting then Robbie is definitely regulated.

Yay! That's great to hear!

I think it will probably take me a little more time in "regulation land" before I'm comfortable taking a vacation from the pre-shot testing, but I know with the busy school year and also doing the cat (who refuses to eat without me keeping him company and moving his food around like it's alive) time might become an issue.

Who am I kidding?

At least I'll give him a break when Hubby is the only one home at shot time. Hubby can give the shots, but has a hard time with the testing.

[Jaye]

Oops! Maybe I spoke too soon. I forgot that today my vet prescribed Amantadine for Robbie's chronic pain which we're attributing mainly to arthritis. He's already on 1/2 Tramadol 2X daily and Metacam in the morning, but this is supposed to enhance those other meds. He's getting more stiff, trouble getting up, but even more so when he lays down. I hear him "thunk" as he hits the floor, like it's painful for him to slowly lower himself down. He's slow to begin walks but one he gets going, he does limber up.

(I bought him an adorable dog stroller, btw, for those times when we get too ambitious on our walks..plus my other little poodle just slipped a disc in her back...no walks for 2 weeks so they sit in it together.)

I see that the main side effects are diarrhea and agitation, but I always wonder how something like that will effect his BG.

So.....I think I'll continue to test him, at least through Monday (school on Tuesday...ugh) and see if there's any cause/effect with it like I saw with the heartworm meds.

Anyone else have experience with this drug?

[k9diabetes]

Chris got four injections a day and I usually tested three times a day, generally skipping the 4am blood test.

But Chris was not the most consistent guy. His blood sugar did kind of a rolling wave between 7 and 8 units and we tried to keep his regulation pretty tight so the dose wandered between 7 and 8 based on his readings.

It depends a lot on the dog. Some dogs settle into a routine and will give you more or less the same blood sugar every day and you get to a point where you don't really need to do a test to know what it's going to be.

But some dogs are minor to major wobblers. They don't do consistent and the only way to keep the regulation pretty tight is to test daily.

So it also depends on how tight you are going to regulate your dog - whether you're going to try to keep everything in the 100s, which could mean that the insulin dose might vary slightly. Or anything over 100 and under 300 is okay, in which case you wouldn't vary the dose much so wouldn't need to test much.

The other variable... lots, huh?... is how big the difference in highest and lowest blood sugar is. The bigger it is, the more likely the lowest BG is likely to be pushing too low. So more testing is helpful when the difference between highest and lowest blood sugar is greatest. With a really flat curve - and Robbie's is pretty flat - you have less reason to be concerned.

Eileen adjusts her dog's blood sugar with fast acting insulin so it's more imperative for her to know what the premeal level is.

So you can see how it really comes out to be an individual decision.

Natalie

[Jaye]

Thanks so much for all the input! I have learned so much from this site and feel so much more in control, both of my dog AND my cat's diabetes because of it. The frustration and fear one normally feels when pets have health issues are lessened with all the info, that's for sure!

[eileen]

Mildred has always been a difficult case, maybe this adds to why I believe it is so important to test every fasting as well as the peak, daily.

Even way before Mildred began using Humalog I tested her faithfully every day. It was just something I learned to do on the very day she was diagnosed with diabetes.
It has become a part of the routine...test, feed, insulin.
She is currently not using Humalog but because her bgs can become so off course for no visable reason I must know where her levels are at all times.


Just yesterday I had her at her vet's for bloodwork and we were talking about home monitoring.
Her vet said that he wishes he could convince all diabetic pet owners to monitor their pets at home, but many refuse.

We went on to talk about how difficult Mildred has always been whereas he said that some of his clients are extremely easy, staying level for months to years but that for the most part these are owners that do stay on top of testing.

I'm sure my vet's very positive attitude towards home testing has played a tremendous part in my way of thinking too.

Have I mentioned lately how much I love my vet ;-)
__________________

[Jaye]

In order to get the low price at Wal-Mart before they switch from the cheap NPH to whatever they're switching to humulin I bought 5 bottles.

Today my vet informs me that NPH will become unavailable as well. She said not to get worried about it yet, that it was a manufacturing issue and may well be available again before my bottles run out. It didn't seem to be just a Wal-Mart switching to Humulin issue.

Does anyone know anything about this? I'm completely frustrated because I just reregulated my dog on NPH after switching from Vetsulin. What's left to use?

[CraigM]

Jaye,
I think your vet is confused. There isn't any thing reported about Novolin-N being discontinued, just Walmart won't be selling their ReliOn branded Novolin-N. I would bet that Walmart will still sell Novolin products, but at a higher price (not ReliOn branded).

BTW, the Humulin-N that Walmart will be switching their ReliOn brand to is also a NPH style insulin. Some people say the Novolin-N and Humulin-N are interchangeable, others think there MAY be a small difference; time will tell.

[eileen]

Jaye,

To repeat what Craig has already posted...your vet is confused and not correct in saying that NPH will be discontinued.

