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k9diabetes
01-02-2009, 09:45 AM
Welcome to you both! Wow, Ella's on a small amount of insulin for her size. Quite a bit like our Chris was. Would love to see her curves - can you post them or email the information to me at k9diabetes@gmail.com?


Dog's name, breed:
Ella, Greyhound

Weight:
About 55 pounds and a little too thin

Diet:
Purina DCO, 3 cups twice a day

Insulin:
Currently trying Vetsulin since mid Decmber; had used Humulin NPH since May 2008

Number of units per injection and injections per day:
average of 5-6 units per injection
2 injections per day, every 12 hours

Brand of BG meter if home testing:
Use AlphaTrak (Abbot); also tried AccuCheck Advantage (Roche) but did not like it as much (larger blood volume, not specifically for dogs, less confidence)

Ella has an unnusual BGL curve and we continue trying (as yet unsuccessfully) to get her into a good consistent BGL range.

Regards,
Dan

Soaphie & Sydney's Mom
01-02-2009, 10:39 AM
Welcome!!!!

Cara's Mom
01-02-2009, 11:38 AM
Dan and Ella,
Just wanted to say "Hi" to you both! Hope to read more about Ella.
Just one question, how long has she been on Purina DCO? And have you seen good results with it? (Sorry, that's two questions:D:D)
I started it abt 5-6 wks ago and I am still on the fence!

rhodesian46
01-02-2009, 02:28 PM
Hi Dan and Ella,
Welcome to the board Yes she is on a low dosage. Plenty of room to increase for sure When my Husky Pebbles was alive she started out on DCO and loved it I did end up having to switch her to Purina OM as it had less fat She had had a bout of pancreatitis. Everyone here is great.PLease post a pic of Ella
MARIANNE

EllasDad
01-02-2009, 03:11 PM
Hello everyone:

Let me introduce Ella…our quirky little diabetic greyhound. Between her adolescent antics and learning about canine diabetes, she keeps us occupied. Gerry has chronicled her antics in a blog and photos, in case anyone is curious, or needs a good laugh. That link is:

http://oaklandgold.blogspot.com/

So, on to her diabetes...
We have not yet been able to stabilize her BGL curve in the target range of 100 – 300 mg/dl. She is currently on a relatively small insulin dose (Vetsulin now, NPH previously) and runs higher than 300 much of the time, with frequent drinking and urination (about every 2 hours after eating). A typical day might look something like this:
7 a.m. - BGL 280 – feed shot
9 - hi (>500 on our meter)
11 - hi (>500)
1 p.m. - 480
3 - 400
5 - 350
7 p.m. - 280, feed, and another shot

We have done a number of curves and tried a variety of things, the latest being Vetsulin which we started in December. Her BGL is pretty far outside of the target range, but we have not had any rapid drop offs in the late hours before her next feeding. We are also more diligent about her feeding and insulin schedule.

She was on NPH 6U twice a day, which was almost enough to stop excessive drinking and urination and keep her BGL below 500 after eating. Unfortunately, she was too close to going into hypoglycemic shock before her next feeding. She had a couple seizure events and close calls, a couple early and some of which came in mid-November, when we thought she was settling into a stable routine on 6U. Very scary.

Since then, we have tried the Vetsulin (beginning 11/29) and erred on lower insulin and high BGL for the past month, which is what the above curve corresponds to.

We have not yet tried a more moderate carbohydrate/higher protein diet. The Purina DCO moves into her bloodstream fast and she spikes for hours after eating. I had read literature on the Eukanuba site and that made me think the Eukanuba Weight Control/Diabetes vet diet might be better for her, but we have not found or tried it yet. She was on Purina OM for a month or so, but it did not have enough calories and could not get any weight on her.

We have not yet tried a faster (regular) insulin or mixture. Vetsulin was the first different insulin that our vet wanted to try. Unfortunately, Ella seems to have worse BGL spikes after eating. Reading Chris’ story made me think some amount of regular insulin might match better with her BGL spikes.

