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ladygirl
02-01-2009, 03:45 PM
Hi to all,

I just stumbled on this forum after hours of searching up on dogs diagnosed with Diabetes. Quite frankly it's a lot to take in as I'm sure many of you know.
I have a 5 1/2 year-old Miniature Pinscher, Princess, who was just diagnosed with Diabetes yesterday late afternoon. We had noticed she had been drinking a lot more water then usual and getting up at unusual times at night to let us know she wanted more water or to go pee. I hate to say that one of our faults as her owners was that she was never properly potty trained, that and we don't have a fenced backyard, so she always usually pees in the house when she isn't on a walk, but we noticed her peeing a lot more then usual. In addition she also appeared to have been losing weight. Ever since she has been spayed as a puppy she had been overweight, around 21 or so pounds, she was weighed in yesterday at around 18 since her last visit about a month ago. She is also one of three dogs in the house that are usually taken on a 20 or more minute walk twice or three times the day.
We went to the vet yesterday to see if maybe she had a UTI or something, and although it came back negative, the vet did notify us that her glucose was unusually high which was positive for Diabetes. Her health is my number one priority of course, but I do have some other concerns.
We started her in training classes around mid-December where she has gotten more treats then she ever really did in life. Before going to the vet yesterday I relayed this to the trainer and she said among the possibility of Diabetes or Cushing's, one contributing factor she thought could have sparked the sudden thirst and peeing was because of all the treats she had recently been getting.
The doctor told me to take today to figure out things and what I wanted to do. Of course if insulin (as the doctor prescribed) and a prescriptive diet is what I have to absolutely do then I will certainly do so. But before getting her on insulin which will make her dependent on it, I want to know if perhaps, if time permitting, I should change her diet to prescriptive and pay more attention to managing her weight. Most of her life she has been on just regular dog food and we never really paid attention to the carbs or fiber, as we were feeding three dogs. That and perhaps stop giving her so much treats that she has been getting recently in the last month or so and see if there is some sort of improvement.
Ultimately before committing to insulin I would like to see if there is anything we can do on our part (i.e. managing strict diet, no more treats, more exercise) and check back in perhaps a couple weeks or a month and see if this perhaps makes a difference.
I came here because I've read how experienced most of you are and would love and appreciate all your advice. I just posed my thoughts to the vet and the assistant said she should get back to me later on tonight.
I would love to hear from any of you really as I'm new to all this and just want to know everything before essentially making her dependent on insulin the rest of her life.
I'm sorry for the long message but I'm sure you all can understand my concern.

Thanks again,

Natalie

AlisonandMia
02-01-2009, 03:58 PM
Hi and welcome.

Just one question, from what you say a urine test was done that showed high glucose but was a blood test done? If it hasn't been done already, I think you need to have a blood test done to check that her blood glucose is in fact high (and to get a baseline against which to assess response to insulin treatment) before starting on insulin. There is a rare kidney condition that can cause high glucose in the urine even when the blood glucose is not high.

If Princess does have diabetes then she will require insulin as there is no other way of managing the type of diabetes that dogs get. Diet is important in so far as it must be balanced against the insulin given but diet alone will not treat diabetes.

Alison

k9diabetes
02-01-2009, 04:10 PM
Hi Natalie,

My name is Natalie also! Sorry to hear Princess has developed diabetes.

The trainer is probably somewhat misinformed. You probably know about Type 1 versus Type 2 diabetes in people. Type 1 diabetics are incapable of producing insulin for themselves so must have injections to survive. Type 2 diabetics have some resistance or do not make good use of insulin but are physically able to make insulin so oral medications and diet changes can be used to better control their blood sugar.

Cats are akin to Type 2 diabetics but dogs are almost without exception Type 1 diabetics in that their pancreases suffer damage and lose the ability to make insulin at all. So they nearly always need insulin injections to replace this vital substance.

The one caveat for me is the potential for pancreatitis from all the treats, especially if they are something like hot dogs or anything very high in fat, for example. Pancreatitis could theoretically result in impaired insulin production, resulting in higher blood sugar with the potential to recover once the pancreatitis resolves. I don't think this is very likely but I don't like to say never...

I hope the vet did blood work and the only abnormal value was the blood glucose.

So most likely the diabetes will indeed require insulin injections.

Please get a copy of all of the test results from the vet and post them here, along with the reference range (the range of "normal" values) for each test.

I'm curious, personally, to know how high the blood sugar was and also whether any other test results were out of the ordinary.

If she needs insulin, no problem. Dogs do great and diabetes that's well managed does not reduce a normal healthy lifespan. Our dog was diagnosed at 9 and lived past 14 and he was a pretty big guy with a lot of other health problems already.

Anxious to hear more about Princess,

Natalie

ladygirl
02-01-2009, 04:22 PM
Hi Allison and Natalie,

Thanks for your response. Looking over the invoice of her visit yesterday, I don't see anything indicating a blood test. Everything listed is as follows:
Urine Sample Collect/Prep
Urinalysis Package
Urinalysis Sediment Exam
Urine Specific Gravity
Urinalysis Test (Individual)
So I think maybe no? The vet assistant said when they took her back that they would be poking a needle into her bladder, I think, to see what she had. They then came back and said they didn't find anything in the urine but that her glucose tested on the strip came back at a brown color as opposed to the deeper teal color. So I don't think any blood test was done.

Update: I just spoke with the vet over the phone and she said looking over labs she sees that they actually didn't do any blood test, so we are going to go in an hour or so to do that.

k9diabetes
02-01-2009, 04:31 PM
That's odd. I'm glad they are doing it today. I wouldn't want diabetes diagnosed and insulin started without a blood panel.

Given the weight loss, I think plain old diabetes that will require insulin is very likely. It's fairly common in Min Pins.

Will she urinate for you and let you collect a sample?

It would be good to check her urine for ketones - ketodiastix (ketostix if they don't have the glucose/ketone combination) are usually available at any pharmacy and can be used to check to make sure she doesn't have ketones, a product of excessively high blood sugar that can lead to a very dangerous condition called ketoacidosis.

The weight loss suggests that she's been running high glucose for a while so grab a box of the ketodiastix if you can and check that while the diabetes diagnosis gets worked out. I'm assuming they won't have the blood panel results back until tomorrow.

Natalie

ladygirl
02-01-2009, 04:45 PM
That's a good idea. Do you think they would have that at PetsMart? We go to the Banfield in there as her regular veterinary clinics. I was surprised as well after reading everyone's posts that some form of blood work wasn't done. Though the vet is very nice, she seems VERY inexperienced as far as diabetes. She says that she had to search some more about diabetes in dogs on the internet earlier today. But she said that when we come in she's going to do some blood work and a chem panel to get more definitive results, and do another urine test on the stick to make sure.
She also said while it would be a good idea to start regulating her diet first and foremost, she doesn't want to say for sure to try this for a couple weeks because it could be that the diabetes progresses and something else may occur during that time that could have been prevented. But she said it would probably help to manage her diet for a week and come back then to see if there are any changes.
She didn't really give me any results because she said she didn't have the stick right after the test? But she brought in a sample one and said, "Where most dogs are around negative and a teal color, Princess was a brown and around 1000" (regarding glucose levels in the urine), but nothing really concrete. So I guess I'll have to ask more questions when I get there, and perhaps go get a second opinion elsewhere? Again she is very nice but I want to make sure I have an vet who is experienced with diabetes before putting Princess on insulin.

And honestly you guys are a god send, really. : )

Oh also one thing I wanted to add is I just noticed her constantly licking her private area for about 10 minutes straight. She keeps doing it on and off just recently today, do you think that could be something to point out?

k9diabetes
02-01-2009, 05:26 PM
I don't think they will have them at Petsmart except possibly at Banfield itself and may not have boxes to sell - usually have to go to a pharmacy. The Diastix used to be very easy to get but with people all moving over to meters instead of urine testing, they are tough to find. Ketostix are still used fairly frequently because only one or two meters test ketones.

For diabetic dogs, the ideal is ketodiastix as they will give you a very rough idea of how high the glucose is - that's what the vet used - plus check for ketones.

I agree that you will want someone more experienced. Even that isn't always enough but this vet sounds like she will not really be able to guide you. We are here to help you assess whether the veterinary expertise seems to be up to snuff.

Urinary tract infections are quite common in diabetics, especially uncontrolled ones. The sugar in the urine is a real treat for bacteria. Presumably they are checking the urine for bacteria so should be able to sort that out for you when the UA results come back but it wouldn't be surprising. Do mention it to them.

Take a look at the information on the main website if you haven't already, www.k9diabetes.com (http://www.k9diabetes.com), and then we can sort this out more when the chem panel results come back. At the Links page there are many additional resources about managing and treating diabetes in dogs too.

Natalie

ladygirl
02-01-2009, 05:33 PM
Thanks Natalie. Just looking at my dog right now brought all my emotions to the surface. I can't help but feel I did this to her, and that is something she really doesn't deserve. I'm trying to compose myself before I head out for the vet.
And I'm sorry for perhaps not understanding entirely, as I'm a little out of my realm right now, but what is it exactly that I shouldn't be mentioning to them? (I mean as far as the whole UA test thing, my mind is just a little foggy right now.)

I'm also a little frustrated that she didn't do all of this yesterday, because going back now means I have to pay ANOTHER office visit fee for something they didn't bother doing. She told me she thought she had done them but apparently didn't. They were busy yesterday with ONE doctor seeing everybody and I spent about 3 hours there to do everything, it was sort of irritating.

k9diabetes
02-01-2009, 05:46 PM
Mention the licking... it sounds like they already sent a urine sample to the lab to check for bacteria but it's good to tell them that she's been licking at herself.

k9diabetes
02-01-2009, 05:52 PM
We have ALL been where you are right now and know how scary and emotional it is... funny thing is, you reach a point after things settle down where you wonder what you were so worried about... remind me to tell you my "Chris' skull" story when I have more time! :)

I think the most likely case is that Princess just plain old developed diabetes - that's how it goes. One day they don't have it, next day they do and you didn't do anything to cause it. It's pretty common in dogs and Min Pins are well represented. We have a few members here with Min Pins -- Helen just was by a few days ago. Her diabetic Min Pin, BeBe, passed away a few years ago (her story is on the website) but she has two new girls now and is looking at getting a third.

It will all be okay and you have time to sort things out. Does sound, though, like you will need a vet at a clinic where there is more experience and good follow up.

Natalie

We Hope
02-01-2009, 05:55 PM
FWIW, Ketodiastix shouldn't be too hard to get at a large "chain" type pharmacy, even if you need to ask the pharmacist for them (behind the counter to keep them from just "walking out" ;) ). We had no problem getting them on the spot at Walgreen's when the visually impaired lady had the emergency.

Why we're talking so much about blood work needing to be done re: the "formal" diagnosis of diabetes is because there are other potentially serious medical problems for which one of the signs is sugar in the urine--diabetes isn't the only one.

As far as diet and changes to it are concerned, they can be a help to you with canine diabetes, but they can't solely be the control of it. When dogs are diagnosed with diabetes, they become insulin-dependent, meaning their pancreas has stopped producing enough insulin for the needs of their body.

This means you need to get another source of the needed insulin, and that's where the shots come in.

Most humans with diabetes don't require insulin shots. They can manage their diabetes by diet, or by a combination of diet and oral medications. Many cats with diabetes are the same way in that they can keep the disease under control with the proper diet. Still, you find a lot of cats using insulin and now you also find many humans with diabetes who are not classed as insulin dependent using some insulin to help them manage their diabetes better.

We'll try to help you and Princess in every way we can! :)

Kathy

ladygirl
02-01-2009, 06:50 PM
Thanks again Natalie.

So some update, I have decided not to go back to the vet tonight, the same one that we saw yesterday. They just seem very inexperienced (despite being Banfield), and the staff there just give off the feeling that they don't care that much for the animals. I called them to let them know that I won't make it tonight but may come back on Tuesday, but in the meantime if they could suggest any better food to give her, perhaps something homemade like peas and carrots and some type of lean meat. The receptionist put me on hold to go ask and came back very rudely and said, "Yeah um no, the doctor won't recommend anything, so I guess you'll have to wait. In the meantime just keep giving her the same food you've been giving her." (which i'm pretty sure the food is not nutritional at all for a dog with diabetes).

Anyways, I just don't feel comfortable going back there and being charged another $200 for them to do more preliminary tests for them to confirm her diabetes, on top of then having to buy all her diabetic equipment. The vet my sister goes to is nearby and she says they provide her with excellent services and care/check up on the dogs and make sure to see all options possible. So I think I may go to them tomorrow to do tests. My one concern was perhaps trying to get on a Wellness Plan before the other vet does some tests on her, so that way it perhaps begins to cover all these things? I'm thinking they may want to get any records from any previous vets, which then I'm sure they'll get the record that she was diagnosed with Diabetes, which then could present a problem, as they most likely won't let her go on a Wellness Plan.

I was wondering if anybody could advise how you go about with expenses? Are most on some sort of insurance plan before your canine was diagnosed, or were you able to get it after?

And perhaps any suggestions of what I can possibly feed her in the meantime before going to a new vet? I would just prefer not to continue her on her dry food, as I don't think it will help her any. It was cheap brand I got as a filler before buying another big bag of her regular food, so I'm pretty sure it's VERY LOW in nutritional value, if any at all.

As of right now you guys have given me 100x information than my vet or her staff did. I can't thank you guys enough.

*Oh also, Natalie I was wondering if you could explain to me a little bit more about the Ketodiastix? I've been looking over the posts, and excuse me as I'm still trying to understand all this, but what is that they do and what information will they be giving me as far as further confirming her diabetes? I hate to bother you as you've been so much help already.*

We Hope
02-01-2009, 08:22 PM
Ketodiastix will let you monitor the amount of glucose in Princess' urine as well as check for ketones. You need to know how much glucose is in the urine and if there are ketones. When ketones are present, they can be an emergency situation. They will also help you keep track of how Princess is doing once she starts on insulin. Many people do blood glucose testing on their dogs and cats, just as persons wth diabetes do for themselves with meters. You don't need to worry about this right now--using the Ketodiastix will let you keep track of how Princess is doing.

http://www.fifty50pharmacy.com/Merchant2/merchant.mvc?Screen=PROD&Store_Code=F5&Product_Code=IKEDI50&Category_Code=TestStrips

"Keto-Diastix Reagent Strips By Bayer Urine Test for Ketones. Ketone is a substance which is usually not harmful when found in small amounts in the urine. Keto-Diastix Reagent Strips By Bayer Urine Test for Glucose. These are the basic test strips for testing for Glucose in the urine. The strip turns a specific color and that color is matched to a color chart on the Diastix bottle. This is an alternative to blood testing for glucose."

http://i37.tinypic.com/34hdmqr.jpg

This is what the color codes for glucose and for ketones look like. Here also is a link to a previous post about collecting and testing urine:

http://k9diabetes.com/forum/showpost.php?p=4344&postcount=15

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

This is a link to a page on ketones and ketoacidosis and why can be so dangerous for those with diabetes.

http://images3.wikia.nocookie.net/petdiabetes/images/f/fe/Dm_009.gif

Ketones: When there's not enough insulin, the body begins to break down fat cells, which produce fatty acids. These fatty acids are passed through the kidneys into the urine--we know them as ketones.

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

"Urine monitoring is also a quick and easy method of detecting ketones (ketonuria) and hence a potential emergency - see diabetic ketoacidosis."

I think your idea of seeing your sister's vet as soon as possible is a good one and believe I would continue on with what Princess has been eating until you see the new vet, who may have some suggestions as to what he/she would like to see in the way of a diet for her.

The sooner you get some bloodwork done for Princess the better because I believe she does have a urinary tract infection. Most of the time that makes the blood glucose go quite high--treating them brings the glucose levels down. With some of our diabetic dogs, the higher than normal bg's are often the first sign there's an infection that needs to be treated. I think once you get Princess' bloodwork done and start with whatever treatments she needs, things will seem a lot clearer than they might seem now.

Kathy

ladygirl
02-01-2009, 08:42 PM
Kathy thanks for explaining that, it helps a lot. And I can't thank you enough for your kind words, it truly helps.
I think the blood work will really help clear up things.
Princess hasn't been drinking a lot of water as incessantly as she has been in the past couple weeks and hasn't been peeing as much as well, but she was up for eating carrots, so maybe that's a good sign? Right now she has just been lounging around/sleeping, which is not uncommon for her, she is/was usually like that before the diagnosis.

Gosh I guess waiting is the hardest part.

eyelostit
02-01-2009, 09:03 PM
Hi Natalie and Princess Welcome

I am glad you are seeing a new vet, yes you need the blood test to confirm the diabetes. I get the Ketodiastix at Walmart and at times they have them but any other pharmacy like Rite Aid, CVS may just have them, I know if walmart does not have what I want I order it and get it by 2 days.