Let this frustration go as there will always (most likely for the lifetime of your pet) be NPH insulin available.

[Jaye]

Thanks for calming my nerves!

This wasn't my normal vet, but the "junior" vet. When I mentioned to my normal vet tonight what I was told, then what information I got from this website, she sounded quite relieved. I'm just assuming that someone who knew about the Wal-Mart switch mentioned it to them and they got it confused.

[k9diabetes]

A lot of vets have been told that NPH will disappear "any day now." Usually by Vetsulin sales reps. NPH is an old insulin and eventually it will go away but I've been hearing that rumor for six years and it still hasn't happened.

FDA requires six months notice of discontinuation of an insulin product so it won't abruptly disappear if and when it's no longer made.

I went through the last discontinuation of one commonly used in dogs - Humulin L - and there was a very prominent notice issued by the makers of the insulin to all pharmacies and announcements via the FDA website, giving people time to try switching or to stockpile as much of the insulin as they could get their hands on.

I knew a couple of people whose dogs only did well on Humulin L and they stockpiled 20 and 30 bottles of it so their dogs could continue to use it after it was discontinued.

I also think that health care expenses will drive continued use of NPH, which is far cheaper than newer analog insulins like Glargine and Levemir for people without health insurance. Doesn't hurt, either, that Walmart is aware of the heavy use of NPH by canine diabetics. We can be a pretty substantial market for that insulin. Companies are taking notice of the pet market - hence the AlphaTrak and iPet glucose meters. So maybe our dogs will help keep NPH available for years to come.

Natalie

[Jaye]

Well, here we go again. Robbie's numbers have climbed to over 300 at am and pm pre shot...exactly in line with his monthly heartworm meds, just like last time.

He usually gets 10 units BID. Since I know the cause of the high numbers, I gave him an extra half unit this morning and tonight. I'm home for the three day holiday weekend, so I can keep an eye on him and test him regularly.

Question: Was this a good idea? I plan on going back down in a few days. Last time it took about four days for him to iron out.

Question: He also needs his flea/tick preventative, but I've read that that can cause bg numbers to go out of whack as well. Am I putting him at more risk doing both meds simultaneously or consecutively, do you think?

[k9diabetes]

I think it's okay to do that. And it's good that you now know the reason for it going up instead of worrying that it's something else.

You might start with the meds separately and see if the flea/tick trreatment has the same effect. That way, you would know which med does what. If they both raise his blood sugar, I'd probably give them together and adjust his insulin up a little bit so it's for the shortest number of days.

I'm running late and I'm not sure I'm making any sense!...

Natalie

[Jaye]

I
You might start with the meds separately and see if the flea/tick trreatment has the same effect. That way, you would know which med does what.

Natalie

Thanks. That's a good point.

[Jaye]

Robbie's number have been beautiful lately. Solidly within the 100s. Now for the past few days he's been fluctuating between low 100s (last night at +2 he was 106 even though at shot time he was 359) and a horrible 442 this morning.

Things that have changed recently: He was put on Clavamox Monday night because he burst a cyst right over his eye that the vet didn't want to treat with antibiotic ointment (because of location). The wonky numbers started Tuesday morning (makes me suspicious.

He's been going to Grandma's house every day this week because our petsitter who lets him out at noon is on vacation. He's been getting his normal 2 Kongs per day filled with boiled chicken breast. Unless Grandma is stuffing him with other stuff (a distinct possibility) that shouldn't raise his bg.

Full Moon last night?

I started a new vial of NPH last night for him. The other was @ 25 days old. Thought that was the solution because of the 106 at +2 hours but this morning tells me differently.

We had him on gabapentin for chronic pain (trying it...sore hips) and it seems that when I took him off it because it was making him VERY sleepy his number shot up. Put him back on it for a day and we got a 118. Off it again and we get a 442. Could be the pain raising his bg. He's also on Tramadol and Metacam.

Ideas? Suggestions?

Thanks!

[Patty]

I would venture to say any of the variables you listed could have an impact.

Robbie's number have been beautiful lately. Solidly within the 100s. Now for the past few days he's been fluctuating between low 100s (last night at +2 he was 106 even though at shot time he was 359) and a horrible 442 this morning.

Things that have changed recently: He was put on Clavamox Monday night because he burst a cyst right over his eye that the vet didn't want to treat with antibiotic ointment (because of location). The wonky numbers started Tuesday morning (makes me suspicious. Every dog responds differently. Clavamox raises my dog's blood sugar quite a bit but not as much as Baytril.

He's been going to Grandma's house every day this week because our petsitter who lets him out at noon is on vacation. He's been getting his normal 2 Kongs per day filled with boiled chicken breast. Unless Grandma is stuffing him with other stuff (a distinct possibility) that shouldn't raise his bg. Slipped food could do it, or even just having more going on if he's in a busier household than when he's alone at home. Maybe he's going a bit low and having a bit of a rebound effect where the liver releases some glucose?

