Peggy's Forbin is gone... April 14, 2010

[k9diabetes]

I'm copying your information over from the other thread so everyone will be sure to see it.
____________________

Dogs name/Breed: Forbin Lab/Border Collie Mix

Weight: 77

Diet: blue lamb and Rice; chicken protein strips for treats

Insulin: Vetsulin 2x a day 15 at the moment; just started this; nerve racking

I just found out forbes is diabetic. He's 9 and a big boy. Not fat, but long legs/shaped more like a shepard. He has cataract in one eye and starting in another.

My vet started him at 20 Units 2 x a day and he came up negative on urine strips for 6 hours so he dropped him to 15 yesterday. Today he is again negative for 6 hours. He is acting perfectly normal. Gave him a few extra treats. Have to see what the reading is at 6p to determine if I give him a shot tonight.

I know I have to have patience, but this is very stressful :(

[k9diabetes]

We have ALL been where you are now and trust me - the first part is the worst part! A few months from now you will look back and laugh at how difficult it seemed at first. Eventually, managing your diabetic dog is about as stressful as brushing your teeth in the morning.

I see you are uploading some pictures so I'm anxious to see Forbin.

We just adopted a border collie mix, Jack, who is a little over a year old. He is mixed with something shorter haired, possibly lab, whippet... we are waiting for the results of his DNA test in hopes of finding out what he's made of.

Our diabetic dog, Chris, passed away on August 1.

You can see their pictures by looking at my public profile gallery.

Welcome... I promise you it does get easier.

Natalie

[peggy0]

Thanks Natalie! I'm so happy I found this website. I love my vet but its very much a 'matter of fact' to him although he is available anytime I call. I'm looking forward to the laughing part :)

[k9diabetes]

With the negative urine test results generating concern about going too low, have you consider home testing blood glucose?

Then you can KNOW whether the BG is going too low - it's a major sanity-saver.

You can see us test Chris on the lip - he weighed about 60 pounds - at http://www.k9diabetes.com/bgtestvideos.html. His movie is a big file so give it time to dowload if you decide to watch it.

Forbin is very handsome. Much darker than the border collie mix we just adopted, who has all the white blazes, socks, and tail tip.

Natalie

[peggy0]

I watched the video's and ordered one on line. Can't wait until it gets here so i have more peace of mind. the lip test looks easier than I thought it would be. Thanks !!

[k9diabetes]

Cool! :) :)

I know you'll love being able to know his blood sugar.

Chris was not big on having his lip handled when we first started testing and he was really wiggly at first. You'd never know it from that video, made four years later, but I was a total klutz at first.

Most of his last four years we tested three to four times a day as he was on a weird regimen of four shots a day. He didn't mind tests at all.

We actually usually had him lie on his side on the floor when we tested (which was not possible for the video), though we could test him sitting or standing too.

[BestBuddy]

Hi Peggy and welcome to you and Forbin.
It really does get easier with time.
Natalie, I just watched your video of testing Chris and your voice doesn't sound like I thought it would. Not sure what I expected but just didn't match my picture of you in my head. And boy do you make it look easy, we also test Buddy on the lip but although he is now a good patient I am a lot more fumbly with it.:p
Jenny & Buddy

[k9diabetes]

Yeah... it doesn't sound like I expected either! :) I always think my voice is deeper but people call me on the phone and think I'm a kid...

[eyelostit]

Peggy and Forbin;)

Welcome to the board :) ask any questions even if you think they are dumb... we have already asked them :D No question is a dumb question.

You will get the help or info you need and the support here, check the info pages and the stories of our dogs with diabetes.

Dolly

[Ricksma]

Welcome!!! We have all been where you are today, and we understand that it can be overwhelming at first...the only dumb question is the one you DON'T ask. There is a wealth of information and knowledge here (these moderators are terrific)...and combined wisdom from the members is invaluable. I am looking forward to getting to know you and Forbin.....welcome, again.

Love and hugs, Teresa and Ricky:D

[peggy0]

My Vet increased Forbins insulin yesterday to 25 U twice a day, This am was his first dose coming from 22 and no luck getting his curve down below 200. His curve today so far is :

730 370
930 351
1130 306
115 239
300 89
345 65
415 76
515
615
715


I took him to the vet at 3 because it dropped to 89 and to see how closely my accu trak monitor was to his testing. His shows 101, and he said it should start going back up. When I came home I checked it and it was 65 at 345. I got very very nervous and fed him early. He usually eats at 6p. I just called my vet to explain this to him and asked him when and if I should give him a shot.

He told me I'm paying way too much attention to the monitor vs. how the dog was behaving and to give him his insulin when it got back up to 250. I'm a nervous wreck. I'm looking for a new vet after many many years, but this is just so stressful.

What would you all do in this situation. Forbin is acting fine. :(

I'd appreciate any of your thoughts.

[We Hope]

Peggy,

If I am understanding correctly, Forbin was increased 3 units AM and 3 units PM--that's way too much of an increase at one time. With smaller dogs, you generally increase by half units and can, if needed, increase by a unit for larger ones.

At this time, to prevent Forbin from having a hypo, I would do as he said about not giving him insulin until his bg's go back up. When I did, it would not be 25 units twice a day. And I would definitely be RUNNING to find a vet who has more experience with diabetes.

Forbin may be starting Somogyi rebound from the large increase of insulin. When you suspect this, the way to stop it is less insulin, rather than more. Rebound makes the bg's go wildly up and down, like your body's on a roller coaster ride.

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

When you're seeing a low that concerns you, as this one did, the right thing to do is exactly what you did--giving food.

HTH and please feel free to post more if you need more help! ;)

Kathy

[peggy0]

Thanks so much Kathy. This vet has a diabetic dog and acts like its no big deal. Forbin weighs 80 pounds so 25 from his perspective twice a day is average.

His BG at 515p is now 248.

I'm waiting to see what happens with the 615 reading.

Thanks so much for your help

[Soaphie & Sydney's Mom]

Wow - I'm so sorry you are going through this. Soaphie has been a tough one to regulate and after five months and thousands upon thousands upon thousands of dollars, we finally switched. Granted, my current vet uses NPH and Soaphie had a bad reaction to it, so we are back on Vetsulin - but with the assistance of this board, I feel like we are in the right track.

Hang in there and PLEASE keep asking questions - it's the only way to figure this out.

[peggy0]

I'm so glad I found this board. Its so worrisome to have a poor animals life in your hands with a disease like this one. I'm away from home 10 to 12 hours a day so that is even more stressful. My pet sitter comes at 2 and lets him out and gives him a small treat. Her mother has diabetes so she is familiar with the disease.

I think the best thing to do is wait for the next reading and if its above the current, go back to the 20 units he was one and work my way up 1 unit at a time until i'm comfortable. This curve had no treats and I'm no expert but it appears he may need 3 meals a day vs. 2. Maybe divide the same amount of food over 3 meals?

[Cara's Mom]

Hi Peggy,
Sorry to hear about your troubles...Find yourself a new Vet ASAP!!!! Most of us have changed vets several times, until we found the right one. Increasing insulin by 3 units :eek::eek:

[We Hope]

Peggy,

To make sure Forbin is not in rebound, why not give him only 11 units--half of his original dosage of 22 units AM & PM?

This makes sure he gets insulin. You will still find him running high some or all of the time until you can get hold of someone else-vet-wise--to help finish the job of regulating Forbin.

I'm concerned about those lows of his and the way he bounces back to being at 248 at 5:15 after being at 76 an hour before.

Kathy

[peggy0]

Thanks much! I will try that vs. not giving any at all. I'm calling a specialist tomorrow to see when I can get in.

[We Hope]

Peggy,

Giving half of the 22 units gives him some insulin for his body's needs but won't let him get to those lows. Many cut the insulin by half when they suspect a Somogyi rebound is happening.

Running high for a little while won't do any permanent damage to Forbin--the damage comes when you're running high for longer than a little while. Running too low can be very dangerous.

If you have some, use the ketone sticks to make sure he's not developing them.

Post if you need us, OK?

Kathy

[peggy0]

His current reading is 304. I do have the ketosis strips and will check him. Again, I appreciate your help so much. I gave him the 11.

[We Hope]

I hope you'll be able to get in touch with someone who will see Forbin tomorrow!

Hang in there! :)

Kathy

[Ricksma]

Kathy has given you great advice...she knows her stuff. I will just add my support and hope that you can find a vet for Forbin who will be a better fit. Sending good thoughts your way...

Love and hugs, Teresa and Ricky

[k9diabetes]

Hi Peggy,

Sounds like things are back under control.

Had you done any curves on Forbin prior to this large increase in insulin?

It has seemed like Forbin might have a pretty "deep" curve for his use of food insulin - that is, the premeal numbers are high but the blood sugar drops quite strongly from the insulin injection, as you saw here today.

So I wondered if the increase was based on a full curve and knowledge of how he processes his food and insulin or only on his premeal numbers.

Natalie

[peggy0]

Hi Natalie,

I just got my BG monitor over last weekend. He increased Forbins insulin to 25 Monday based on his BG level being 340 at 4p which is 10 hours after his injection. This was a consistent reading for a week. I had to bring him into his office each day at 4p.

I have no idea what his logic is; he has a dog with diabetes and many patients. He does not like home monitoring devices; he prefers to have you watch the dogs action, water, urine and activity level. I was a nervous wreck when he wanted to increase the dosage and bought one. I have shared my concern with him but he thinks I'm obsessed I'm sure. The poor dog went from a happy running around the yard, loved his long walks with me in the am to a bewildered blind guy who is doing his best to get around the house and yard. It's pitiful. I stayed home today to do the curve based on this 25 Unit dosage and immediately took him to the vet at 3p when it dropped so low. He thought the 3p reading was ideal and said it would start to go back up. It didn't and he told me I was watching the monitor too much when I called him. Anyway, I'm changing vets.

Sorry for the long winded vent. I gave Forbin 11 and going to leave him alone tonight. He gets very stressed going to the vet and monitoring him has just added to it

I appreciate everyones concern and help. If I can't get to another vet tomorrow, Ill be out here looking for more help :(

[peggy0]

Thanks Teresa! I love your pups picture.What a sweetie

[k9diabetes]

I'd bet dollars to doughnuts that the curve you saw today, as far as how far Forbin's blood sugar drops after he gets his insulin, is very very common for him. So maybe on 22 units he was going into the low 100s at the nadir (lowest point of his blood sugar) - meaning possibly ANY increase was too much but a whopping 3 units sure was!!!

His blood sugar at 4pm doesn't tell that guy anything about his blood sugar six hours earlier and that is the time when you really need to know because that's when the lowest BG values will start to show up.

Very glad you're changing vets. Apparently he thinks his diabetic dog is the standard and all other diabetic dogs will act exactly the same.

Sadly, this vet is reflecting some currently popular approaches to canine diabetes management that are being touted by endocrinologists at UC Davis and I expect to see more of this if vets take the UCD advice - I find that very very depressing...

Natalie

[k9diabetes]

One other note: I don't think a lot of vets realize that the profile of the old Humulin L and of Vetsulin can be very very very different.

They are both "lente insulins" but that's pretty much where the comparison stops - they are different species of insulin and different dilutions of solution, both of which can have a HUGE effect on the profiles of action.

So I've seen vets who used primarily Humulin L before it was discontinued treating Vetsulin like an exact substitute without considering that they can be so different.

And that's even presuming that all dogs get the same effect from any insulin!

[eyelostit]

I'm glad you went down to the 11 units, yes go to another vet, I had to do this also.

I don't understand the 1 reading a day myself at the vet, as my old vet was similar in me bringing Niki in every week for 3 months just to do a draw of blood and base her decision on insulin needs from that. that vet never mentioned a curve at all. As time went on Niki went into shock, I used the syrup and gave food no insulin, I go to vet next day and she was at 70 and thats with no insulin and food. Niki was rebounding and the vet didn't know this?

Were you getting charged for all these daily visits? I'm thinking you were.

Alot of the vets like to pull this, keep you coming, uping insulin,using the RX food, taking your money and the pet gets sick. I'll post a link in a bit.