I'd go to the new vet ASAP, as for feeding No Peas and carrots very high in sugar, I am thinking now, as to food with no insulin at the moment, turkey and chicken is good, cooked egg, I get ground turkey in tubes at Aldi's or Save a lot, they are a discount food store. It does not cost alot to take care of a diabetic pet.

Alot of us use NPH Insulin Walmarts brand is Relion NPH and you do 2 injections per day 12 hours apart. That insulin runs about 20.00 and will last about month depending on size of your dog. The Vetsulin you get at the vet is more expensive, some dogs are on this kind, then some owners chose to use the NPH. Whatever the vet says insulin is injected 2 X day 12 hours apart, if they tell you one time per day ask them why and what type of insulin they are prescribing.

Also if the vet prescribes N insulin (NPH) you can get this without a presription at walmart, Eli Lily brand is over 45.00, what you want is Relion Novolin NPH. Relion brand is same as Novolin, but box has to say Relion Novolin NPH to get the price for 20.00.

If Princess is DX with diabetes, that is why she is losing weight, she needs insulin to get the nourishment from food into her system with out it, she will continue to pee, leak urine and drink alot of water that is how they get rid of the excess sugar they cannot process. Have you noticed a nail polish like smell with her breath?

It does not cost alot to manage a diabetic pet, I manage my Niki very well, she eats some dog food (mid priced one) vegetables (gr. beans and brocolli) and turkey, she has been diabetec for over 6 yrs now, she is 11.

Don't let this get you down, this is not your fault, I have had dogs most of my life and Niki just happened to get diabetes, I cryed, cryed and got that out of my system, then just said, OK, lets get ahold of ourself and just take control of this. You can do it too, like all of us.

You are not alone, we are all here for you, hang in there, chin up. :)

ladygirl
02-01-2009, 10:41 PM
Thanks Eyelostit, that's definitely comforting to hear, although now I feel bad because I just fed her some baby carrots and she liked it, but I definitely know now not to give her that, or peas (which I also gave her like 10 peas earlier).

She has been a little bit more normal today, not drinking water incessantly, just normal like she used to, which was like three or four times the day but would drink for like 10 seconds as opposed to like 2 minutes. She also hasn't been peeing unusually today as well, just during her usual walk in the morning, once during the day, and then regularly on her night walks, do you think this is just a momentary thing?

For right now all she has had done was the urinalysis tests, which the vet then diagnosed her with diabetes and wanted me to get her started on insulin that night, but I told her I wanted to take the night to research more about it before coming back what would have been today.

I then found this board and realized from all of you guys that she has not had blood work done yet so it was probably a good thing I didn't get her started on insulin right away. I'm going to go to another vet either tomorrow or on Tuesday to get the rest done, I'm just trying to see if there is a way I can get her on a Wellness/Insurance plan before the other vet possibly diagnoses her with diabetes as well. I was wondering what the rest of you do as far as insurance or if you guys are on some form of wellness plan?

Also thanks for the advice about the Ketodiastix, I just want to know if that is the same as the urine test or does that help confirm for a blood test? I'm sorry if I seem misinformed but I'm still trying to get a hold of all of this. I'm pretty sure the previous poster said it was probably the same as urinalysis, though I may want to do my own on her since the vet didn't show me her stick.

Any advice or suggestions you have is so appreciated, really. I can't thank you guys enough. I broke down crying earlier today because I was so sorry I did this to her. I know it's not entirely my fault but you can imagine as any owner the last thing you want is for your dog's health to be anything but healthy, especially when you feel you could have prevented it.

BaileyBear
02-02-2009, 02:39 AM
Dogs end up with diabetes for many different reasons so you can't beat yourself up for it. It's one of the most common canine diseases (I've read 1 in 200 dogs is diagnosed - and think how many aren't diagnosed, so it's probably even higher!) and even the most fit and healthy appearing dogs develop it. A higher number of treats recently was not very likely to "give" her the diabetes. What it *may* have done is alert you to it a little sooner and that can be a good thing. The sooner she is diagnosed and begins insulin, the sooner you can get it under control and hopefully prevent further complications. It's also important for her to be seen by a good vet because some diabetic dogs can have other health conditions along with the diabetes and they are also more prone to things like bladder infections. A quickly diagnosed and treated bladder infection can be easy to get under control - but left untreated can lead to a much more serious kidney infection and can send a diabetic dogs blood glucose out of control. The sooner you're on top of things, the better off Princess will be.

The Ketodiastix are a relatively easy way for pet owners to monitor the blood glucose in the urine and to watch out for ketones. But they are less exact then the blood tests performed at the vet's office. They're not used as a form of diagnosis - more an easy way for you to keep track of your dog's numbers at home between visits. But it's VERY important for you to get Princess to a new vet so she can be properly diagnosed and treated. Diabetes will not resolve itself with diet alone and she can become very sick, very quickly.

I know you're concerned about the cost and I completely understand. My dog was just diagnosed in January and I felt very overwhelmed in the beginning. It's a lot of information to take in and process in the beginning. But you'll be surprised how fast it starts to make sense and feel less overwhelming.

I personally wouldn't waste any time trying to sign up for pet insurance before you get Princess treated. From what I've read about some of the plans, they limit payment for chronic diseases either yearly and/or lifetime. Most of the limits I saw were around $300, so the cost of the plan would not have been worth it for the coverage long term. When you go to the new vet, be upfront about any financial concerns. I truly believe that a good vet will be able to take everything into consideration and work with you. That's not to say that they won't recommend whatever test they feel will help. But you can then take them one step at a time with your vet's recommendation and guidance.

The supplies are financially manageable. Like others have mentioned, if she is put on Humulin N, you can get it at Walmart for about $20 (it's $22 at our Walmart). How long one vial lasts will depend on how many units Princess ends up needing per day. Smaller dogs tend to need less insulin. My dog weights 65 pounds and is currently on 18 units, twice a day, but is having that increased every few days since he is not well regulated yet. But even at 32 units a day, a vial should last me about a month. One vial holds 1000 units...as I found out recently after mistakenly thinking it had only 100 units and having a minor freak out. I thought my dog (Bailey) was going to be going through vials every few days. Thankfully I was SO wrong. :)

Syringes are not expensive. I have the Walgreen's brand and I *think* they were under $10 for 50 of them. If you and Princess can successfully home test, you can pick of a blood glucose meter for free or very inexpensive. I currently have a Walgreen's version. Test strips for the meters can cost a chunk, but once your dog's BG is well managed you won't have to use nearly as many of them. I paid less than $50 for 100 of them. Walgreen's has a discount prescription membership you can sign up for that will get you a small discount on certain supplies and is good for pets too. We initally signed up for it to get the discount on his insulin before I knew about the less expensive version available at Walmart. Our membership card just arrived last week and says "Bailey Dog ***** (our last name), lol.

In the end testing at home saves you money because you will be able to monitor blood glucose at home and report the numbers to your doctor, instead of your dog constantly going there for testing. It's one way to save some money long term, if your dog will let you test her, and to lesson the stress on your dog (and you) since she can stick to her normal routine at home. Blood glucose tests at our vet are $16 and it was about $100 for him to spend the whole day there for his first curve - a day of blood glucose testing they do to see how the dog's body is reacting to the insulin throughout the day. But now that our vet knows I keep detailed notes and can test Bailey at home with ease, I'm doing all of his curves myself. Many dogs aren't bothered by it at all - some are, but it's worth a try. Check out the videos on the website of some of the dogs getting their blood glucose tested at home. I use the inner lip method on Bailey and I swear he could sleep through it. ;)

The most important thing to focus on right now is getting Princess to the vet for a definite diagnosis so that you can proceed from there. You can do this - I promise! You found this place and that is half the battle. The members here are so knowledgeable and offer tremendous support. Read the main part of the website and you'll gradually see that a diabetic dog's life can be just as high quality as a dog without diabetes. It does take a commitment on your part - schedules, injections, good health care. But I've only been traveling this road for a couple of weeks and it is already feeling much more manageable. Most dogs just get used to it and take it in stride. I think it's the "parents" who take it the hardest. But once the dog is well regulated, the shots are just a few seconds out of their lives...and an excuse for a treat! It's just a healthier treat now and he is just as thrilled. Bailey already comes right to me for testing and injections and flops down on his side. :D

Deep breath & hang in there - you & Princess will BOTH be fine. ;)

k9diabetes
02-02-2009, 08:29 AM
I wouldn't worry about the insurance either, at least in terms of getting it started before the diabetes is officially diagnosed. You will have to lie to get her diabetes covered and that's probably not a good way to get started with an insurance plan that has to be renewed every year, plus it will delay getting things sorted out.

We are experimenting with insurance for our new adoptee, Jack, but see it more as coverage for something big and unexpected like an accident or cancer. It's $282 a year just for the major coverage - that doesn't include wellness care - which will buy a lot of insulin and syringes. And they exclude anything he's already been seen for. He had a brief exam just after we adopted him and the vet noted a little tartar on his teeth... excluded. He had a red bump on his nose that has since gone away... excluded.

Do be forthright with the vet though that the expenses must be a consideration, which means NPH insulin instead of Vetsulin. It will be a good sign of the vet's skill and concern if s/he works with you on this.

The test the vet did with Princess over the weekend was a diastix test. Not sure if she used ketodiastix or diastix, but they just put a drop of urine on the test strip and checked for color change just like you would do. When she told you it should be teal and was brown instead, that's the result of a test with the keto/diastix (see the pictures Kathy posted for the color strip).

They also drew a sample though for a complete urinalysis - they send that sample out to a lab - and that will tell them whether any bacteria are found so determines whether she has a UTI that is causing the licking.

The main thing, since she's losing weight and potentially has a UTI, is to get her a new vet appointment and get this all sorted out as soon as possible so you know what you are actually dealing with.

I hope the new vet is wonderful! :)

Natalie

ladygirl
02-02-2009, 10:10 AM
Thanks for all the advice you guys, really. I have learned more in a couple days then I ever thought I would. I think I'm going to have my sister take her tomorrow to the new vet to get all the tests done. I agree that I don't want to start the relationship by lying, and the wellness program probably wouldn't cover a lot of the requirements for diabetes anyways.

Early this morning I went ahead and picked up some prescription diet food from PetsMart (Hills W/D) and bought some Ketodiastix. I incorporated some of the food for her this morning and she loved it! She wouldn't even eat her regular terrible kibbles. I also did a stick test on her and it turned around the 1000 for Glucose and "Small" (lightish pink) for Ketones. She is now still licking her private area again continuously, so I will definitely mention that.

I did relay to the vet assistant this morning when picking up the diet food (I guess the morning staff is a lot nicer because they were very warm and helpful) that since our vet visit on Saturday, she is essentially back to her usual ways. No excessive water consumption or urination, all just regular. She told me that is probably a good sign. The only thing really we're noticing now is that she keeps licking her private area.

Really you guys are so helpful. I'm keeping her for right now on a cup and a half of prescription diet a day. I did also want to ask if it is alright to just put the other two dogs on that as well? I fed them a little this morning combined with their regular kibble and they were the same as Princess, picked out the prescription and pushed the regular kibble aside. The vet assistant said as long as their liking it its okay to incorporate a little more or just substitute it. They may have some runny stool or a little vomit, but it will settle in a couple days.

And again any advice you guys have before I send my sister to the vet on Tuesday? Or am I starting on the right track? (I wish I could take Princess today, but I don't think I'll have enough time off work.)

We Hope
02-02-2009, 10:51 AM
Right now, I would advise that Princess get in as soon as possible because of her trace ketones. Getting some insulin started with her right away would help control the high glucose which is where the ketones come from.

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

What you want to do is to prevent this from becoming a full-blown emergency. I would call the new vet where you intend on taking her and tell the staff that she is at about 1000 glucose with trace ketones on your ketodiaxtix test. They can then tell you or your sister as to if Princess needs to come in now or can wait until her appointment tomorrow.

Kathy

ladygirl
02-02-2009, 11:58 AM
Hi Kathy,

Thanks for the advice I will go ahead and call up the new vet and see what they say. As far as her licking and going back into normal drinking and urinating habits, is that something you guys have ever experienced prior to going on insulin? I'm going to weigh her on later tonight to make sure there was not another drop in weight, or if there is.

We Hope
02-02-2009, 12:16 PM
My thought is that she has a urinary tract infection and that's the cause for the licking in that area.

Usually, what you see with diabetes is drinking and urinating more than normal. There are some vets who go by these signs and not much else regarding whether or not there's something wrong with the regulation. In this case, I think they would miss the boat because you did the ketodiastix test and it came up with both high glucose and trace ketones.

While it is important to watch the various signs, it's also important to know what the blood glucose values are--to look at the "total dog" and be able to know him or her.

My little one was running terribly high until we got to pork insulin, but he never had any ketones from it. Most people say their dogs are lethargic when they are high--mine became hyperactive from it.

When we switched him to W/D just a bit before going to pork insulin, he was drinking and urinating quite a bit less. We'd ordered the pork insulin because what we were using was at resistance dosage and wasn't doing any good--the W/D had helped to lower his bg's. He still needed the insulin switch and it was a combination of the W/D and pork insulin that got him regulated.

Keep us posted on Princess! :)

Kathy

ladygirl
02-02-2009, 12:32 PM
Kathy do you mind telling me a little bit more about pork insulin? How does it differ from regular insulin?

pgcor
02-02-2009, 01:18 PM
Hi Natalie:

Just wanted to say welcome and that my Pip was diagnosed about 1 1/2 years now. He's a Min Pin too. I felt exactly (and I mean exactly) as you do now. What did I do to cause this? I shouldn't have been feeding him table scraps, etc. While, I shouldn't have been feeding him table scraps for a number of reasons other than diabetes! - I never had a dog with diabetes and wasn't even aware they could get it!

I cried for weeks after his diagnosis. But, I have to take care of him - and you will take care of Princess too. And you'll get better at it. As she gets healthier, you'll feel better...I can promise you that. Have you posted a picture yet? I'd love to see her.

Pam and Pip

We Hope
02-02-2009, 01:22 PM
First of all, the insulin you can now get at a pharmacy is all r-DNA human insulin or human insulin analogs (the analogs are by prescription only). Here in the US, there are only 2 brands of it--various types of Humulin made by Lilly and various types of Novolin (and ReliOn Novolin which Novo-Nordisk makes for Wal-Mart/Sam's Club). These insulins are cloned to be a perfect match to the insulin of human beings.

Pork insulin used to be available at pharmacies made by Lilly and Novo-Nordisk, but not any more. The same is true for beef or beef/pork insulins--they used to be available but have been off the US market for a while. For people, they can either buy CP Pharma's Hypurin pork R and pork N from Canada or import them from CP Pharma in the UK. All beef insulin for people comes from there now and has to be imported.

The only pork insulin that's on the US market, period, without importing now is Vetsulin, which is a pork Lente insulin.

Canine insulin and pork insulin are a perfect match, while canine insulin and human insulin differ by only one amino acid--this is why most dogs can be regulated on human insulin--it's very much like their own.

My Lucky had immune-related insulin resistance. What that means is that when he was given human or beef insulin, his body recognized that it was not just like the kind his pancreas used to make. Lucky's system viewed those insulins as "invaders", just as the body views bacteria or viruses--and the immune system goes to work to destroy them before they cam do harm to the body.

Within a couple of hours after Lucky would get a shot of either human or beef insulin, his system would destroy it before it really ever got a chance to do the work it was meant to--controlling his blood glucose. Using pork insulin for him meant that his system "saw" that this insulin was just like his own--and it wouldn't destroy this insulin but would allow it to do its work.

When Lilly stopped making pork Lente insulin, we tried him with pork NPH, which they still made at the time. But Lucky had problems with the suspension and preservatives of the NPH insulin, which are different than in a Lente type insulin. We applied for permission to import Caninsulin/Vetsulin for him, because it had not yet been US-approved. He was the first US Caninsulin/Vetsulin patient who had not been part of a previous study, and was at least 14 years old at the time.

Vetsulin is gotten by prescription either directly at your vet's or at one of the online pet pharmacies with your vet's prescription. Humulin NPH and Novolin or ReliOn/Novolin NPH can be bought at the pharmacy without any prescription. Vetsulin costs more for the most part than the ReliOn/Novolin NPH. The ReliOn/Novolin NPH from Wal-Mart/Sam's Club is cheaper than the non Wal-Mart/Sam's Club Novolin NPH, and Novolin NPH is cheaper than Humulin NPH.

Keep in mind, though, that Vetsulin is a U 40 (more dilute) insulin than the human ones, which are all U 100 strength. There's a difference in the syringes you need for Vetsulin and the ones used for the human U 100 insulins also. U 40 syringes have red caps and U 100 syringes have orange ones to denote the strength of insulin they are to be used for.

A 1 cc syringe for U 40 insulin holds up to 40 units of U 40 insulin. The U 100 1 cc syringe holds up to 100 units of insulin.

Whatever insulin you start Princess with, you need to make sure that you have the right syringes to go with it--not having them can mean under or over dosing.