Full Moon last night? :D Always possible.

I started a new vial of NPH last night for him. The other was @ 25 days old. Thought that was the solution because of the 106 at +2 hours but this morning tells me differently.

We had him on gabapentin for chronic pain (trying it...sore hips) and it seems that when I took him off it because it was making him VERY sleepy his number shot up. Put him back on it for a day and we got a 118. Off it again and we get a 442. Could be the pain raising his bg. He's also on Tramadol and Metacam. Pain is a possibility. If having him on it makes him sleepy with less activity, perhaps the increased activity is driving his blood sugar up at the end of his curve when insulin is running out? Or the drug itself may have a glucose lowering effect?

Ideas? Suggestions? Sounds like there are a number of possibilities. If you're able to eliminate some variables (such as being back to his normal routine with the petsitter letting him out next week, etc.) you might be able to tweek out the cause a bit easier and know how to respond in the long run.

Patty

[Jaye]

And now, all of the sudden it seems, his BG has ironed itself out!

I gave him 10.5 yesterday morning, thinking that, after being on 10 units for almost 2 months now, we needed to bump it up with the rising numbers. After only one dose of 10.5, however, his numbers calmed down.

At pre-shot this morning he was 113 (compared to the 442 of yesterday). He had a post meal spike at 9:00 a.m. to a whopping 148 and now, 10:45 a.m. he's back to 106.

The only thing that has changed, besides the dose increase, has been that he didn't have to go to Grandma's for the day. Still getting his clavamox.

This morning I got a bit worried that the 10.5 was going to be too much for him. I know consistency is the key, but I'm not sure he's ready for the dose change now. This morning I gave him a "fat" 10 units and he's already to 106. Hoping I made the right decision.

Yesterday I decided to take in a urine sample today and, even though the numbers are lovely, I think I'll go ahead and do it anyway. Can't hurt, right? (except for my bank account!)

[Jaye]

No UTI, numbers looking good again.

I'm thinking it was the stint at Grandma's all week (during the day) that did it. Stress, treats, who knows?

Well, actually, we might get the chance because he's going there again Monday and Tuesday.

[k9diabetes]

Some dogs like Patty's Ali are extremely sensitive to differences in excitement and activity level. Chris wasn't nearly that sensitive but walks and vet visits usually dropped his blood sugar pretty sharply.

Glad to hear he's settled down and that you have another chance to test the Grandma theory! :)

Natalie

[Jaye]

Well, today the "Grandma Theory" went right out the window. Robbie's beautiful numbers of yesterday went sour and we didn't even go to Grandma's.

I have a new theory! Those blasted antibiotics. Maybe...just maybe...he managed to spit yesterday's out (it's certainly happened before).

I'm taking him off the antibiotic tonight. I know it's usually a very bad idea to quit antibiotics midway but I'm thinking that this is a slightly different situation. We started the antibiotics as a cautionary measure because Robbie had a profusely bleeding cyst (scratched it) over his eye and ointments weren't possible. He didn't have an active infection going on. The wound is now completely scabbed over and isn't causing a problem.

Yesterday I took in a urine sample to check for UTI...absolutely none detected (and no glucose in the urine yesterday as well. Today would be another story entirely). So there's no infection just waiting for it's chance to rear it's ugly head if I stop the clavamox.

I have to do something. The full moon is over and I can't very well blame that anymore. And it seems that poor Grandma is off the hook, as well. I already started a new bottle of NPH so that isn't the culprit.

I gave him several pieces of boiled chicken breast last night around 10:30 p.m. because he was just barely above 100 and I needed to go to bed. But that shouldn't have effected him numbers that much, should it? He went from 108 at 10:30 to 343 at 5:00 a.m.

Could the NPH be petering out too early suddenly? It hasn't before. We have almost two months of lovely numbers since we switched this past summer.

[k9diabetes]

The antibiotic is a potential candidate and it makes sense to me that it's okay to stop them and try out the antibiotic theory since there seems to be no infection involved.

I'll bet Grandma's relieved! ;)

Natalie

[Jaye]

Well...to tell you the truth...I never told Grandma that I suspected she was to blame!

And now I'm thinking it might not be the antibiotics, either. Saturday his numbers were beautiful but we woke up Sunday to a miserable number...

Any clues? Sunday morning was his last Clavamox. Today (Monday) he was back at Grandma's again.

Saturday:

5:00 am 113 (Shot 10 units NPH)
9:00 am 148
10:45 am 106
1:30 pm 97
5:00 pm 141 (Shot 10 units NPH)
9:30 pm 245

Sunday:
5:00 am 343 (Shot FAT 10 units NPH)
9:00 am 218
12:30 pm 138
5:00 pm 141 (Shot normal 10 units NPH)
9:30 pm 245

Monday:
5:00 am 114 (Shot 10 normal units NPH)
5:00 pm 211 (Shot 10 normal units NPH)

[peggy0]

Well I wouldn't say that they are miserable numbers :) It takes a few days for the antibiotics to get out of their system if you have stopped them. I'd wait for 3 to 4 days once they have been stopped to get concerned

[k9diabetes]

I wouldn't say they are horrible either! You can get a bit bogged down when you test all the time and worry about a 343 popping up out of nowhere. But a random high reading happens to every dog now and then and you really don't need to worry about it unless it becomes a trend instead of an off-moment in an otherwise good week.