The vet don't have to worry as much about a hypo with his pet as he is a vet. We are not... Grrrrrrrrrr.

I hope you feel better now, I know how it gets.:) Hang in there, I'm glad you found us. ;)

Read the link when you feel better.
http://www.caninediabetes.org/diabetesvets.html (http://www.caninediabetes.org/diabetesvets.html)

[peggy0]

I was thinking the exact same thing natalie. AND everyone this morning after that crazy episode yesterday, a very restful night and 11U of Vetsulin, Forbins am BG is 270. I thought it would be sky high. And yes, I certainly was charged daily for the blood readings. It's 3 weeks I'm already into Thousand Plus. Thank the Lord for this board :) You've gotten me through this one and I greatly appreciate it and from the wagging tail chomping blue and turkey this am, so does Forby.

[eyelostit]

I'm glad things are looking up today :),

Its a shame how some of the vets are.

We just live in a give me the money world and when things are wrong with any money exchanged anywhere, they make it like we are wrong, then you have to go thru all the channels to make it right.

Well enough about that, I'm glad things are going better.;)

[peggy0]

It is all about money. I have an appointment with the endocronologist on Tuesday am. The first available. They told me to call if anything goes south. So far today his readings are pretty high but no nose diving....knock knock.

630 274
830 440
1015 398
1230 437
130 374
245 370
400 412
500 462
600

[We Hope]

Peggy,

Once you have a rebound situation, it will take a few days for the counter-regulatory hormones to settle back down again, even after you lowered the insulin.

When blood glucose takes a nose dive, the body has a built-in automatic response to try to save itself. It can't recognize that the bg's might not be low enough to need to do this; all it sees is that the bg's are going down at a rapid rate, and then the counter-regulatory hormones are sent out.

These hormones, cortisol among them, raise the blood glucose. This is how you could be seeing Forbin at 76 one hour and then over 200 the next one.

Even though you've lowered Forbin's insulin, these counter-regulatory hormones are still in need of settling back down to their normal levels.

So perhaps it's good that he goes in Tuesday, because when the doctor sees Forbin, he/she will be seeing him after they've reverted back to their normal levels.

Kathy

[peggy0]

Hi Kathy, Thanks, sure hope so. I should leave him then at the lower dose for a few days even though its high? I tested for ketosis and its negative. Thanks much!

[We Hope]

Peggy,

I think if possible, until Forbin goes in, I would try to leave the insulin where you have it. Am fairly sure that you discussed what happened with the new vet when you got the appointment and told him/her what you needed to do for Forbin re: cutting the dose in half yesterday.

The thing about being high for a little while is that it's less dangerous than being too low. You can be running high for a little while and not have any permanent ill effects from it, but too low can be a disaster.

As Forbin's counter-regulatory hormones start settling down some more, you may see that his bg's lower too. Not lower to the point where they're perfect or to the point where he's getting close to being too low again, but you probably will see them go down somewhat and "level" off.

One of the secrets with insulin is to be consistent with it. We had a weak vial of the old Lilly pork insulin around the time they were discontinuing it. There was no Vetsulin in the US yet, and pharmacies didn't keep pork insulin in stock. They would need to order it for you, so you couldn't just go to a drug store and pick up another vial.

What we had was the old vial of insulin which the new one was replacing because we knew it wasn't 100% potent any more. We went back to using the vial which was going to be discarded because we believed it was more potent than the brand new one. (Tested a draw from it and found the new vial was 45-50% potent).

But what we didn't know, was just how much potency was left in that old vial we were getting ready to throw away. That meant that we couldn't raise Lucky's dose because we might have sent him into a hypo if we did, not knowing that. So we had no choice but to stay at his usual dose he got when the insulin was 100% potent.

It took about 3 days for his bg's to calm down after going back to that old vial. They were high enough that he had panting--a visible sign of his post meal spike 2 hours after eating. Every time I fed Lucky and gave him his insulin, I would see that the visible signs of that post-meal spike were getting better--they were gone on the third day back to the old vial.

We had to work with less than potent insulin and no way to raise Lucky's insulin safely, but we got him back into line until I could order a new vial--we did it with being consistent with that less than potent insulin.

You, your new vet, and Forbin may have to work your way up the "insulin ladder" again, but I think this time the increases won't be such large ones at one time. It's much better to make increases a little more frequently, with an eye to safety, than to be making such drastic, large ones.

Kathy

[peggy0]

Yes he thought Forbin would be fine until Tuesday. He's acting normally; and every 2 hours ducks somewhere so I can't find him. Smart doggie. Thanks so much for the great advice kathy.

[We Hope]

Forbin thinks you're mistaking him for a pincushion! :D

Kathy

[peggy0]

He does. His latest reading indicates his BG is going up again. I'm very nervous about feeding him when its going up knowing he spikes. He isn't scheduled to eat for another hour. This is going to give me ulcers!! Do I adjust his food or just keep going?

[We Hope]

Peggy,

I think you're feeding and giving insulin every 12 hours, right?

In order to have consistency give you a hand, you also need to keep feeding Forbin at the usual time.

Try keeping to the insulin dose you've cut back to and the usual meals at the usual times.

Is what's worrying you the idea that he will spike and perhaps have another low? If that's what you're thinking, you can breathe easy because by cutting the insulin as you had to last night, the "threat" of Forbin going too low isn't there.

Kathy

[peggy0]

Yes he is fed every 12 with insulin at the same time. I'm not afraid of low i'm afraid given its 462 that it will spike and be so high :(

[eyelostit]

Peggy, I know how concerned you are, till his body settles down leave things be as Kathy mentioned, I don't think you are going to get a low tonite.

[peggy0]

No I'm not worried about low; it's high I'm worried about given the current 462

[eyelostit]

Somewhere something got explained to me it went like this.

If you get a headache and take an asprin the headache starts to ease up (Onset) then the headache goes away (Peak) but the asprin is still in your system (duration)

If we still have the headache a human can take another asprin, but insulin is much more different than asprin.

Some of the prev insulin from the higher doses can be still in system, thats why insulin gets lowered.

Things should look better tommorrow or by say Saturday.:)

This little info helped me a long time ago, as it took me awhile to understand things, its stressful at the beginning, but it will all work out, I can just see you more relaxed in a few more days, and no doubt next month you'll feel even better. The vet put you on the wrong path, now we are going back that path and on to the new one:)

[peggy0]

Ah that makes alot of sense :) I'm usually calm. I took care of my mom for two years and she had congestive heart failure and I was pretty calm after the first episode. Of course she could talk to me:( Forbin is acting perfectively normal. I'll get through this with all your help. Thanks again

[eyelostit]

Anytime, take care ;)

[k9diabetes]

Personally, I think a one-half reduction of the insulin is too severe, especially with the highs now.

We can't really say with certainty that the BG is high from rebound... with half the usual insulin the BGs would be high without any counter-regulatory hormones in play so BG in the 400s on half the insulin dose makes me think there isn't a rebound crisis here.

Chris (and I believe other dogs) almost never rebounded from lows. And I could give Chris half his insulin if he didn't eat anything.

I would opt for at least 3/4 of the usual insulin dose with food. Three quarters of the insulin dose should be enough of a reduction to avoid a low in the future.

I don't like seeing him on such a low dose of insulin for days at a time. I could see cutting the dose in half right after a low but then I would bring it up further.

Those of you who have known me a while know I personally believe that rebound is not a given and not as common as sometimes believed so it may be my prejudice talking. But if Forbin was rebounding and getting his food and getting only half his insulin, I think his BG would have been 500 plus.

Natalie

[peggy0]

It was 466 at 6am. It may have been too low. I'm increasing it a bit today and see the curve.

Update very disturbing

530 466
600
730 477
1030 494
1230 HI
130 HI
300 HI
430 375
600 323

[peggy0]

Well I got very nervous about all these high readings and the new vet squeezed me in and spent over an hour with me. What a difference. Not sure if the curve is a rebound. She doubts it but said its hard to tell. Agrees that the dosage should have been cut to 75% and in fact that specific dosage is where she would have started forbin. SOOOO, we're starting over. She wasn't wild about him not being on diabetic food but said she wouldn't push that at the moment.

She said while the highs are not good, not to panic, need to get his body use to one dosage that is safe before anything else. I think I'll sleep tonight.

Was shocked at the curve ending in 64..................and no action advised. Thanks again everyone for your help

[eyelostit]

"She said while the highs are not good, not to panic, need to get his body use to one dosage that is safe before anything else. I think I'll sleep tonight"

Yes that is correct, at this point don't worry about the highs as much, the lows are more scarier.

What dosage of insulin did the vet instruct you use, is it 2x a day still?

[peggy0]

Yes its still 2x a day. 17 u. he weighs 80 pounds. so far so good last night and this am

Here is the breakdown for Blue Senior Dry



Crude Protein 18.0% min
Crude Fat 8.0% min
Crude Fiber 5.0% max
Moisture 10.0% max
L-Carnitine* 100 mg/kg min
Omega 3 Fatty Acids* 0.20% min
Omega 6 Fatty Acids* 2.75% min
Glucosamine* 400 mg/kg min

Ingredients

Deboned Chicken, Whole Ground Brown Rice, Oatmeal, Whole Ground Barley, Chicken Meal, Rye, Rice Bran, Tomato Pomace (natural source of Lycopene), Whole Potatoes, Natural Chicken Flavor, Chicken Fat (preserved with Natural Mixed Tocopherols), Whole Carrots, Whole Sweet Potatoes, Blueberries, Cranberries, Flaxseed, Barley Grass, Dried Parsley, Alfalfa Meal, Dried Kelp, Taurine, L-Carnitine, L-Lysine, Glucosamine Hydrochloride, Yucca Shidigera Extract, Green Tea Extract, Turmeric, Garlic, Sunflower Oil (natural source of Omega 6 Fatty Acids), Herring Oil (natural source of Omega 3 Fatty Acids), Dried Chicory Root, Black Malted Barley, Oil of Rosemary, Beta Carotene, Vitamin A Supplement, Thiamine Mononitrate (Vitamin B1), Riboflavin (Vitamin B2), Niacin (Vitamin B3), d-Calcium Pantothenate (Vitamin B5), Pyridoxine Hydrochloride (Vitamin B6), Biotin (Vitamin B7), Folic Acid (Vitamin B9), Vitamin B12 Supplement, Calcium Ascorbate (source of Vitamin C), Vitamin D3 Supplement, Vitamin E Supplement, Iron Amino Acid Complex (source of Chelated Iron), Zinc Amino Acid Complex (source of Chelated Zinc), Manganese Amino Acid Complex (source of Chelated Manganese), Copper Amino Acid Complex (source of Chelated Copper), Calcium Carbonate, Potassium Chloride, Sodium Selenite, Salt

[We Hope]

Peggy,

Glad to hear that Forbin saw his new vet and things seem to be working better now!

Kathy

[peggy0]

Thanks Kathy! We will see how his readings go today but already he was soooo much more relaxed with this vet. :)

[peggy0]

Well this is upside down but it's not bad for a first try :)

615a 194
630 feed 17 u
830 248
1030 322
1230 373
330 248
430 206
530 184
600 230

[k9diabetes]

I think upside down curves are the best kind. With action like that, you can test premeal and know that's as low as the BG will go!

[peggy0]

Well I only tested Forbin 4 times today because like Sophie, he's a little pin cushion. His BG never went high but his curve was almost a straight line in the high 300's for 12 hours. I didn't change anything. I'm staying on this path all week. I'm assuming its not unusual to see these variations while you are trying to regulate. I did check for ketones though and there wer none. Yippee.

[We Hope]

Peggy,

It looks like Forbin will need to have more insulin when your vet's ready for that:

http://www.vetsulin.com/vet/images/insulin_resistance.gif

When we were initially working with Lucky, we were seeing him stay in the 500-600 and upward ranges. This was because he initally responded (first week) to human insulin and stopped doing that from week #2 on. He did the same thing with beef insulin. We went nowhere until getting to pork Lente insulin (Iletin II Lente/Caninsulin/Vetsulin).

