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  • Levemir in Teaka

    My baby, who is going to turn 12 this year, was just diagnosed with Diabetes last Saturday (Mar 10/12). Teaka is a miniature pinscher, which we believe has something else in her as she takes after her dad who is 19 pounds in good physical shape. Teaka unfortunately is 29 lbs. She began drinking lots of water and peeing constantly. I feel guilty because at first I thought this was aging then she started to pee in her sleep which I thought coud be a urinary tract infection (which was the prompt to go to the vet).
    In Canada we use mmol/L vs mg/dL the equivalent is mg/dl divided by 18 = mmol/L. My husband is a diabetic so we have glucometers and the insulins, Novo Rapid and Lantus. The vet told me that for a dog norm is 3.1 - 6.1 mmol/L
    On Mar 10th her BG was 21.9 mmol/L at 3:00pm
    At 7pm we gave her 5 units of NovoRapid mostly because we both know what out baby was probably feeling like and did not want it to be that high.
    I gave her a bit of dog food (Royal Canin Med Aging 25) with a little bit of canned dog food to entice her to eat.
    At 9:2pm her BG was 6.4, I fed her a wee bit more of food because we were concerned that she dropped so much in a couple of hours.
    At 11pm it was back up to 24.7 (apprx 489 mg/dL) so we gave her 2 units of Novo Rapid. My husband was more panicked than I was due to his diabetes, I decided we were not doing anything til the vet called.
    Mar 11th, Sun at 2:41pm her BG was 27.2, we gave 2 units of Novo Paid and 10 units of Lantus. Fed her some dry and wet food (my vet had called to check in, she discussed with another vet that Levemir was the way to go as Lantus does not regulate well in dogs due to the acidity). At 7:10pm she was still high at 23.4 at I gave her was a bit of cooked broccoli.
    After doing research on the net I decided to use some cooked veggies.
    Mar 12th 5:50 am gave her a little dry w/cooked broccoli
    8:00am BG 15.9, fed 1/2c dry food with cooked broccoli
    I picked up the Levemir from the vet and started her on 1.5 units of Levemir at 4:30pm. Schedule is 8am and 8pm feedings with 1.5 units each time.
    5:00pm 1/8 c dry food with cooked beans (all the veggies I had left) she was acting more herself, playing a wee bit, gave her the same amt of food at 10:15pm.
    Mar 13th we started her schedule: 1.5 units Levemir and I fed her 1/2 c dry food with cooked broccoli/cauliflower/carrots (pureed in magic bullet)
    The vet told me that it can take a week or 2 for her to become stable with the insulin and there was no need to check her BG - but we have the equipment and I could not just leave her, I need to know where she was at.
    2:10pm, BG 16.9 starting to come down.
    8pm 1.5 units insulin 1/2 c dry food with 3 Tbl veggie puree
    14th same insulin/feeding schedule 2:00pm BG 4.3
    15th same insulin/feeding schedule 2:00pm BG 4.1
    16th same insulin/feeding schedule 3:00pm BG 4.7
    My vet called last night to check again and was very shocked and very pleased at the last 3 days results. We are going to do a curve tomorrow.
    I am looking into possibly making homemade foods with added vitamins and whatever else dogs require. We are praying that this is not temporary and that we are lucky enough to get it controlled so quick. I have been giving her either a very small piece of carrot or broccoli as a treat once between feedings and I had 1 day where she was very hungry (acting very normal) and was banging her dish at 4pm so I fed her 1-2 TBL of the veggie puree.
    Yesterday I tried adding pureed raw broccoli to the remaining cooked mix, but she is not a fan of the raw so I will have to go back to partially cooking and having the mixed veggies in it.
    There are so many sites available for homemade recipes can anyone suggest one that works for their puppers?
    Sherry
    Teaka, born June 10/2000, Min Pin, diagnosed Mar 10/12 Currently feeding 1/3 cup boiled Chicken (boneless skinless), occasionally low sodium Tuna + 2/3 cup vegetable puree (broccoli, cauliflower) and 14-20 pieces of dry Royal Cannin Med Aging. 1-4 Baby carrots as a treat if BG is dipping.