Blood sugar is naturally highly variable so you'll save a lot of sanity if you can concentrate more on the forest than the trees.

Natalie

[Ladybug]

I also think they are beautiful numbers! :) I wouldn't worry about anything.

Ladybug started high this morning at 315....when she starts high, she stays high all day. I really don't worry because I know by tomorrow AM or late afternoon, she'll be back to normal.

BUT, we have the huge rainstorm coming up the coast tonight through tomorrow which is a low pressure system and that really affects her BG readings. So, she may stay high until it passes late tomorrow night! I guess she's just a highly weather-sensitive dog!

Linda/Ladybug :)

[eileen]

Those readings look pretty darn good to me too!

It's not unusual for Mildred to be running pretty consistant then to have a goofy higher reading pop up out of the blue.

It's the big picture and overall trends that need to be watched.

[Jaye]

Thanks, Folks...

Your replies were reassuring. I'm just used to pretty consistent lower readings so to see a 300+ shocked me. Yesterday was his last day at Grandma's because our sitter came home unexpectedly early. I think Robbie (and his sister, Callie...who is very stressed by car rides) were both grateful to stay home today.

My vet isn't concerned with the numbers. Robbie has been sleeping a LOT lately, which also concerns me, but he's eating well and jogs out ahead of me on walks. She reminds me that he is, after all, 15.5 years old and older dogs have different sleep patterns. *sigh* I hate remembering his age and yet, I'm thrilled that we've been honored to have him with us for 13 of those years.

Today was a 182 and a 175.

[CarolW]

Those are great numbers! I wouldn't be concerned with an occasional 300.

Remember, too, that stress - good stress (bringing joy and pleasure) and bad stress (anything that could cause anxiety) have the same physiological results.

Since Robbie is stepping out joyfully, I'd take that as a very good sign, and merely watch that he doesn't drop too far assuming his BGs drop on walks, which is a normal pattern for diabetic dogs.

Also, I wouldn't be concerned if, at his age, he sleeps a lot. The main question is, is Robbie mostly enjoying life!

love and hugs, licks and wags, from Kwali, Kumbi, Camellia and me!

Thu, 30 Sep 2010 06:59:49 (PDT)

[Jaye]

Since Robbie is stepping out joyfully, I'd take that as a very good sign...
The main question is, is Robbie mostly enjoying life!

love and hugs, licks and wags, from Kwali, Kumbi, Camellia and me!

Thu, 30 Sep 2010 06:59:49 (PDT)

Thank you!

Yes, he's definitely enjoying life. I think he's even really enjoying his long sleeps. He look so comfortable and content. Of course, those two $65 (each) beds Hubby insisted we buy him (because his other beds were what? Still perfectly fine!) might have something to do with it. He still hasn't met a dog he didn't want to play with, regardless of size. He's SO loved.

[Jaye]

VERY low for him. I caught it before I shot, but I have to leave in one hour! I gave him Karo and his regular breakfast plus a piece of bread. Do I shoot? How much do I shoot? He normally gets 9 units. NO ONE WILL BE HOME TODAY!

I'm used to handling this in my cat but he's on a different insulin. I'm VERY nervous! No symptoms however.
n't
Editing in: Okay, now with the Karo and food (20 minutes later) he's 197. This is a food/syrup spike, though. His general tendency is to be more of a mountain instead of a curve, but I've seen him low mid day as well. Should I shoot half a dose? Maybe 6.5 units?

I can have someone come over mid day and give him a snack but this guy doesn't know how to test him.

[peggy0]

Dogs do ok with 1/2 their dosage with no food for medical procedures. Typically if you are worried about a low you drop 25%, so 6.5. I don't know your dogs curve. If it typically goes up from breakfast then the 25% should be fine. If you are really worried, give him the half

[Patty]

Yeeks...glad you caught it :)

[Jaye]

We're still giving Robbie a reduced dose (from 9 to 7.5) until he irons out a bit. This morning he was a decent 210 (even on the reduced dose, which surprised me). We're taking him "over the river and through the woods" with us instead of leaving him home so we can test. It'll stress him a bit, but I've decided to give an alprazolam. Don't know if the stress will raise or lower him so I'll try to play it safe.

Have a happy Thanksgiving, all!

[MaryLea]

Good morning and Happy Thanksgiving!

We are watching your posts with interest. Hope you and Robbie have a basically uneventful day as far as BG readings go. :)

[Jaye]

Robbie's numbers have been all over the map lately, due probably to my tendency to "chase the numbers" with my dose. My vet has recommended that I settle in to his current dose (8.5) and see how things go.