All the introductory news for today...we will hopefully learn and post more in the near future. This site has a lot of experience that has already given us a number of things to talk over with our vet.

Regards,
Dan and Gerry

k9diabetes
01-02-2009, 03:49 PM
This could be a very manageable type of curve, even though it's sort of upside down, because the lowest BGs occur at meal time, really eliminating the risk of hypo during the day. I actually prefer curves like this because they are less risky.

Did the NPH curves look the same in terms of shape?

Because if they did, you could use a lower dose of NPH with some Regular added to flatten out the curve.

I'm not aware of anyone who has injected Vetsulin and Regular... would have to be done in separate syringes. I believe it is possible to mix more than one injection where the insulin injected in different syringes comes from different species - Kathy and I discussed this once and I believe human diabetics have done so.

But it would be a lot easier to do with NPH if the curves on NPH looked more or less the same. Then the two insulins could be mixed in one syringe. You would reduce the amount of NPH - could reduce it markedly perhaps. And then add Regular, which would tackle those highs early on. This has a very good likelihood of improving Ella's regulation.

The typical effective time of Regular is timed very well with the rises in Ella's BG.

I took a look at your blog (and, by the way, my anti-virus software noted a trojan while I was there... not sure if it was real but my AV system was treating it very seriously). Ella is absolutely gorgeous!! It was wonderful to see all of her pictures!

You mentioned adolescent... how old is she?

Natalie

We Hope
01-02-2009, 05:16 PM
Re: mixing species of insulins. Both Lilly and Novo had a manufactured mixed product on the market which was 90% beef insulin and 10% pork insulin. Lilly called theirs Iletin I.

This was brought out when both still had pure beef insulin products on the market. The pure beef ones were withdrawn by 1990; the mixed beef and pork insulin remained on the market, and pure pork was available.

In 1998, Lilly withdrew their mixed beef and pork insulins--what follows is a link to an ad advising about this-the graphic is large and would probably mess up our formatting on this thread if I posted it.

http://petdiabetes.wikia.com/wiki/Image:Lilly1a.jpg

This is the same mix of beef and pork--90% beef, 10% pork, that IDEXX's former insulin, PZIVet, was made up of; IDEXX purchased the rights to Lilly's Iletin I PZI insulin formula from Lilly.

Can say that I know people with diabetes who import both beef and pork insulins from CP/Wockhardt--what they do is to make their own "replication" of the old Iletin I insulin because it was what worked best for them. I also know people who have never stopped using a beef insulin for their basal-presently using Beef Lente from CP/Wockhardt-but are using human or analog insulin for their bolus, or meal insulin.

What you run into with this is--reading the fine print from all of the pharmas who produce insulin, you see that they have conducted no formal testing into what happens when you use human insulin or an analog insulin with animal insulin. So you enter into a sort of "at your own risk" area. AFAIK, those who are using both beef and human or analog insulins are doing it with separate syringes; those using beef and pork are combining them.

CP/Wockhardt has both pork NPH and pork R available in Canada without the need to import it from the UK. The big "ouch" point in this is that one vial of either is about $125.00 in Canada.

Something else to keep in mind is the composition of Vetsulin, which is U 40 pork Lente insulin. Lente insulins, regardless of the species they're made from, are made up of two other insulins in the Lente family. Ultralente, which is a long acting insulin, and semilente, which is a fast-acting insulin. Both of these used to be available separately in three species--beef, pork, and human. Lente insulin is 70% long-acting Ultralente and 30% fast-acting semilente combined.

When they were still on the market separately, people used either Ultralente or Lente for a basal insulin and semilente for a bolus, or meal insulin.

Just wanted to bring this point up because there is some fast-acting insulin present in Vetsulin. If there's a decision made to add some R, the knowledge that there's 30% fast-acting semilente insulin in the Vetsulin should be factored into it.