Happily, we know this isn't Forbin's problem because we saw he sure DID respond to the insulin when he was getting 25 units twice a day--responded by hitting some lows.

So now it's a matter of learning how much insulin a day will spell "regulation! for Forbin! ;)

Kathy

[peggy0]

Thanks so much!! That sure looks like his curve from today. I thought this may be the case. It was weird that he did so well yesterday. I'd rather it be flat than going up and down all over the place. I'm going to need a hair colorer before this gets much further. Thanks Kathy. He is 2 units below where they typically would start a dog of his weight but she wanted to be safe given his 25 U ordeal.

[We Hope]

Peggy,

You're right--better to be flat, even if it's higher, than to be all over the place.

Everyone varies--it's difficult to impossible to make today a photocopy of yesterday or to make tomorrow one of today. People with diabetes also have their ups and downs, just as the animals with it do.

http://avmajournals.avma.org/doi/abs/10.2460/javma.2003.222.317?journalCode=javma

Journal of the American Veterinary Medical Association-February 1, 2003
Evaluation of day-to-day variability of serial blood glucose concentration curves in diabetic dogs

"Conclusions and Clinical Relevance—There is large day-to-day variation in parameters of serial blood glucose concentration curves in diabetic dogs. Day-to-day variability of serial blood glucose concentration curves has important clinical implications, particularly in dogs with good glycemic control. (J Am Vet Med Assoc 2003;222:317–321)"

Tell everyone that you paid a lot of $ (and you did--in vet bills) for the "frosted" hair-do! :D

Kathy

[peggy0]

Thanks for the article! Very interesting info. The body is a mystery :) Expensive hair do yes, but he's worth every thousand :)

[peggy0]

Hi everyone. Well the vet has up'ed Forbins insulin from 17 to 18.5 and I'm curving again :) She wants to start fooling around with his food and I wanted your opinion on this. i would have thought it was best to see how the insulin is doing then the food but you all are the experts :) She is pushing the DCO which of course they sell, but I've read the ingredients and sorry to all who use it, but I'm not feeding my dog DCO. Forbin is on senior blue 2x a day with his insulin. It's complex carbo's with real protein and I add 1/3 cup of boiled white chicken.

thanks everyone

[We Hope]

Peggy,

I'm gonna agree with you here--there's just been an insulin change, so let's see how things look after the increased dosage gets established. If you start making more than one change at a time, when things either go well or poorly, you don't know what to praise or what to blame. ;)

Marion (Cara's Mom) just recently stopped the DCO because it wasn't working right for Cara. Not to say that it isn't the answer for some diabetes patients, but it wasn't Cara's answer.

Kathy

[k9diabetes]

I think the curve should guide the food decision. With a diabetic, you use food changes to change the "shape" of the curve - usually working toward it being flatter - less difference between the highest and lowest blood sugar.

If there's a problem with the shape of Forbin's curve, then diet changes would be good to consider. If the curve shape is fine, so is the diet!

Vets have mostly been trained that the high fiber diets are required so I think many of them are uncomfortable with anything else. They are also used to seeing curves look a particular way. They may see an upside down curve as undesirable but I personally don't care which way the curve faces or how many "humps" it has. All that's important to me is that the blood sugar stays in the best range possible. Flat curves allow for tighter regulation, which is why we aim for them to be flat.

So the curve will tell you whether the diet needs to change!

Natalie

[peggy0]

Thanks much Natalie. I love his flat curve with lowest points at feeding, especially given my work schedule. I will aim to get the flat curve lower first and fight off the food encouragement. He eats well and barks for those meals so I sure don't want to change something the poor dog enjoys :)

[eyelostit]

Peggy,

At DX the vet put Niki on DCO, it did not work for us, some dogs do well, but in all these years I think mostly all of us with diabetic dogs, tend to switch from DCO after a time, or use that with some green vegetables.

No i would not start on the DCO yet either, you have good instinct.!!;)

[Cara's Mom]

My Vet put Cara on DCO...she was on it for little of 1 month. One day she vomitted 5 hours after meal . The amount of food that this girl brought up was masive!
After each meal it took Cara about two hours to recuperate!
We will never use DCO again. It worked good on the BG but was just not right for Cara.

[peggy0]

Thanks all. I love this support group :) I have a question for all you experts. If insulin is raised and the food is left alone, should the insulin affect duration be longer? or should it just bring the BG down? or none of the above :) I appreciate all of your help. I truly do.

[We Hope]

Peggy,

If you're staying with the same amount of food but raising the number of insulin units, this will lower the bg's. You're right in that it can increase duration too:

http://www.childrenwithdiabetes.com/download/hanas_insulin.pdf

Page 6

"A larger insulin dose will give a stronger insulin effect which also lasts for a longer time."

In the example graph on the page the insulin dose has been doubled--from 8 units to 16 units. You might see a bit more duration on Forbin's increase; it depends also on how he personally uses insulin. ;)

HTH!

Kathy

[peggy0]

Question folks. Forbin is running about 150 points difference between his highs and lows on average. His lowest is at feeding time. Given that shouldn't I add 150 to at least 80 and make sure his BG at feeding is at least 230? My vet is telling me its ok to give him his insulin when its less than that, in fact today at feeding it was 160. His BG doesn't typically rise until 2 hours after he eats. Trying to make sense of it all :) One more question if I may, I believe I read somewhere here that the bottom of the insulin bottle (last dose) can be stronger/weaker. Can't remember which.

Thanks for the help.

[rhodesian46]

Pebbles did fine with DCO till she got pancreatitis Then they switched her to Purina OM which was lower in fat .

[We Hope]

Question folks. Forbin is running about 150 points difference between his highs and lows on average. His lowest is at feeding time. Given that shouldn't I add 150 to at least 80 and make sure his BG at feeding is at least 230? My vet is telling me its ok to give him his insulin when its less than that, in fact today at feeding it was 160. His BG doesn't typically rise until 2 hours after he eats. Trying to make sense of it all :) One more question if I may, I believe I read somewhere here that the bottom of the insulin bottle (last dose) can be stronger/weaker. Can't remember which.

Thanks for the help.

Peggy,

I'm not sure I understand what you mean about the bg at feeding time. Is Forbin running about 160 before a meal, is he lower than that? If you're not running any serious lows with Forbin before meals, then I do agree with your vet on this.

What you are seeing 2 hours after Forbin eats is his body starting to digest the food--this is where most diabetes patients (no matter how many legs they have) see their bg's start going up. It's called the post-prandial or post-meal rise.

http://petdiabetes.wikia.com/wiki/Post-prandial

In the days before insulin was isolated and there was no such thing as insulin shots of any type, it was known that when someone with diabetes ate, their blood sugar went up. To try to keep people alive before there was insulin, they often put diabetes patients on starvation diets--giving them only the bare minimum of food to keep them going. It was the only known way to keep their blood sugar down.

Insulin is strongest in the beginning of the vial--when you've just opened it, and it's weakest after it's been opened for a while, no matter how well you work at keeping it. It has to do with the time it's been opened and the number of draws you do from the vial.

I could keep a vial of the old Lilly pork Lente for about 3 months or more until it started losing potency. We still had 1/3 to 1/4 of the vial left when that would happen. When we got Caninsulin/Vetsulin, I was able to use the vials until the last "drop"--about 5-6 weeks after opening them.

Hope this helps at least some! :)

Kathy

[peggy0]

he is 160 at mealtime, however, if I am late by 30 minutes even, it drops to less than 100 :( Given that, and the fact that I know his BG doesn't start to go up again after a meal for over an hour, I am concerned. Makes sense?

[eyelostit]

Makes perfect sense, When was your last curve, if you are concerned about the lows, decrease the insulin by 1/2 unit or 1 unit or give more food at mealtime or a snack in between, you usually can tell when your dog is not feeling right, we can usually see signs, does he seems OK? More tired than usual? Hiding?

If I see a low I am uncomfortable with I decrease the insulin, or add more food.

If you get a high after doing this, we can always put our heads together and figure this out.

I myself worry about lows especially if I cannot see when the lowest point was during the day, I would be concerned as you are.

Take care Dolly

[peggy0]

I am petrified of lows. He is still in the 300s for a few hours during the day, so I think food is the answer. thanks much for answering me :) I am still doing curves on the weekends as we are still regulating. while I work i check before I feed.

[eyelostit]

Niki will always get a rise after food, 100+ sometimes more, then the insulin starts to kick in anywhere between 1.5 hrs and 2 hrs. She could be at 200 1/2 hr or 45 min after food, 1 hr after food could be 300 as the food is making its way into her system, but the insulin takes care of that.

[eyelostit]

Maybe just a little more food is all you need, what are you feeding now? Sometimes the small increase in food will make all the difference.

[peggy0]

I am feeding him 2 cups of blue with 1/3 cup of boiled chicken. he gets 1/2 of a blue treat at 2p from a friend who stops by and lets him out. its equal to 1/8 cup of food calorie wise. Forbins rises 1 and 1/2 hours after eating and it varies as to what the spike is. I give him his insulin 30 minutes after he eats to make sure he doesn't get sick :( The insulin seems to work on him for 12 hours as his lows are always around feeding time.

[eyelostit]

What is insulin dose right now?

[peggy0]

18 twice a day

[k9diabetes]

Hi Peggy,

If Forbin's blood sugar follows the general pattern of your curve from the 10th - and it sounds like it does as you mentioned that his lowest BGs are at meal time -- then you shouldn't have to keep his blood sugar so high for premeals.

6:15a -- 194
6:30a feed 17 u
8:30a -- 248
10:30a -- 322
12:30p -- 373
3:30p -- 248
4:30p -- 206
5:30p -- 184
6:00p -- 230

From what you've described, it sounds like Forbin still has some active insulin at 11-12 hours, which is why his blood sugar drops still further if you're late feeding him.

So really the only time you'd be worried about a low would be during that first hour right at meal and injection time.

You could test this theory by doing a little pin cushioning starting at 6:00am and checking at 6:00a, 6:30a, 7:00a, 7:30a, and 8:00a to see how that first couple of hours usually goes.

If you test at 7:00a and his blood sugar is already rising, then you could cancel the rest of the tests that morning.

You can see in the curve on the 10th that his insulin had pretty much given out at 11-12 hours as that's when his BG started going up again. Since insulin doesn't work like clockwork, some days it's probably 11 hours and some days 12 and some days 13, which is why you see variation in the premeal and spike after.

Thing is... his blood sugar during the day is always higher than his premeal level so you should aim for a premeal level that's on the low end of your ideal range.

I would aim for a premeal number of 100 - that would give you some cushion in case he drops at little at first. Especially if you test his response during the first hour or two and find that he sometimes drops in that first hour before his food and new insulin get started.

Since if he's at 100 at premeal, per the above curve all of his readings for the next 12 hours will be higher than 100 - the magical upside down curve!

If you start at 100 at premeal and he rises about 150, that would put his highest blood sugar at around 250 sometime around lunch time according to the above curve.

Does that make sense?

It really helps me to graph it out, even if you just do it by hand. Plot this curve and it's very easy to visualize how low his blood sugar will go and when it will reach that low point.

Plus, if you can overlap several curves, you can start to look at trends even though the starting and ending points might be in somewhat different places. If you plot four curves that all start at different BG levels but all have basically the same shape - a hill instead of a valley - you have the magical upside down curve and you can mostly monitor premeal BGs, knowing that's about as low as it will go.

Curves come in all shapes, one hump camels, two hump camels, valleys. Makes no difference to me what shape they are as long as they BG stays in a good range throughout the day.

Natalie

[peggy0]

Thanks so much Natalie. I am home friday through Monday this week and yes, I will plot out over those 4 days the hour 11,12,13 situation. It is the one I don't understand yet but it does appear its consistently the lowest point on his curve. I get nervous when it drops so suddenly at hour 11 to 12 from 160 to 60 though which is what I posted here. I'll let you all know how this weekend works out and again, thanks for being here for us newbys :)

[k9diabetes]

Hi Peggy,

The 160 to 60... is that if there is a delay in feeding and injecting him?

That's the thing I think you need to check is what happens in that first hour after you check his premeal blood sugar and are in the process of feeding and injecting him over the next half hour or 45 minutes.