Yesterday we had some glorious numbers. Here's a link to his spreadsheet if you're interested...
https://spreadsheets0.google.com/ccc?key=tsyASxcl_5qk9uVH1WWDZJw&authkey=CM2G5PIL&hl=en&authkey=CM2G5PIL#gid=0

Today, however, at his pm pre-shot Robbie threw me a very nasty 384! And this was after a very invigorating run around the block and playing like a puppy! Called the vet and she recommended keeping his dose the same despite this disgusting number.

After hanging up the phone I read the notes that I had taken this morning after giving him his shot in which I noted that I felt a LOT of resistance when I pushed the plunger in and even mentioned to keep an eye on his numbers because of it (hard to believe I had forgotten that since just this morning).

Robbie has some pretty significant shoulder lipomas but freaks out if you try to shoot him anywhere else. The upside is that I never worry about shooting through him! It never seemed to be much of an issue before, but with this morning's notation and tonight's number I'm wondering if I hit a big chunk of lipoma or perhaps some scar tissue. That at least might explain the number in a less worrisome way.

Anyone else ever have this issue?

[CarolW]

My vet once mentioned to me that if I felt that heavy resistance, I was probably injecting into the SKIN, instead of subcutaneously (under the skin). With your description, maybe you injected into a lipoma - who knows!

But gosh; especially as a one-time number, 384 isn't all that bad! I agree; there could have been an absorption problem.

And I think you're right about chasing numbers. It really does little to no good to do that; consistency is key, over a fair period of time. My vet said to allow at least a week - and do to a curve - before changing a dose. So I think your vet is advising you well.

Over and over, my vets mentioned consistency as key to good control.

Sorry about the jumping around of the numbers, but remember that BGs vary anyway; that sometimes activity changes the numbers, and sometimes, we just don't know why the numbers vary.

Hang in there! Lots of love, hugs, licks and wags to Robbie and you!

Wed, 8 Dec 2010 16:35:18 (PST)

[Patty]

Oh yes...Ali is a land mine in trying to inject. She builds up thick tissue quite quickly despite rotating sites. She also has some deep lipomas.

These are some of my theories from our experience:

When her shot goes in way too smooth (the needle is definitively in the tissue and no wetness on her fur) and it seems her insulin has had little to no effect, I believe I've injected into a lipoma. The insulin doesn't seem to absorb from this tissue.

When my shot is stiff, I believe I'm in scar tissue or have caught a skin fold. Her insulin has a delayed absorption and isn't complete causing high bgs.

Patty

[Jaye]

Thanks for the replies and the info. That must be what happened, I must have hit scar tissue. Funny how you "know" things and then forget them. I've had this experience with Robbie and my cat, Chester, before...I think... Yet I forgot that scar tissue could be an issue and got all worried.

The shot went in just fine tonight, so I'm hoping for some more normal numbers.

[MaryLea]

Not specifically about absorption, but related to seome extent. We found that insulin injected into the scruff area did not absorb as well. I tried using other areas but Ruffles always reacted . . . .

Until I got on the floor with her, putting a small plate of turkey and gravy baby food in front of her, placing one leg across her body while she was licking the food, and sneaking the injection into her hind quarters area. She could not see what I was doing because my body was in the way and she was distracted by the treat. If she moved, I put a little pressure (not much) on her with my leg to hold her still. I'm convinced she did not feel the needle prick. (BTW, always warm the insulin in the syringe before injecting.)

I don't remember how big Robbie is or know if this or something similar would work for you. Hope so!

[jjefferjo]

Real interesting,
When I moved away from Eddie's scruff his numbers leveled beautifully most recently on the curve I did at home.
Not sure if that means anything, but it is interesting! I have been going from side to side just behind the shoulder. I saw a post here suggesting this with pictures.

[eileen]

The area in which one injects the insulin can/does make a difference with the rate of absorption.

It is important to rotate injection site so that scar tissue does not build up. Unfortunately I did not do this enough in the beginning because it was just easier in Mildred's scruff /shoulder area and she does have hardened areas.

Keep in mind that when insulin is injected over a muscle area the insulin can be pumped thru the body at a quicker rate.

http://www.bd.com/us/diabetes/page.aspx?cat=7001&id=7395

[Jaye]

Hi, Folks...

I'm wondering if it's time to try Anipryl with Robbie. He's begun to exhibit symptoms of Canine Cognitive Disfunction that weren't there two months ago, although it's been a slow progression. The biggie (besides housesoiling, which I had been attributing to separation issues...which he hadn't really had before either) is the aimless wandering at night. My mother had Alzheimer's Disease and this nighttime wandering is exactly like the behavior she exhibited.