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

Semilente insulin

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

Ultralente insulin

http://petdiabetes.wikia.com/wiki/Category:Lente

Lente insulin

Kathy

EllasDad
01-02-2009, 07:23 PM
You mentioned adolescent... how old is she?


Ella was born in April of 2006, so she is coming up on 3 years old.


Just one question, how long has she been on Purina DCO? And have you seen good results with it? (Sorry, that's two questions)
I started it abt 5-6 wks ago and I am still on the fence!

Ella has been on DCO since about May. It has worked better than OM...she was able to put on some weight with the extra calories in the DCO. She could not eat enough OM. Our 2 concerns with DCO are the high carbohydrate content, which seems to get into her system quickly, and the high fiber content. The latter is not really a problem, but she has to go...and go...and go. If there were a lower fiber, slow glycemic response food out there with some calories in it...we would consider it. The Iams/Eukanuba Weight Control/Diabetes produc looks like it was formulated with more protein, fat, fewer slower carbs, and moderate fiber, but I have not heard of anyone using it, yet, and we are hunting for a supplier. We are thinking of a an alternative food, preferrably with a slower glycemic response. A link to an interesting Iams research paper is:
http://www.eukanuba-scienceonline.com/download/symposia/5/Nutritional_Management_of_Glycemia_and_Diabetes.pd f

Did the NPH curves look the same in terms of shape?

Because if they did, you could use a lower dose of NPH with some Regular added to flatten out the curve.


Basically similar pattern, but we were running closer to the low side and she occaisionally ran low on BGL late in the cycle, dropping below 100 and having a couple really low BGL events (below 60, wobbly, or worst case...siezure).

Sounds like adding some additional faster acting insulin would fit her response to food better than what we have tried so far.

Maybe additional semilente (is it available separately?) together with Vetsulin.

Maybe going back to a 30/70 or 50/50 Humilin mixture might fit her response to food better. We have an unused bottle of Humilin N and I think we could get some Humilin R to try the various mixtures.

Do you think the same total U of insulin would be a good place to start? Like 1U semlente + 5U vetsulin, or 3U R + 3U N? Of course, we will discuss with our Vet, but any suggestions would be much appreciated.

Thanks,
Dan

Soaphie & Sydney's Mom
01-02-2009, 08:03 PM
I'm still learning - but from everything I've read - I believe everyone on this board would say no to 3R + 3U to start with....they say to start much lower on the R....much much lower. I'm sure someone with more knowledge will answer soon - but thought I'd respond since I saw the post....

k9diabetes
01-02-2009, 08:41 PM
She is young! Glad you're working to establish the best regulation possible since she will be living with diabetes for many many years.

I would start with a small amount of R, probably just 1 unit, only because some dogs are very sensitive to it. You can always gradually increase the ratio of R to NPH or Vetsulin after a few days until you find a ratio that works best for Ella.

We used BD syringes with half unit markings (31 gauge needles) so that we could adjust insulin by quarter units - very handy when you're working with such a small number of units of insulin.

To use the U100 syringes with Vetsulin you have to do a conversion:

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

eyelostit
01-02-2009, 09:57 PM
Welcome to the board, I looked at your site very nice and great pictures.

The vet had started Niki out on Purina DCO also, she was on this food for about a year, but high BG remained even after insulin kept getting increased, my situation back then is sort of like what you are going thru, I got high spikes from the DCO, it works for some dogs but not all, I changed her diet and it worked wonders for her BG levels, no more 400's all the time, no more HI on the meter.

In the future you may want to reconsider changing the food a bit, you may not need to use the R insulin and things could look brighter with the food change or the NPH or the Vetsulin.

Nat and Kathy can help you with this.

I'm trying to put some weight on my dog also.

