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Chief
01-19-2012, 03:52 PM
My 9 y/o Schnoodle Chief was newly diagnosed yesterday, with the follow up vet appointment tomorrow morning. Hopefully I can keep this short(er). Spine injury from a run/tumble last April. Steroids and anti-inflams for a few weeks. He still has some deficit in hind quarters, but seemingly pain free and happy. Last two months he started with all the symptoms... panting, water intake, and recently in-house urination 3x. His blood draw was in the a.m. and his BG was in the mid 400's. My big question.... is this managable with a slightly hectic work schedule? I'm a FF/Paramedic, so I do have 2 out of 3 days off. My fiance would have to care for him the days I work, but return to work herself. We definitely want to fight for him, but we're afraid of dosing him and leaving for 5 hours on certain days. Thoughts? Thanks in advance for any input.

k9diabetes
01-19-2012, 04:13 PM
It's very definitely manageable - many folks work 8-10 hours a day and can't come home to check on their dogs.

The best thing would be to learn to test blood sugar at home - no doubt a breeze for a paramedic type person! :)

That way, you would closely monitor the blood sugar, learn his pattern of food and insulin use, and know when his blood sugar is likely to be lowest and how low it is going.

So even if the vet discourages it, as, sadly, many do, I really enourage you to take it on.

The meter I would recommend is a OneTouch Ultra, a NovaMax, or the AlphaTrak which is for pets. The AlphaTrak is a lot more expensive to buy and use than the meters for people and I used a OneTouch Ultra with my dog for years even though I had an AlphaTrak part of that time. The OneTouch Ultra has a really good track record with dogs and the NovaMax is developing one recently.

You can see video and picture tutorials of how and where to test at www.k9diabetes.com/bgtestvideos.html (http://www.k9diabetes.com/bgtestvideos.html).

Also, please don't feel a need to keep it short in the future. :) The more information, the better.

You can get quite a bit of general information at the main website: www.k9diabetes.com (http://www.k9diabetes.com).

Natalie

CarolW
01-19-2012, 04:25 PM
Hi! That IS a tough work schedule. I believe that with careful planning, and a good vet who understands the principle of, Start Low, Go Slow, you and your fiancee can probably manage Chief's insulin/food schedule all right.

The best vets for us are those who are well-educated in canine diabetes; but above all, those who work closely with their clients as team-mates, ask us for any and all relevant information about the dog, and help us adapt and adjust. By no means all vets have solid education in canine diabetes; it's not necessarily a standard part of the basic curriculum for vets in school.

To help your dog, it would be best if BOTH you and your fiancee could learn to test Chief's BG (blood glucose) levels at home. Since you're a paramedic, I trust this won't be difficult for you to learn, and I'm guessing your fiancee might be similarly inclined.

Please ask us for any assistance in learning to do these tests.

You'll want to aim, most likely, for meals/injections 12 hours apart. On any given day, you'd want to have no longer than a 13-hour interval and no shorter than an 11-hour interval between the meal/shot schedules.

I use a computer Calendar program to help myself with this; it involves having the computer running, of course!

Please tell us everything you can think of about your dog; don't be afraid to take all the space you need; long posts are extremely welcome here, for exactly the purpose of assisting you as best possible.

For instance:

Date diagnosed (I think you gave that - yesterday);
Weight of your dog;
His age;
Sexual status - neutered?
What type of insulin is Chief on? Brand, and current insulin dose?
What are you feeding, and how much? and when?
Any other food? (treats, etc.)
Any other complications or medical conditions?

Many dogs here have owners who have to be away from home most of a working day. You'll be wanting to be conservative with insulin doses; letting Chief run a bit high rather than risk sinking into low readings (say, anything below 100 mg/dL.

You'll get lots of assistance here, generally, very good assistance. I'm out of practice, as my Kumbi died (of cancer, not diabetes) about a year and a half ago.

Here's a Big, Fat Welcome to you and your fiancee and Chief, to this very fine forum on canine diabetes.
Thu, 19 Jan 2012 16:25:20 (PST)

SandyL
01-19-2012, 06:35 PM
Welcome!!
It's definitely manageable!!! I'm gone for 9 1/2 hours a day.....leave at 6:30am home by 4:00. My husband has a schedule very similar to yours and we have no problem working things out!! She eats at 6am and 6 pm

You don't have to be home all day to watch Chief, and you'll realize that once you get into a routine. Like others mentioned, it is so very helpful if you home test, then at least YOU KNOW if he's running a little low and can give him an extra treat or decrease your insulin if you won't be home. Having to feed and inject every 12 hours does put a little kink in your social life outside the home but that can be worked around also:D

Sandy

Chief
01-19-2012, 07:35 PM
Please tell us everything you can think of about your dog; don't be afraid to take all the space you need; long posts are extremely welcome here, for exactly the purpose of assisting you as best possible.