Let's say you check his BG at 6:00am sharp, put the bowl of food in front of him at 6:10am, and then wait half an hour to inject so you inject the new dose of insulin at 6:45am.

A lot could happen during that 45 minutes if he still has a fair amount of insulin working and no food to go with it.

With this kind of curve, a delay in feeding him definitely could be a problem but the problem won't come from the number of units you inject this morning since that doesn't start working the moment you inject it. The cause of the problem will be insulin left over from the night before.

One solution to a concern about that first hour is to just give Forbin a quickly digestible snack as a reward for his premeal BG test if his test result is on the low side. Not vegies or protein, something like a cracker or biscuit maybe. If it's a lot lower than you're comfortable with, even a tbpn of syrup - that would put an immediate stop to the falling blood sugar for the time it takes his new meal and insulin to get started.

And if circumstances require you to delay feeding him, as life tends to do, a tbspn of syrup would shore up his blood sugar so you don't have to worry.

But before jumping to that conclusion... though there's no reason he couldn't have a yummy quickly digestible snack as a reward for his premeal test... I'd do some checking on what tends to happen during that hour so you can go by information rather than strictly from worry.

Giving him a little food boost first thing will allow you to keep all of his blood sugar numbers at a better level since they will tend to go higher than the premeal level for the rest of the day. If you start his day off with BG no lower than 230, he will run in the 300s for most of the day. It's really just that first hour or so that's potentially a problem so it seems better to me to give him a food or syrup boost, which will be a short-term support that raise his BG only for the period needed rather than for the whole day.

Time and experimentation will tell you whether it works.

Hope that helps,

Natalie

[peggy0]

His BG is still dropping between 6 am and 630 am. And his food doesn't kick in until almost 2 hours later. So what you are saying is the 'issue' is insuline from the night before, not the shot i would give him at 630? That makes sense to me given his curve, but I also thought there was some fast acting insulin as part of the medium working vetsulin? someday I'll get this all straight :)

[We Hope]

Lente insulin is 30% fast-acting semilente insulin and 70% long-acting ultralente insulin. When you put them both together in these fractions, you come up with an intermediate-acting insulin.

There are also NPH/R insulin mixes of 30% fast-acting R insulin and 70% intermediate-acting NPH insulin and another one with 50% R insulin and 50% NPH insulin--both of them are classed as intermediate-acting insulins, just as "straight" NPH and Lente are.

The two NPH/R mixes aren't used often for animals because of the amount of fast-acting R insulin in them. Here's a look at the Humulin insulin profiles for these types of insulins. Humulin R is fast-acting insulin, Humulin 70/30 is the one with 30% R insulin added 70% NPH, Humulin 50/50 is 50% R insulin and 50% NPH insulin, Humulin U is ultralente (70% of Lente insulin) when it was still available, and Humulin L is human Lente insulin--70% ultralente and 30% semilente. Semilente insulin has not been available alone in North America for a long time.

http://tinypic.com/avj510.gif

You can see how the addition of the R insulin to the NPH in Humulin 70/30 and 50/50 makes the start of the time activity profile a lot "sharper" than the one of just Humulin N alone.

Now take a look at the Humulin L and Humulin U profiles. You can see that the 30% semilente insulin in the Lente type makes Lente work harder than plain ultralente U.

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

"Semilente's time activity profile is very much like that of R/neutral. It begins working within 45 minutes, peaks in 2-4 hours and has a 4-6 hour duration. In dogs, both r-DNA/GE/GM and Bovine species have an onset of 10-30 minutes, peak of 1-5 hours, and duration of 4-10 hours."

http://www.wholehealthmd.com/ME2/dirmod.asp?sid=17E09E7CFFF640448FFB0B4FC1B7FEF0&nm=Reference+Library&type=AWHN_Drugs&mod=Drugs&mid=&id=8E17B4A837314392BF69CC4ACD34F13F&tier=2

http://www.walthamusa.com/articles/wf103fle.pdf

Page 2

Upper left hand corner has a table showing onset, peak and duration for the various types of insulins in dogs.

What you have here is some fast/short acting insulin and some slow/long acting insulin in 30% (fast/short) and 70% (slow/long) parts to make up an intermediate-acting Lente insulin. When 100% ultralente insulin was still available, it was meant to act as an all day basal (body's needs without considering food) insulin. Forbin may be "hanging onto" some of those larger, long acting ultralente crystals, and that's why you see him dropping at the point you do.

You've got it right! :)

Kathy

[peggy0]

So If i'm reading the link charts correctly, his fast acting/short should kick in within the hour after injection, so if he is hanging on, there is an overlap where he could be affected by the hanger on (new term) AND and the fast acting

So if thats the case Natalie's 'fix' is something I should definately try to see if we get over this little hump. Otherwise, I have to lower his dosage and he has a few high 300's during the day.

[We Hope]

Not a medical term, but sort of descriptive re: the insulin depot

http://www.childrenwithdiabetes.com/download/hanas_insulin.pdf

Pages 9 & 10--Depot Effect

and the large ultralente crystals which take the longest time to be broken down into the dimers and monomers the body can use. :)

http://www.childrenwithdiabetes.com/download/hanas_insulin.pdf

Page 5

I'd see what Forbin thinks about Natalie's "fix". ;)

Kathy

[peggy0]

I'm getting it :) I sure do think Natalie's fix will do the trick. Thank you both!

[k9diabetes]

Just checking in on Forbin...

Natalie

[peggy0]

Hi natalie, Thanks for checking in.

I'm going to post his new curve after this weekend. He has stabilized on 18.5 units with no readings over 302 and none under 100 :) We are getting there. I used your treat trick at Premeal BG and I really messed up the first time and drove his BG to 455. YIKES. I found special k whole grain crackers; you have to eat 17 of them to get 3g of sugar. I give him one, It just keeps his BG from lowering much for that first hour after his injection. I think I'm learning thanks to all of you. I've changed his food from two cups of Blue senior to one cup of blue senior, one cup of blue weight mgmt. The weight mgmt ratios are very close to Hills w/d. I've added a sprinkling of brown rice to make up for a few grams of fiber it lacks. I have a 3 day weekend to do a new complete curve and will publish the results of our experiment! Meantime, he's acting like his old normal self!

[k9diabetes]

I think we should change the title of your thread.... as I hope you're not nearly so stressed! :)

Congratulations on making so much progress!

Natalie

[peggy0]

Thanks Natalie, :) I'm not so so stressed anymore. Only occassionally, when I can't figure it out I want to cry, but it is getting easier and I'm not so afraid to experiment a little. I read this board everyday so I learn from everybody. Sophie is my hero !!

[eyelostit]

All will be OK :), you'll figure it out, at times I still can do a wimper myself because of this disease our doggies get.

[peggy0]

thanks Dolly. I Hate that he has it. Wish they knew what caused it or could find a cure. :( Meantime, I've got you all :)

[eyelostit]

You bet ;), anytime you have a problem come here, even late at night I am usually on the internet searching for one thing or another. Where are you located, or what part in US, I am in the Northeast.

[peggy0]

I'm in dallas; from the northeast but moved here for work about 8 years ago.

[peggy0]

So we went to the vet Friday and given he had some 300's she asked me to increase his insulin to 19.5 from 18.5

Here is his curve today:

530 174
600 fed
630 113 and 19.5
8 195
10 276
12 280
2 195
230 194
315 150
4 89 FED!!! treat(has maple syrup in them)
430 87
5 169


Needless to say, 4 to 5 was nerve wracking and I'm sure I'll have more grey hairs tomorrow. I knew at 230 we were going to go too low given his nadir is 11 to 12 hours after his shot. I let it go to see what would truly happen jabbing the poor guy every 30 minutes.

So we cannot stay on this dosage as I work, and i'm not jabbing him every hour tonight. 18.5 it is for now.

Do you all agree?

[We Hope]

I agree that 19.5 seems to be too much for Forbin and that tonight it should be back to the 18.5. Think you should let the vet know what you got in the way of numbers today and why you're back to 18.5.

It might be that 19 (no half unit) could be a good number for Forbin, but for now, I agree that you need to go back to where you were with the 18.5 for safety's sake.

Kathy

[peggy0]

Thanks Kathy. I appreciate your help. I'm letting the Vet know tomorrow am.

[eyelostit]

Yep, I'd stay with the 18.5 as Kathy mentioned, and also for less worry on your part.:)

[peggy0]

Thank you! I'm working on the food part. Switched him to all Blue WEight Control with green beans. The rice was raising it. It's come down a bit. He still has a 300 during the day. I think we're almost there. I can tell he feels really good now. Last night he was yelling at me because I was on the phone instead of getting his dinner :)

[Cara's Mom]

Hi Peggy!
Just wanted to let you know you are doing a very good job!!! Have been following your thread and reliving Cara's and mine first weeks after dx!! Keep up the good job..you wil get there:)!
Best wishes

[peggy0]

Thanks Marion. Hopefully we're getting closer to the eye operations :) following in Cara's footsteps

[Cara's Mom]

Keeping my fingers, my legs , everything crossed for you and Forbin :). You'll make!!!

[peggy0]

So forbin was 420 when i came home last night; there were storms all day and his is petrified of thunder and lightning. This morning he was 62 :( scarey. He got a treat dripped in Karo. He acted fine but his eyes were red. So I'm not sure what is going on. I'm lowering him a unit this am and tonight to get through this rollercoaster and doing a curve this weekend. Would a storm cause this high low episode? Thanks everyone.

[We Hope]

We don't know if Forbin has a history of going high or low under stress, and there was quite a bit of it going around with the storms. You were doing very well until the storm problem, so I would have to believe that played a part in this.

I agree with you to lower Forbin's insulin after this; if he did start rebounding, lowering the insulin is the only way to put the brakes on it. Where people sometimes get in trouble is that they only look at the high number and forget about the low reading they saw. The high reading makes them want to increase the insulin, and that's only going to result in another lower "low" number, followed up by higher "high" ones after the counter-regulatory hormones go to work.

I hope that things settle down for both of you by the time you're ready to do Forbin's curve this weekend. I think the storms are to blame for what happened.

Kathy

[dctexan]

I am new to this forum, but I have been reading this thread and just wanted to thank you for posting your storm story. Dixon is also quite anxious during storms and it is good to know that I should be checking him more frequently when they occur (of course given the crazy draught we are experiencing that may be never). I hope Forbin is feeling a bit better as the day moves on. Please keep us updated!

[Cara's Mom]

Peggy, are you adjusting Forbin's food? With adjustments in the insulin dosage, I would not do anything with the food. One change at the time is my motto. You get a better picture with only one adjustment. Just my 2 cents worth:)

[peggy0]

Hi there, I adjusted it last week, but not by much and he's been good all week long. He had a bad day yesterday and he is terribly frightened of storms. I'm home for the next 3 days so I'm going to see what is going on :) Thanks for the help, I moved him over th weight control from senior blue over a course of 2 weeks. Last week I took away 1/4 cup of brown rice and replaced it with green beens. If it bothered him, it took 4 days. Could it take that long?

[We Hope]

From what you posted, you were doing well with the food changes. I would believe yesterday's storms were more to blame than anything else because Forbin's so upset by them.

Now, it can take 2-3 days for his bg's to "settle down" after what went on yesterday, so I think you'll be able to see some "true" information when you do the curve over the weekend.

Hang in there! :)

Kathy

[Cara's Mom]

Green beans should not bother him at all, no carbs no calories! Cara gets a handfull of frozen green beans as snack!
My oldest dog, Polly is terrified of thunder too.....thankfully she is not diabetic and all she does is hide!

Keep up the good work!

[peggy0]

Ok great everyone thanks. I'll stay on course. Looks like tornado season is going to be a challenge for us. Yikes!! He is fine tonight but still at 250 which is 100 points higher than I had him. We'll see what tomorrow brings. I'm keeping him a unit lower for a few days as suggested.

[k9diabetes]

I could definitely see thunderstorms causing lower blood sugar. I always assumed that Chris' lows at the vet were as much about anxiety as anything. He was never very active at the vet.