Again welcome and post any questions, even if you think they are silly, we have already asked them.:)

Cara's Mom
01-04-2009, 09:35 AM
Dan,
The Iams/Eukanuba Weight Control/Diabetes produc looks like it was formulated with more protein, fat, fewer slower carbs, and moderate fiber, but I have not heard of anyone using it, yet, and we are hunting for a supplier.

Can your Vet not order it for you? Mine can, I might give it a a try.

EllasDad
01-04-2009, 09:47 AM
Thanks for all the feedback and suggestions. We are slowly ramping up her Vetsulin dose to 6.4U starting this morning and will see how she responds after a day or 2 of settling in.

I changed her diet and it worked wonders for her BG levels, no more 400's all the time, no more HI on the meter.

In the future you may want to reconsider changing the food a bit, you may not need to use the R insulin and things could look brighter with the food change or the NPH or the Vetsulin.

Nat and Kathy can help you with this.


Dolly: Wow, I started to read over Niki's story for food ideas and it sounds like you have had a difficult few months. Hope Niki feels better soon. We are definitely going to try some other food. I would like to try to find a dry food that she resonds to a little slower. Did any of the dry foods seem to moderate Niki's highs after eating better? It sounds like you had the best results with home cooking. We would not rule that out, but I am interested in any experiences with dry foods that generated a slower BG rise after eating.

If we cannot find a slower food, then a faster acting insulin mix seems like our the next step. We are thinking that staying on a pork insulin mix would be our first plan, since we are half way down that road.

Is there a source of US semi-lente insulin as a possible mix with Vetsulin to speed its response? If we cannot find any, we will probably try the N/R mix strategy after food/vetsulin combos.

We Hope
01-04-2009, 10:36 AM
Hi Dan,

Am going to ask whether having dry food is a must for you. Most dry foods have more carbs in them than canned--it has to do with the extrusion process (pumping it out to make it kibble pieces) that most of them go through.

We were using W/D canned, using that because Lucky had a bladder stone removed years before diabetes. Back then, the W/D dry contained peanut shells as a fiber source. In a dog who has had bladder stones, peanut products might cause another stone to form. Since then, W/D dry has been reformulated and peanut shells are no longer the source of its fiber.

If all dry food isn't a must, you could also think about giving Ella a mixture of dry and canned, which might be helpful with the carb situation. Some people with diabetic dogs do a mix of canned and dry because this is what works for their dog.

Unfortunately with the semilente insulin, the only source I know of pork semilente is Polfa in the EU. After Novo discontinued producing their pork semilente which was available there, Polfa began to produce it. Semilente has been off the US market for a good many years; many human diabetes "veterans" still grumble about that. ;)

HTH!

Kathy

EllasDad
01-04-2009, 01:45 PM
Kathy:

No good reasons why we would not try some canned food. The bad reasons are that: a) we never thought about it until now, b) we had always fed dry, and c) we thought (mistakenly...absent any info) wet food would get into her system faster. We had her on w/d dry initially, but went to DCO for more calorie content.

Would Hills w/d be a good wet food to try to mix to try to slow the dry food uptake? Are their any others people have used to lower spikes after eating? Would it be best to stick to a vet/diabetic formula, or are their any off the shelf wet foods that have worked well? Sorry for the zillion questions, but we have a consult coming up Tuesday with our vet and a lot to talk over with her.

I guess we will consider trying R with either the Vetsulin or NPH if the food strategy alone does not do the trick.

Thanks!

peggy0
01-04-2009, 02:19 PM
Hi Dan

I use Blue holistic dog food. Its a high protein food with complex carbohydrates that digest slowly. My vet advised me to leave Forbin on it. He is on Vetsulin only at the moment as we try to regulate him. :) They also have a food called Wilderness that is low carbs.

We Hope
01-04-2009, 02:40 PM
Dan,

A lot of people have done well with W/D dry, a lot have done well with the canned, and there are people who mix them both who have done well too.

Much of this depends on the individual dog re: what food or foods work out best. Some people have had a lot of success with the prescription foods, while others have been able to use various non-prescription canned and dry ones.