Last night was bad. No one got more than a couple of hours of sleep. Robbie, meanwhile, was wide awake and somewhat anxious. Nothing I did seemed to make a difference. Checked his BG, which was 153, took him out multiple times, even tried some time on the treadmill, finally resorted to giving him one of his anxiety pills, Alprazolam, which didn't even do anything.

A couple of months ago he was on a clinical trial of a new supplement for Canine Cognitive Disfunction, Neutricks, although I really hadn't noticed symptoms. We stopped it because I thought it might be playing around with his BG. Now, however, I see that we really need something, and I think he's to a stage that a supplement isn't enough.

My husband is going to the vet today with our bunny, and I think I'll call her and see about starting him on Anipryl. Robbie will be 16 this summer and, other than this new anxiety, diabetes, and cataracts, is in good health, but I want what time he has to be joyous, not anxiety filled.

His spreadsheet link is below if interested in his current numbers, which have been somewhat high until I increased his dose the past couple of days.

Has anyone had any adverse reaction to Anipryl, particularly in the way of wonky BG numbers?


Robbie's Spreadsheet:
https://spreadsheets.google.com/ccc?key=tsyASxcl_5qk9uVH1WWDZJw&authkey=CM2G5PIL&hl=en&authkey=CM2G5PIL#gid=0

[peggy0]

I've just started anipryl for my springer. She doesn't have diabetes. Its too early to see if the med is helping. Others on the board have used it though with positive results.

[k9diabetes]

What you describe sure sounds like that's the problem.

I can't, off the top of my head, think of a diabetic dog I know who has used it but I've seen a couple of nondiabetic dogs who did and who definitely got some relief from CCD symptoms.

Natalie

[Jaye]

My vet decided to put him on Senilife first. Apparently treats the same thing but works a different way than Anipryl. I haven't done any research on either yet. I suspect it's because she had Senilife handy and had to order the Anipryl.

The capsules are pretty darn big! But they are streamlines and slick, so with a little fat free cream cheese smeared on go down well. You can also cut off the tip and squeeze it into their mouths, but Robbie didn't like that.

She suggested 1/2 tab melatonin about an hour before bedtime and...YAY! It's been working wonders. We've had three uninterrupted nights of sleep in a row. I can't remember the last time that's happened.

[peggy0]

My vet suggested the sinilife as well. apparently its the same product, the difference being anipryl is fda approved.

[Jaye]

We actually started the Senilife as well because the vet was waiting for the Anipryl to come in. I did some reading on it because my vet wants him on both at the same time because she says they work in different ways. I'm hesitant to overload him on drugs, however.

It seems the Senilife is more of a natural product with all sorts of supplements and has been getting very good reviews for bringing dogs back (rather quickly) to and earlier, "younger dog" state, whereas the Anipryl is definitely a drug. Some have experienced good results with Senilife in as soon as 7 days, the website says.

The 1/2 melatonin I've been giving him at bedtime has given us four straight nights of uninterrupted sleep! I've decided to talk to the vet about waiting for a while on the Anipryl. I'd like to keep the melatonin going for about 5 or 6 more days, then take it away and see if the Senilife has kicked in before giving him another drug.

If the whining/crying decreases, however, I'll know it's the Senilife and not the melatonin at work.

So far I can live with what he'd doing now...only hoping that it will improve further. At least we're sleeping!

[peggy0]

Abby sleeps all night. She paces during the day but its definately decreased since the senilife. They also found very low thyroid function so she's on a thyroid pill. Poor old things.

[Jaye]

I'm becoming a BIG fan of the Senilife. Although he's only been on it for about a week and a half, I'm seeing changes already. He's more energetic when he goes outside, jogs back in the house instead of stumbling. Goes down the few steps to the back door again, which he had totally refused to do for the last couple of months.

Less whining for no apparent reason. I've slept through every night since we started him on it. That's probably largely from the 1/2 tab of melatonin we've been giving him at bedtime, but I'm going to start tapering off on that to see if the Senilife has "taken over" that problem as well.

The change that brought a tear to my eye, however, has nothing to do with the melatonin. Robbie always used to like sleeping between me and my husband. I could wrap my arms around him and hold him (Robbie...not necessarily my husband! :) but for the last couple of months he wanted nothing to do with my affection. He would either turn away or get up and move entirely. The other night I woke to find him between us again. When I reached out to wrap my arms around him and snuggle him he allowed it willingly...and stayed that way all night!

Since one of the symptoms of Canine Cognitive Disfunction is a disinterest in interaction and petting, even to the point of intolerance to it, I find this latest change to be the most heartening.

We won't go to Anipryl as long as he's the "old" Robbie on the Senilife. Maybe down the road, but don't want to dose him unnecessarily.

[buddingartist]

The other night I woke to find him between us again. When I reached out to wrap my arms around him and snuggle him he allowed it willingly...and stayed that way all night!

How sweet. Isn't this what encourages you to keep you going and give them all the love in the world. Here, we call these little gestures <thank you for not giving up on me<.

Hope it continues to go well.