Jack gets very worked up about anything that scares him - terriers, thunder was a little upsetting, and the e-collar a dog wore to the dog park the other day completely freaked him out! The dog's owner had to take it off her dog and hide it behind her back for Jack to settle down. If Jack was diabetic, I'd bet his blood sugar would plunge.

[peggy0]

Well poor Forby is at the vet for his doctor blood curve. She has the same monitor as I do so I don't know why, other than $$, that she can't just take my curves. This will be the last time I submit him to this given we are a new patient. Sorry I had to vent. He gained 5 pounds :) and is 3 away from his normal weight. Yeah!! His curve was all over the place for the last few days either from the low, or the bottom of the insulin bottle is weak. Yesterday he was in the 400s all day which is very unusual. It was the last 2 shots in the bottle. His ketones are negative, no fever. Anyway, I want to get him home with new insulin and get him back on track. We'll see what she discovers when I go to pick him up.

[We Hope]

Peggy,

When you get to the end of the insulin vial, it can start losing its potency. Since Forbin's re-gained 5 of his pounds, that says something's been going VERY well most of the time.

I think getting Forbin home with some fresh insulin will get him back on track! ;)

Kathy

[peggy0]

Forbins BGs were between 100 and 200 at the vet. Of course she thought this was great, however, I know it was stress. Today they are back up 250 to high 300's. So I believe , as with the storm, Forbins BGs drop under stress. Given he has gained a few pounds, he may need a bit more insulin, but I'm going to let him rest today as he was there all day yesterday and see how he is tomorrow. I have the lovely flu so I'm not giong anywhere. I just hate winter :(

[We Hope]

It seems like we have more dogs who tend to go low under stress than ones who go higher on this board. This is why you can't just take a "blanket statement" and run with it--some are going to go lower with the stress while others are going higher under those conditions.

I think you're right with the idea that Forbin tends to stress and go low. You've seen it happen with the bad storms and now, the difference between yesterday, all day at the vet, and today at home with no stress.

I agree with you that it is possible he might need a bit more insulin because he's re-gained some of the lost weight, but think, as you said, you need to see a little more bg "information" before making any changes.

Take care of yourself and give that flu a GOOD kick in the you-know-where! :)

Kathy

[peggy0]

FYI, I asked dog food company BLUE what their fiber mix was insoluble/soluble. here's their answer:

Dear Peggy,

Thank you for your interest in BLUE; and we apologize for the delay. All the added fiber is moderately fermentable, soluble fiber, coming from Rice Bran and Tomato pumace. Small amounts of fiber come from other whole grains and herbal grasses that are part of the overall carbohydrate ingredient matrix. We do not use insoluble, non-fermentable fibers like cellulose, peanut hulls, cotton seed hulls, etc. in Blue Buffalo diets.

[eyelostit]

I'll have to look for the Blue Buffalo, I always thought Blue was Blue Seal. I'm glad you posted the info.

Dolly

[peggy0]

My dogs love it. It has very good ingredients

[We Hope]

And it seems to be doing very well by Forbin, who's regained quite a bit of the weight he lost. While we see a lot of information about insoluble fiber and canine diabetes, the thing to remember is that if a food is working for your dog, there's really no reason to start changing things. ;)

Kathy

[peggy0]

Thats what I keep trying to tell every vet i meet :)

[We Hope]

Would: "If it's not broke, don't fix it." work? :D

[peggy0]

:) Yes, but she keeps telling me he could be on a much lower dosage with DCO. She's even seen dogs go off insulin completely. I took the comparisons showing the ingredient %s are almost identical to Buffalo Blue Weight Control and with the Green Beans I add, they are, but I got no comment.................. hmmmmmmmmmmmm

[Cara's Mom]

Yes, that is the same song and dance I got from my vet regarding DCO!! We changed and month later we had to change again! There is no quarantee it works for your dog! So I agree with Kathy:"If it ain't broke, don't fix it"!

[peggy0]

And look how good lookin they are :)

[peggy0]

PetSmart sells Buffalo Blue. It comes in puppy, adult, small bites, senior and weight control

[We Hope]

:) Yes, but she keeps telling me he could be on a much lower dosage with DCO. She's even seen dogs go off insulin completely. I took the comparisons showing the ingredient %s are almost identical to Buffalo Blue Weight Control and with the Green Beans I add, they are, but I got no comment.................. hmmmmmmmmmmmm

When dogs get diabetes, they are insulin-dependent--I'm surprised at her statement that dogs can go off insulin totally.

If something such as pancreatitis occurs, and that illness somehow (rarely, though) "kick-starts" the pancreas back into producing enough insulin, it can happen. It can happen if the diabetes was related to Cushing's, the Cushing's gets controlled and it turns out that the pancreas was not "burned out" by the continual demand for insulin. It can happen if the diabetes is steroid-use related--stopping the steroids can mean the temporary diabetes is gone, as well as the temporary diabetes which can be found in females during pregnancy and heat cycles. In that case, spaying can end the diabetes.

http://www.vetinfo.com/ddiabt.html

Controlling Diabetes with diet

"Dear Dr. Mike, I have been reading through all of the questions and answers from your website and see nothing about controlling diabetes through diet only and no insulin. Our 8 year old schnauzer was diagnosed with Diabetes Mellitus on October 10th. We have not put her on insulin to date as I wanted to know if it was possible to control the diabetes with diet only. I check her glucose and keytone levels daily. The glucose is at 2000 or more mg/dl and the keytone (sic) level is negative. However, there was one day that it looked like there could have been a trace of keytones (sic) in the urine. Am I fooling myself trying to control the diabetes through diet? She is on a high fiber diet. We are feeding her Purina OM formula from the vet, and then I give her carrots for treats.....

"I have had a number of clients try to control diabetes through diet alone, in both dogs and cats. Once in a while this approach seems to work in a cat when moderate fiber, restricted calorie diets are used and there is weight loss in an overweight cat but I can't remember this approach succeeding in a dog.

"It is my opinion, for what it is worth, that it would be better in most cases in dogs to control diabetes with insulin therapy rather than trying other approaches such as dietary control or oral medications. The actual risk of not treating depends on how high the blood sugar levels are and how long the diabetes has been present. I am assuming that your vet is advising you during the dietary trial and has considered these factors."

Diabetes

"Dear dr. Mike, I have a dog (a dachs called "Willie") who's 12 years old, and suffers from diabetes. His blood values are around 300, before and after eating, and his condition is worsening since last week. He's watering a lot, eats a lot, and loses weight. All in all, he's an old dog but still very lively. I've been looking around about diabetes, talked to my vet (who doesn't seem to be very animal-loving, I'm afraid to say) as well as to my GP. The vet, at any rate, suggests administering insulin; however, he also tells me that the risk of giving too much insulin is very high, and the dog may get hypo and fall into a coma. My GP suggested administering "Glucobay", but then I found out that this is for type II diabetes, and what my dog has looks more like type I diabetes (right?).

"Patrick- Dogs only rarely have non-insulin dependent diabetes (Type II). Most dogs require the use of insulin to regulate diabetes."

Diabetes with rebound hyperglycemia

"Diabetes that starts out in conjunction with pancreatitis can be really hard to deal with at first since there are other pressures on the hormonal system from the pancreatitis. In addition, once in a while a dog with diabetes in conjunction with pancreatitis will suddenly experience a resurgence in insulin producing capability and a sudden "recovery" from diabetes. If you aren't thinking about that possibility it can lead to insulin overdosage. I doubt that will happen after all this time but if the pancreatitis returns and affects insulin dosage in the future, it may be good to keep this in the back of your mind."

Some cats can control it with diet alone, as well as some people who are not insulin-dependent can.

Kathy

[peggy0]

Forbes has never been diagnosed with pancreatitis and he was never sick prior to the drinking and urinating routing that led to his diabetes diagnosis. I think she's just a good DCO sales person :)

[peggy0]

Forbins BG dropped to 42 per the meter tonight. Got him back up to 75 in 30 minutes. He was higher than normal all day which is what I expected after being lower than normal at the vet all day the day before yesterday. I don't understand the yo yo'ing.

[peggy0]

While I've had the lovely flu, I've been researching alot of doggie foods. I'm very puzzled that the perscription foods recommended by vets are very high in carbs, but the Glycemic Research Institute awards dog foods very low in carbs as 'pet food of the year'. Orijen is #1 this year and has only 18% carbs vs. the others that have over 40%. Would someone have a go at that one for me:confused:

[k9diabetes]

Peggy,

Did you see signs of low blood sugar yesterday that made you decide to test and found his BG was low?

I hope Forbes isn't one of those dogs whose blood sugar is somewhat unpredictable... anything you can attribute the low to?

Glad you caught it!

Natalie

[peggy0]

It was 30 minutes earlier than his normal period of going low, but it went way lower than normal. I have no idea what caused it. No difference in food or dosage,however since he's been on this 19 U dosage, it seems his BGs have been rising. Its almost like he has this reserve of insulin and after 10 days he just lets it loose. He's been at 19 for 8 days. The only time it was perfect was when he was at the vet and I know it was lower given he was stressed. i was shocked to see a 45 at 430pm. I'm glad i was home. This is what scares me the most. I typically don't get home until 6p

[We Hope]

And I am remembering when Forbin was given 19.5 not long ago and you needed to make that 18.5 (back to old dose) after he got into a similar situation.

Kathy

[peggy0]

Yes, he doesn't seem to like the number 19 or 19.5, but his BG is still too high at 18.5 so I was looking at food options. Did you see my post about carbohydrates Natalie and Kathy?

[We Hope]

Peggy,

Most of the time (have been told recently that some foods are dry and low-carb now) dry foods will have more carbs in them because of the way they are made.

http://www.peteducation.com/article.cfm?c=2+1661&aid=2653

How pet food is made

http://www.peteducation.com/article.cfm?c=2+1661&aid=3328

"Dry pet food requires a fairly high carbohydrate content in order for the kibble pieces to stick together."

Have heard that dry foods which are extruded ("forced" into formed nuggets, chunks, or other shapes) are higher in carbs than those that are baked. Extruded kibble has pieces which all look pretty much alike; baked kibbles don't have regular shapes--they look something like smashing a cookie--you get all sorts of sized and shaped pieces.

I know Orijen is not an extruded product. In the last year, Orijen has had some fairly bad press. First in May of last year with bones in some of their foods:

http://www.pets.ca/forum/showthread.php?t=52081

The original letter is no longer on the Orijen site; just checked and it's not in the Internet Archives either. The text of it is copied on a message board post at the link above; I remember reading the letter when it was on the internet from Orijen's website and that's what it said.

Around Christmas 2008, it was learned that cats in Australia had been suffering a "mystery disease"--all they had in common was eating Orijen. Quite a bit of pet food imported into Australia has to be subjected to radiation as per their laws. Orijen did not meet any of the criteria that would permit their products to forego this radiation.

It became clear that the radiation altered the food and this was the reason for the illnesses of the cats. Orijen stopped selling all of its product--both cat and dog food--in Australia shortly after this made the news.

http://www.championpetfoods.com/Australia_Consumer_Release_Dec20.pdf

I'm not pro or con Orijen--just wanted you to be aware that there have been some "negatives" with regard to it.

Kathy

[peggy0]

Yes I've read that info. I was just wondering about the support for low carb when perscription is so high carb

[k9diabetes]

I can't speak to why the prescription foods are so much higher in carbs - even the canned - but I will say that some diabetic dogs actually need those carbs.

Dogs don't process these insulins the same way that people do. People have typically used NPH, for example, as a basal insulin and something like R as a bolus insulin to handle the rise in food.

Most dogs don't need a bolus insulin and in fact often can't tolerate much faster acting insulin because it drops their blood sugar too sharply. The NPH for a lot of dogs functions like both an intermediate and a faster acting insulin.

And to go with that faster processing of insulin they sometimes actually need some carbs, which are usually digested faster than protein so they get into the bloodstream as glucose much quicker.

If a dog is on a high protein diet, sometimes all that protein can be digested so slowly that the insulin overwhelms the supply of glucose during the first couple of hours and adding something like rice can level out their blood sugar by better matching the supply of insulin.