What seems to be helpful for those with post-meal spikes is having a food with enough fiber in it; this can slow glucose absorption.

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

When we went to W/D canned, we were in the process of changing insulins for Lucky. Having immune-mediated insulin resistance, neither human nor beef insulin was doing anything about his horribly high bg's. We'd hit resistance level with the beef insulin when we changed him to W/D canned; his previous food didn't have much fiber in it. At the time, Lilly still had pork insulin in the US (no Vetsulin yet), but most pharmacies didn't stock it; we had to order the Iletin II Lente and wait for it to arrive at the pharmacy.

So we were still on beef insulin when he started the W/D canned. I'd asked about how long before I might see any encouraging signs and was told it could take up to a week if this was going to help Lucky.

Within 24 hours of his going onto the W/D canned, there was a marked improvement in his PU/PD. So much so that I phoned our friend and vet about lowering the number of units of the beef insulin to make sure Lucky couldn't possibly have a hypo. With both of us knowing that his improvement had nothing to do with the insulin but with the food change, we lowered his insulin and went along that way until the pharmacy had the Iletin II Lente for us. Had we changed both food and insulin at the same time, I'm sure Lucky would have had a hypo--and he never had one of those.

We had another dog on another diabetes board who was not a problem re: regulation, but his vet thought changing him to W/D canned would be even better for him. He had the same 24 hour results, but since his diabetes was under control at the time he was switched, the poor little thing did have a hypo from it. Can still remember the "Hypo-Help!" post and posting back to her what we had seen with Lucky and the W/D canned, but not with the right insulin for him.

There is another Prescription Diet food that has even more fiber in it than W/D--it's called R/D and I have known some people who were using that very nicely with their diabetic dog. With the results we got with Lucky and the W/D, we saw no reason to think about R/D for him.

Gosh--we're gonna keep you busy with all of this! :)

Kathy

EllasDad
01-04-2009, 07:42 PM
Cara:

We will ask our vet about the Iams formula this week, but we are good friends with her and do legwork whenever we can. We have a very close relationship with her which was instrumental in our decision to adopt Ella. We will post whatever we end up trying next on the food front along with BG results.

We will probably switch to the Iams diabetic formula if/when we get it, or possibly something else if we can decide on another kibble to try.

Will probably try a canned/dry DCO combination. The dry DCO is loaded with fiber (and carbs...at about 46% by wt, more by % of calories), so I'm thinking about trying some canned Blue (thanks Peggy0), Wilderness, or Evangers cooked chicken, just to see if a mix with more protein helps. I'll try to maintain the same calorie content...if I can get the info and do the math.

k9diabetes
01-04-2009, 10:15 PM
I LOVE the picture!!

BestBuddy
01-05-2009, 11:11 AM
Hi and welcome,
The food issue is a biggie as there are so many to choose from and each dog will do differently compared to another. I have always found that dry food is slower to raise Buddy's BG but it goes higher and stays longer so I mainly feed canned. Until recently buddy was eating about 2/3 canned and 1/3 dry but some dental issues made us change to all canned and he is doing better on that so we will just stay with that. I thought feeding the dry would help with Buddys teeth (the few he has left) but he really wasn't crunching them just swallowing them whole so they really weren't helping that.
Jenny & Buddy

bgdavis
01-06-2009, 06:16 AM
Hi Dan and Ella,

Just wanted to pipe in and say that my Crissy has been on Science Diet Light, a mix of 3/4 cup dry and 5 large Tablespoons of canned (about 2/3 cup) for almost 5 years. She has never eaten any type of diabetic specific food. I add 1 thin slice of low-fat OM chicken, turkey, or beef deli meats, about 1/2 cup of either green beans, chopped broccoli, or spinach, 1/4 cup cooked yellow and green squash, and a sprinkling of American cheese (her many daily pills are wrapped in them). Criss has eaten this for almost 5 years. She was well controlled until last fall when she began to have 2 to 3 days of high bg's. We could not find any sign of infection, but Criss also is hypo-throid, has atypical Cushings', and discoid lupus. Someone suggested that her bouts with the lupus had provided a hidding place for bacteria and she has been put on metronidazole (Flagyl). Things have been going pretty well for her the last month. She will soon be 13.