  • #2
    Re: Levemir in Teaka

    Hi Sherry,

    I got your note and approved your membership, and then moved a copy of your thread here to the main discussion area. So now I'll go and actually read what you wrote!

    Natalie

    Comment


    • #3
      Re: Levemir in Teaka

      Hi Sherry,

      I certainly understand how panicked you must have been to find your dog had such high blood sugar.

      The good news for Teaka - and the reason why I had a somewhat panicky reaction to your giving her 5 units of Novorapid - is that there are some significant differences between human and canine diabetes. Lots of them, most of them good for the dog.

      One of the big ones is that dogs tolerate high blood sugar a lot better than people do.

      So while Teaka's blood sugar of 21.9 (399) was high, it wasn't panicky high. It's a pretty common level for a newly diagnosed dog, and as long as she doesn't have ketones, she can tolerate that level fairly well. Naturally you want to get it down quickly, but it is generally better to start slowly with less insulin than you think they will need and work the dose up slowly.

      The reason I was worried is that dogs tend to process all insulins faster than people do. There are dogs for whom Novolog drops the blood sugar so quickly that they can't tolerate it. And even on intermediate insulins like NPH and the longer acting insulins like Lantus and Levemir, some dogs experience very sharp drops in blood sugar if their meal and insulin aren't working at the same time.

      Not sure if the vet was involved in your decision to give Novolog, but it's not something I would ever recommend doing in a newly diagnosed dog. So I think all were lucky that severe low blood sugar did not occur. In a 29-pound dog, I would expect the starting dose of a longer acting insulin to be around 5-6 units so that was a lot of Novolog.

      It actually can be somewhat of a handicap to be a human diabetic because you have to set aside a lot of what you think and learn the canine version of diabetes, with the speed of insulin processing being a big big difference.

      Interestingly, cats metabolism insulin even faster than dogs and they generally have to use a long acting insulin like Lantus or Levemir.

      Levemir may work well for Teaka but if not - and it definitely does not always work well, in part because it's such a potent insulin in dogs - NPH is an extremely good insulin for dogs that often works great given twice a day.

      Levemir is only now coming into heavier use after another canine insulin went off the market two years ago. The results so far are decidedly mixed. Sometimes it works well by itself, sometimes not. Sometimes it creates overlap. Sometimes it acts as a basal insulin and requires something faster acting to compensate for meals but often it doesn't and has quite a strong impact on blood sugar by itself.

      The other good news for diabetic dogs is that they suffer very few long-term consequences from diabetes and even from moderately high blood sugar. Cataracts are the big one - they are extremely common... I think the stats are that something like 75% of dogs will develop cataracts, in part because the diabetes often isn't caught until the blood sugar has been high for a long time. They don't suffer organ failure, vascular problems, or other types of eye problems. Reasonably well managed, diabetes does not affect their lifespan and they can lead long healthy happy lives.

      This again is probably largely genetic plus their shorter life spans so they don't live with diabetes for 30 or 40 years. But the big species differences between cats, dogs, and humans suggest a lot of it is genetic.

      One last example and then I'll shut up!

      Cats very often get diabetic neuropathy in their back legs. Dogs rarely do, generally only if the blood sugar has been extremely high, like 38 and higher, for an extended period of time.

      Cats rarely ever get diabetes-induced cataracts even when their blood sugar is very high for an extended period. Cats are technically closer to Type II in people while dogs are almost all Type I.

      Is Teaka spayed?

      Natalie

      Comment


      • #4
        Re: Levemir in Teaka

        Hi Sherry and welcome to you and Teaka!

        So glad Teaka is now falling into more of a routine. That makes all the difference in trying to achieve regulation.