In truth, as much as many people dislike the ingredients in WD, it has worked very well for a lot of diabetic dogs. Definitely not all of them. And probably more often for NPH than for Vetsulin. But it does often do a great job of matching the insulin profile.

Only in the last few years have many vets branched out from the prescription foods so it is going to be a period essentially of experimentation to see whether these other foods make regulation easier or more difficult. Most likely it will be like all the other foods - depends on the dog.

Natalie

[peggy0]

Thanks Natalie, that's what I was thinking....depends on how the dog deals with it. I really don't know if Forbin does well with high or low carb food or a combination of it. I'm just trying to figure out how to get his day hours down a bit without making the nadir lower.

[peggy0]

Hi Dollie

What do you feed Nikki? I"m studying up on foods, low carb vs. medium carb and the impact of proteins.

[peggy0]

More info in regards to carbs. Seems like most of the perscription dry foods as well as weight control foods, including buffalo blue have moderate carb percentages, about 45%. I've researched about 10 and they are pretty consistent. There are a few with low carbs that are dry like Orijen and Blue Wilderness. Where they are different is the glycemic rating. So you may have moderate carbs, but ingredients include sweet potatoes (low glycemic) vs. white potatoes (moderate glycemic). So you can't just look at carbs as a percentage. This is interesting. If I worried about what I put in my mouth as much as I did my dogs, I'd be in good shape :) Just thought it was interesting. Now I am going to experiment a bit, after Forbin gets back to normal from his fur shot.

[We Hope]

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

More on carbs and the glycemic index if you want. :)

Kathy

[peggy0]

I feel like a mad scientist trying to figure out the correct potion :) I'm starting to think that a consistent BG curve of 125 to 300 isn't so bad.

[Cara's Mom]

Peggy, has Forbin recovered from his "furshot"? Cara did, but dropped little too low!

[peggy0]

Yes he has and he is running a little low. He was 89 yesterday morning so I've been watching it. :) There was suppose to be storms last night so I was really nervous as his drops alot but.........they never came :) yeah. He's back in the 100's this am. It's interesting though Forbin is much more alert in the high 200's than in normal ranges. Not sure why.

[peggy0]

I changed Forbins food to 1 and 3/4 cup of Weight Control and 1/4 cup of Wilderness Low carb (CANNED). I also dropped his insulin to 17.5 He's been on this for 3 days.

Here's his curve today :)

630a: 170
830: 184
1230: 284
230: 257
430: 282
630: 191

What do you think :)

[Cara's Mom]

Looks very good Peggy! Good job! Congratulations!
Forgot for a minute that Forbin is "the upsidedown boy" with his lows 12 hrs after shots :o

Keep up the good work:)

[peggy0]

Need some advise. Forbins BG's have been in the 400's all day. He has a small discharge coming from his penis. He is eating, has no ketones. We have a vet appointment tomorrow. Do you think he has a UTI? Should I be concerned about waiting until tomorrow?

[We Hope]

Peggy,

If Forbin's acting OK, I think it will be all right to get him in tomorrow. Do think he has a UTI. My non-diabetic had one in December; there was no warning except I saw he had passed a little blood. Once you get that on the way to being taken care of, Forbin's bg's will get back to being normal.

Kathy

Forgot to say that if Forbin's scheduled for a curve, with what looks to be a UTI, you won't get any good information from one, as he's running high, most likely from the infection right now. But he does need to go in to the vet as planned to get this looked into.

[peggy0]

Thanks Kathy, they aren't doing a curve. Just checking him over. I want to have his cataracts removed as soon as he is ready. Took him for a little walk and he was raring to go. I think he's ok.

[eyelostit]

Hi Peggy,

His bg will go up with some infections, if your vet has you increase the insulin and you get antibiotics keep an eye on the bg (you usually do) as the infection gets better the needs for the amount of insulin may need to be decreased some.

I hope all goes well at the vet.;)

[ladysmom06]

Hi Peggy,

Have never posted on your thread before but I have been reading it. Just wanted to wish you good luck at the vet's today. Hugs to you and Forbin.

Luv,
Lynne and Lady

[peggy0]

Thanks Lynn! Forbin is fine. He has conjunctivitis. The tinkler thing is typical; I haven't paid much attention to that before. He has no UTI. His BGs are normal today so I don't know what the highs were yesterday. He and the springer may have been counter surfing while I was in the shower. It was bagel day :(

He is going to have his teeth cleaned on Monday, then we are going to set up the appointment for his eyes :)

We are working on food adjustments to see if we can catch that 302/304 reading and bring it down a bit. Otherwise, he's very happy with his numbers. I'm relieved. Oh and he gained another pound :)

[eyelostit]

Glad all is well, are you trying to put on the weight also ?

[peggy0]

He lost 8 pounds in the beginning. He has now gained 6 back thank goodness. I told my vet about this board and what a help it has been. He was very excited that I was so involved in his monitoring and in his diet. He told me there are many patients he has where no one is paying attention to what they eat and are not willing to monitor. He had a cat in the hospital there over the weekend, and fed him regularly for 3 days on perscription food and he said he was a different animal.

He was glad I found you all and said you were doing a great job educating me on the disease and helping me help forbin :) You are all wonderful!!

[eyelostit]

Aw shucks :o no thanks needed.

[k9diabetes]

Hey Peggy,

Glad there was no UTI!

I love that your vet is comfortable with you participating in a forum - that he likes close monitoring says good things about him! It's the ones who want you to stop testing and don't read anything that scare me!! As if they could stop me! :rolleyes:

Nice curve. Hope the other day was just one of those days.

Natalie

[peggy0]

Thanks Natalie. Yes i think the 3rd time is a charm on vets. hopefully :)
Has anyone used these treats? They sell them at Petco.

Sister Joan's Nutri-Bits Dog Treats


Nutritious, 100% natural dog treats recommended for dogs with special needs like diabetes and heart and kidney problems. Crunchy bite-sized treats have no added salt, no sugar, and no preservatives. 20 calories each

[We Hope]

Peggy,

Tell Forbin not to be grabbing carbs (bagel) like that and throwing everyone off track! :)

Knew someone who used to order the diabetic cookies from the Old Dog Cookie Company:

http://www.olddogcookie.com/dog_nutrition.html

Took a look at Sister Joan's--

http://www.sisterjoans.com/index.html

and was pleasantly surprised to find out this isn't just a name for the product.

http://www.sisterjoans.com/story.html

"Sister Joan Schneider is a Benedictine nun in the community at St. Paul's Monastery in St. Paul, MN. (Royalties from the sale of this product are used for the retirement of religious orders.)

"Sister Joan has bred quality German Shorthair and German Shepard dogs for 18 years. Her first Shepard, Sara, was from the Monastery at New Skete in Cambridge, NY."

If you try these for Forbin, please give us a review of them--don't know anyone who has used them before. :)

Kathy

[peggy0]

those nuns follow me everywhere. i went to catholic school forever. I am going to get some of those this weekend and will let you know. Forbin et al LOVE bagels. It was a family tradition. Now we all are stopping this one.

[pgcor]

Hi Peggy:

We order from the Old Dog Cookie Company and my dogs really like them.

I didn't know about Sister Joan's cookies, but being a "Catholic" all my life - I think I better try them - or go to hell!

I feel guilty already for not ordering them...

[We Hope]

Not something for the dogs with diabetes, but for easing the stress of their Moms:

http://www.trappistine.com/

http://www.trappistine.com/whoweare.asp

"Our Lady of the Mississippi Abbey is a cloistered, monastic community of 30 Trappistine nuns of the Order of Cistercians of the Strict Observance. We are situated on a farm on a high bluff overlooking the Mississippi River, about seven miles from Dubuque, Iowa. Our main means of support is the production and sale of Trappistine Creamy Caramels."

http://www.trappistine.com/specials.asp

http://www.trappistine.com/aboutcandy.asp

The candies they make/more information about them

http://www.trappistine.com/departments.asp

Buying them online

I've heard they are spectacularly good! :D

Kathy

[peggy0]

Can't ever get over that catholic guilt thing can we :) LOL. I've already ordered them.

[peggy0]

they have TRUFFLES. YUM. I just might buy some of those for being a good mommy. ;)

[eyelostit]

those nuns follow me everywhere. i went to catholic school forever. this one.

LOL me too !!

[eyelostit]

Hi Peggy:


I didn't know about Sister Joan's cookies, but being a "Catholic" all my life - ...

Well thats 3 of us here.;)

[eyelostit]

Peggy,

I wanted to tell you, Nutro's ingred are good, I just got a subscription to a dog food detective site, all ingredients USA is what I read, let me know what product you want and I will post info. Can't do a link cause its a subscription.There are some treats on this website also.:)

[peggy0]

Great! Thanks so much. Nutro senior and lite would be great!

[eyelostit]

Peggy here tis, Nutro is rated below Orijen well naturally Orijen cost double !, if you'd like email me your fax if you can and I will send this 13 page doc which describes in detail all of what is in the dogfood ingredients which is good, bad, meaningless, filler etc. I think the bran has to do with lowering the bg some, with Niki anyway! Maybe at a later date I can post some of this in off topic, or we can talk about the ingredients if anyone wants to.:) Of course all dogs handle food differently, but i really like being able to get this info. As long as we use a good quality dogfood and it works for us, thats all that matters, course you may have to add veg's to it depending on your pet,but my notes with bg back then are somewhere lost in this house at the present time. :o Also I wantedre to add I have read that once any type food gets to the US such as ingred. and once it gets mixed up in the product it gets branded as made is the US, this goes for human food also.:o Alot of bad ingredients are the by-products in most commercial foods these days. Nutro does not have by-products. IMO to save $ you add some of your own turkey or chicken etc. which is what I do.

Nutro Pet Foods
Nutro Pet Foods are a product of Mars Petcare. All Mars pet foods sold in the U.S. are manufactured by company owned U.S. facilities.

Natural Choice Lite Dog Food Dry

Ingredients: Rice Flour, Lamb Meal, Ground Rice, Rice Bran, Dried Plain Beet Pulp, Powdered Fiber, Natural Flavors, Soybean Oil (preserved with mixed Tocopherols, a source of Vitamin E), Poultry Fat (preserved with mixed Tocopherols, a source of Vitamin E), Yeast Culture, Calcium Carbonate, Sunflower Oil (preserved with mixed Tocopherols, a source of Vitamin E), Potassium Chloride, Monocalcium Phosphate, Taurine, Dried Kelp Meal, Choline Chloride, Ferrous Sulfate, Zinc Sulfate, Vitamin E Supplement, Ascorbic Acid (source of Vitamin C), Manganous Oxide, Biotin, Garlic Flavor, Calcium Pantothenate, Niacin, Copper Sulfate, Vitamin B12 Supplement, Riboflavin Supplement (source of Vitamin B2), Glucosamine Hydrochloride, Vitamin A Supplement, Pyridoxine Hydrochloride (source of Vitamin B6), Thiamine Mononitrate (source of Vitamin B1), Chondroitin Sulfate, Calcium Iodate, Vitamin D3 Supplement, Menadione Sodium Bisulfite Complex (source of Vitamin K activity), Sodium Selenite, Folic Acid.
Red Flag Ingredients: None
US Only Ingredients: Yes
Natural Preservatives: Yes
Shelf Life: 14 months
Crude Protein: 14% Crude Fat: 6% Crude Fiber: 8.5% Moisture: 10%
Plus: The Nutro Representative told me ingredients are human grade/quality. This food does appear to contain friendly bacteria (benefits the intestinal system and in turn the immune system of the pet). Contains Kelp – health promoting ingredient.
Minus: The mineral listings do not read to be chelated or proteinated (for better mineral absorption). This pet food contains Menadione Sodium Bisulfite Complex (source of Vitamin K activity) which is a controversial synthetic Vitamin K.

