Let me introduce Sally!

[Sallydog]

Sally, is my 9 year old mixed breed canine baby. Two weeks ago, she became extremely ill and I took her to the local vet ER. We were immediately directed to the University Vet ER in our area. She was dx with severe Pancreatitis. Her BG was 579 at admission. She stayed in the ICU for 5 days, before being discharged.

She was on an IV drip on R insulin while in the ICU and later went to sub Q N--7units. I have a diabetic cat, and I am very proactive with Kitty's treatment. I hometest before every shot and do my curves at home. I say that to lead into this...I started testing Sally immediately when she came home. She stayed in the 100s most of the time and I actually skipped some doses, because she was so low. I reduced her dose to 4 units and she now is "normally" between 250 at preshot and 100 at nadir. But, as her appetitie has returned and she is eating more, her BGs are starting to climb again. This morning her AM preshot test was 278. What is the acceptable range or desired range to keep a dog's BG in? I am hoping the diabetes is transient and will subside once her Pancreatitis ceases. Is there a standard BG reading that is too low to shoot "N" into? I realize, every dog is different, but I don't have a lot of data on Sally.

I am feeding Sally boiled Chicken or Hamburger and rice--mainly due to the Ptitis. She HATES the Perscription foods, and if the same holds true as with cats, the perscription diets are exaggerated (in my opinion!) Are there some commercial foods that are Okay for diabetic dogs?

Once again, thanks for the help! I am looking forward to learning as much as possible, so I can help Sally!

[k9diabetes]

Re: Let me introduce Sally!

Welcome to you and Sally!

I hope her diabetes is transient but that has occurred so rarely in the eight years I've been associated with forums for diabetic dogs that I will be surprised if that turns out to be the case.

You've probably done some reading already, so know that feline diabetics are akin to Type 2 while the vast majority of dogs are akin to Type 1 in that the islets cells are destroyed and they, sooner or later, usually lose the ability to produce insulin.

Dogs also process these insulins different than cats do. Dogs often can be maintained well on an intermediate insulin like NPH and have it cover both the basal and meal-related sugar needs.

But every dog's curve is different. Some dogs have the classic shallow bowl. A small percentage actually come up with a mountain-shaped curve where the blood sugar is lowest at meal time. Another fairly common curve for dogs is a sharp drop in blood sugar in the first couple of hours and then a gradual rise back to the premeal level after the sharp drop.

So there really isn't an automatically safe dose at which to give insulin. You will want to collect information on Sally to find out what she is doing with her food and insulin and base your decisions on that.

Since most dogs lose the ability to produce insulin altogether, we generally recommend giving some insulin even when they don't eat and to try to avoid having to not give any insulin at all. Which may be somewhat different from how it's done with cats.

Once you know how Sally's insulin is absorbed and how it matches up to the diet, you will have a baseline by which to know if you need to drop the dose given a premeal glucose reading.

As far as diet, if you look at the thread about diet and insulin used that is stickied at the top of the page, you will see that dogs here eat everything from strictly the prescription diet (which does tend to work well in many dogs) to fully homecooked food and everything in between.

Many have had good success with Blue Buffalo's healthy weight - it does not come in canned though.

Some of the high protein grain free diets will not necessarily work in a diabetic dog unless they are supplemented with some kind of carbohydrates because the insulin gets ahead of the slow digestion with a high protein diet. Quite a few dogs truly need some carbs to go with their insulin. So for people who really want to use those kinds of diets, they often supplement the commercial food with brown rice, white rice, pasta, and/or vegetables as needed.

The general blood sugar goals are the same - as close to between 100 and 180 as possible, which leaves some room on the low end for days when the blood sugar goes lower than average. Many dogs can't be regulated that tightly, at which point the goal is usually to try to keep the blood sugar under 200-250 for as much of the day as possible. A lot depends on the food / insulin balance and the flexibility of their humans' schedules.

Natalie

[Sallydog]

Re: Let me introduce Sally!

Thanks, for the welcome and comments!

I did forget to mention in my initial post that Sally weighs 65 pounds. From what I have read, it seems if the 7 units of N, perscribed by the vet is a very low dose. Is that correct?

Tonight her premeal BG was 327-- I shot the 7 units.

She is going back to the Vet hospital tomorrow for follow up blood work related to the Ptitis. While there, I have agreed to let them do a curve. Hopefully, after that, they will be able to advise me more on her dose.

I am pricking Sally's ear for the BG test. I have read that with dog's that is not the "best" place to get blood. Where do most people prick their dog?

Yes, I have already discovered that Canine and Feline Diabetes are very different. And, I am lost here!

Thanks again for the help!

[Judi]

Re: Let me introduce Sally!

welcome to the forum! we all prick our dogs wherever we can get blood! I don't think dogs have as many veins on their ears as cats do but if it is working for you and Sally, run with it!

Craig uses his dog's ear. I use my dogs lip. Hope the curve provides some good info. If Sally is already in the 300's hopefully you are on the way to regulation

Judi

[jesse girl]

Re: Let me introduce Sally!

hi and welcome

we test on the lip but it doesnt matter where you get

fantastic your testing at home you might want to bring your meter to the vet to compare during the curve

it takes some time for the pancreas to heal my jesse was in the same boat she had a few flare ups vomiting that foamy kind of liquid when she got home we did not force her to eat normally until her body would accept it .

it may take up to a month for things to settle down so dont expect regulation to be quick and as your baby gets better it is possible the need for insulin may change up and down home testing will help with that

probably a good idea to be at a lower dose to start the pancreas when healed could have the potential of producing insulin and the one number you posted is not that high for such a low dose and who knows the numbers may be quite a bit lower the curve should help with that

its early into this look for physical signs on improvement if they are feeling better that is a good sign

[MaryLea]

Re: Let me introduce Sally!