        The vet told me that for a dog norm is 3.1 - 6.1 mmol/L
        I have to say I'm uncomfortable with striving for the range your vet gave for a normal dog (56-110 mg/dL). My dog will go hypo in the mid-50s complete with head shaking. Most try to achieve around 5.5-11.1 mmol/L (100-200 mg/dL). The urinary threshold is around 10 mmol/L.

        I'm also glad you are able to test her! What type of meter do you use? Most human meters will measure a dog's blood sugar slightly lower than actual. This is due to the difference in size/shape of a dog's red blood cell. You can run a comparison at your vet's office. Just test Teaka as you normal would (so you're using capillary blood) then have them draw blood to run on the vet's lab machine to find the difference.

        The 5u NovoRapid scared me a little . I've used Humalog at times with my dog and 1/8u can drop her 80 points at times.

        If you are looking at homecooking, there are many here that can offer advice. You will likely find an insulin adjustment needed as you switch things up. With lows of 4.1 (74) you don't have a lot of wiggle room. I think I'd cut back her dose slightly as you establish new patterns.

        Again, welcome to you!
        Patty
        Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~

        Comment


        • #5
          Re: Levemir in Teaka

          Hi Sherry and Teaka, and a Big, Fat Welcome to you, to this magnificent forum on canine diabetes.

          I'm in Canada; therefore very familiar with the measurements in mmol/L. I always used to translate, including first, mmol/L; then mg/dL in my lists of readings, since we have so many people here from the U.S.

          My vets are just great; my main vet is a board-certified specialist in Internal Medicine, and her partner, while without that qualification, is excellent too, as is the part-time vet. So I can count on any of the three vets in the practice (especially because they all consult with one another, and also, all vets and staff keep up with current information).

          Lucky me!

          Anyway, my main vet said, when she diagnosed Kumbi with diabetes, that above all, she wanted to avoid ANY hypoglycemic episode. And sure enough, we managed to avoid ANY at all!

          She put Kumbi on Novolin-NPH insulin. Nothing else in the way of insulin. I used OneTouch Ultra and Ultra2 meters, and went by the actual readings (which were likely slightly low).

          My vet said she preferred to see NOTHING lower than 5.5 mmol/L (roughly 100 mg/dL). It's the LOWS that matter; that is, we always worked by the lows, when considering dose-changes. Highs, we could stabilize in other ways. I tested for ketones when in doubt; Kumbi never threw any!

          Kumbi died of cancer, not diabetes, a little more than a year and a half ago, but I remain here because of the excellence of this forum - it had become my home by then.

          If I were going to suggest anything, I'd suggest you might want to try NPH insulin - whether Novolin or Humulin probably doesn't matter. And I agree with what has been said so far - playing with the rapid stuff is tricky indeed. I was a bit shaken up by those 4.x readings you posted, largely because, as somebody said, you REALLY don't want to go any lower than that, in a dog!

          I know I would have found Levemir far too tricky for my taste. Kumbi did weigh somewhat less than Teaka does, but still, I wonder if you could discuss with your vet the possibility of changing from Levemir to one of the NPH insulins. That just might remove the perceived need for the fast-acting insulins.

          I'll be watching, and cheering you on. Delighted you and Teaka found us here!
          Sat, 17 Mar 2012 21:55:37 (PDT)
          http://www.coherentdog.org/
          CarolW

          Comment


          • #6
            Re: Levemir in Teaka

            Welcome to you and to Teaka! Glad you found us! Lots of information from all here so far!

            My only question is...are you only testing once per day? If so, you may not be getting the best idea of what is really going on with her and her bg. Even if you don't do a full curve, getting a few random here and there and before meal tests will help you to really see. You might be testing her at her high point without realizing it...or her low point. Is always a good idea to get more information if you possibly can.