Natural Choice Senior Dog Food Dry

Ingredients: Ground Rice, Chicken Meal, Rice Bran, Poultry Fat (preserved with mixed Tocopherols, a source of Vitamin E), Soybean Oil (preserved with mixed Tocopherols, a source of Vitamin E), Natural Flavors, Oatmeal, Oat Bran, Sunflower Oil (preserved with mixed Tocopherols, a source of Vitamin E), Potassium Chloride, Dried Egg Product, Vitamin E Supplement, Dried Kelp, Zinc Sulfate, Zinc Proteinate, Choline Chloride, Taurine, Ferrous Sulfate, Ascorbic Acid (source of Vitamin C), Biotin, Glucosamine Hydrochloride, Manganese Proteinate, Manganous Oxide, Chondroitin Sulfate, Niacin, Garlic, Potassium Iodide, Calcium Pantothenate, Vitamin B12 Supplement, Riboflavin (source of Vitamin B2), Vitamin A Supplement, Vitamin D3 Supplement, Copper Sulfate, Pyridoxine Hydrochloride, Thiamine Mononitrate (source of Vitamin B1), Copper Proteinate, Sodium Selenite, Menadione Sodium Bisulfite Complex (source of Vitamin K activity), Folic Acid.
Red Flag Ingredients: None
US Only Ingredients: Yes
Natural Preservatives: Yes
Shelf Life: 14 months
Crude Protein: 20% Crude Fat: 10% Crude Fiber: 4% Moisture: 10%
Plus: The Nutro Representative told me ingredients are human grade/quality. This food does appear to contain friendly bacteria (benefits the intestinal system and in turn the immune system of the pet). Contains Kelp – health promoting ingredient.
Minus: The mineral listings do not read to be chelated or proteinated (for better mineral absorption). This pet food contains Menadione Sodium Bisulfite Complex (source of Vitamin K activity) which is a controversial synthetic Vitamin K. Contains Garlic - controversial ingredient.

[peggy0]

Thank you!! I'll have a look after work. This is great info

[peggy0]

Well sister joans cookies arrived. Look like milk bones, but they love them. I gave one to Forbin when he first got up and his BG continued to drop as usual until I fed him 1 1/2 hours later. Looks like a winner. You can get them at petco. $329 a bag

[JazzyGirlsMom]

Dolly, can you look up the science diet lite biscuits and what ever other treats you guys recommend? Most appreciated.

Tracey

[peggy0]

science diet lite treats 19 calories

Corn meal, cracked wheat, powdered cellulose, chicken by-product meal, chicken liver flavor, soybean mill run, chicken, corn gluten meal, animal fat (preserved with mixed tocopherols and citric acid), glyceryl monostearate, minerals (calcium carbonate, potassium chloride, salt, ferrous sulfate, zinc oxide, copper sulfate, manganous oxide, calcium iodate, sodium selenite), vitamins (choline chloride, vitamin A supplement, vitamin D3 supplement, vitamin E supplement, niacin, thiamine mononitrate, calcium pantothenate, pyridoxine hydrochloride, riboflavin, folic acid, biotin, vitamin B12 supplement

[Fishslayer]

Looks like a winner. You can get them at petco. $329 a bag

:eek:



Rick

[peggy0]

oops how about $3.29 :)

[eyelostit]

Sounds like Sister Joan is a winner.;)

[peggy0]

I just watched a video of a dog getting his teeth cleaned on Pet Doctor. I'm cancelling my appointment tomorrow. I won't put Forbin through that right now. The following day must be very painful for them. He'll have his site with tarted teeth. i'll brush them.

[peggy0]

Well Forbin has to have his teeth cleaned or no eye surgery. Mouth bacteria can cause complications and they cannot have their teeth cleaned for at least a year after eye surgery. Sometimes I wonder if its all worth it. I feel so sorry for this dog. We're on again for the 20th

[Cara's Mom]

When Cara went in for her initial eyedoc visit, I did asked if her teeth needed cleaning (they could use a good cleaning!!) He assured me, that was not necesary!! She would be on heavy duty antibiotics afterwards and she was!
Is this an other money grab? Just wondering:rolleyes:

[peggy0]

Well they are two different doctors not affiliated so I don't think so. My new doctor specializes in dentistry so I thought he may be but when I called the eye doctor this am, he said definately. I go to the eye doctor first, so we'll see what he says in person.

[BestBuddy]

I know it sounds awful but teeth cleaning is really important. Apart from the bad breath the tartar can hide other problems that even in a normal healthy dog can cause massive problems but in a diabetic....... Buddy always did really well after teeth cleaning and even when the had to make extractions.
Jenny

[peggy0]

He's going next week. I hope I live through it

[ladysmom06]

Hi Peggy,

Lady had her teeth cleaned last spring - like you I was a real mess but she did really well and had no problems:). When are you having it done? Hugs to the two of you.

Luv,
Lynne and Lady

[Margaret Boyle]

He's going next week. I hope I live through it

Peggy I am sure Forbin will be fine I know how you must feel it is a worry and like you I do not like to see them in any pain. I am sure it will help Forbin and especially if you are thinking about eye surgery. I know where you are coming from when you say you wonder if it is all worth it but you know Peggy
at the end of the day we know it is if they are happy and content,and I bet your Forbin just loves you to bits.
Your Dad being Scottish Peggy would say "Keep your chin up pet":)

All the Best Peggy

LOL

[peggy0]

He goes to the eye doctor Monday to plan the operation I can't wait for :) and then Tuesday he gets his teeth cleaned so he will have a nice clean mouth with pearly whites and one less complication for his eye surgery. Yikes!

[peggy0]

Thanks Margaret, and yes my dad would say that and 'he's a grand lad' and needs it done luv. Thanks for the encouragement; it would be much easier if you could explain things to them wouldn't it?

[Margaret Boyle]

He's going next week. I hope I live through it

Peggy I am sure Forbin will be fine I know how you must feel it is a worry and like you I do not like to see them in any pain. I am sure it will help Forbin and especially if you are thinking about eye surgery. I know where you are coming from when you say you wonder if it is all worth it but you know Peggy
at the end of the day we know it is if they are happy and content,and I bet your Forbin just loves you to bits.
Your Dad being Scottish Peggy would say "Keep your chin up pet":)

All the Best Peggy

LOL

[Margaret Boyle]

Thanks Margaret, and yes my dad would say that and 'he's a grand lad' and needs it done luv. Thanks for the encouragement; it would be much easier if you could explain things to them wouldn't it?

Yes Peggy it would but at the end of the day it is unconditional love they they put their trust in us completely. So we must really do what makes them more comfortable and infection free from bad teeth and all that tartar. I brush Lucy's teeth every second night and she has a dental chew every morning, but that does not mean she wont have her teeth cleaned she has had it done and she was only about 3yrs at the time. Try not to worry Peggy
when does she have it done?
I was giving you my worries when you had enough of your own Peggy I always worry when they are having things done but then when it is all over you wonder what you worried about.

LOL

[Margaret Boyle]

He's going next week. I hope I live through it

Peggy I am sure Forbin will be fine I know how you must feel it is a worry and like you I do not like to see them in any pain. I am sure it will help Forbin and especially if you are thinking about eye surgery. I know where you are coming from when you say you wonder if it is all worth it but you know Peggy
at the end of the day we know it is if they are happy and content,and I bet your Forbin just loves you to bits.
Your Dad being Scottish Peggy would say "Keep your chin up pet":)

All the Best Peggy

LOL

[ladysmom06]

Peggy,

and then Tuesday he gets his teeth cleaned so he will have a nice clean mouth with pearly whites and one less complication for his eye surgery. Yikes!

Sending prayers and positive thoughts - I'm sure he'll do just fine. Hugs to the two of you.

Luv,
Lynne and Lady

[peggy0]

So Forbes and I have been experimenting with some food since our last vet visit to try to even out some bumps, but it sure didn't work. I tried royal canin diabetic, swapping 1/2 a cup of it for my blue wilderness high protein. It raised his BGs 150 points. They were consistent from 10 through 3 but high. Did that for a few days and went back to buffalo blue. This weekend, we splurged and bought some merrick low glycemic canned. Both yesterday and today, his BGs were in the 3 and at the moment 400. So much for low glycemic. We're sticking with buffalo blue and wilderness for now. I'll live with the 1 and 1/2 hour bump for now. As Natalie and all say, every dog is different.

[k9diabetes]

I found that Chris didn't cooperate well with food changes either... tried adding kibble at one point, before he was on Regular insulin, to get more food into his system earlier... he took forever to digest the kibble and wound up going high later in the day!

I suspect digestibility has a lot to do with it too. Chris got a bigger spike from any canned food - I think he just digested canned foods in general more quickly.

[Cara's Mom]

Peggy, Cara had problems too with high BG after meal. I have changed her to Iams Vet. Formula, Weight Control D. She's been on it since middle Jan. and it cured our problem! And it's not too expensive. Just a thought:)

You can only get it at your vet's.

[BaileyBear]

Decided I should of posted this to Bailey's thread.

[peggy0]

We just came back from the eye doctor and Forbin has been blessed as a candidate for eye surgery !!! 4/7 he gets a test that they have to give while they are sedated and then the following Thursday is eye day :) YEAHHHHH. His BG right now is 89 given the stress of another vet visit so we just had a piece of bagel. I'm going to have to watch this all day now given its this low so early in the day. They eye surgeon is a saint he said given them sight is what keeps him going and I knew he meant it. So on to the teeth cleaning tomorrow. Yikes.

[ladysmom06]

Hi Peggy,

Good luck tomorrow with the teeth cleaning. Sending prayers and positive thoughts from our house to yours.

We just came back from the eye doctor and Forbin has been blessed as a candidate for eye surgery !!!

Great news. Hugs to the two of you.

Luv,
Lynne and Lady

[peggy0]

Thanks much lynn!

[Cara's Mom]

Great news! I am soooo happy for Forbin ( and you too;)). Hope everything goes allright with teeth cleaning.
Do you have to start him on Prednisolone drops? If so, that might raise the BG.

Will be thinking of guys......Good luck!

[peggy0]

Yes I have two types of drops. I'm going to start after the cleaning so not to confuse me completely with the BG. Thanks Marion. I'm very excited.

[We Hope]

We just came back from the eye doctor and Forbin has been blessed as a candidate for eye surgery !!! 4/7 he gets a test that they have to give while they are sedated and then the following Thursday is eye day :) They eye surgeon is a saint he said given them sight is what keeps him going and I knew he meant it. So on to the teeth cleaning tomorrow. Yikes.

http://bestsmileys.com/party/5.gif

[peggy0]

Thanks so much, love Forbin

[BaileyBear]

Fantastic! I'm happy for you both that eye surgery is a go. Good luck tomorrow - I know you've been really stressed about it. Hoping everything goes extra smoothly. Forbin's going to be such a handsome guy, with his pearly whites and beautiful blinkers...like he could get any cuter. :D

[peggy0]

My house will be clean as a whistle tomorrow. When i'm a nervous wreck, I clean like crazy. :)

[BaileyBear]

OK - my husband just walked by and almost saw that. Don't give him any ideas. I handle stress by eating copious amounts of chocolate and using stress as an excuse not to accomplish anything. Shhhhhhhh! :D

[eyelostit]

My house will be clean as a whistle tomorrow. When i'm a nervous wreck, I clean like crazy. :)

Sounds familiar, great news !!! :)

[k9diabetes]

Hoping Forbin sails through tomorrow and gives you lots of sweet sloppy kisses when you pick him up. Great news about the surgery!!

Dang, I wish I cleaned when I am stressed or nervous! LOL

Natalie

[Margaret Boyle]

Hi Peggy,
Great news about Forbin hope everything goes really well and fantastic news about the eye surgery wishing you all the best. hugs to you both:D

LOL

[peggy0]

Thanks Margaret and all...... Forbin is awake and doing well. I'm picking him up at 5 central. YAHOOO. I had the whole house vacuumed before we even left this am. The Lord was kind and his BG was in the 100's so I didn't have to panic about it being 80 at 5am. Life is good.

[Cara's Mom]

The Lord was kind and his BG was in the 100's so I didn't have to panic about it being 80 at 5am. Life is good.

Glad that's over....first step! Hope the rest goes just as good!

And yes indeed....life is good (sometimes :D:D)!