Bonnie and Crissy

eyelostit
01-06-2009, 06:20 PM
Dan, sorry I am late to get back to you, the DCO just never worked for us, i found a new vet and she put Niki on Eukenuba special diet, that did not work, so I worked with a bunch of different foods for awhile.

What I found was with adding some vegetables and taking away some of the dry i had better results with BG.

What was goin on with Niki was that she got a huge rise in BG after food, the insulin would kick in 2-3 hrs later, but always high BG before next meal, DCO just wasn't going to work, I started using Nutro Senior or Nutro Lite, adding green vegetables and a little oatmeal, and her BG came down, no more over 300's, of course you can get a high that just seems to come out of the sky at times, but thats just their bodies at times. I was able to decrease insulin also.

Right now I have switched to Orijen with added veg's, this is working as I am having to keep an eye on Niki now with decreasing insulin again. Orijen label says 70% meat and 30% carbs no grains, bad thing it is expensive, I used to have 2 other dogs around so its not so bad buying the food at this time.

I tried the EVO but with the potatoes and other things in it made BG go too high. Geez I tried all kinds, had to order from the internet etc. The Nutro Senior and Nutro Lite did work well, but I had to add the veggies etc to keep her BG in a good range.

If you'd like I can post some of the diets Niki was on, and how her BG came down.

Its all trial and error, all the doggies handle the food different, I found with my dog being a border collie does not need as much insulin as other dogs with the same weight, but thats with Niki.

Take care

EllasDad
01-06-2009, 07:32 PM
Thanks to all for the info and suggestions. Met with our vet tonight and agreed on the following plan:

Continue ramping up the insulin, until we either get peaks below 300 or approach 100 for our daily low.

Next we will try some other foods or combinations to see if we can level out the BG spikes after eating. We tried mixing in some Buffalo Blue canned chicken (in place of some of her dry DCO) the past 2 days, but it has not appeared to put a dent in the duration of her HI period (which currently lasts about 6 hours). We may try other dry +/or canned foods, veggies, etc.. as suggested (thanks Dolly...sounds like you and Niki tried them all!). Hopefully we will find some food that helps regulate her BG and gets her up to 60 lbs.

Next we will some (small amount of) R with vetsulin with separate injections to moderate the BG spikes.

The drop off in her BG has not been as rapid on the vetsulin during hours 9-12 after food and shots as with the NPH. Not sure if that is because of different insulin speed, low insulin dose now, or more routine meal/shot timing. Hopefully that stability stays as we increase the insulin dose.

Cara's Mom
01-06-2009, 08:35 PM
Dan, Kathy told me once that if the dog has "bright angry-red" eyes, she/he is High. When the eyes are darker red (maroon) she/he is Low!
And that's just the case with Cara. But that's the only warning I get! But that's better than nothing!

We Hope
01-06-2009, 09:01 PM
When we were first regulating Lucky to Iletin II Lente, this was how I spotted the low for the eyes. When we tested Lucky, he was at 35--with no signs other than the eyes being bloodshot and being a maroon color red instead of the brighter red bloodshot of being too high.

When you see no bloodshot at all, that means you're in a good bg range. If I was worried about Lucky, the first thing I'd do would be to take a look at the whites of his eyes.

Kathy

eyelostit
01-06-2009, 09:05 PM
You probably already know that the heavy panting and urine leaks mean hi's, with Niki she will lie around more than usual. Some pets will pant awhile after food until the insulin catches up to the food. This can happen at times even if BG is in a stable range.

With a low the signs I will see is her walking with head down and a funny look about her, she never walks with her head down this particular way.