            Again...welcome to you and to Teaka! Hugs!
            Shell and Hank (aka Mr. Pickypants) - now deceased (4/29/1999 - 12/4/2015) Cairn Terrier mix who was diagnosed 8/18/2011 and on .75 U Levemir 2Xday. Miss you little man!

            Comment


            • #7
              Re: Levemir in Teaka

              Welcome to the boards, lots of excellent information is shared here

              Comment


              • #8
                Re: Levemir in Teaka

                Adding my welcome to the bunch already received
                Eddie is a 14yr old Rat Terrier Who is very well loved.

                Love, Released and All promises kept. My Heart, My Heart, My Heart

                Comment


                • #9
                  Re: Levemir in Teaka

                  Originally posted by Shellie View Post
                  .....My only question is...are you only testing once per day? If so, you may not be getting the best idea of what is really going on with her and her bg. Even if you don't do a full curve, getting a few random here and there and before meal tests will help you to really see. You might be testing her at her high point without realizing it...or her low point. Is always a good idea to get more information if you possibly can....
                  Hello and welcome to the board! We are a family here, and a good one at that. (if I do say so myself!)

                  You've many good questions and comments so far, so I will add only one. Our testing with Ruffles was never random, it was always planned. We tested before meals and insulin (typically called "fasting" BG readings) and at least once in between--2 or 6 hrs. after meal/insulin. So most days, after we had her to some level of "regulation" (meaning her BGs were not too high and not too low on an all-day curve), we tested her three or four times. Whether you will need to continually do that depends on how Teaka does as you go along. Once you reach an agreeable level of BGs and know how she reacts when her BG is high or low, you may be able to test much more infrequently.

                  You will receive many suggestions from those here who have years of experience. It helps to know you are not traveling an unknown road and you are not alone.
                  Glad you are here!

                  Mary
                  Ruffles May 1997~~12/6/2010~~She was "a heartbeat at our feet"~~
                  Izzy--BD unknown;~~ RIP 7/13/2013 ~~; she was a sweet Yorkie spirit and we miss her
                  Bella--Yorkie rescue; BD 9/2013 +/-; RIP 5/2015
                  Ruby--senior Yorkiepoo foster

                  Comment


                  • #10
                    Re: Levemir in Teaka

                    THANK YOU so much for the welcomes! It so good to know there is discussions about what our babies are going through. To answer some of the questions:
                    Teaka is spayed.
                    I use the One Touch Ultra2 meter.
                    I was only testing once a day until we perform a curve, which is today.
                    When we took her to the vet on Mar 7 (urine test) Mar 10 (blood tests) they did not find any ketones present.
                    My vet was not involved with our giving her the NovoRapid, it was our distress that led us to make the choice to try it. My husband has not read anything about canine diabetes so he is assuming she is in the same boat as himself. I have though and knew to watch her carefully. We started the Levemir per our vet on Mar 12 (Mon).
                    We are doing a curve today, so far:
                    8:00am 17.9 (fed and gave insulin after BG reading)
                    10:30 11.6

                    This is still all so new but those numbers are high. Will post on more results later today, I'm sure my vet may call tonight to check in on how it's going.

                    Thank you again, I am so very glad to have found this forum!

                    Sherry, Teaka's worried Mom!
                    Teaka, born June 10/2000, Min Pin, diagnosed Mar 10/12 Currently feeding 1/3 cup boiled Chicken (boneless skinless), occasionally low sodium Tuna + 2/3 cup vegetable puree (broccoli, cauliflower) and 14-20 pieces of dry Royal Cannin Med Aging. 1-4 Baby carrots as a treat if BG is dipping.

                    Comment


                    • #11
                      Re: Levemir in Teaka

                      if you can post the curve after you are done that would be great

                      yes diabetes in dogs can be a bit different in dogs jesse uses nph which kind of acts as a combination of fast acting and basal but it leans more to acting like fast acting pretty strong .
                      Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
                      Jesse earned her wings on 6/21/2021

                      Comment


                      • #12
                        Re: Levemir in Teaka

                        Sherry, try not to worry. I know, easier said than done! But you are taking action, so Teaka is doing better than before you began intervening. The process of "regulation" takes time, so we advocate "go slow." If you overshoot her maintenance dose, she will rebound and you have to back up and essentially start over because her body will overreact and overadjust.