Louise

[Patty]

That's encouraging!

[Jaye]

Robbie got VERY sick Saturday night! About 1:00 a.m. he started vomiting. Not terribly concerned at first. His BG was 204 and it was relatively late in his cycle. I gave him a little boiled chicken breast and we went back to bed. Then, an hour later, same thing. Kept checking the BG which went down but never dangerously so (lowest was 129 then started back up by 5:00 when it was 155) This continued until 5:00 when I had to make a decision what to do about breakfast/insulin.

Called my vet (love my vet...no complaints about me calling any hour day or night) and she had me give him an anti-nausea pill...which he promptly threw up. Long story short, we headed to the emergency room.

Anti-nausea injection, sub-q fluids (which I could have given myself, but decided to go the easy route and let them do it) and an x-ray. The x-ray showed he has lovely insides, especially for an almost-16 year old. Because the ultra-sound tech wasn't there we went on the assumption that it was a flare up of his pancreatitis.

No food or insulin until 5:00 p.m. when his BG was a whopping and frightening 604! He wasn't ketotic, though, and kept his supper down nicely. A reduced dose of NPH followed. This morning he was at 95! What a rollercoaster!

The long and short of it is that he's feeling fine today. Good BGs and a happy, bright-eyed and quasi-energetic (for a 16 year old) dog.

VERY scary episode, though.

[buddingartist]

He sure bounced back quickly for a 16 year old.

Hope things continue to go well for you and Jay

Louise

[peggy0]

I second that poor guy! He's a real trooper

[Jaye]

Thanks for the well-wishes. Robbie continues to do well today, even though we've had quite the upset in the house with kitchen remodeling. His BGs ranged from stayed in the mid to loww 100s all day.

I find it hard to fathom that a bout of pancreatitis could have cleared so quickly. The e-vet mentioned a possible virus, but would that have cleared in one day? He had no fever and his breathing was fine.

I don't know what it was, but you're right, he did bounce back fast...thank goodness!

[buddingartist]

When it happens to my 2 and they only throw up once or twice, I always suspect that they picked up something off the ground on their walks. Even though we watch them like hawks, they can be fast:)

Although when Buddy threw up that one time, it was mostly his behaviours before and after that made me suspect something more serious and made me call the vet... sure enough it was pancreatitis and the blood test confirmed it. He was hospitalized for 2 days.

Louise

[Jaye]

This was definitely more than what we would see if he picked up something on a walk...in fact, haven't walked for quite a long time due to the snow and extreme cold. Robbie looked miserable, all hunched up, shaking...I felt horrible for him.

It's been one week today and he's doing great! His BGs are better than I've seen them in ages. He does reach into the 200s during his normal post-meal spike, but it's back to the low to mid 100s at pre-shot (Robbie is normally a mountain, not a valley, so pre-shots in the low 100s don't make me nervous anymore).

Tomorrow it's time to start a new bottle of insulin. That always makes me nervous.

[Jaye]

Hello, Folks...

I haven't been on in a while, which means, thankfully, things with Robbie have been okay. He's mostly sleeping through the night with the help of a 1/2 tab of melatonin given at suppertime.

However, we've hit a new little snag. His BG is fluctuating quite a bit lately...getting higher (in the 300s) than I like and not coming down as far as I'd like. I've changed insulin bottles (his was just under one month old) to no avail.

I've noticed that the BG seems to be high since my husband has been home and taking an active role in his feeding (hubby usually works away from home during the week but is now home for the winter). Tonight hubby told me he's been giving Robbie twice the amount of arthroflex that I normally give him both at night and in the morning. That's 2 small scoops 2X daily instead of the 1X daily that I give him.

I thought I remembered reading somewhere on this site about arthroflex having an effect on BG but I can't remember, nor can I find it.

Can anyone vouch for or again the idea that the arthroflex might be a contributing factor to the flux in numbers.

Thanks for the input!

[Jaye]

Hi, Folks...

I haven't been here for a long time, as my dog, Robbie, has been doing well. Lately, however, he REFUSES to eat his canned Royal Canin Urinary SO canned food, one that he had been prescribed for urinary crystals (sorry...don't remember what kind) many years ago. He has always eaten very enthusiastically. Now I find I have to cut his food with a tablespoon of canned cat food (low carb) to even get him to smell it. He doesn't act nauseous. In fact, he's very excited to eat until he smells the food. I wonder if they've changed the formula?

Anyway, his problems are 1) previous crystals, 2) diabetic and 3) flare ups of pancreatitis.

I'm afraid of switching quickly to a low carb food without being home to frequently monitor his BG. I need to stay low fat for the pancreatitis and Lord knows what I need to do for the crystals if I don't feed him the Urinary SO anymore.

Any suggestions? I'm at my wit's end here. He's just passed his 16th birthday and still runs me around the block on a good day. He's not overweight. Approximately 22 pounds. Blind, arthritic, but otherwise a happy guy.