Also I caught that when we were in the car, she was sitting and sorta leaning hard into the seat with that same look.

EllasDad
01-12-2009, 08:00 PM
Thanks to all for the signs of highs and lows to watch for. We had never heard about the whites of their eyes check. We have been looking at them, or trying to, and realized we have almost never seen them! So far, have not been able to interpret that one well, but will keep trying.

Ella is now up to 8U/8U as of this morning and I will post a curve in a couple days after she settles in. No food changes until we get a little closer on insulin.

This weekend we noticed that she has a runny nose and a tiny amount of blood in it (looks clear, but enough to leave stains). Some sneezing, but no cough. Vet trip and amoxicillin started on Sunday. Hopefully it is nothing serious... a cold or something she snorted. Next step will be flushing her nasal passages if it is not clearing up in a couple days on the antibiotics.

Dan

P.S. Gerry has had issues with Ella's blog as of a few days ago (no pictures). We will post another link when a new one gets established.

eyelostit
01-12-2009, 08:13 PM
I hope it clears up, ugh I'd even hate a nasal flush, my mom had to have that done, and i know others dogs that have had it.

Hopefully the antibiotics will do it, keeping fingers crossed.;)

k9diabetes
01-12-2009, 09:35 PM
Looking forward to her curve - nice to hear from you!! :)

Natalie

EllasDad
01-18-2009, 09:14 AM
Things have been a little chaotic here between vet discussions all week about Ella's nose...and we are dog sitting for friends and have 5 greyhounds this weekend! Finally able to get an update posted. Ella's nose is still running and a little bloody...not much better. Unless we get a dramatic improvement from the antibiotics, she will have an x-ray and nasal flush on Tuesday. Saw another vet this week, who had treated Ella 6-months ago, and their clinic will do the procedure. We have been getting him caught up on her case most of the week. He switched her from 500 mg amoxycillin to 300 mg clindamycin, both twice a day.

BG wise, we seem to have gotten closer.

Is it common for what seems like a 3-4 day delay before a sudden (1-2 day) drop in BG levels like she had between the 14th and the 16th?

We ran low on strips and have held off doing detailed curves as a result. We were ramping up her Vetsulin a little at a time (0.4-0.6U steps) with several days at each step. She has an upside down curve, going up after eating and then trends down until hitting her low before her next meal. The following is a bit of her recent history since the holidays. We are working to get her regulated after switching to vetsulin in mid December.

1-4-09 (1st day at 6.4U 2x/day)
6:30 am 316 (before feeding)
10 hi
1 pm 420
3 376
5 354
630 311 (before feeding)
830 hi
11 pm hi

1-11-09 (2nd day at 7.6U 2x/day; after a 3 day run at 7U; noticed runny nose w/blood and started amoxycilin that night)
7 am 227
9 484
5pm 323
7 303

1-14-09 (3rd day at 8U 2x/day; switched to clindamycin)
7 am 327 (before feeding)
8 420
9 hi
10 hi
11 hi
12 noon 420
4 pm 299
7 pm 238 (before feeding)

1-16-09 (began reducing insulin...8U a.m. 7.6U p.m.)
7 am 125
930 429 (huray...at least she was not hi!:))
530 pm 127
6 104 (oh oh...fed early:eek:)
11 pm 326 (a few treats before bed)

1-17-09 (back at 7.6U)
7 am 109
10 442
5 pm 104 (fed 1/3 cup food)
6 115
630 139
1030 337 (a few treats before bed)

She was at 149 this morning at 7, so we are getting closer.

We Hope
01-18-2009, 09:53 AM
Dan,

What I think you were seeing was the beginning of the infection (bg's normally run high with an infection, but they can also run in the low areas), followed by amoxycillin at least starting to do something about the infection.

When you got to Clindamycin, this may have been more effective against whatever type of bacteria's ailing Ella.