Right now, I believe I would let your new vet tell you which insulin he/she prefers to start Princess with and go with that, whether it's Vetsulin or Human NPH. :)

Kathy

ladygirl
02-02-2009, 02:29 PM
Wow thanks you guys for all the plentiful info, it's certainly overwhelming but comforting as well knowing that you have all been through it. Kathy thanks for explaining all that, it definitely makes it better to know all that before going to the vet tomorrow (or possibly today if I have time.) I just sometimes look at her and think, "God am I really going to be able to do this? Stay on schedule for everything? Have enough time to do everything? What if I screw up and it turns fatal?" I know the owner stresses much more then the dog, but what else can we do? These are our children that we love.

If the diabetes is confirmed then I know I will learn how to manage it. My only concern is time. I'm at school in the city on Tuesdays all day and Thursdays until about 4 pm. I work all day MWF, but can leave for an hour lunch to check on her.

The thing is that she is one of three dogs that lives at my parents house, and they all work as well. At my parents house it is currently my mom, dad and my oldest sister (as she pays her way through grad school). My father is primarily the one who takes them on their walks and feeds them in the morning. He usually heads to his agency at about 10 am, my mother goes to work about 8 am, and my sister is on this new 4 day work week where she has Tues/Wed/Sat off. So my concern is that Princess will have someone there to monitor her, is that what most of you guys do? Are you at home most of the day or how does it work? At nights I can certainly monitor her or have my sister monitor her those days that I stay at my place to go to school, but I just feel like with my dad, sister and I taking rotations I don't want one of us to skip something or double something and put her in danger. Gosh I'm getting really stressed/overwhelmed just now thinking about it.

My dad is hurt just as much as I am. He cares for these three little guys more then anything. When I told him she probably had diabetes his heart broke and he rocked her like a baby all night. (I'll edit my profile picture as the one of my dad with both Princess and her brother PJ sleeping on him, it's too adorable. Princess is the one with the pink collar, I call her "ladygirl" as her nickname, hence the username :)

If any of you guys could offer your stories of how your day usually is, I would so appreciate it. Admittingly I got a little intimidated over in the stats thread seeing how often some test the blood glucose, is that daily or a less often thing?

Cara's Mom
02-02-2009, 03:45 PM
Hello Natalie! Welcome to this forum:)

My Cara was dx 6 month ago and I know all about panic...schedules etc. It all looks like a huge big mountain in front of you :eek: However it gets to be a routine and in no time that mountain turns out to be just a bump in the road!

With your Dad's and your sister's help and keeping a daily log, so everybody knows what needs to be done or has been done....... you'll have it under controle in no time;);)

We have all been were you are now!! Believe me, it will get better:D:D

Best wishes

Fishslayer
02-02-2009, 04:37 PM
If any of you guys could offer your stories of how your day usually is, I would so appreciate it. Admittingly I got a little intimidated over in the stats thread seeing how often some test the blood glucose, is that daily or a less often thing?

Lucy is my foster dog. Here's her story
http://www.k9diabetes.com/forum/showthread.php?t=458

I was a total newbie as far as diabetes goes. I knew nothing but thanks to a whole group of people Lucy is doing OK and I am learning.

I get up about 6:00 AM, depending on how late my other Cattle Dog Dingo figures I should sleep.

I let Lucy out of her crate & take all the dogs out to do their business.

Between 7:00 AM & 7:30 AM I take Lucy's BG.

After that I feed the dogs. Our two permanent dogs are fed in the house & Lucy & I go out to the garage for her meal & clicker training. She gets rewarded with small handfuls of her meal kibble. This is good because she is a gobbler. She would eat her food far too fast if I just put down a bowl.

At about 8:00 AM she gets her AM injection.

Sometime during the day I get a Diastix test done.

Same routine 12 hours later. Test, meal, injection.

At present I'm unemployed so my schedule is very flexible. When I go back to work I will rearrange the schedule as necessary.

Right now we are trying to get weight on her so she can be spayed. I take her to the vet every couple of days & weigh her.

Luckily, Lucy is VERY submissive for BG test & injections. It's no big deal. The hardest part was figuring out the setting for the lance to get a consistent amount of blood for the BG test. Now I only waste about 1 test strip out of 4 or so and getting better.

I keep a Word document on my puter desktop with all of Lucy's BG results, curve results, diet & Vetsulin information, etc. I also have a book for notes & stuff.

Good luck & prayers for your little Princess.

Rick

BestBuddy
02-02-2009, 05:47 PM
Hi Natalie,

It's hard to imagine but your life with Princess can get back to normal. The initial shock and getting routines for feeding and injections is tough at the start but it really does get easier.

My sweet little Buddy lost his battle a few weeks ago but that was after dealing with diabetes for 6 years and 8 months. He was nearly 16yo and had a diagnosis of cushings 2 1/2 years ago as well so he was a battler.

Anyway after the initial shock of diabetes we decided on a 6am and 6pm food and injection schedule and that worked well as at the time hubby and I both worked full time. We fed Science Diet Light and changed to Science Diet Mature after a few years. The first 4 years we only ever urine tested with occasional vet visits for a BG check. After the cushings dx we had to learn to BG test so we did and over those two odd years only ever did about 5 full curves when things were not right.

I didn't even check fasting most days depending on how he was acting. After a while I got to know the signs very early if his BG was high or low so I would test to make certain. Even if he was high I wouldn't make a food/insulin change until I had done more tests to see if it was a once only bad reading.

So you can make your own decisions on how often you think you should test, more often will give you more information but you can only do what you can. I also believe that too much micro managing isn't good for the dog because they need to have a pleasant life too. It may take a while for you to get to this point of "comfort" but it can be done.

Jenny

eyelostit
02-02-2009, 07:47 PM
Hi Natalie,:)

Well you really did some homework, so you are armed for the vet. I'm anxious to hear what they say.

Take care,
Dolly

BaileyBear
02-02-2009, 10:18 PM
You'll find a schedule that works for your family. Right now I'm doing all of the injections, testing, feeding, etc. But when Bailey is better regulated I would like my husband and daughter to both be adept at caring for Bailey as well, in case I'm not home at the moment.

My husband works an odd schedule and I have a teen with lots of evening activities that I attend, so right not I give meals and injections at 10am & 10pm. You can give them at pretty much any hour that works for your family as long as they are 12 hours apart.

We have a calendar on our pantry door that has everyone's schedules on it. It has vertical rows instead of the normal boxes so that you can list family members names across the top and see at a glance what everyone is up to that day. Mine is Sandra Boynton's "Mom's Family Calendar" and you can check it out on Amazon to see what I mean about the rows. Now Bailey has his own row where I note his meal, insulin injection time, and dose so that everyone in the house will be on the same page when they start participating more. Maybe something similar would help with your busy family. :)

eyelostit
02-03-2009, 02:16 PM
Previously when Niki did her leaking and was licking herself, it was because she was kinda scared or thought she was being bad or the urine left there was irritating there and she would actually start licking the urine spots on the floor, I got her out of that.

I started to clean that area with some Tucks pads, Wamarts brand, that seemed to help, I think its the sugar in the urine that irritates that area, and i will put a teeny amt of vaseline on her pp if I see any redness.

AlisonandMia
02-03-2009, 04:40 PM
The urine of an untreated diabetic is sweet and diabetics are hungry so this could possibly be another reason for licking.

An infections is very likely though. Sometimes when a dog's urine is very dilute because of something like diabetes, bugs may not appear as they normally would in the urine when there is a UTI. In situations like that (where it looks like a UTI is happening but the urine is dilute and no bugs can be seen) the dog is often given an antibiotic anyway, just in case. Very often the response to the antibiotic indicates that a UTI had been present all along.

Alison

Ricksma
02-03-2009, 04:44 PM
I just want to welcome you to this board...I am so glad you found it. The people here are the best...knowledgeable and supportive. Don't worry, we have all been where you are now, and I promise you, in a few months, you will wonder what all the fuss was about. I know it seems like a monumental task--the schedule, the shots, the testing---pretty soon you will be doing all three things while talking on the phone. The most important thing right now is to get Princess started on treatment ASAP, so she can get on this journey with the rest of us...and start to feel more like herself again. We are here if you need us...let us know what's happening.

Teresa and Ricky

ladygirl
02-04-2009, 01:59 AM
Thank you so much you guys for all your concern and support, I can't express how much it means.

Since I had class all day today my sister took Princess to the new vet. Needless to say the vet was anything but amazing as my sister puts it. She says he was very kind and not wanting to rule out any option is going to run all tests on her. He even said that she was "one of the cutest dogs" he'd seen in a long while, even though she was being fussy with him.

So as of right now he is going to call back tomorrow to give me the test results. Like any of us my desire is that she does not have diabetes, but if she does then I think I will be a little more prepared for it then hearing it for the first time like I did at the last vet. Much of that is owed to you guys.

I will try and keep you guys updated. Sorry I didn't post before but I have midterms all this week and I'm trying to stay as open as I can for Princess and to make sure I start getting on a schedule for her anyways. I've already changed her diet to Hills W/D along with some homemade shredded boiled chicken, egg whites, asparagus (though I'm not sure if that was an approved veggie or not) green beans and broccoli. I give her about a cup and a half of this a day divided once in the morning and once and night, though I think I may refrain from the homemade mixture in the morning as it might be a little much for her stomach at that time.

Any advice you guys have on how I'm doing so far or anything for future reference is always, and I mean seriously, always appreciated.

ladygirl
02-04-2009, 01:56 PM
So I just got off the phone with our new vet and he confirmed that Princess does have diabetes. :(

He said that her BG was about 416 and that she had 1+ Ketone, which I guess is not terrible but it's not good, so they just want to keep an eye on that after the inuslin.

He does want my sister and I to come in tonight with her to get all the info and to give her her first demo shot tonight and that he will get her started on Vensulin and that we will have to change her diet. (I don't know how to approach that part because I already changed her diet since the last vet gave me a prescription card for Hills W/D which I already got her started on, but I don't think I want to mention that to him, any advice?)

Anyways he said most likely he will want to see her two days after the first shot to see how she is adjusting. I let him know about our schedules and he said we would go over that more in detail tonight but that we can be a little leniant as far as scheduling and that if we get shots around the 10-12 hour mark it shouldn't be too harming.

I just want any advice or suggestions from you guys as to things I should ask him or be ready for tonight. I would really appreciate it, truly.

Natalie

We Hope
02-04-2009, 02:24 PM
You'll need to just tell him that you had Princess to someone else but you believed they were not knowledgeable enough about diabetes to help you treat her properly. You can then tell him when you started her on W/D as per the other vet--when you started feeding it and how much you've been feeding.

Right now, your new vet is believing that Princess is eating some type of non-prescription dog food and that's why he mentioned the diet change. If he wants you to stay with the W/D, he'll be glad to keep on prescribing it for Princess.

Some links with some good questions to ask:

http://www.petdiabetes.net/questions/questions.html

http://web.archive.org/web/20071221112332/http://www.petdiabetes.org/diabetes_questions.htm

Since Princess will need to go back in two days, if you forget anything or think of something else, you can ask when she goes in again.

Kathy

ladygirl
02-04-2009, 08:45 PM
So we just got back from the vet. Needless to say once we got in the car I started breaking down in tears. I know eventually it will get into routine but I guess it's just a lot to take in at one time.

Anyways they started her on 4 units of Vetsulin twice per day and we will go for a follow-up on Friday.

The vet said that while Hills W/D was more the go-to product in the beginning of this disease, but he feels that Purina O/M will be more calibrated to her needs, as its lower calorie and higher fiber.

I printed out the list from one of the diabetes websites of all the questions to ask and tried to go over as most of them as I could. They were the nicest staff and seemed so genuinely vested in her health, so I feel a little more at ease.

I guess my primary concern is just time management. I know the first weeks are key in monitoring the dog, but with all our different schedules I just feel that we're gonna mess up at some point and come home and find her sprawled on the ground. I mean we're definitely not going to just give her her shot and scat, but I just feel like everyone else stays home the whole day and I feel guilty for not being able to do the same.

For example, and I relayed this to the vet, we gave her her first insulin shot with the vet there today at around 7:45 PM, which means we'll give her the next shot at around 7:45 AM. My concern is that I'm the one who can stay the latest until 9:30 AM, maybe some 10 minutes later after that and I don't want to potentially not be able to make my way back to my parents until around 12:15 after class and find her unconscious on the ground.

The vet said that if I give her her shot as scheduled at 7:45 AM and hang around until 9:30 AM, then that should be enough of monitoring time to ensure that she'll be fine until at latest 4:15 PM when I can get home on Thursdays.

I don't know I guess I'm just really overwhelmed right now with the schedule and hoping we can all stay on top of it and always ensure there is someone here (at least for the first few months) in to stay and monitor her for enough time and make sure we don't mistake anything and put her in serious harm.

I'm going to go ahead and type out a schedule for everyone in the household so that we all get in line.

I'm probably going to be on the board all night tonight as I have a lot of homework and want to stay up monitoring her. I forgot to go get Kero syrup on the way home so I may go on later tonight. Do you think that we'll be okay? I'm just hoping all goes alright. :/

We Hope
02-04-2009, 09:06 PM
If you keep pancake syrup at home, you can use that instead of the Karo--it works fine. ;)

There are some people here who work full time--husband and wife--and they are able to make things work out. Getting a schedule together is a smart idea because that lets everyone who's going to play a role in Princess' care know what needs to be done, when it needs to be done and makes sure nobody accidently gives two shots or forgets to give the one due.

There have been times I've felt exactly as you do now--either over Lucky or an ailing family member. You wonder how you're possibly going to do what you need to do and do it right. When your head starts spinning like this then try taking things one step at a time as they come; you can make things work if you don't jump too far ahead because that's when you start worrying too much.

I think you can all do this! :)

Kathy

ladygirl
02-04-2009, 09:16 PM
Thanks Kathy you've been so much help I can't thank you enough.

So do you think as far as monitoring time of an hour and a half we should be fine for the first few weeks on the days that we have more limited time than others?

Also, I was wondering if Princess sometimes gets hungry after her meals, like say right now she ate at 6 PM and now it's 9:15 ish and you can see she probably wants a little something. I probably gave her a little less then 1 cup and a 1/2 today so I was wanting to know if there are any general treats I can give her from home once in a while to curb her appetite that are good for her? Like a little broccoli or perhaps a little bit of cheddar cheese or...? I really don't know anything you guys can advise me I would appreciate so I know what to go out and start getting for her.

The financial aspect I know will get a little bit easier but in just two days I've spent nearly $500 on her in vet visits.

Fishslayer
02-04-2009, 09:22 PM
I know exactly how you feel. The first couple of weeks I would dash to Lucy's crate when I woke up to see if she was still alive.

Lucy's crate is still my first stop in the AM but now it's to let her outside to drink & well... you know.:rolleyes:

You will get used to it. Her care will become routine. You (and "I") both have an entire community available with a wealth of knowledge & experience to share.

With multiple people involved there IS the danger of two people giving her a shot. For this reason "I" am the only one in the house who feeds and injects Lucy.

You can do it!:)

Rick

ladygirl
02-04-2009, 09:25 PM
Thanks Rick! I read all about your story the other day and really commend you for doing such an honorable thing as adopting Lucy, she is lucky to have you.

I just gave princess like 7 little kibbles of her food as a treat because she kept telling me she was wanting a little food. Do you think this was okay to do? She got her first insulin shot at 7:45 PM tonight. I hope I didn't do anything wrong by giving her a little bit.

Fishslayer
02-04-2009, 09:38 PM
I doubt it will hurt her terribly, but when getting her BG regulated it's good to keep track of what she's taking in.

I caught Lucy in the cat food one afternoon & sure enough, she had a high BG reading that night.

This AM she jumped during her injection and I lost some insulin in her fur. Her BG was a bit high this PM but nothing serious.

Low BG is way more dangerous to life than high BG.

I probly put a lot more time & energy into this than really necessary but since I'm unemployed I can spare it. When I get back to work I have no doubt that we'll be able to work things out.

BTW, I am only Lucy's foster human. She's going to be up for adoption if you know anybody...;)

Rick

We Hope
02-04-2009, 10:01 PM
Most people do give some type of reward after giving the shot. Lucky's was a bit of roast beef--no carbs and no sugar. Many people have said that their dog was wild about getting a green bean--fresh, canned or frozen--as a treat. Green beans are low carb and low sugar. I know that others will be posting here to say what they give as a post-shot treat.

I was on another board some time ago with a fabulous lady who had one dog with diabetes. There was no one else living in the home but the lady with her two dogs. She worked full-time to keep that roof over her head. :)

When some people would ask her how she could manage diabetes and work all day, I never forgot her answer. She'd tell the person that it was in God's Hands. She home tested and was appropriately cautious where it was needed; I never recall her little one having a hypo--whether she was at home or at work.