                        Hang in there and take one step at a time. Good that you are testing at home. And no ketones!!!

                        Take a deep breath!!!!! You will do fine and so will Teaka.

                        Mary
                        Ruffles May 1997~~12/6/2010~~She was "a heartbeat at our feet"~~
                        Izzy--BD unknown;~~ RIP 7/13/2013 ~~; she was a sweet Yorkie spirit and we miss her
                        Bella--Yorkie rescue; BD 9/2013 +/-; RIP 5/2015
                        Ruby--senior Yorkiepoo foster

                        Comment


                        • #13
                          Re: Levemir in Teaka

                          Still checking every 2 1/2 hrs, I have been taking her blood from under her lip and she's beginning to pull away. I don't know if it's the sound of the lancing device or if she can feel it. I changed the lancet which was good because the one in it was pretty wide, the new one is far more finer but she still pulls away. Does anyone check anywhere else? She is a Min Pin however her weight should be around 19-20 lbs, currently she is overweight at 29 lbs. I'm wondering if because she's not a large breed dog her lip is more sensitive?
                          I know it could be her response to this being something very different, I just don't want to hurt her.

                          And thank you for "talking me down", I am trying to stay very calm over this. I've just had some many experiences over the last 22 years with my husbands BG levels dropping it's tough to stay completely calm. I am sticking to her like glue today, and she's pretty much doing the same with me following me everywhere.
                          Teaka, born June 10/2000, Min Pin, diagnosed Mar 10/12 Currently feeding 1/3 cup boiled Chicken (boneless skinless), occasionally low sodium Tuna + 2/3 cup vegetable puree (broccoli, cauliflower) and 14-20 pieces of dry Royal Cannin Med Aging. 1-4 Baby carrots as a treat if BG is dipping.

                          Comment


                          • #14
                            Re: Levemir in Teaka

                            Sherry this is just a "moral support" post from another newbie. I don't think anyone panicked as much as I did in the beginning. The first week I didn't sleep at all...no kidding, I was on the floor with my boy every night. The second week I managed to get back to the bed but seemed to always have one eye opened and every time he moved I got up. The third week I took naps but only when he napped.... The only good news from all of that was the I lost 15 pounds in just over 3 weeks!!!!

                            The fact that you are home testing and here on this site with all the wisdom from its members puts you WAY ahead of the game. Take comfort in knowing that we where all in the same place you are with all the same fears and emotions. You will do GREAT and Teaka is in very good hands.

                            It does get better, I promise. After 5 months life is almost back to normal and so is my wonderful fur baby. Sure I still worry but much less so and my dog really is back to normal.

                            I test spirit on his elbow callus but that is because he is a giant breed. I've also used the base of his tail and his carpal pad but he seems to tolerate the callus area the best. I tried the lip in the beginning without much success for me. Again, keep at it, stay positive and try and remember to take care of yourself.
                            Jim/Marijane & Spirit, Newfoundland, born Dec 22, 2007, 115lbs. DX Oct. 2011, 18.5 units Humulin 2x per day. Hills WD kibble, Hills WD can made into gravy, boiled chicken. Spirit passed on June 9, 2016 and it had nothing to do with diabetes.....farewell my buddy.

                            Comment


                            • #15
                              Re: Levemir in Teaka

                              I use the lancet but not the devise. just the needle part and do it by hand. That way there is no noise. Seems to help
                              Maggie, 70 lb golden Lab. dx 12/30/11 w/d kibble with a little canned innova, boiled chicken pieces after shot for treat.. starting on Levemir 3 units. 2/25/12

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