Some antibiotics are more effective against specific types of bacteria than others. This is why cultures are done at times--to determine what type of bacteria this is and thus better match an antibiotic to it.

A lot of times the infections are hidden, or subclinical, meaning they don't give you much of a clue they are there--sometimes only high bg's are the only sign. And again, when there seems to be no infection when you do other forms of testing but you suspect there is one, the cultures come into play again.

With most of the antibiotics prescribed, you mostly see signs of things improving between 24-48 hours after beginning with them.

It looks like you are in the "regulation neighborhood" now that Ella's infection's on the way out. Let's hope she finds a spot in that "neighborhood" she likes very quickly and decides to "settle down" there! :)

Kathy

k9diabetes
01-18-2009, 05:32 PM
It will be hard to know for sure what all is in play until the nose question gets settled. I'll be anxious to hear how things go on Tuesday.

Natalie

EllasDad
02-28-2009, 07:18 PM
I regret that it has been ages since I have posted any news and now it is very sad news. We had to let Ella go on Thursday.

Her nose never responded to anything a team of several really wonderful vets tried for over 6-weeks and her quality of life had deteriorated. They were fairly sure that it was a non-responsive lymphoma in her nasal cavity. So we let her go peacefully on our terms, as there was a significant risk of her taking a rapid and unpleasant turn for the worse. We did not want her to suffer. She would have been 3-years old in April.

She was a wonderful little girl and taught us a lot in our short 10 months together. Thanks to the many people here who gave us advice and information with her diabetes.

P.S. if anyone would like more of her story and illness, Gerry started another blog (after the original one had problems) at the link below.

http://stickykibble.blogspot.com/

Soaphie & Sydney's Mom
02-28-2009, 07:22 PM
Wow Dan, so very very sorry for your loss. No words can help you - just know that we are all here to listen.

peggy0
02-28-2009, 08:06 PM
Dan, I am so sorry for your loss. My prayers and thoughts are with you and Gerry.

k9diabetes
02-28-2009, 08:21 PM
Dan and Geri,

My heart is broken at this news... it's just not fair...

I am thankful that she spent her last year with the two of you, so deeply loved and cared for and with someone to let her go free of suffering.

With deepest sympathy,

Natalie

BaileyBear
02-28-2009, 08:52 PM
I'm so sorry to hear of Ella's passing. She was fortunate to have had such a loving family the last 10 months. You did everything possible to help her recover and loved her enough to let her go when you felt it was time. That takes a lot of strength. My heart goes out to you both.

BestBuddy
02-28-2009, 09:25 PM
Dan,
I am so sorry. Ella's time was too short. She was such a lucky girl to find you and know you would love her and not let her suffer.
Jenny

Cara's Mom
03-01-2009, 05:01 AM
Dan, I am so sorry to hear about Ella. Her time here was so short and not without turbulance. You and your wife gave her love, care and stability during this last year of her life and making the decission to let her go must have been hard on the both of you. But it was the right thing to do and she is free to roam now with all our furbabies who have gone before her.

My thoughts are with you both.

Rags' Mom
03-01-2009, 07:56 AM
Dan,

I am so sorry for your loss. It is evident by your posts that you gave her a wonderfully, loving and secure life. I hope that your fine and silly memories of her will ease your pain.

Janie

Patty
03-01-2009, 08:09 AM
Dan, I am so very sorry for the loss of your girl. We are thinking of you.
Patty

eyelostit
03-02-2009, 01:41 AM
I'm so sorry for you and your family, its never easy.

God called your name so softly
That only you could hear
And we never heard the footsteps
Of the angels drawing near.
It broke our hearts to lose you
But you did not go alone
For part of us went with you
The day God called you home.

Take care.

ladysmom06
03-02-2009, 04:40 AM
Dan,

I am so very sorry to hear about Ella. Keeping you and your family in my thoughts and prayers. My deepest sympathy.

Luv,
Lynne and Lady