For instance:

Date diagnosed (I think you gave that - yesterday);

Weight of your dog; 26lbs.

His age; 10 yrs. next month.

Sexual status - neutered? Yes

What type of insulin is Chief on? Brand, and current insulin dose? Nothing yet, as I'm on shift today, and vet appointment is in the morning, so I'm guessing we'll start tomorrow night between 6 and 7. I'll have two full days to start with, then the fiancee gets to roll with it for one night.

What are you feeding, and how much? and when? Beneful for food, and they've always been grazers, no specific feeding time, but not overweight.

Any other food? (treats, etc.) Dry treat in the am and again in the pm after morning and evening duties. They don't get table scraps.

Any other complications or medical conditions? Besides his spinal injury, nothing. It was a compression lower in the cord with minor hind leg weakness as a final result.



Here's a Big, Fat Welcome to you and your fiancee and Chief, to this very fine forum on canine diabetes.
Thu, 19 Jan 2012 16:25:20 (PST)

I understand people have different hours for work schedules, but sticking to the 12 hour schedule will be difficult at times. Can the hours of injection fluctuate from time to time? It shouldn't be by more than an hour.

I realize if I do nothing, he'll probably die a miserable death, so I'm not going that route. It just breaks my heart to think there's a possibility we'll fail him because of our work hours. I'm home for two straight days with them, it's the time we leave and get home that'll occasionally be different.

What can I expect to pay for insulin monthly? This isn't a make or break deal, just a question. I do plan on monitoring at home myself... I guess it's OK to take work home once in a while!;)

Thanks you all for the responses!

jesse girl
01-19-2012, 08:09 PM
1 hour would probably be the max

home testing will help greatly with that if you need to make some adjustments before you leave for work say if the numbers are a bit low you can lower the dose of insulin to keep him safe

CarolW
01-19-2012, 08:39 PM
If you don't vary schedules for feeding and insulin more than an hour either way, that should be okay; if not ABSOLUTELY ideal, it should work fine. It's good that you're willing to test BG levels at home; you won't find it all that difficult.

Thu, 19 Jan 2012 20:38:40 (PST)

Abby's Mom
01-19-2012, 08:53 PM
What can I expect to pay for insulin monthly? This isn't a make or break deal, just a question. I do plan on monitoring at home myself... I guess it's OK to take work home once in a while!;)

Thanks you all for the responses!

I was initially told by my vet that within the hour is ok. I think when they get regulated this will be fine.

Costs.. A bottle of insulin at Walmart for the Humlin NPH costs about 29.00 and it lasts for me about 4-6 weeks. the other costs are the syringes.. For a Box of 100 they are between 15-20 dollars. The test strips in my opinion are the most expensive, but that depends how often you test. Just say at min 2x a day .50 a strip = 1.00 a day 30 dollars a month.


I think of it as a wash... Insulin, needles, testing in replace of all those expensive treats I use to give. :)

k9diabetes
01-19-2012, 08:54 PM
What's ideal and what's doable aren't necessarily the same thing. Keeping a consistent schedule is the ideal but even those of us who are or were home much of the time (I work from home) periodically get delayed or have to be somewhere for an event. Stuff like that is inevitable even with a more flexible schedule and when that's what you have to do, you make it work as best you can.

Shorter answer - occasional off-schedule things are not a problem.

Once you get started testing, you will be able to identify the typical food/insulin profile and will learn how to adjust things when needed. It's almost more art than science because dogs are all so different. So you learn to read your dog's version of diabetes and then work with that.

The best price for insulin and supplies is from Walmart and Sam's Club at about $25 for a bottle of NPH as "Relion N." Relion N is Humulin N packaged as a house brand under contract with Walmart. So exactly the same stuff as the name brand but at one-third the price. Syringes there are also very affordable - I believe they run between $17 and $20 a box, somewhere in there.

The insulin bottle holds 1,000 units so often lasts quite a while unless a dose is fairly large.