What you want to try to do is to keep the meals centered around the time you give the insulin shots; not doing that can interfere with the action of the insulin. When you're giving an insulin shot, the ideal "match" is that the insulin is going to work at the same time the dog is beginning to digest that meal and turning it into glucose. A lot of times when you give a substantial amount of food between that, you can wind up with problems.

http://www.k9diabetes.com/insulinfood.html

We had someone at that other board whose vet never mentioned that you feed a meal, give the insulin, and then do the same darn thing 12 hours later. The person was not giving the insulin around the time the dog was being fed, and the dog's bg's were all over the place.

So we asked the member when he/she was feeding meals and when the shots were being given. Getting the member onto the routine of food, shot and then do it all over again 12 hours apart, the dog regulated very quickly. But up to that time, he/she just couldn't get anywhere with getting those bg's under control.

It will get easier--it's something like driving. When I was in high school, some people were so nervous about getting behind the wheel for the first time in Drivers' Ed. Later on, you know they never stopped to think about it at all--it became automatic. It's always tougher when you're new at something. ;)

Kathy

k9diabetes
02-04-2009, 10:21 PM
It happens that most of the folks at this forum at the moment are home during much of the day - I work from home so mainly have to go to occasional appointments - but I've seen many people who work away from home care for a diabetic dog.

There are some things you can't do when a dog stays home alone for a big part of the day, such as there's no opportunity for mid-injection-cycle snacks or BG checks. Which is just fine! Sometimes mid-day snacks can finetune regulation but they are not a requirement by any means and many dogs do just fine without them.

Probably a lot of folks who are not home during the day run their dog's regulation a bit looser - allowing the BG generally to run a little higher overall - so that they don't worry. I would sometimes drop Chris' insulin dose a little if I was going to be gone for many hours and I had any concern about it going too low. Better for it to run higher than too low so always lean towards too little insulin if you're in doubt.

As far as the schedule, you might even go so far as to make up a checklist for the day and actually have the person who completes some task, like feeding and injecting Princess, check it off on the list by initialing it with the time it was done.

Try to avoid any snacks between injections for now. Broccoli or green beans would be okay as they have virtually no calories so won't affect her blood sugar. Other than that, I'd avoid giving anything between meals. At some point, Princess should have a curve done to see how her Vetsulin and food and working together...

And I personally don't think you have to change foods. I don't necessarily like to see too high a fiber content with Vetsulin as its action profile is often sharper than NPH's. Sometimes high fiber food and Vetsulin are not a good match.

Maybe talk to the doc, if you'd rather, about leaving her on the WD for now so you don't have to change her diet again so soon and see how she does before worrying about changing foods. Could be the WD will work just fine. Could also be that high fiber food will not be what she needs. It would just eliminate yet another variable right now.

You're getting there!! And taking a very organized approach, which is great. I know you'll do fine.

Natalie

ladygirl
02-05-2009, 01:43 AM
Wow thanks you guys, so much useful help. I will get right away on the green beans, she loves those as treats anyways.

I'm going to see how it goes until Friday before we have to go check in again. Tomorrow I'll give her 4 units of Vetsulin with 3/4 cup mixed of her Hills W/D and Purina O/M. I figured since I already spent money on both I'll just gradually change over to Purina O/M, though it does look a little more expensive which is not economically fit right now, but I already bought the bag.

I did have a question about exercising. So tomorrow I'm going to have her eat at around 7:30 AM, give the injection at 7:45, and then take her out for her walk? Or how is it that you guys usually do? Unfortunately she had a little swollen foot that the vet prescribed some antibiotics for, (he said they should have no effect on the insulin) so he said she shouldn't walk too much on the foot for the next week, just short walks. But do most of you feed, inject then exercise, or do you do it in a different order?

I'm trying to get all our schedules planned out. Luckily I have both my sisters and my cousin and we're all doing rotations. It looks as though on Mon, Thur and Fri. Princess will have two slots of about 1-3 hours each where she will be unmonitored. But we're making sure that we have enough time with her after giving her her injection to stay and monitor her. But I'll be coming home for an hour during work and classes to check on her. What sorts of things should I be looking for when coming home? No treats right (or at least ideally)? Normal water that we set out for all three dogs?

I have her journal I've started where we're monitoring the time/amount of food, time/amount of injection, and any observations about that day. Do you think there should be something else I should add for right now? (Eventually when we start to do the BG tests at home I'll include that in the journal.) Should I do some Ketodiastix test on her tomorrow when she pees?

I'm sorry if this is a lot of questions, I just want to make sure I'm doing everything right, I don't want to harm her.

Oh also, since she doesn't usually wake up this early, if at 7:30 she is not wanting to eat and on the off chance that by 9:30 AM, when I'm the last one to leave, she still doesn't want to eat, am I to forego the shot altogether and wait until her next shot at 7:45 PM? I guess I'm still a little confused as to how all that works and if giving insulin w/ little food means lower BG or if it means higher BG, which I know is not as bad.

Natalie

BestBuddy
02-05-2009, 02:45 AM
Hi,
When Buddy was diagnosed with diabetes both my husband and I worked full time and left for work at 8am and didn't get home until around 6pm. It was too far to come home at lunchtime and yes we worried about how Buddy would go but it all worked out. We decided to get up early around 5.30 and feed and inject by 6am so we had a couple of hours to see how he was going and then as soon as I got home it was feed and inject again. Is there a reason you cannot get the morning injection earlier?
Jenny

ladygirl
02-05-2009, 03:11 AM
Well she had her shot at 7:45 PM last night, so we want to stay in line with that. I'm going to feed her at 7:30 and inject her at 7:45ish, but my main concern is if we can take her for her normal walk after the insulin? Then the latest we can stay is around 9:30 AM when I leave for class. Do you think this will be alright and enough time?

Actually my two main concerns are that it's okay for me to take her on a 10-15 minute light walk and that staying until 9:30 AM will be enough monitoring time. I will be back at around 12:15PM to check on her once my class gets out and I drive back to my parent's house.

BestBuddy
02-05-2009, 03:16 AM
It may be a good idea to keep it at the same times for now but you can bring it back when you feel a little more comfortable. For instance your could adjust the time 15 minutes earlier each morning to get to an earlier time if that would work better. I can't help you with the exercise as Buddy's consisted of running to the food bowl or rolling over in bed.;)
Jenny

k9diabetes
02-05-2009, 11:56 AM
I know this is kind of freaking you out right now but things will settle down over the next week as Princess gets settled into her new routine and you have a chance to see how she does.

At 18 pounds, she's starting out a little below 1/4 unit per pound, which is pretty typical.

If you're at all worried that it's too much insulin, you can always talk to the vet about reducing her dose 1 unit.

I would keep the exercise to a minimum for this first few days. It's a variable that's really hard to predict and since she has an injury anyway, keep it light. It can raise or lower the blood sugar... with Chris, it always dropped his blood sugar.

That two hour window is great as the problems I've seen with Vetsulin usually occur during that first couple of hours - in some dogs... remember, some! not all! :) the insulin gets moving faster than the food so the blood sugar drops during the first two hours. So you will be available to keep an eye on Princess during that time.

But again, if you're very concerned, talk to the vet about reducing the dose and starting out a bit more slowly. You will know more when he checks her blood sugar tomorrow too.

You're actually setting up lots of checking on her so I am not worried. Try to breathe a little and take credit for setting up very good monitoring of Princess. Keep the exercise really light until you have a chance to have her BG checked tomorrow and go from there.

If she shows any sign at all that looks like low blood sugar (not likely), treat it as if her blood sugar is low - better to just assume that's what's happening until you know something about her BG on insulin - but don't panic and give her a ton of syrup or snacks! :) And urine test too - that will give you an idea of how she's doing as well.

She's getting more monitoring than many many diabetic dogs get. I think she will be fine. So try to relax a little. After a few days on insulin and a chance to check her blood sugar, there will be a lot fewer unknowns and it will get easier.

Hope your exams go/went well!

Natalie

ladygirl
02-05-2009, 05:34 PM
Thanks Natalie. Yeah it's definitely alot and sometimes, actually often I feel like the tears are going to (or already will) start pouring out.

Do you mind if I ask some general questions?

1) At the latest how long after feeding should you inject insulin without potentially harming the dog? On average do people usually feed and then inject right after?

2) How long before do you take out the Vetsulin to get it a little warmer so it is more comfortable for the dog?

3) Since she is not settled yet, is it okay to continue feeding, injecting and taking a 10 minute or less walk as her normal routine? Or should any of this be adjusted time wise?

4) What sorts of common household foods are acceptable to feed the dog as a treat? When is it ok to give a dog a treat without it significantly changing their BG?

5) What are ways to deal with hyperglycemia? Hypoglycemia? And is maple syrup/honey an appropriate alternative on the chance that Kero syrup is not available?

6) If she does not eat at all at her scheduled time or even an hour or two later do we forego the shot altogether and wait until the next injection time? How will this affect her if so or is there something else we should do?

7) Is it okay to get the other two dogs gradually on Princess's diet as well so that we don't have to buy two separate foods, or should we keep them separate?

8) If she pulls away before injecting entire dosage, should we try again? (I'm afraid of poking her too much and not wanting to give her too many little treats. I gave her about 3 little slivers of cheese as she pulled out at around 3.75 units.)

If you don't mind I'd love to be able to ask more questions, but they're all getting lost in my head right now so I can't think of more but they'll come.

Seriously if this forum was a vet clinic you guys would be phenomenal vets, if only it were that easy though.

BestBuddy
02-05-2009, 06:01 PM
Hi,

You will probably hear a lot of different answers to your questions so I'll start with what we did with Buddy.

I always injected straight after he had eaten his canned food and he then got the small amount of kibble as part of his meal. I could tell by the way he ate the canned that he was going to finish the whole meal and by doing that way we never actually gave him a treat (although he may have considered the kibble as a treat) and it was just part of the feeding routine. This worked as it seemed that Buddy, insulin and food were all in sync and worked together at the same rate. The only time I didn't inject like this was when Buddy was low and I held off for a bit probably 1/2 to 1 hour to see how his BG was. I could usually tell if Buddy was low by the way he was acting and then confirmed with a urine stick and a blood check to make sure.

I didn't leave the insulin out to warm as I believed that this would make it degrade quicker, I just filled the syringe before getting the food ready and if it still felt cold I would then place the capped syringe in my mouth for a minute and then inject.

Sorry can't help with the exercise stuff.

I rarely gave Buddy a treat but when I did it was usually a kibble or two from his normal food and that was only when I checked his BG or he was low.

Maple syrup/honey would be fine in an emergency but you have to give something more substantial to keep the BG from dropping after the sugar hit. I used a bit of his normal food to do this as soon as he would eat.

Running late by and hour or two, I would feed and inject as normal and just delay the next shot a bit so there was no overlap until I was back on schedule again.

I tried to get all my dogs on the same diet as they were all mature aged and didn't need to put on weight BUT the others wouldn't eat the bland diet that Buddy was on. If it was cost effective and the food was suitable that would be fine.

If Buddy pulled away before all the insulin was injected I would just inject again to get the remained in. I hated to do it twice but I wanted to make sure he got it all. I didn't top up the syringe if I though some of it was lost because it would have been impossible to know how much went in.

Hope this helps.

Jenny

ladygirl
02-05-2009, 06:09 PM
Thanks Jenny for your advice, I'll definitely refer to some of those things later on.

I did just want to ask (in the off off chance) that she doesn't want to eat at all for one of her schedule shots, is it ever a good idea to just forego it? My worry is that if we have her injecting at around 8 AM and by 9:30 she is still not wanting to eat, when all of us have to leave for work what are we to do?

Oh also my vet said that they usually feed an hour before injection, do you think its better to feed and inject right after (like 10 min) or feed and wait a bit before injecting? i.e. Princess has her shot due at 8 PM tonight, would feeding at 7 PM be good or should I feed her at like 7:45 or closer to 8 PM?

And please if anyone can put in your own answers I would so appreciate it. I like to hear what everyone does so I can have a broad sense of what is right and wrong. I know it depends on the dog but I would still like to follow some sort of regulation you know?

eyelostit
02-05-2009, 06:40 PM
1) At the latest how long after feeding should you inject insulin without potentially harming the dog? On average do people usually feed and then inject right after?

I inject 30 min after eating, if Niki is low at 100 I wait for 45 min.

2) How long before do you take out the Vetsulin to get it a little warmer so it is more comfortable for the dog?

I take my insulin out of frig before I do food, by the time she is fed and 30 min later the insulin is at room temp.

3) Since she is not settled yet, is it okay to continue feeding, injecting and taking a 10 minute or less walk as her normal routine? Or should any of this be adjusted time wise?

I think I'd rather do the 10 min walk before shot.

4) What sorts of common household foods are acceptable to feed the dog as a treat? When is it ok to give a dog a treat without it significantly changing their BG?

I use chopped brocolli or green beans, little piece of hard boiled egg.

Treat I determine by former BG curve before low point.

5) What are ways to deal with hyperglycemia? Hypoglycemia? And is maple syrup/honey an appropriate alternative on the chance that Kero syrup is not available?

Hypo-low I use maple syrup or Karo about 2 Tablespoons followed by some food.
Hyper-high would mean either food or insulin adjustment

6) If she does not eat at all at her scheduled time or even an hour or two later do we forego the shot altogether and wait until the next injection time? How will this affect her if so or is there something else we should do?

I would try to get some food to entice her to eat, white rice/brown rice to get her to eat I would use this with some cooked egg, parmesan cheese if only a little is eaten I would give 1/3-1/2 dose, depends on how you know your dog.

7) Is it okay to get the other two dogs gradually on Princess's diet as well so that we don't have to buy two separate foods, or should we keep them separate?

I think thats fine, if its not WD, DCO or a special diet, the special diets cost more, (I remember well I had 4 dogs)

8) If she pulls away before injecting entire dosage, should we try again? (I'm afraid of poking her too much and not wanting to give her too many little treats. I gave her about 3 little slivers of cheese as she pulled out at around 3.75 units.)

You have to inject again, she needs the insulin regardless, I'm still having trouble with Niki, she pulls away, but I have to have her sit again, and do it, I know its upsetting to us humans, but she needs her shot, Niki is forgiving ;)

Re: feeding & shot,I do the feed and injection 30 min later, I don't know where the vet gets this hour thing? Its best to wait the 30 min, I do, reason is, what if Niki decides to throw up and I have already injected her.


Hope this helps, Dolly:)

ladygirl
02-05-2009, 06:51 PM
Dolly thanks so much for that.

Do you think it would be good to feed her at 7:30 PM, take out insulin, take her on a walk at like 7:45 and come back at 8 and inject? If she hesitates would it be okay to give her a sliver of cheese or green beans? I just knw that once she feels me grab some of her skin for the shot she knows what I'm doing and starts to weasel her way out.

So how long is it okay to leave insulin out without it going bad? I know Jenny said she likes to do everything at once so as not to degrade the insulin. I thought (and this is just me not knowing a lot right now) that you couldn't leave insulin out for like more then 10-15 minutes?

My other concern is feeding her then taking her on a walk right after won't be enough time for her to poo, which sometimes means that she'll get up in the middle of the night and poo in the living room. (This wouldn't be unusual to me, as sometimes on her walks when she wouldn't go poo she would eventually at home hours later.)

I guess I'm just a little confused because I read and hear from some that you should feed and inject at the same time and others that say you should feed like an hour or less before so that the insulin does not move faster then the food. And also I guess I just don't see a lot of people posting about exercise and how they factor that in with the food and insulin and when they do it?

Before her diabetes we used to take her and the other 2 dogs on 2-3 walks per day. About 20-25 minutes around the neighborhood for them to do both pee and poo and then come back. We have a backyard but its not fenced so this is how we've always done it. I know that since she's also on antibiotics and just getting started on insulin I should limit this to at most 10 minutes and preferably taking her out on her own, but once we get regulated how should I incorporate their daily walks as far as when to feed, inject and walk?

Oh gosh I'm starting to overwhelm myself again. Does exercise mean BG will go up or down?

k9diabetes
02-05-2009, 09:43 PM
1) At the latest how long after feeding should you inject insulin without potentially harming the dog? On average do people usually feed and then inject right after?

I always injected Chris as soon as he was done eating. He digested his food pretty quickly so the faster I got the insulin in him the better. I think most people inject right after.

2) How long before do you take out the Vetsulin to get it a little warmer so it is more comfortable for the dog?

Usually, it's preferrable to load the syringe and let that come to room temperature rather than bring the whole insulin bottle to room temperature. The bit of insulin in the syringe will warm up quickly.

3) Since she is not settled yet, is it okay to continue feeding, injecting and taking a 10 minute or less walk as her normal routine? Or should any of this be adjusted time wise?

I don't think any of us can tell you what exercise will do with Princess. It depends on the dog, how the food and insulin are processed, where they are at - highest or lowest blood sugar - when you do the exercise, temperature, how much they exert themselves... most of these are unknowns at this point.

Chris' blood sugar always dropped with exercise so if we were going to exercise him at a lower point in his blood sugar I would give him some syrup or a snack and take syrup with me.

The ideal is to exercise them when they have both some glucose going into their bloodstream and some insulin. But again, Princess' trend isn't known yet.