Thanks!

[Abby's Mom]

Hi Jayne,

I have read (see link below), and we use Cranberry powder. Abby had a UTI, and since then I have put her on Cranberry powder (mix it up with her food), and we haven't had one since!

http://www.b-naturals.com/newsletter/bladder-stones-crystals/

My vet also suggest anything less than 10% fat is recommended for a diabetic dog which is prone to pancreatitis. Blue Buffalo - Healthy Weight Mangement is a food that alot of members are using with success, and it has less than 10% fat (6%), There are others out there.

I have Abby on the Blue Buffalo and she absolutely loves it. Add some warm water and it is even better.

I'm sure others will post soon, and give their thoughts.

Welcome back!

[AZPitasmom]

I have Pita on Wellness Core Reduced Fat - 8.5% fiber, 31% carbs and 10 - 12% fat. Through her whole life, Pita had to be bribed to eat (it is amazing what a little peanut butter - just peanuts with no oil from the health food store - would accomplish in the past), but she eats this one "plain"!

[Jaye]

I have Pita on Wellness Core Reduced Fat - 8.5% fiber, 31% carbs and 10 - 12% fat.

I wish I could find out how many carbs are in the Royal Canin Urinary SO canned. So far I'm not having any luck finding information past the basic crude analysis of Protein, Fat, Fiber and Moisture.

31% carbs seems really high for me, though. That's what scares me...switching without a carb/carb comparison.

[AZPitasmom]

Jaye
I actually called the company and asked how many carbs.
With my vet encouraging W/D (it is 51% carbs by their own website), I figured I was doing pretty good with this one.

[jesse girl]

well as we know as for any animal gets older they just arent as excited about eating and there tastes change I know my 82 year old mother is not very excited about food anymore maybe its just a lifetime of eating and we get tired of it

it may be a temporary thing but at that age i would think that going back to that youthful appetite may be fading so its how to adjust to this new way of life well it appears the food you are giving has worked well with his ailments so you would like to continue

maybe you can feed that at a mealtime where appetite is at its best and maybe feed a reduced amount of something he likes where appetite is less desirable for your friend it may not be ideal as for ingredients but with a reduction in the amount it may work fine

of coarse you will have to do a bit more testing to see how everything works as far as food and insulin I think everyone on the forum will have to adjust over time and be prepared for that its just the reality of getting older

[Jaye]

Just the way he looks when I give him the food makes me suspicious that they have possibly changed the formula. They did that once before, although my vet hadn't noticed it, we did. The texture was very different. Or maybe the particular cases we have sat on a shelf too long, got too hot or cold.

The thing that makes me suspicious is how excited he was to eat this morning. Literally jumped off the floor in excitement...pretty good for a 16 year old dog. Then when I gave it to him he turned his head away with a look of "You've got to be kidding me." When I tried one of the new foods, he wasn't excited about it either, but on can number 3 he was a happy camper.

At over $3.50 a can I hate to waste his Urinary SO but the pet store stuff, even the really good stuff, is less than that. I bought one can of several varieties that are low in fat (for his pancreatitis). Curious to see if he likes the Merrick Turducken, which is very low in carbs.

[jesse girl]

it is possible the pre excited behavior gives you the indication he did want to eat

did he give you a problem before when the formula was changed ?

to test your theory if the food went bad do to environmental or processing issues you would have to get a new batch from somewhere else

maybe you can call the company and explain the problem and maybe they can get you a newly processed can to at least rule out a bad batch

a complete food change can be challenging and there is low fat commercial food out there then you must find something he will eat if he is turning his nose up at everything something else maybe going on

[k9diabetes]

After the Menu Foods recall, I tend to be cautious with any food that a pet has eaten cheerfully and then rather abruptly starts refusing if a new bag or can has been recently purchased. There were reports of some dogs who turned up their noses at what turned out to be tainted food.

I suspect that Science Diet probably makes something similar to the Royal Canin Product. That would be one avenue to try.

And often the vet will take back any unopened canned food.

How about contacting the vet and seeing what your options are? Maybe there is another prescription type formula you could try.

I'm not generally opposed to trying other kinds of foods and nonprescription foods. But when you have several health issues that restrict the diet, it's often a whole lot easier to stick with prescription foods meant for those issues.

Natalie

[CarolW]

Sorry troubles bring you back, but I'm SO glad to see you again and get updates on sweet Robbie! He is REALLY getting up there - and still quite lively at times, I gather!

Hope you can get the food issue sorted out. I always trust my dogs when they turn up their noses at food they've generally eaten well - so I think Natalie has a good point.

If your vet is willing to switch off prescription diets, you'd still have to make a somewhat gradual change, I'd think, to avoid upsetting Robbie's tum - but how possible that is if Robbie has been turning up his nose at the once-favored urinary diet, I don't know.

Please keep us posted! Wishing you tons of luck!
Sun, 25 Sep 2011 17:34:47 (PDT)