As far as home testing supplies, you can often buy the test strips, which are the real cost long term, through Ebay or online cheaper than at the pharmacy. Even a place like Hocks, which is where I used to buy them (www.hocks.com (http://www.hocks.com)) sells them for quite a bit less than the price at the pharmacy (OneTouch Ultra strips I checked recently were $35.50 for a box of 50 strips through Hocks).

There's a lot of variety in curve shape, sensitivity to changes, how the insulin is used... but home testing blood glucose will sort that out for you and make it easiest to manage.

That said, management isn't ever perfect and perfect regulation isn't needed for your dog to live a good life. So I know the three of you will be fine!

Natalie

Shellie
01-19-2012, 10:48 PM
Welcome!

Don't worry so much about those times when you absolutely can't help it and can't get home. I have days that I end up being several hours late with Hank and while I am not happy, I just keep a closer eye on him those days. The main problem with dosing later than usual is insulin overlap. You don't want the insulin from shot one to still be working by the time it's time for shot two. What I tend to do is to feed him a bit less and give him a bit less insulin then expect him to run higher. Not a great solution but when it's the only choice!

Essentially, you do the best you can and with home testing, it can work out well and you get by! Obviously, you care a lot about Chief so THAT right there is a great indicator of how well you will do.

farrwf
01-20-2012, 06:37 AM
I understand people have different hours for work schedules, but sticking to the 12 hour schedule will be difficult at times. Can the hours of injection fluctuate from time to time? It shouldn't be by more than an hour.

I realize if I do nothing, he'll probably die a miserable death, so I'm not going that route. It just breaks my heart to think there's a possibility we'll fail him because of our work hours. I'm home for two straight days with them, it's the time we leave and get home that'll occasionally be different.

What can I expect to pay for insulin monthly? This isn't a make or break deal, just a question. I do plan on monitoring at home myself... I guess it's OK to take work home once in a while!;)

Thanks you all for the responses!

Hello & Welcome.

The Walmart Relion Humulin insulins are $24.88 a 10 ml vial and their insulin syringes are $12.58 / 100.

As much as I'd like to, it's a rarity for my Otis to get his shots or meals exactly 12 hours apart. He can be food finicky at times, so if we're within a hour (or so) of 12 from his last meal & shot and he indicates he wants to eat, I feed him. It's much better than him deciding in another hour he doesn't want to eat and go on a food strike for a day or so. For us, it's just best to get the food in him when we can.

You know, there is so much variance in dogs as to how long insulin lasts (duration), and when the onset begins, and when it peaks, etc ... (same with the food ingestion dynamics) that it's almost folly to adher to a rigid 12/12 schedule. In fact, it's almost as much "art" as it is "science" timing each dog's dose and meal. I shoot for 12 hours apart, but don't get a rash if I miss. Otis appears to do just fine as long as we are reasonably regular and "about" 12 hours apart.

Chief
01-20-2012, 03:09 PM
OK, so vet went well this AM. He got his first insulin dose @ 9am... 5 units of Humulin N. We also switched his diet to the w/d everyone has been talking about. He seems to like the food, but definitely not the amount. Per the vet, we're going to stick with the 5 and 5 for the week, with another draw on Friday. He'll go in next week for his BG reading, approx. 8 hours after morning injection. Sound about right? He already seems a bit happier, with much less water intake today. Wal-Mart was the key... 1000U and 100 syringes for under $40.

Patty
01-20-2012, 03:43 PM
Per the vet, we're going to stick with the 5 and 5 for the week, with another draw on Friday. He'll go in next week for his BG reading, approx. 8 hours after morning injection. Sound about right?

At 26 lbs, 5u twice a day is about 20% of his weight which is a good starting point.

The only thing I would recommend is instead of going in for 1 bg reading on Friday, taking him in for a full curve OR use that 1 reading to compare your meter if you are able to test by that time. Then you could do a full curve at home.

We see a lot of vets who just take one reading at what is the "classic" low point and then raise insulin based on that one reading. But you don't actually know what your dog's low point is and how the food/insulin are working together.

Some dogs have a mountain shaped curve where the low points are at injection time. Others have a steep initial drop, etc. There are many variations to the 'standard' curve. It would be good to see a full picture of how Chief is processing the insulin.