4) What sorts of common household foods are acceptable to feed the dog as a treat? When is it ok to give a dog a treat without it significantly changing their BG?

The one time you can pretty much always give a treat is during or right after their meal. Chris got a mini milkbone after each injection. It was just part of his meal calories so not really extra but was a big treat for him. He used to get annoyed if I took too long to get his injection done cuz he wanted his milkbone! :)

Otherwise, best not to give treats between meals unless you find that their use of insulin would be helped by it. Green beans and brocolli tho are essentially freebies as they have almost no calories.

Pretty much anything else will raise their blood sugar as it gets digested and too far along after an injection and they may not have much insulin left to use with that extra food. So better not to give it.

Right now especially, the vet wants to see how her meals and insulin match up so avoid any treats other than green beans and broccoli. Treat any sign of low blood sugar, of course, but no treats otherwise. It's the only way to "see" how the meals and insulin injections are interacting.

5) What are ways to deal with hyperglycemia? Hypoglycemia? And is maple syrup/honey an appropriate alternative on the chance that Kero syrup is not available?

We always used maple syrup. Chris didn't care for Caro and I would always start with syrup, followed by food, when his blood sugar was low. The syrup goes in fast and immediately works to keep the blood sugar from dropping further. But it won't last long. So you give some food after the syrup that will continue to deliver some sugar in the coming hours.

In the car and on walks we started taking tubes of frosting cuz it was tidier and easier. But I've found with myself (I sometimes get low blood sugar) that frosting does take longer than syrup to get into the system.

Aside from being uncomfortable, the only major concern with high blood sugar in the short term is the ketones. Those need to be avoided and if they show up more than a trace it's a veterinary emergency.

6) If she does not eat at all at her scheduled time or even an hour or two later do we forego the shot altogether and wait until the next injection time? How will this affect her if so or is there something else we should do?

Personally, I'm not a fan of giving no insulin if they won't eat. You can usually safely give 1/4 of their insulin dose without food. With Chris I could give a third to a half of the usual dose, depending on his blood sugar.

BUT it takes time to learn how your dog responds to the insulin. So probably the best thing to do until you have more experience would be to give no insulin if she doesn't eat or if she won't eat at first but eats later. Just get back on track at the next meal and injection.

We always found something Chris would eat so he could have his insulin. Wasn't always his established diet, especially in his last few months when he wasn't feeling well and would refuse what he'd eaten for the past few days.

Usually there is something you can add, like a sprinkle of cheese or a dollop of cottage cheese or tuna juice or low-salt or salt-free broth that will entice them to eat without totally changing their meal.

If they aren't used to eating twice a day, they usually get used to it after a while. Seems like a lot of dogs aren't crazy about eating in the morning.

7) Is it okay to get the other two dogs gradually on Princess's diet as well so that we don't have to buy two separate foods, or should we keep them separate?

We didn't have to deal with this... I would say that the diabetes type foods are very low in fat and very high in fiber and probably aren't ideal for a lot of dogs. Plus they are expensive. If I was in your situation, I probably wouldn't change the other dogs to it. I've got cats who do not do well with food changes so I tend to avoid it if I don't have to.

Chris, when on WD, needed a bit of fat added back in. His skin and coat got very dry on WD alone. And the poop production goes way up! With three dogs... you might have to hire a professional scooper! ;)

8) If she pulls away before injecting entire dosage, should we try again? (I'm afraid of poking her too much and not wanting to give her too many little treats. I gave her about 3 little slivers of cheese as she pulled out at around 3.75 units.)

If there's still insulin in the syringe, I would inject her again to give her the rest. This will get easier with time. She will get used to this. Rick made some excellent points in his thread about Lucy - that she is easier to inject if he sticks to a routine, including where she is when he injects her. Some have put small dogs in the sink, which kind of throws them off guard and restricts their movement. Princess will guide you on this as well. But a few lost injections early on just comes with the territory. It will get easier.

Natalie

k9diabetes
02-05-2009, 09:47 PM
Some of this will work itself out with time. Diabetes is, as much as just about anything can be, a "gray" thing. There's almost no "black" and "white," no "this will happen" and "this will not happen" to it. The only rule you can really count on is that every dog is different and you have to learn what Princess' version of diabetes is.

And you will. But you will need some time. I didn't know squat when I started out with Chris. I had had a diabetic cat so had given injections before but she never regulated at all and cats and dogs are different enough that there's not much to carry over. So we all start out kind of dazed and confused and then one day you look up and you wonder what you were so worried about because Princess' diabetes is just part of your daily routine, about as stressful as brushing your teeth in the morning...

Natalie

ladygirl
02-05-2009, 11:38 PM
Ok seriously where/to whom can I write a letter of praise about you Natalie?

I mean I don't know if I found you (and the rest of the board) by luck or if maybe all along I was supposed to find you guys for guidance, but seriously I don't think I would have been able to even remotely understand/ get a grasp of ANY OF THIS if it wasn't for you and the rest of the board.

I hope other diseases have as supportive/experienced administrator as we do! :)

Ricksma
02-06-2009, 04:59 AM
I'm tellin' ya....there are other boards out there, but this one is by far the best. The moderators here are amazingly knowledgeable, and there are no personality issues to deal with...just a lot of supportive, caring people. You are going to get into the routine, I promise, and you will wonder what all the fuss was about. As the doctors used to tell us about our "colicky" baby...tincture of time...tincture of time.

Love and hugs, Teresa and Ricky

peggy0
02-06-2009, 05:03 AM
I'll second that one! I've had 2 vets and they have not given me near the coaching and knowledge base that natalie et al have. They deserve the hero award

k9diabetes
02-06-2009, 08:45 AM
(blushing...) That's very kind of you all - I owe everything I know now to Chris. There's a tremendous amount of joy that comes back to me from all that he went through being put to use to help other dogs and I know Kathy feels the same way about her Lucky.

Kathy and I both learned by the trial-by-fire method as our dogs were not keen on going by the "official" book of canine diabetes. So we learned early on that the rules don't mean a heck of a lot if the dog ain't gonna follow them! You're left with writing your own book.

I also owe, in a backhanded way, my motivation to participate in forums to poor veterinary advice - some that Chris received and much that others have received. Chris' case study was a direct product of bad veterinary advice from a teaching hospital endocrinologist with a tremendous amount of influence over how diabetic dogs in this area are treated and I wanted to do whatever I could to give the veterinarians here in our area and elsewhere a different perspective on managing diabetes.

In the end, Chris met so many of the vets and specialists around here that he was probably more effective in conveying that message. Every vet and specialist he had got a copy of his case study and could see in Chris how effective more assertive management of his diabetes was.

I do remember, vividly, how scary it is at first...

Natalie

We Hope
02-06-2009, 10:13 AM
I remember initially reading on another diabetes board and seeing how well others were doing. I was doing exactly what they were but we weren't having any success with at first, human insulin, and then beef.

John had been in practice 35 years at the time he diagnosed Lucky. Having known him and his family most of my life, I asked him if he'd ever seen a diabetes case like Lucky's and he told me no. (I was fervently hoping he'd be able to cite a "happily ever after" for me.)

He told me that if we worked together, we would be able to get Lucky under control. And so the three of us set off for places none of us had ever been before. Lucky went from being his most difficult diabetic case ever to his easiest and best controlled one, once we went with pork Lente insulin.

He was well-regulated when Lilly decided to discontinue its Iletin pork Lente formula, and we had to try him with the pork NPH, which they were still producing at the time. And we had a dog who had respectably controlled bg's with more NPH than Lente insulin, but one who now had skin, coat and eye problems, some neuropathy and a lot of lethargy. He had none of those even before we were able to get his bg's under control. This is when we applied to import Caninsulin (Vetsulin) for him.

Within 2 weeks of getting the Caninsulin, they were all gone for good. Since this is U 40 insulin, he got an even better "groove" than he had on the Lilly U 100 pork Lente. At about 8-10 hours after breakfast and morning insulin, we would "clock" him doing a happy, healthy 85 with his bg's. This was a little old man who was about 14 when he was diagnosed.

When I tell John he taught me everything, he always says that Lucky taught us both. We're both grateful that we were able to be good listeners for Lucky's sake, for all the other "Luckys", and that we can somehow "give back" what we received when helping him.

Kathy

pgcor
02-06-2009, 11:44 AM
I just want to say that I met Natalie on another board and she was not only kind, which I needed, but very knowlegeable. There's no substitution for folks like Natalie and Kathy and Carla (not on this board).

I can say that some of us get it and some of us don't. There's a lot about diabetes that I just don't understand - and I've been at this over a year! Thank God for Natalie and Kathy and many members as well, because they are smart enough to get it!

If it weren't for folks like these I believe Pip would not have made it this far. We went through six (6) Vets! Two of whom were specialists - and the information I received was sketchy and sometimes just wrong.

I felt like you do, and still do sometimes. But this is my life line. My visit to the Vet just yesterday is a great example. My Vet never mentioned the hormone issues that dogs can have when the sugar gets too low. But Kathy knew.

This is a trial and error process for me. Could Kathy be wrong about why Pip went really high yesterday? Sure, but how can you make an educated decision about your dog's health without all the information! By the way, I don't Kathy was wrong!

It will get better. If it got better for me (and I'm extremely neurotic) it will for you!

Hugs,

Pam and Pip

We Hope
02-06-2009, 12:09 PM
Pam,

I was a member of that other board for a while--left in 2005. While working on helping Lucky, I read everything I could find about diabetes, period. At the time I left, there wasn't any other board like this, so I spent over a year contributing to this project:

http://petdiabetes.wikia.com/wiki/Special:AllPages

Counter-regulatory hormones are there with all of us. Even if you don't have diabetes and do something like go without food for a while or go on a crash diet, you can have low blood sugar from it. When that happens, diabetes or not, your counter-regulatory hormones go on the job to try to rectify things and bring your blood glucose levels up.

When you hear about the ups and down of rebound, it's those counter-regulatory hormones who are driving the bg's up in response to hitting a low. With regard to Cushing's, it's too much of one of the counter-regulatory hormones, cortisol, that keeps the bg's of a Cushing's patient high until the Cushing's is brought under control.

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

Natalie and I have always thought that if we can teach people what the "mechanics" of diabetes and the various insulins are, everyone will be able to do a better job caring for your diabetic furpeople. ;)

Kathy

pgcor
02-06-2009, 02:16 PM
Kathy and Natalie - I so admire your dedication to helping folks like me!!! It's so comforting to me to know you are there, as I know it is to Princess and her family! We're not all alike and I know Pip would not be here if it weren't for you guys!!!!!

I've learned so much over the past year!!!! It's priceless!

ladygirl
02-06-2009, 07:05 PM
Gosh I fifth and sixth all these comments! You guys (and I say that in the most plural way) are truly amazing.

I have a question I had my cousin monitoring Princess and he decided to head out for a bit and left the laundry room door open where their food is (so mad at him), and when my mom got home later she said she found PJ, Princess's brother, had knocked the bag down and was eating out of it. She is not sure if Princess did or not, but she said she would assume so.

On the chance that Princess did eat some, (I honestly can't say if she did or not, because PJ often becomes protective of food and growls and scares her away, but sometimes they both go at food like there is no tomorrow) what protocol should I follow regarding giving her her scheduled shot at around 8:30 PM tonight?

BestBuddy
02-06-2009, 07:20 PM
I wouldn't make any changes on the what if scenario. If she didn't get extra food everything will stay the same and if she did it may mean she will run higher for a day or so.

Jenny

We Hope
02-06-2009, 07:23 PM
I'd just do what I've been doing all along. The worst thing that can happen is that Princess has some higher than normal bg's from the extra food. This will straighten out by just staying with your usual routine, but if you have a vet appointment scheduled in the next couple of days, you should mention what happened so that if Princess does happen to have a bit higher than expected bg's, everybody knows why.

This isn't going to put Princess' regulation back any more than if someone had a little accident and she only got part of a shot or someone forgot to give one. I think every last one of us has gone through the partial shot and or missing one for one reason or another. Nothing that won't all work out has happened. :)

Kathy

bowens2
02-06-2009, 07:38 PM
For new members! Natalie was my lifeline also in Sept 2006 when Monkey was diagnosed. Like a lot of newbies I was a mess and she stepped right in there, helped me out, and assured me I could do it and it would get better. It did!

First day I had Monkey home on my own after he was diagnosed, he was throwing up. Of course I didn't expect or know how to handle that. Natalie was instantly on chat helping me out and calming me down.

Love you Natalie!

eyelostit
02-06-2009, 07:43 PM
Thank you both Natalie ;) and Kathy ;) my greatest teachers.

ladygirl
02-06-2009, 09:47 PM
Can I get a "raise the woof!" for Natalie, Kathy and the rest of this board?

*happy dance, "raise the woof!", happy dance, "raise the woof!"*

So Princess had her first BG today at the vet and they said she was perfect! Her BG was just right (I'm sorry I got so excited I forgot to hear the number, but I think she said 126 which was a teensy high but very good regulation for just starting) and the vet (who is very cute by the way, hey this diabetes thing might work out! i kid i kid :) ) said that she was one of the best/fastest regulated dogs he's ever seen.

So I guess all in all I just thank that we're all getting through this a lot smoother then I thought. Much, if not all, is in thanks to you guys. Let's hope she continues on this streak, but if not, I think I'll be okay to expect the unexpected..... :)

k9diabetes
02-06-2009, 10:41 PM
I am overwhelmed by your comments... when I decided to start this forum, Kathy and I talked in quite a bit of detail about the kind of place we hoped it would be and you all have made that dream come true. It is an honor to share the company of so many wonderful dogs and of so many wonderful dog lovers...

Natalie

k9diabetes
02-08-2009, 10:45 AM
That is a pretty quick drop into good numbers. I wouldn't consider that "high" for a diabetic dog. You need a little safety cushion so 126 is a great number.

What time of day was the glucose test relative to the meal and insulin?

Natalie

ladygirl
02-08-2009, 01:41 PM
Hey Natalie,

Princess had been fed and injected at around 8:30 AM that morning and the test was done at around 2:45/3 PM.

ladygirl
02-09-2009, 10:47 PM
Okay so some more questions:

1) What if I think I didn't inject the insulin all the way into the skin? I mean I didn't feel it wet after and I couldn't smell anything, but I just don't think I got it in there. I know I shouldn't try and inject her again (for fear of putting her into hypoglycemia), so do I just wait until the next injection time? What signs should I be seeing if the insulin didn't get in?

2) If any of you can offer any methods of how/when you give the dog the injection? Princess, a pretty squirmy little Min Pin catches on to everything. I've tried giving it while she's eating, FAIL. Tried giving it while she's sitting with me after her little walk, FAIL. Tried giving it while putting her body collar, FAIL. Not so much that I can't get it in, but it takes like 5-10 minutes of wrestling her down. Seriously my left inner thigh is bruised up and down like you wouldn't believe from her clawing me and trying to get out of my grasp. I just wonder if there is any easier way you guys could advise me to seek.

Literally the second she starts to feel me pinch some of her skin, she begins to wrestle out, and I don't think my leg can get used to many more of these bruises, its brutal. :/

We Hope
02-10-2009, 04:54 AM
If you ever think that you didn't give all of the insulin, you need to leave it at that because you have no idea how much didn't go into Princess. Trying to make up for it could mean a hypo.

When you come to your next scheduled shot time, you give the same number of units you were going to give--no adding anything to make up for the previous problem. You go on with things as if the problem with the shot never happened.

Feeling the skin and fur is good because there's no odor to Lente insulin. The smell you hear people talking about is because of the preservatives and those in Lente have no smell at all.

If you didn't get all the shot in the right place, you may see some things like a bit more drinking/urinating and higher than expected bg's when testing.

http://k9diabetes.com/forum/showthread.php?t=167

This is one of our older threads about giving shots--I wasn't "allowed" to pinch Lucky's skin either! ;) I'm sure others have their "secrets" to share too.

Kathy

k9diabetes
02-10-2009, 08:12 AM
Min pins are tough... do you have any technique/toy/treat that you have used successfully for other times when you needed her to cooperate or calm down? If so, those may work for you.

You don't have to pinch up the skin if you think that will help.

And you can try putting her into something that restricts her movement... the sink, a basket or box, a bed... anything that tends to calm her.

I can't help much here as Chris was always a breeze to inject.

Natalie

ladygirl
02-10-2009, 11:31 AM
So pretty good news, I injected her this morning and she didn't even notice!

I foregoed (is that the right word?) the tent mechanism because she would catch on VERY QUICKLY and start to pull away. So this time just while she was eating, I just lightly pinched up some skin, so that it looked like a little hill/mound, inserted needle at the base, then dropped skin and injected and slowly pulled out. She just went along as if nothing had happened. I think I'm starting to get there, or at least I hope!