[ladysmom06]

Hi Peggy,

Happy:D:D to hear that Forbin is doing well. Hugs to the two of you.

Luv,
Lynne and Lady

[peggy0]

Thanks all. Forbin had no food or insulin this am and the vet said his BG hovered around 195 the whole time. He said he did better than alot of young lads. All that worry :) He's pretty looped still, so we'll see when he's going to want to eat. His BG right now is in the 300's so I may need some help in a bit trying to figure out what to do with him tonight. Thank goodness you are all here!

Did I read something about clavamox making one of our pups sick? Forbin has never been on an antibiotic. he wanted to put him on clindamycin but that almost put me in the hospital. It's extremely hard on the digestive system. I don't have to start him on it until tomorrow and he said he really didn't need it but was using it as a precuation.

[We Hope]

Peggy,

When are you going to keep that guy out of those spots where he can get looped? :D

Zeus is the fellow who had bad issues with Clavamox. I had to use it both in December and January for my non-diabetic (UTI and as a preventive for some hot spot bites he had); he had no problems with it at all. This was my first time giving him any antibiotics also. A lot of them seem to have GI side effects--for people too.

Kathy

[peggy0]

LOL he looks like he's been into the Coors Lite. I need to be!! Thanks Kathy. He ate about 4 ounces of his canned food and he's snoozing again. I'm going to give him 1/3 of his dosage and leave him be.

[We Hope]

Spoken like a truly well-informed veteran of the diabetes "war"! :)

Kathy

[peggy0]

I went to the k9diabetes.com boot camp :) They keep us in line ya know :>)

[ladysmom06]

Hi Peggy,


We have used Clavamox and Lady never had a problem with it. She was diabetic when we first used it. Hugs to you and Forbin.

Luv,
Lynne and Lady

[peggy0]

Thanks Lynn! Hopefully his tummy can deal with it

[We Hope]

I went to the k9diabetes.com boot camp :) They keep us in line ya know :>)

Ah--we HAD a hat camp, but we had to burn it, and we couldn't get the T-shirt camp off the ground, so it's boots, I guess. :D

Kathy

[k9diabetes]

Peggy,

What wonderful news about Mr. Forbin!!!

Chris was one of the dogs who had a bad time with Clavamox - threw up three or four times a day while taking it and it took about 24 hours for him to stop throwing up after he took it. He had trouble with lots of meds. Tramadol (pain killer) was another one that had him throwing up all the time.

Natalie

[eyelostit]

Peggy, I'm glad Forbin is Ok, you sure sound like a trooper now !! ;)

[BaileyBear]

Happy to hear Forbin made it through the dental visit with flying colors...though apparently still flying a bit. :p

I hope the meds don't mess with his stomach too much. :)

[NancyB]

Peggy,
I'm glad that the cleaning went well for Forbin. We're new to living with diabetes and I can see that it's not for the weak of heart! I'm happy that one step is over for you.

We are considering cataract surgery for Milo...down the road, sometime, and it is quite a process from what they've told us.

Did Forbin develop cataracts suddenly? I will be following his progress and wishing you the best.

Nancy

[peggy0]

Hi Nancy,

Yes forbin developed cataracts within weeks. The good thing is, its his only eye problem. He's a good candidate for the surgery and, while its expensive and involves alot of dedication, (see cara's story), they won't come back. Both doctors encouraged a teeth cleaning to minimize any complications from bacteria. They can't have them cleaned after the surgery for at least a year. It's been some ride already but they are so worth it arent they? Milo is so cute and looks like he's got the lab sweetness. :)

[Margaret Boyle]

Hi Peggy,
Fantastic news about Forbin you will feel on top of the world I am glad everything went well :D:D

LOL

[peggy0]

Hi Margaret, I am greatly relieved. He was barking for his dinner tonight, feeling great. His BGs are a little high, but he had very little insulin yesterday. He'll be good as new by the weekend. Thanks for checking in. Hope your little ones ok as well.

[eyelostit]

Glad all is well Peggy ! ;)

[peggy0]

Thank you. The Clavamox hasn't bother him yet either knock on wood.

[peggy0]

Hi everyone. Well forbin doesn't seem to have any issue with clavamox but his BGs have not come out of the high 300's since his cleaning Tuesday. I even bought a new bottle of insulin today to make sure. You know how patient I am :( but is this normal? The vet said he didn't need to give him any glucose during the procedure just electroytes and he has not started his eye meds as I wanted to get his BG back in control first. Any ideas?

[peggy0]

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

Interesting info

[We Hope]

Peggy,

Forbin had his schedule disrupted for most of Tuesday--had no insulin until evening and got only 1/3 of his usual dose Tuesday evening:

LOL he looks like he's been into the Coors Lite. I need to be!! Thanks Kathy. He ate about 4 ounces of his canned food and he's snoozing again. I'm going to give him 1/3 of his dosage and leave him be.

So he's only been getting his entire insulin dose (because he's back to eating all of his meals now) all day Wednesday and this morning. When there's any type of changes to insulin doses, it's the same deal as when you do an increase--it can take a few days for it to start "showing".

Let's take another look at what Dr. Hanas wrote about insulin changes and the insulin depot:

http://www.childrenwithdiabetes.com/download/hanas_insulin.pdf

Page 10

"When changing the dose of insulin at bedtime (this refers to bedtime doses some people need to take) the size of the insulin depot makes it necessary to allow 2-5 days of adjustment before achieving a new equilibrium."

Now to Intervet:

http://www.vetsulin.com/vet/DosingAdjustment.aspx

"Following adjustment, wait to reevaluate until the new dose has been given for at least 5 to 7 days, unless evidence of hypoglycemia appears."

While they're both directly addressing increases of insulin, Forbin's depot went down somewhat when he was having his teeth cleaned--no insulin in the morning and only a part of it that evening because he wasn't eating all his meal.

Now you're to the point where you're "building" the insulin depot back up again since you're able to give him all his insulin with him eating normally once more.

When we had the weak Lilly pork Lente and couldn't increase Lucky's insulin since we had no idea how much potency was left to the old vial we had to return to (which was on the way "out" because it wasn't 100% potent anymore), we had to go with his usual insulin dose. At the time, you couldn't get pork insulin except for having your pharmacy order it, so we had to wait to place an order and have it come in.

He had visible signs of his post-meal spike (bad panting) because of the weak insulin, but it turned out that the vial we were getting rid of was more potent than the brand new one. Every time he got a shot from the old vial, the post-meal panting would get less and less. It did take 3 days for it to be gone (and a new vial could be ordered--happened on a weekend), but that less than potent insulin used consistently got his bg's reasonably under control. They sure weren't his usuals--where we had him and wanted him to be--but this less than potent vial did the basic job of bringing down his bg's. The more potent insulin was going into Lucky's insulin depot over that weekend.

While there are no written advisories about Clavamox and higher bg's, I have heard some people say they've noticed this with their pets. This then would be one of those "individual" things where it may not be so for everyone, but for some.

HTH!:)

Kathy

[peggy0]

Thanks Kathy

I won't worry and hope he'll be back to normal over the weekend. He's acting just fine

[Margaret Boyle]

Try not to worry Peggy Forbin's system has just been upset with the
anaesthetic give him a few days and he will be fine, also the reduction in insulin will set him back a wee bit but he will soon be back on track.
He will be saying to himself " Get me does my breath not smell so sweet I am so kissable now" I am so glad he is getting better Peggy. :D


LOL

[Cara's Mom]

Hi Peggy,
Glad to hear Forbin is doing great! He must be proud of is pearly whites:D:D
Cara was one of those with higher BG when taking Clavomox, luckely they only need it for abt 10/14 days. But it's still a pain:rolleyes:

[peggy0]

Thanks Marion. His teeth do look great :) Feel bad about the BGs, Guess I'll have to up his insulin a bit if its still going on this weekend

[peggy0]

Thanks Margaret. He is truly kissable :)

[eyelostit]

I think Forbin's bg will turn around by or on the weekend.:)

[peggy0]

And once again you are correct! 207 this am

[peggy0]

My springer was operated on yesterday for a lypoma under her leg. It looked the size of an egg. They usually don't like to mess with them as they are typically benign but hers was starting to effect her walking. No wonder!! When they removed it, it was the size of a canteloupe. Poor thing. We were up a good part of the night but she is doing very well today. 12 1/2 and a real trooper. The vet asked me if I wanted to see it. YUK, no thanks. What a week. I'm going to sleep away the weekend

[We Hope]

Glad to hear all seems to be well now with both of your "furry folk" and that you might get a bit of a chance to relax this weekend! ;)

Kathy

[k9diabetes]

Poor girl... yuck, I wouldn't want to see it either!

[eyelostit]

The vet asked me if I wanted to see it. YUK, no thanks. What a week. I'm going to sleep away the weekend

Yep, what a week you've had, its all over now,( i would have wanted to see it)

Short story, had some parts removed, I told doc I wanted to see the thing that was causing me all the trouble, on way to ER they ask if I am taking the part to bury it. I say God no, I want to see it and you can do what you want with it, they thought I believed in some kind of religion that must take these things and bury them.;)

[peggy0]

LOL Geez where do you live Dolly? My mom came from Portage Pa outside of Johnstown and they were always telling me to go bury something to cure something. Potatoes for warts, poor St. Joseph to sell your house!

[Margaret Boyle]

My springer was operated on yesterday for a lypoma under her leg. It looked the size of an egg. They usually don't like to mess with them as they are typically benign but hers was starting to effect her walking. No wonder!! When they removed it, it was the size of a canteloupe. Poor thing. We were up a good part of the night but she is doing very well today. 12 1/2 and a real trooper. The vet asked me if I wanted to see it. YUK, no thanks. What a week. I'm going to sleep away the weekend

Peggy,
Was this your other dog that was operated on I must have got lost somewhere along the way I do hope she is alright I must have missed a thread. Have a relaxing weekend Peggy you have had a tiring few days :)

LOL

[peggy0]

Yes it was my springer. Tough week

[BaileyBear]

Geez - glad to hear they are both doing well. Hope you all get some much deserved rest and a long break from vet visits. :)

Is the thing she had removed like a fatty tumor? Bailey has one on his leg too. It doesn't seem to be bothering him so they said to leave it alone unless it starts to get bigger. Our Border Collie mix (who passed away) had one on his chest for years. But toward the end of his life, it started to grow and got large enough that he was scheduled to have it removed. He died of CHF before they had the chance. :(

I sure hope Bailey's stays nice and small. It must have been shocking to hear it was the size of a cantaloupe! Good grief, where the heck was she hiding that thing? :eek:

[peggy0]

They are so soft and fatty,you really can't tell how big they are. Gross. It grew very quickly that's why we had it removed. It was under her back leg as well and starting to bother her. She has others but none that affect her mobility so they don't bother with them.

[rhodesian46]

Peggy,
Just wanted to say that I am happy to hear that your spinger spaniel is doing well. Gosh darn that was a big growth!! Did the vet feel that it should go to pathology? Or was it obvious that is was a fatty tumor?

[peggy0]

We sent it to pathology although she has a history of benign lypoma's.

[rhodesian46]

Great, Better be on the safe side! My chi is having some lumps removed this Wed!

[peggy0]

Good luck with them. She was in so much pain afterwards, I slept on the floor with her. Pain meds helped alot

[peggy0]

Well Forbin must be one of those who's BGs are low with Clavamox. He was 65 this am an hour after I fed him. I start the eye drops tomorrow so maybe they will balance each other out. Needless to say, the poor boy is going to be pin cushioned around feeding time. I can't wait until normal returns.

[eyelostit]

LOL Geez where do you live Dolly? My mom came from Portage Pa outside of Johnstown and they were always telling me to go bury something to cure something. Potatoes for warts, poor St. Joseph to sell your house!

LOL, I lived out west then, must be religious people who ask about keeping the parts, I just wanted to see it, they did clean it ;), and Oh St Anthony to find something !:D

[eyelostit]

My springer was operated on yesterday for a lypoma under her leg. It looked the size of an egg. They usually don't like to mess with them as they are typically benign

Peggy, was this lump under the thigh area and over a bit underneath ?