Welcome to the forum! You've already received some excellent information and advice from Natalie. Glad you found us!

You are still early in the process of regulating Sally, so don't be discouraged. Even if her highs go into the 300s, an increase in dose will help. Just watch the low numbers, which I'm sure you already know to do.

Congrats on hometesting! The data you receive there will be your most reliable and valuable asset, IMO. Please let us know how the vet visit turns out and the results of the curve.

Mary

[CraigM]

Re: Let me introduce Sally!

Welcone! As Judi mentioned I test Annie on the ear and usually can get a blood droplet. Seems many here test on the lip. I tried the lip once, but since Annie is a small girl, it didn't go well.

Let me mention how I test on her ear, it might give you some ideas. I use a small battery powered groomer / shaver and shave a small strip along the front edge of her ear. At first, we did this on the outside of the floppy ear, but she complained that it looked funny For the last two years, we've flipped the ear over and shave / test on the underside of her ear. I smear a very small amount of Vaseline (pin head amount) on the area. The Vaseline helps the blood form a ball, and not run into the hair. I use a 25 or 26 gauge lancet, without a "clicker", just held between my fingers. During cold weather I might have to warm the ear for a minute (cup my hand over it) to help blood flow.

I think if she had a bigger mouth, of I had smaller hands, I'd try the lip like others do.

Guess it really doesn't matter. Just go with the area that works for you.

[Cebe]

Re: Let me introduce Sally!

Welcome!

I test my 65 lb dog on her carpal pad (above the foot).

And you will get the hang of this in no time, considering your cat diabetes experience. You have a base of knowledge that is well ahead of most folks, and you'll just need to fork off a in a slightly different direction to treat your dog.

[SandyL]

Re: Let me introduce Sally!

Welcome!! I test my Tiggy at the base of her tail... Actually a little to the right where there's more meat . We all tet wherever we can get a drop of that red gold!!

Sandy

[k9diabetes]

Re: Let me introduce Sally!

There are video demonstrations for most of the test spots at www.k9diabetes.com/bgtestvideos.html.

We used the lip with Chris - very few nerve endings there so not painful for them - from a human perspective it doesn't naturally seem like a good place but it works well for a lot of dogs. Vets don't use the lip much, of course, as their patients aren't always very happy with the vet and could bite so they generally aren't familiar with using that spot to test.

Dogs' ears aren't constructed the same as cats and often don't bleed as well but can be used if other areas don't work out.

Natalie

[jjefferjo]

Re: Let me introduce Sally!

The lip is our place of choice tried teh ears very early on and was only midly successful. Now, 100% successfule with each stick- I also use a lancing device as I am not fond of sticking w/o one

[Sallydog]

Re: Let me introduce Sally!

Thanks to everyone for the generous welcome!

As I mentioned yesterday, Sally is at the vet today for follow up blood work and a glucose curve. But, I wanted to share some cycles and test from the weekend for your feedback and thoughts.

Saturday: 8AM preshot was 233 (5 units of N)
3PM (+7) was 162
8PM (+12) was 292 (5 units of N)
Sunday: 8AM preshot was 291 (5 units of N)
2 PM (+6) was 220
8 PM preshot was 304 (5.5 units of N)

I have been varying the dose, based on the preshot. I have shot as much as 7 units and as low as 3. Her appetite is varied, due to the Ptitis-- I am assuming the food intake is effecting her numbers.

She was on Tramadol, and I read in some other post, that can make the numbers run lower. The week I shot 3 units, she was in the 100s consistently and still on Tramadol. Now she is off of the Tramadol and eating more-- and her numbers are increasing. Last night her preshot was 378-- I shot 7 units.

I am just curious what you think of the numbers this weekend. Do you think there is room to increase her dose. I will know more also, once I get her vet curve back today.

Thanks again to everyone!

Kim

[jesse girl]

Re: Let me introduce Sally!

once i have found a dose that has worked and then i see a need for an increase i may take a week to up to 2 weeks to increase the dose of coarse at a lower level you must adjust immediately

the reason for this is i dont know why the numbers have increased as you said you have other things going on illness and medication and it takes some time for those things to not have any impact on blood sugar and needs to clear from the equation or settle if it is permanent to make the best evaluation on dose adjustments

i might make very small dose adjustments depending on fasting maybe .25 unit but in most cases it really isnt needed larger adjustments may deepen curve (larger drops ) which in some dogs can be sensitive to and may bounce back up blood sugar so yes it may get down to better numbers but they may bounce back up and you may have that same higher fasting number you started with

numbers do look good congrats

[Sallydog]

Re: Let me introduce Sally!

I just got back from the vet hospital with Sally after her curve today. The vet is going to email the results, but she said the test were in the low 300s to mid 200s today and that we needed to get more aggressive with her dosing.

BUT, the part that was hard for me to accept was, she told me to quit testing Sally and to just shoot the 7 units bid for a week. She told me this was a really low dose for Sally and that she probably would need more units. I am very uncomfortable shooting blind.

I am certain I will continue to test, but I don't even know what would be too low to shoot the 7 units into.

Please give me your thoughts!

[peggy0]

Re: Let me introduce Sally!

I would never give a dog a shot of insulin without testing. I don't agree with your vet at all