......but my leg is still BADLY bruised. Seriously the whole inner left thigh is brown, purple and black all up and down. So hopefully once I get this injection thing down my leg will learn that there is hope :)

rhodesian46
02-10-2009, 12:19 PM
Just a suggestion. If you are going to inject while Princess is eating I would wait when she almost done just to be on the safe side. Because if you inject in the beginning or middle of her eating she may not finish the food and you take a chance on going hypo. Glad that Princess is tolerating this But remember dogs can pick up on our anxiety SO if you are tense she will be too.

k9diabetes
02-10-2009, 12:56 PM
Congratulations!! I sure hope for the sake of your leg that this continues to work!

Natalie

pgcor
02-10-2009, 01:08 PM
Hi Natalie:

I had quite a number of problems trying to inject Pip! As soon as I tented his skin he would turn around and look at me...just waiting. He actually hit my hand once and injected himself!

Here's what I do:

1. I break up a few diabetic cookies on a plate.
2. I lift Pip on top of the counter
3. I make him lie down completely and then push the plate o' cookies in front of him.
4. Then I tent his skin and inject.

He still stops eating to look at me, but is so food oriented that he doesn't make it as awful as he used to.

He would squirm and cry and jump around. For the first few months he had to be muzzled.

I feel for you Natalie - I really do. They are such the little dickens'. Very uncooperative. But, Pip is doing much better now and doesn't need to be muzzled!

Pam

rhodesian46
02-10-2009, 01:38 PM
We all have or have had a system to inject. I had to change the routine many times as Pebbles caught on way too quickly or I flat out hurt her The dog never forgot.

ladygirl
02-10-2009, 04:21 PM
Wow, thanks you guys for all your suggestions, especially Pgcor! (We Min Pinners must stick together : ) )

One thing I'm glad at is that she won't bite me, or doesn't attempt to, she just squirms like the dickens and claws into my legs, so its hard to try and pin her down, which I hate to do because she gets out of breath and begins panting from all the struggling we are doing. That and I don't want her associating everytime we have to give her a shot her and me have to struggle, it's just not right.

A couple times I have given her the shot at the beginning of eating (a little worried right after because I had a momentary lapse where I remembered she had to FINISH ALL her food before injecting), but all in all she has gone back to eating her entire meal. She just prefers that her dry food have some wet food in there as well, or else she will definitely not eat all of it.

I may ask my vet next time to see if maybe we can get a thinner needle? I was reading on some of the other posts and found that it could/could not be possible. Right now she is on Vetsulin, 4 units 2x a day, and on the U40 1 1/2 cc, 29 ,1/2", but for her sake, as she's pretty small, I hope that we can maybe get her on a 30/31 (though reading the other posts's I'm not sure that the U40 will come bigger than a 29.)

Annnnyywayyysss I guess I'm just glad this is going a lot smoother then I planned. Granted we haven't started the at home BG's yet, but I have confidence that we're doing pretty good for now.

BestBuddy
02-10-2009, 04:29 PM
I always used a U100 needle with Caninsulin (U40) as they were much easier to get and also a better choice of sizes. The only thing you need to remember is the conversion. U40 insulin needs to by multiplied by 2.5 to give in a U100 needle. So 4iu of Vetsulin would be marker 10 on a U100 needle. There are several sites that have conversion tables and I will try to find one and post the link. Just remember that if you do decide to go to the U100 needles is that you make sure that when you are talking to vets or even other that you tell them the actual numbers of insulin units rather that the marker number on your U100 syringe.

Jenny

PS Here it is

http://www.felinediabetes.com/insulin-conversions.htm

k9diabetes
02-10-2009, 04:45 PM
You can do a conversion to use U100 syringes with the Vetsulin.

Basically...

Vetsulin is U40 insulin - 40 units of insulin molecules in 1 mL of the fluid in the bottle.

U100 insulins like NPH are more concentrated... there are 100 units of insulin molecules in 1 mL of fluid in the bottle.

Same amount of fluid but 2.5 times more insulin molecules suspended in it with a U100 insulin - 40 x 2.5 = 100.

The syringes are marked to account for this difference. They draw up an amount of fluid that is based on the type of insulin they are designed for.

So if you do the conversion to use Vetsulin in a U100 syringe, you:
Multiply the number of units of Vetsulin you are giving x 2.5 and fill the U100 syringe to the mark on the syringe that corresponds with that number.
It's very very important to understand this if you are going to do the conversion... it's the difference between "units of insulin" and how much liquid you put in a syringe to deliver those units of insulin. You're still giving the same "number of units" of insulin but you're filling the syringe to a different "mark."

Say the Vetsulin dose is 10 units.

You would fill a U40 syringe to the "10" mark because the insulin and syringe match.

You would fill a U100 syringe to the "25" mark (10 units x 2.5 conversion factor = 25)

Here are links to two tables that do the conversions for a range of insulin doses:

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

http://felinediabetes.com/insulin-conversions.htm.

Thinking about this conversion really gives you a sense of how much fluid you have to inject a large dog with when using Vetsulin! If a very large dog's insulin dose was 50 units of Vetsulin, you would have to fill a U100 syringe to the 125 mark!

The advantage to Vetsulin being a more dilute solution is that it's easier to make small adjustments in the dosage as there's a lot more fluid delivering half a unit of Vetsulin. So for small dogs it can be very handy.

Hope that makes sense!!

The most important thing to remember IF you do the conversion is to know how many units of insulin you are giving. Because if you ever have to go the emergency hospital in the middle of the night, for example, and they ask you how many units of insulin your dog gets, you don't want to tell them the amount that you're filling the syringe to! That would be a massive overdose of insulin!

Having scared you witless now... you probably won't want to do it!! ;)

But I know many people who do. There are many more choices of syringes and needle gauges available plus the U100 syringes are available everywhere and usually very inexpensively.

k9diabetes
02-10-2009, 04:47 PM
Wanted to add, though, that if the injection doesn't actually seem to hurt her, you may want to stay with a somewhat heavier needle as it will be "stiffer" and that sometimes helps with a squirmy dog as it doesn't bend as easily.

We did use the 31 gauge short needles and and really liked them. Chris could definitely tell the difference between a 29 gauge and a 30 or 31 gauge and preferred the thinner ones.

CarolW
02-11-2009, 09:01 AM
Since you have multiple people who might care for Princess, I'd suggest you try this program for a computer; a Calendar, on which you can set up daily tasks as "Tasks" that have to be checked off when you do them.

This would mean you'd need the program to be running! - at least, much of the time, or, you could turn the computer on several times a day, before the task-time is due, and check off the tasks as they are done.

That could help ensure that a task is done once, and only once.

Of course, you could do the same thing with paper and pen(cil)!

For instance, make a list of daily tasks, and then lots of photocopies of it, and keep that handy - put the date on each new page you use. The trick would be to have people remember to check off that they've done the task (feed, inject, and so forth).

I depend VERY HEAVILY on this computer program. It makes sounds, to call me to do the task. It's not free, but it's not very expensive, either. It's crash-proof! - Well, it's for Windows; I don't know whether they have an Apple (Mac) verison or not.

They also have a free program called DSClock, which I use as well, both the synchronize my computer-time with an atomic clock, and to cound seconds when I'm warning insulin in the syringe in my armpit!

Wishing you and Princess the very best!

Wed, 11 Feb 2009 09:01:13 (PST)

We Hope
02-11-2009, 10:22 AM
You can make sure you're giving the shots with the needle's bevel side up:

http://k9diabetes.com/forum/showpost.php?p=5025&postcount=4

Lucky was always a wagger and wiggler at shot time--thinking about the roast beef he'd get after it was done. Since I was giving insulin to a "moving target", I felt more comfortable with the thicker 29 gauge needles and with those 29 gauge needles with the standard 1/2" length.

For me, this gave me peace of mind that I didn't bend or break a needle and also that by having the standard length ones meant I was less likely to lose insulin by the needle coming out of his skin before all the insulin was under it.

Kathy

pgcor
02-11-2009, 11:00 AM
I think you are doing VERY well!!! It's especially difficult with the hyper ones. And your pups are so darn cute!!!

CarolW
02-11-2009, 11:49 AM
Hi LadyGirl,

First, I forgot to include the URL for the computer calendar program I use! It's here:

http://www.coherentdog.org/vek/calendarscope.php

Next, numbers of my friends use U-100 syringes with Vetsulin (or Caninsulin, which is the same stuff). I'd expect your dog's dose will likely stay well within the capacity that a BD U-100 syringe that holds 3/10 cc can deliver (12 units of Vetsulin will fit, to the "30-unit" BARREL-MARK on a U-100 syringe).

You could, then, use the BD 3/10 cc syringes with 31-gauge needles (the thinnest), which are SHORT - 5/16" (8 mm) compared to 1/2" (12.7 mm) of a U-40 Vetsulin syringe. The thinner, shorter needles probably fit a MinPin really well.

It becomes much easier to make injections painless if you use the thinnest needle possible. With a MinPin, the short needle should work really well. You merely have to be cautions when filling the syringe, not to bend the needle; a little practice does the trick. If the needles bend TOO easily for you, you could go to 30-gauge, but then you'd lose the half-unit marks on the syringe barrel, which can be helpful when converting doses! As Kathy or Natalie said, you MUST have two kinds of numbers in mind: First, the ACTUAL number of units of Vetsulin you are delivering, and second, the number you are going to read on the barrel of the U-100 syringe, which I've called "barrel-mark" (in consultation with some friends who do this conversion).

I have two other suggestions for places to look and study from:

1) To learn an almost INTUITIVE approach to the conversion, so you make SURE to get it right, try this:

http://www.coherentdog.org/vek/merrymeasure.php

It's full of adventures! - worth reading, though, I think, as by the time you're through, you should have a good understanding of which way to go with a conversion. And it provides a couple of examples of conversions, at the end of the entire series.

To move from one page to another, use the NEXT button above the main picture on the page, or, if you need to go back, the PREV button, OR, if you lose your way, the UP button!

Kumbi is ON a U-100 nsulin (Novolin-NPH), so I don't have to convert. But if I were converting, I would triple-check that I have the conversion right, and then, using a felt-tip pen, I'd MARK the place on the syringe to fill it to. I would only mark the syringe I'm about to use, in case the dose changes for some reason later.

Nowadays, I ALSO mark the end that holds the needle - a line that shows where the bevel is up! Have to hold the needle (syringe) under a lamp to achieve that. Again, I only mark when I'm about to fill the syringe, to avoid uncapping and re-capping. I mark BEFORE I fill the syringe, to make sure not to contaminate the needle. (But then I re-cap the syringe anyway, in order to warm the dose in my armpit!)

I'll be revising this series again:

http://www.coherentdog.org/vek/painlessinj.php

just to add a few details and a bit of trouble-shooting, but it should do you well as it is now. The following pages mght also be helpful to you:

http://www.coherentdog.org/vek/dogcoop.php

Distracting the dog with food can be helpful if the dog is squirmy. I have a fair bit to add to the cooperation section, too, but that will take time. I hope what's up there so far will be halpful - and get you breathing - laughing!

Wed, 11 Feb 2009 11:44:01 (PST)

ladygirl
02-13-2009, 11:34 AM
Okay so we had a major setback today...

It took me a HALF HOUR to inject her. She became so unbelievably squirmy that I couldn't hold on to her skin more than a second. I got so mad at her and now I feel terrible. Anyways I'm now starting to get disheartened again because I hate the fact that this poor little girl has to be injected twice a day for the rest of her life. I can't imagine a human having to go through that, much less a little 16 pound Min Pin. I mean no matter how much the vet says it doesn't hurt them, I imagine for anyone having a needle poked into you twice a day is quite uncomfortable to say the least. I poked myself twice yesterday trying to inject her and waisted a days worth of insulin and let me tell you the poke did not "not hurt". Which then made me think how much it must hurt her when I have to poke her several times to finally get the injection in, no wonder she started to cry a little bit trying to get out of my hands, poor baby.
I can't even try and distract her with a treat of some sort, because she just becomes so focused on getting out of my grip.

Suggestions? I know I'm still in the early stages but I just can't help feel that she is NEVER going to get used to getting injected or that it will ever become EASIER.

:(

Oh also the past couple times I've been having a hard time determining whether or not the insulin got in her. I'm pretty sure last time it did but this morning, after the whole struggle, I thought I had got it in but when we went on her walk I noticed a little patch of of her fur (which looked relatively close to where I injected) was wet. It might have been that it was wet outside, but I'm not sure. I tried to smell it but it didn't have a scent. How do you know or not?

We Hope
02-13-2009, 12:28 PM
How are you doing the shot? Are you using the tenting method, where you pull up the skin to form a "tent" for the injection or are you "pinching" a bit of skin to give it?

I could do neither with Lucky--both of these things didn't suit him at all. It wasn't the shot that was upsetting to him, it was the idea that I was trying to pull or pinch his skin. We talked about another way to do shots here:

http://k9diabetes.com/forum/showthread.php?t=167

After I found out that getting rid of the pinching or pulling of the skin was what was making him try to avoid me at shot time, I had no more problems. He quickly learned to come into the kitchen after finishing his food (while he was eating I'd be getting the shot ready) for his shot and treat.

Lente insulin has no odor; the smell of the NPH isn't always a reliable indicator of whether you got all of the insulin in because a little of the NPH odor can go a long way:

http://k9diabetes.com/forum/showthread.php?t=495&page=4

The best way is to check as you did, whether the skin or fur is wet. You won't be able to really know just how much of the insulin was lost; trying to give another shot to make up for it can be dangerous as you might wind up using too much insulin total.

I know that testing blood for glucose isn't possible for you but you can monitor Princess with the Ketodiastix which test for both ketones and glucose in the urine. By seeing how much glucose is in the urine, you can at least have an idea of about how much insulin actually went into Princess.

With blood glucose testing or urine glucose testing, you can tell you didn't quite make it with all the insulin if you're getting higher than usual readings from either one.

Let's see what others who have had shot problems at one time or another can tell you about what happened with them and how they solved it.

Kathy

ladygirl
02-15-2009, 09:02 PM
So a bit of an update:

Friday night and Saturday morning I went with the whole "pretend shot" thing, pretending to inject her hours before continually with the capped needle in hand and low and behold when I went to inject her she didn't even flinch :)

Then Saturday night and this morning came and she has caught on to the whole pretend thing and now starts to pull away even when I do the pretend shot, despite praising her every time when I even just pull up some skin.

So now I'm stuck again because I had to struggle with her again this morning to the point where she was panting from being so worn out, but still had so much energy in her. I guess the only good thing in all of this is has been very regular and in "norm" with everything, no changes. Hunger is good, thirst is regular, peeing regular.

Please please please offer me any advice or guidance. I read on one of the older threads that there is a shot that has the insulin premeasured and literally just once it touches the skin it injects? I know they are more expensive but I'm really getting disillusioned.

We Hope
02-15-2009, 10:09 PM
I think what you're asking about is the Inject-Ease.

http://www.palcolabs.com/section_products/injectease.html

http://www.palcolabs.com/section_support/downloads/InjectEase_FAQ.pdf

Inject-Ease FAQ's

This device automatically inserts the needle into the skin--you dispense the insulin by depressing the plunger. What it does is to hold the syringe you've already loaded with the right number of insulin units.

Now, it's only compatible with BD brand U 100 insulin syringes, so this would mean that you would need to be doing the X 2.5 conversion of the number of your Vetsulin units to get the correct amount of insulin into the U 100 syringe.

http://hocks.com/hocks-healthcare/hocks-product/A449850.html

Here it is at Hocks.

It sounds like Princess is like Lucky in that she doesn't like the skin being pulled up, that it's not the issue of the injection itself, but the pulling up of the skin.

If that's wrong and she's reacting or flinching when you pierce the skin with the needle, you might want to think about numbing the area where you plan to give the shot like this:

http://www.caninediabetes.org/pdorg/tips.htm

"For extreme situations one owner reports that using an anesthetic like baby Orajel or Ambesol can help make injections more comfortable. She said she coated the needle with a bit of Orajel before the injection. I would rub a bit of Orajel on the skin a minute or so before you do the injection. This should numb the skin, and you aren't touching the needle."

The baby Oragel or baby Ambesol numbs the skin so that the prick of the needle isn't felt.

Hoping we can get something going that isn't so tough for both of you!