Take care,
Patty

Chief
01-31-2012, 08:48 AM
Chief's sugars were running in the 500's when he got diagnosed 2 weeks ago. Since then, stict diet of w/d and 5u insulin every 12 hours. So far, so good. I ran another curve on him yesterday, and he never moved out of the 300's. I consider this good news, since he doesn't have a huge drop in sugar levels. The vet just called and wants me to start giving 9u. He's about 26lb. Even though I'm 2 weeks into this journey, and still learning, the 9u seems a bit high. I'm thinking of starting with a lower dose of maybe 6u or 6 1/2u just to see where it goes. Ideas?

farrwf
01-31-2012, 09:10 AM
Chief's sugars were running in the 500's when he got diagnosed 2 weeks ago.
Since then, stict diet of w/d and 5u insulin every 12 hours.
I ran another curve on him yesterday, and he never moved out of the 300's.
The vet just called and wants me to start giving 9u.
He's about 26lb.

Even though I'm 2 weeks into this journey, and still learning, the 9u seems a bit high. I'm thinking of starting with a lower dose of maybe 6u or 6 1/2u just to see where it goes. Ideas?

Hello and welcome. I agree with you. That is a huge increase from the 5U you're giving him now.

Looks like the insulin is having a nice impact, reducing BG from the 500's to the 300's in a couple of weeks. If it were me, I'd go slow and raise it up to 6 and see how that goes for several days. In any event, I sure wouldn't increase it to 9U.

Some of the more experienced members may have some reco's for you.

jjefferjo
01-31-2012, 09:14 AM
I agree that is a rather large increase even for a very large dog- I would go from 5 to 6units and let it stew for 4-5 days then curve again-

Cebe
01-31-2012, 09:47 AM
Agreed. Go slowly. 6 units for a few days and do another curve. Then increase again, slowly. :)

Chief
01-31-2012, 11:02 AM
Thanks for the posts. I was looking for some reassurance on the 6u from some experienced people. Thank you!

Chief
12-14-2012, 09:04 AM
We're almost a year into this adventure, and now the big switch at Walmart from Humulin to Novolog. I understand everyone says it's the generic version and there's no difference. Chief gets 9 1/2u 2x daily. We're on day 5 with the Novolog and his levels are all over the map. One morning he's running 340, the next morning he's at 58, and the next at 210. Feeding and daily activities have not changed. Anyone had this similar experience between the two insulins?

Cebe
12-14-2012, 09:21 AM
So far my dog has simply trended higher, but I'm overdue to do a curve on her. Her behavior is pretty good - not a lot of excess water drinking, etc.

Tell us about going from 6u to 9u? What's been happening since we last chatted?

Kat Negron
12-14-2012, 09:36 AM
Gigi's numbers were all over the place when we first did the switch. Finally about a three weeks to a month in, she stayed steady and still is today. Novolin seems to have a 8-9 hr span. I think humulin seemed to last a little longer than that. Just a few things to keep in mind.

jesse girl
12-14-2012, 09:47 AM
yes they do say its basically the same but there are some differences chemically which may have a different reaction from the body and may take a bit of time to adapt you may want to drop the dose down a bit and see if things become more stable

we just made the switch the other day i would say its more potent then the humilun and we seen the same results when the switch was reverse back a few years ago she has run a bit lower with a few bounces up i know it will probably be a minimum 2 weeks for her body to adapt maybe longer for jesse a bit more testing will have to be done till the transition becomes more stable

stylynjm
12-14-2012, 09:58 AM
Did u switch from humilin to novolin n or novolog. ?? I think they r different

Judi
12-14-2012, 11:27 AM
we had exactly the same experience when we switched. 330 one morning 41 the next morning. We backed her dose down and did a curve after 2 weeks. She had finally stabilized and like Kat's Gigi, one month in, she seems to be more stable on it.
(we are in our 2nd month of Novolin now)

We were at 1.75 u of Humulin; have recently increased from 1.25 to 1.50 of Novolin.

It is definitely different. Judi

Patty
12-14-2012, 01:56 PM
Just to add some information...neither Humulin or Novolin are actually generic. Both are brand name made by Eli Lilly and Novo Nordisk but Walmart can sell at a lower rate because they've contracted with the company and stamp their Relion name on the box.

I think the differences between the 2 have been dog specific really. I had a shorter onset and longer duration when first switching to Novolin back in January.

CraigM
12-14-2012, 04:25 PM
We're almost a year into this adventure, and now the big switch at Walmart from Humulin to Novolog.

You probably just mis-typed this, but please confirm that you are now using Novolin-N and NOT Novolog.