Kathy

We Hope
02-15-2009, 10:45 PM
Even though this talks about giving an insulin injection to a cat, the process is basically the same when giving a shot to a dog; those with cats are also taught to use the tent method, etc.

http://www.petalk.com/feline-diabetes.html

Tips and Tricks from Pet Owners

"We had a terrible time with Scooter when we tried to inject using the 'tent' method, which was taught to us by the animal health technician at the local vets office. On a subsequent visit with the Vet, himself an owner of a diabetic cat, he displayed a different technique which works VERY WELL with Scooter, and she displays much less reaction and definitely less pain. The technique is to pinch some of the skin (for me using my left hand) between your thumb and forefinger (trying to avoid grabbing muscle underneath) and ROLL your hand sideways (for me, rolling my hand over to the left) pulling the skin over your finger.. this makes the cats skin MUCH TIGHTER than pinching it up into a tent, and the tighter the skin, the easier the needle penetrates without pulling. The technique literally meant the difference between night and day, success and failure in our commitment to do what needed to be done to keep Scoots going. Just thought it worth sharing, some people might find it makes the difference for them.
(Pat and Shelley and Scooter)"

Kathy

BestBuddy
02-15-2009, 10:56 PM
I struggled the first few weeks with Buddy. It was as much my fault as his because I was so scared of hurting him and he picked up on my fear and it was just horrible. I purchased a BD inject ease and it worked like a dream. Maybe mind over matter but it gave me confidence. I didn't have to guess how hard to push in the needle, I just set the spacer to the right depth and it was so simple. I also found that Buddy hated me pinching his skin and I learnt to just grab a few hairs and pull up. I loved the inject ease so much that after I wore it out (5 years later) I purchased another.

Jenny

k9diabetes
02-16-2009, 08:34 AM
You may need to give a very concrete reward, like a food treat - keep it really small for the fake shots - and she only gets the reward for sitting quietly and letting you inject her. You may have read on Rick's thread that he's been teaching Lucy a "Still" command and it might be worthwhile to work on this with Princess too relative to the pretend injections.

Even if the treats raise her blood sugar, getting past this is important enough that it would be worthwhile. I suspect praise will not be enough - get her nose and stomach involved to distract her and motivate her.

And especially for after her real injection, save up a really high value treat for her. Something she really really really wants. Lean meat would be a good choice... And then she doesn't get it until she peacefully gets her injection. If she starts to put up a fuss, tell her "Sorry" and set everything aside for a few minutes. Then come back and try again. Don't get into a power struggle with her. Offer her the opportunity to cooperate with a high value treat as a reward and if she throws a fit, the treat goes away. Wait again, try again.

To teach recall with Jack, we use fresh turkey slices... he about breaks his neck to come back for those!

I don't think forcing her into it through a physical struggle so intense she's exhausted is going to help you. The "we are going to do this" is a frame of mind with you, not the approach on the ground in handling... does that make sense?

Will she run away if you don't "hold" her?

I never restrained Chris. He just sat for his injection and waited for his mini milkbone.

You may need to change the environment and your physical approach in handling her - more hands off if you can.

Our cats, for example, go ballistic when you put a towel around them to restrain them. It works with a lot of cats so that's what the vet did but these cats do better unrestrained with just a scruffing or in a confined space. Towels just don't work for them.

The Inject-ease probably will help speed up the injection process and so could help too.

With nail trims, for example, the time it takes to line up the clipper is too long and Chris would yank his foot away. If I could have clipped it very quickly, I probably could have gotten one or two trimmed at a time. Same thing with setting up the injection so an Inject-ease would be worth trying... plus it would let you use the finer needled syringes.

But Remember...

You aren't going to overcome this in a day or even in a week. It stinks, I know, but it's true. This is going to take time. You are changing the way you deal with her and doing conditioning of her response, which doesn't happen overnight. You will need to practice every day and make the practice injections a completely positive experience with a high value reward. And still some days will go well and some will not

I can pretty much guarantee you that she can "tell" the difference between your state of mind with the pretend shot where there's no pressure on you and the real one where you are very anxious to succeed.

Although you want to have a "we are going to do this" attitude, it's a state of mind in you that's calm and determined but also something you can walk away from, if only for a few minutes.

In training, they really stress that you maintain a cheerful, kind of "whatever" attitude. Good behavior brings rewards; bad behavior makes what Princess wants go away and your state of mind is "doesn't matter to me." A cheerful, unannoyed "oops" or "sorry" is the cue that her behavior made the treat go away.

In your mind, and perhaps actually with Princess at first, you may need to be willing to walk away from the injection instead of a power struggle physically to force it into her. And see if you can find a reward so wonderful that she can't resist it to associate with injections.

How is she at the vet with procedures?

That can sometimes tell you whether it's your interaction with her that's the issue.

Just remember your new mantra... patience, patience, patience... :)

Natalie

CarolW
02-16-2009, 09:53 AM
You may need to give a very concrete reward, like a food treat - keep it really small for the fake shots...

Even if the treats raise her blood sugar, getting past this is important enough that it would be worthwhile. I suspect praise will not be enough - get her nose and stomach involved to distract her and motivate her. ....

Just remember your new mantra... patience, patience, patience... :)

Natalie

I really agree with this. I'd suggest what you can do, as I do with Kumbi to limit stress - is, limit the number of pretend-shot sessions! Dogs can get tired very quickly. I think it's very possible that Princess has become sensitized, rather than de-sensitized, only because it's been more sessions than her stress-hormones would let her manage! So her stress-hormones stay high, and you would still get a certain amount of panic, even for the pretend-shots.

An advantage to smearing food on a saucer is that Princess would get less food that way. too.

It's just possible that - two things =

1) if you've been using praise but not treats, as Natalie says, Princess probably needs the additional motivation of treats;

2) She's begun to take even the pretend-shots as a cue to panic again! Using treats instead of praise, and keeping pretend-shot session to only, say, one a day, could help with that.

Please keep us posted!

Mon, 16 Feb 2009 09:53:13

We Hope
02-16-2009, 10:36 AM
We need to clarify stress can either raise or lower blood glucose. Some people and dogs respond by having their blood glucose raised by stress, while others respond to it by going low:

http://diabetescontrolforlife.com/articles/monitoring-How-Stress-Affects-Blood-SugarLevels-200093

"Mental or emotional stress has mixed effects, depending on the type of diabetes you have:

"Type 1 diabetes: Mental stress can increase or decrease blood sugar levels."

The hormones which are called upon by stress are the same ones which are considered the counter-regulatory hormones, those that raise blood glucose.

http://www.rnceus.com/dmeds/physio.htm

"Counter-regulatory hormones are hormones that block the effects of insulin, thus increasing blood glucose. Important counter-regulatory hormones include: glucagon, epinephrine, norepinephrine, growth hormone, and cortisol."

I guess the only good thing in all of this is has been very regular and in "norm" with everything, no changes. Hunger is good, thirst is regular, peeing regular.

The counter-regulatory hormones would be driving up the blood glucose levels, which would mean you would be seeing more polydipsia (excessive drinking), and the polyuria (excessive urinating) which follow it. I don't believe you've seen any of the signs of hypoglycemia with Princess:

http://petdiabetes.wikia.com/wiki/Hypoglycemia#Symptoms_and_Treatment

depression/lethargy
confusion/dizziness
trembling
ataxia (loss of coordination and/or balance)
loss of excretory/bladder control
vomiting, and then loss of consciousness and/or seizures.
sleepiness/unresponsiveness

which would indicate that she's been driven too low. Any lows would stem from the system having used most to all of its stored glucose, in response to the call from the counter-regulatory hormones for that extra glucose. There's only so much stored glucose available to the body at one time before the system needs to replenish itself. This takes some time, and it's the reason why hypos don't resolve themselves without some outside treatment--sugar source and food.

A true panic situation should mean that you'd be seeing symptoms of either high or low blood glucose and I don't see anything you have posted that described your having these issues with Princess.

You're saying that appetite, drinking and urination are normal--extreme upset or panic can mean a change in appetite--either eating too much or inappetance. Princess doesn't seem to be showing any physical indications of panic.

Kathy

Fishslayer
02-16-2009, 12:25 PM
With better regulation Lucy has a lot more energy.

Unfortunately, this also means she has "those" times when she'd rather wiggle & squirm.

I've found that when I get frustrated she squirms more. Sometimes I just have to wait it out. I put off worrying about the injection for a bit & we snuggle & I baby talk her etc. She usually calms down in minutes.

Lucy also is sensitive to having her skin "pinched." Sometimes I have to be very gentle tenting up the skin. If I pinch, she does NOT like it.

One time she just was NOT cooperating. Squirming, trying to crawl on me...

Turned out I had forgotten I had a shirt pocketful of bikkie treats!:rolleyes:

Hope Princess learns the procedure quickly.



Rick

pgcor
02-17-2009, 02:02 PM
How's our little min pin girl cousin doing today? I hope you both are doing better!

Believe me when I tell you that I have been at this over a year, in fact it will be 2 years in September - and I cried everyday for at least a month when Pip was diagnosed. I even had horrible nightmares about it. He was so hyper and I have no control over my dogs. I hate to admit it, but i'm a push over (although not with people!) Neither one of my dogs listen to me and they don't obey any commands.

I never wanted to train my dogs and I didn't have any reason to. Once they were housebroken that was enough for me. But this diagnosis has brought me to a place where I have to do some things that are extremely uncomfortable for me and it would have been nice if my dogs obeyed me!!

But, even I have figured out how to do this. Pip has taken to not coming for his shots at all even with a treat. But, if I fake him out by giving the other dog a treat - he'll come running! It's all trial and error for me.

I know you'll find a way. I screwed up so many shots in the beginning and I thought everytime I missed one, Pip would go blind and it would be my fault. But, hey he's not blind! And for the most part he's a happy hyper dog. And, after only 1.5 short years, I don't need as much medication. :eek:

Just kidding....

eyelostit
02-17-2009, 07:54 PM
I tried oragel awhile back, but maybe I did not use enough, Patty in GA suggested Amnbesol, maybe I will buy some of that tommorrow, I just may coat that needle, if its good for a babys mouth I doubt if its harmful to Niki.

Eventually we'll figure this out, I need it figured out, I never had these problems before.:o

ladygirl
02-18-2009, 10:48 AM
So a bit of an update:

It has really only gotten harder. The other morning after she caught on that it was shot time I used the "sorry" and "oops" to her and coddled her like a baby till she calmed down, and eventually I was able to inject her no problem, she just squirmed out of my hands after and I gave her some cottage cheese which she seemed to enjoy.

Well, later on that night when I thought I could use the same technique she caught on after I started baby talking her, she would squirm out of my hands. And now this morning, as she was not wanting to finish all of her food because she knows what comes at the end of it, when I tell her "oh what a good girl" she moves even further away from me. This morning I tried to inject her and I'm pretty sure nothing got in cause it all squirted on me. She still wants to eat, but now I have to hand feed her every kibble and she will not even touch it if it is dry, it has to be coated in wet food, so it takes forever.

I mean I seriously don't know what else to do. We have been really calm throughout all of it, setting it aside if she doesn't want it and coming back to it a few minutes later and literally she gets just as "spazzy". My problem is not injecting her, it's that everytime we hold her still for more than two seconds she jumps up so it's hard to get the needle in without the hand being pushed up and the needle potentially poking something or SOMEONE else.

I even tried to do it without the tenting technique, because she knows that once two fingers grab some skin, it's shot time. So I tried to just do it Kathy's way by injecting at a 90 degree angle, parallel to the skin, and she still caught on. She just jumps everytime you get the needle within 2 inches of her skin, no matter where.

I really want to try the Inject-ease, but now I have to talk to the vet about converting the dosage, which is not a problem but it's just more of a process for all of this. Anyways, I'm really at a loss of what else to do. She's a pretty savvy girl and will catch on after only a couple minutes, you can't really try and run anything by her. Her brother PJ on the other hand forgets something after 2 seconds. :/

peggy0
02-18-2009, 12:22 PM
I have a yorkshire terrier who is very wise. When I go to clip his nails, i swear he hears me getting the trimmers out of the pantry. I tried the sweet talking for awhile and the treats. He won everytime. Now I pick him up with a towel on my lap so he can't slide off, tell him to stay and clip his nails. He knows he's going to sit on my lap for the evening until its done so he finally just gave in. Couldn't ever find anything to make it pleasant for him :(

BestBuddy
02-18-2009, 12:29 PM
Hi,
The inject ease really gave me confidence. Buddy got his injection after he had eaten his canned and got the kibble after the injection. With the device I learned how to be calm and firm and I never made a big deal out of it and it was really only a few days and he seemed to understand that this routine was just how it was.
Good luck
Jenny

We Hope
02-18-2009, 02:56 PM
It sounds to me like the Inject-Ease might be the answer because it makes the shot process a lot quicker.

Princess is like the kids who start crying up a storm when they see the doctor coming with a syringe--never mind that he/she has yet to come near them with it. ;)

Think that once this turns into some type of routine with Inject-Ease or whatever you settle on, it won't be the "big deal" it is now with Princess.

Kathy

ladygirl
02-18-2009, 04:07 PM
Thanks you guys I think you are right. We have an appointment to go in on Tuesday to get her next BG done and at that time I will ask them about possibly converting the dosage so that we may purchase the Inject-ease.

Oh and just for info, as I forgot to include it in the original BG post, these are her BG results to date (let's hope on Tuesday it still stays regulated, fingers crossed!)

2/3 (Diagnosis Date) - 416
2/6 - 126

I think at that time they are going to also schedule the date for her all day BG, which I'm dreading because I hate thinking of her in a little kennel for a day without her brother. Oddly enough despite she's a female, she NEVER cries. But when she gets seperated from PJ, her bro, her little cries are so sad to hear. PJ, a male, on the other hand cries even when you tell him to get off the bed. Weird little children :)

AlisonandMia
02-18-2009, 04:20 PM
Can PJ go with her? The less stressed she is the better for the testing so maybe the vet will OK him going along too.

Just a thought.

Alison

PS: I have birds and if one of them has to stay at the vets I always have another of their friends along too to keep stress levels down as much as possible.

ladygirl
02-20-2009, 12:12 PM
Actually I think Princess will be alright. I think it's just when PJ leaves her she starts to cry, but when she leaves PJ she actually gets a little bit happy/cocky? She's a clever little girl.

Anyways so I tried a new method last night that gave me a little more success. Instead of having my fingers on the syringe all in "ready to inject" mode, which made it easier for me to potentially poke myself, I instead went off some advice another website which suggested that you just hold the needle to poke first, THEN position your fingers once the needle is in the skin to push the plunger. That way you have more success getting the needle in and then have to worry about pushing in the insulin.

Sure enough I did this last night on my own and it worked! I did it while putting on her body collar for her walk so she was a little distracted and got the needle in and quickly pushed the plunger in and took out and she was fine! I mean sure after she realized what happened and up and ran, but I rewarded her with some cottage cheese which she loved.

Nevetheless, this morning when I tried to use the same mechanism, she knew the second I was taking a couple seconds longer on her collar she started to wiggle out of my hands. So I guess I will have to try and devise something new.

But I think I like this method better because or else I'm too worried keeping my fingers in place with some on the barrel and one on the plunger, and she senses that. It really does make it easier for me to poke myself. The other way, even when I used it this morning, despite it taking longer, gave me more confidence in at least getting the needle in and then pushing the plunger in.

I don't know if I'm making sense but I will try and keep doing it this way. If any of you guys have tried it this way could you let me know how it is working?

Princess has another appt. on Tuesday to get her BG checked. We ordered the Inject-Ease on Hocks this morning so that we can take it to the vet on Tuesday to see if it is something we can use and how we can convert the dosage (because she is on the U40 Vetsulin 29).

okay message done..... :)

CarolW
02-20-2009, 01:25 PM
Oh, Ladygirl, you are doing so well! This is wonderful news! You really will get the hang of it, in time, and so will Princess. Princess may never cooperate any more than my Kumbi does - lately, Kumbi has begun to walk away as I begin to take his skin in my hand to make a tent. However, he's not seriously trying to escape, so I just wait a moment, my tent-making hand on his skin, and he stands there. Then I proceed with the rest of the procedure!

You may remember that Kathy remarked on possibly rolling your hand to the side when holding skin, tightening the tent over your finger. I tried that, out of curiosity; I might try it again. There might be times that would be useful.

Also, Kathy has illustrated how she injected Lucky without making a tent, because Lucky would NOT put up with having his skin pinched up. You could look at that again, too.

I've been injecting now for about 2.5 years, and am essentially really comfortable with it, almost no matter what Kumbi does. I stay relaxed and comfortable, and that also helps Kumbi do the same. However, I am ALWAYS considering all the excruciatingly fine details of keeping injections really comfortable for Kumbi. I can't remember when his last yelp of pain was - probably the time I injected an air bubble! (on purpose, to test a friend's remark that you can't harm a dog that way but Kumbi told me it hurt! I DID adjust the dose to allow for the air bubble!).

People have also mentioned that if you have two dogs, often enough, you can get the second to tempt the diabetic one into coming for injections. I've now begun to give treats to both dogs. I do things in this order now:

1) prepare the syringe (without purposely calling my dogs' attention, but they are watching, because they are expecting their treats).

2) warm the insulin in my armpit (needle capped, of course)

3) Walk to where I have the treats ready, on a little chest-on-wheels. The dogs are now following me.

4) Extract the syringe from my armpit, and then I begin my chant:

5) "Is it warm enough? Glorious! Glorious!" - and I pick up the bit of canned food I have ready, and feed a tiny bit to each dog - BEFORE the injection (!)

6) Quickly wipe my food-finger, so it's dry (paper towel handy)

7) Place my hand gently on Kumbi at intended tent-site

(This is where, lately, he's been turning to walk away)

8) At whatever angle Kumbi and I are, I pick up a bit of skin, and feel it to make sure I have skin on both sides of the tent, but haven't picked up anything else in particular.

9) As you remarked, place the needle at the base of the tent

10) I may now either slide the needle under the skin, or place my finger on the plunger

11) Now, if the needle is already under the skin, I place my finger, and if I have already placed my finger on the plunger, I slide the needle under the skin

12) inject, withdraw needle, and check for wet spots.

13) pretend to inject Kwali (!) (The syringe is now empty, so I really can't make a mistake and really inject her)

14) Sing out, "Treats! Treats!" - and feed both dogs tiny bits of the canned food. They lick it off my fingers. When done, I say, "All gone!"

Sometimes both dogs still watch me, hoping for more, but by this time, I'm also standing up and walking away; putting things away, and so forth. I do add, "That's all for now. I'll give you more tonight (or tomorrow)."

I think the essence of this is, first, as you observe so well, Princess, like so many dogs, is a clever little girl. It takes an awful lot to fool a dog. Dogs can and do learn routines. This is as much a learning experience for Princess as it is for you. The more we build ritual and chant (which serves as extra cue) into this twice-daily necessary routine, the more familiar it becomes to us, and to the dogs, and the more practiced all of us become with it. In general, dogs find ritual and routine very reassuring. And they also take their cues for being calm from us, so the calmer we are, the calmer they can be.

I think you're doing a great job - congratulations! If the InjectEase works out, so much the better. Please keep us posted!

Fri, 20 Feb 2009 13:24:57 (PST)

ladygirl
02-20-2009, 02:22 PM
Thanks for the advice Carol! It almost sounds right on par with what I do. I usually try and sing something while we're trying to do it or I cuddle her (with her of course wiggling out of my arms) and say, "Oh my goodness what a good girl! No shot? Okay, sorry!" and let her go and then try again minutes later.

The thing is that when I pinch some of her skin in the middle of the day, even sometimes with the capped needle in my hand, she doesn't get AS squirmy as she does after meal time, and I think it's because she has already associated it.

So like Rick, Lucy's foster dad, suggested I may try and inject her AFTER going on her walk, because she doesn't really expect it at that time? Or....and please tell me if this is too crazy, I may try and inject her on her walk while she is -ahem- you know....doing her business, that way she can't really back away. I don't know I'm trying to consider all options :)

And Carol I love that you went into detail about your morning routine! That really helps me and confirms that I'm not the only one who tries to sing or try and make some nice noises for Princess to hear! (Despite my sister telling me I'm a little cuckoo).

pgcor
02-20-2009, 02:24 PM
Just wanted to pipe in here and say I LOVE the new picture. What a little doll!

ladygirl
02-20-2009, 03:49 PM
Thanks PG! Yours is so very cute as well, but I guess we're bias, being Min Pin owners and all :)

I'm trying to find the cutest picture of her, but the only ones I have been able to put are the ones off my phone, but there are really adorable ones of her on our computer so I'm going to try and get those tonight!

I've been meaning to ask you, how do you go about giving your Min Pin his/her shot? How has he/she responded or adapted over time? I'm really interested specifically because you share the Min Pin complex we have, though cute and totally irresistable, they put up quite a little fight.

Jerry
02-21-2009, 08:10 PM
So sorry to hear that Princess has diabetes, Your story is almost like mine. I have a 9 year old female min pin that developed diabetes in Sept 2008 and I am still having a hard time with it. I have 2 min pins (Mandy and Nikki), it was during Mandy's illness (teeth problems) that Nikki came down with the diabetes. I just notice like you the excessive drinking and weight loss (she was 22 lbs now down to 14 lbs). She also had bad breath. I thought the problem was teeth just like Mandy. I took her in to have her teeth cleaned when the vet called and said that she has diabetes. She is on insulin twice a day. We started at 4 units total for about a month. However, her blood curve at well above 400. Then increased to 6 and not 8 total units a day. The weight has stablized but she looks so thin. She does seem to have increased energy and is more playful. Nikki is not a dog to eat early in the morning. I go to work at 6am and she needs her shot before I leave.

My main problem is what can I feed her. I give her vegetables, kibbles, prescribed wet dog food. Can anyone give me an idea of what else she can eat? I would help me alot.

Thanks for listening......I can't tell you have many days I have cried over this?

Nikki sends Princess a woof to get well

k9diabetes
02-21-2009, 08:19 PM
Hi Jerry,

I created your own thread for you and Nikki so you have a home for all of your posts about your girl!

Welcome to the forum... and I promise you will stop crying eventually! :)

Natalie

ladygirl
02-21-2009, 09:09 PM
Hey Jerry, welcome!

Well I'll try and summarize Princess's story, because its essentially like Nikki's. Princess is also one of two Min Pins, her and her brother PJ. Anyways late January we noticed all of sudden she was getting up in the middle of the night crying for water and peeing like crazy. At first we didn't think anything of it, but it got really unusual that I took her to the vet where they confirmed she had diabetes. She is almost 6 years old, so she's relatively young. She was originally about 21 pounds when they weighed her in December for another vet visit, and in the beginning of Feb. when we took her to the vet she had went down to 18 pounds. This was without a change in diet or anything, so it definitely gave confirmation.

Anyways, on Feb. 4 we got her started on 4 units of insulin twice a day per the vet. At that time they weighed her again and she was down to 16 lbs. Initially they said her BG was 416, and when she had her BG checked a couple days after starting her insulin, it had gone down to 126, so the vet said that surprisingly she had gotten regulated very quickly, which was good news. (She goes for her 2nd BG check on Tuesday, and I'll make sure to give you guys an update then.)

My only concern now is actually injecting her, because I'm sure as Min Pin owner you know, Min Pin's catch on very quickly and she now puts up a fight for about 15-30 min before we can inject her. She's just so darn squirmy!!

But that is where this board comes in. I don't think I would be anywhere near as informed about this disease if I had not found this board. The original vet knew VERY little about diabetes, and simply by reading the info here and some of the stories I knew more about it then she did. (I eventually switched vets and now Princess has a specialist as her vet :) )

Everytime I want just the littlest advice or even just a question answered, the board is there to help. I see that Natalie already started a thread for you, which I'm so glad about. If you look back a couple of pages some of us on the board here went for about a page commending and giving thanks to Natalie and Kathy (and the rest of the board) for all the help/inspiration they give, and we couldn't be more grateful, because they truly deserve that honor. They are experienced when it comes to diabetes, and even if they may not know the answer, they will help you to find it, which is rare on a message board.

So to not make this an essay, I just want to say welcome and we are always here to help/support you. As a Min Pin owner I know a lot of the challenges both you and I face, they are tough little guys, but just as adorable as well. I am still learning, as I am not even a month into the disease! But the times that I feel insecure about whether I can keep going, all I need to do is come here and I get that confidence right back. I know that Princess and I will continue on because in the end we're both stronger than we think. :)

And please let us know all about Nikki! I want to hear about all the other Min Pin's that share this disease.

P.S. pgcor is also a Min Pin owner and gives great support!

ladygirl
02-23-2009, 11:00 AM
So good news, I think I found the easy(er) way to inject little miss Princess!

Even though she is still squirmy, I find it's easier to hold her in one hand, and inject her in the skin around her arm which is much more loose and less thick. I think the reason she was so hesitant before was because the skin around her shoulder blades was thick and she felt the sting alot more when it went in. These last two times I've injected in the skin around the armpit area, she hasn't even felt when the needle went in, I think only when the liquid begins to go through that is when she feels, but by then she's a little more calm.

So far both injections have gone well! I mean she still tries to squirm, but you can tell she doesn't know when the needle goes in.

Not going to lie I'm a little relieved and ALOT of the stress has been lifted. I'm a naturally stress/anxiety driven person, so this was adding alot to the multitude of other stresses I already have. Now lets just hope that on Wednesday her BG is still regulated!! :)

We Hope
02-23-2009, 08:41 PM
And it sounds like you've gotten your "needle technique" downpat quickly! :)

Glad you found a way that works for you and Princess! What one dog doesn't mind, another dog can't stand, so that's why it's sometimes so hard. We can all try telling you what worked for us and our dogs and you can try them, but it comes down to you using that as a "guide" for finding your own way that works.

Everyone was using the pinch or tent method when I was starting with Lucky--they weren't having any problems with that with their dogs, and I felt like something of a failure until I found a way that worked for us.

The thicker the skin, the harder it's going to be for you to pierce it with the needle. Getting into places where the skin is thinner means that the insulin is better absorbed too.

When you work hard at anything and no matter how hard you try, when things aren't working at all, it's frustrating!!!! Now that there's not the stress level over how to give Princess her shots, I think things will go much better for you both. ;)

Kathy

ladygirl
02-23-2009, 09:30 PM
Thanks Kathy!

I definitely felt after reading your post that you don't always have to follow the guidelines. I was very nervous at first not to do it the tenting way in fear that I may incorrectly inject her, but when you gave me your story it really gave me more hope that I don't always have to go "by the book." :) Thanks for that.

She's eating right now so we'll see how this next shot goes!

We Hope
02-24-2009, 07:32 AM
The credit goes to you for doing, as Dawn (Brandy's Mom) says--"thinking outside of the box"! :)

Most of our dogs haven't been good "readers"--they aren't interested in what "the book" says. They seem to prefer to be "authors" and write their own pages to it. ;)

The book is a great place to start for the basics, but it can't solve all of the possible problems that you may face, so while you read it and use it as a guide, some of the answers need to be those you come up with.

In the end it's what works that counts and it sounds like you have a nice plan going for you both now! :D

Kathy

k9diabetes
02-24-2009, 02:38 PM
Phhh... books... what is it with humans and their rules?!?!?!? ^..^

pgcor
02-25-2009, 07:55 AM
Whew glad to read this! It does take time, but even our little min pins have to get used to it!

It's so funny you should mention the "book" on giving insulin....When Pip was diagnosed the first Vet told us to stay in the upper quadrant of his body - never, never at the back end. The second Vet told us to inject at the back quadrant - he'll never feel it there.

Well, we've been to five different Vets and two specialists and I can tell you everyone has their opinions.

The information you get from people who have to do this everyday is priceless! I don't know what I would have done without the "board people"!!!

Kathy and Natalie are spot on with their advice as usual! And I am really happy that Princess is calming down.

I'm so glad you are feeling some relief too!!!!

ladygirl
02-25-2009, 09:47 AM
Thanks pgcor! Yeah I definitely have come to realize that while my vet is extremeley kind and caring, the advice they give (at least the injecting method) is sometimes personal opinion. Though now remembering Princess's main vet, who is such a sweetie and quite cute (blush), has a diabetic dog of his own and is also a diabetic himself, said that really you can inject anywhere, it is just that some areas are not as effective to absorb and hurt more than others.

Nevertheless I'm proud to say that we now have 100% success with Ms. Princess! It takes me now no more than 1-2 minutes to inject. She doesn't squirm as much because she doesn't feel/expect when the needle is going in. Before it was taking me around 15-45 minutes to inject her because I'd have to chase her around the house and we'd get into a struggle. The only thing now is teaching my sister and my father. My sister has been able to once, but she has sort of a fear of injecting anything, whether a human or a dog, but she gets over it. Her main fear is just that she hates having to hurt her. I told her that she wasn't but that the more nervous and stressed she got it the more Princess would feel it. I think she is finally starting to get it down though.

That said today Princess has her next BG taken at the vet. We ordered the Inject-Ease on Friday from Hocks but now I'm thinking we won't really need it. (That and it hasn't arrived yet b/c I wanted my sister to take it to the vet to show him if it would be a possibility to convert the dosage so that we could use it, but that will just take more work for a process we have finally figured out.) Princess's diet is now solid on Purina O/M of 3/4 C a day mixed in with the Purina O/M wet food. After her shot I let her lick out of her own cottage cheese container I bought for her. I think she is starting to associate her shot with cottage cheese which is a good thing.

So now let's just hope her BG is still regulated.....please please please please. I'll post after what it is.

Thanks a lot you guys for all your help, seriously I wouldn't be able to get all this done without you guys. :)

eyelostit
02-25-2009, 11:46 PM
I'm glad to hear you found a good spot for injections !! :)

k9diabetes
02-26-2009, 12:38 PM
I'm so happy for you and for Princess!!! Perseverence really is the name of the game with diabetes.

Natalie

Fishslayer
02-26-2009, 04:04 PM
The only thing now is teaching my sister and my father. My sister has been able to once, but she has sort of a fear of injecting anything, whether a human or a dog, but she gets over it. Her main fear is just that she hates having to hurt her. I told her that she wasn't but that the more nervous and stressed she got it the more Princess would feel it. I think she is finally starting to get it down though.

One thing you will want to be VERY sure of is that everyone is on the same page as to who gives the shots.

Though my wife knows how to inject, I am the ONLY one who feeds & injects Lucy. This avoids any potentially deadly mixups.

Better to miss a dose than double it by accident.

Rick

ladygirl
02-26-2009, 06:16 PM
Oh absolutely Rick. Ditto on my part. For right now my sister has injected her only twice, but it was under my supervision. I ALWAYS right down the injection right after in Princess's journal. As for now it is only me that is injecting, but eventually I will incorporate them in properly and make sure we have standard guidelines/ set procedure to avoid ever harming Princess.

The only reason I am having to divvy it up between my sister, my father and I is that I don't actually live here. Princess, along with her brothers, lives here at my parents house and I live in the city. So for the past 3 weeks I have essentially been living back home (and sleeping on the ever so comfortable couch) to ensure that it's really only me doing everything for Princess. A lot of this is because I don't want to leave it to other people because quite frankly I really only trust myself in making sure everything goes right. If I leave it to someone else then I have no control, which makes an anxiety-driven person like myself nuts.

But on the other hand I can't stay here forever, which is why I have to incorporate my father and sister, because since I can't always be here, they need to know protocol/be prepared for when I need their help. If it were up to me Princess would live with me that way I could be in constant care of her, but this is her home and this where my parents want her to be, and they love her too much for me to tear her away from them.

Wow that turned into a long story I didn't really intend to write, but oh well. Thanks for your advice Rick, I definitely know what you mean. Eventually when I feel secure enough I will start to blend them in so that we can all work at this efficiently and safely, because at the end of the day that little girl is our main concern, and should anything go wrong with her because of one of us I couldn't live with myself. So until then I guess it will be good 'ol Princess and her mama!

Fishslayer
02-26-2009, 09:16 PM
Boy, do I know THAT feeling. I worry all the time about screwing up with Lucy. It's getting better but still...:(

Rick

Dollydog
04-27-2009, 08:04 AM
Hi again,
Just checking in again to see how you made out with the injections. Congratulations on your progress!! :D
Several months after Lady became diabetic, I spent a weekend thinking that I would have to let her go because the injections were taking up to 30 minutes and my legs would shake for another 30 minutes afterward. My husband came up with an idea to help out and after a few months of that I did the shot myself and we've been doing it by ourselves for almost 2 years now.
And I've found that if I'm holding my breath, Lady will fight the shot....that's when I know to breathe slowly.
Take care,
Jo-Ann & Lady :)

We Hope
08-23-2009, 08:14 AM
Bumping this up again for Ruby. :)

ladygirl
11-19-2009, 05:02 PM
So hi to all (after quite a break), but thought I would come back and chime in on how Princess is doing and her new situation.

So we got Princess regulated on Vetsulin fairly quickly per her vet, and she was doing just fine. I still am not doing the BG tests at home because I don't think I'm at that comfort level yet, but hopefully with some guidance from you guys I could get there quick because quite frankly going in every so often to her vet gets expensive for those tests on top of her blood panels.

Anyways, a little over a month ago we started noticing that she displaying the same characteristics she did prior to her diabetic diagnosis (i.e., frequent thirst, peeing in the middle of the night, unwilling to eat some mornings), so I knew something had to be going on. I delayed a bit just to see if it was maybe some sort of temporary reaction to perhaps getting the occasional treat from my parents (which I keep having to diligently reprimand them for, I swear its like it goes in one ear and out the other) but I knew that wasn't it. I called her vet finally last week to let him know (really spurred by the Vetsulin warning sent to me via e-mail from this board) and he said he had heard about it as well and was just going to give me a call to check on Princess. When I told him what was going on he asked that I bring her in to run a blood panel on her.

I took her yesterday and after doing her tests, they informed me that they will discontinue Vetsulin effective immediately at that practice, and prescribed Princess to start on Humulin N, which luckily they were able to get done straight away so that I could pick up at a local pharmacy.

Okay, so now Princess is on Humulin N at about 1.8 IU (her vet wants to start low I guess), but now this means we have to start ALL OVER, which quite frankly I'm willing to do out of my concern for Princess's health, but its just a little stressful after her doing so well. On top of that I now how to incur the same costs I did at the beginning of her diagnosis, which (and tell me if I'm being irrational) seems unfair. But I guess that is life. (I am going to ask her vet tomorrow when I bring her for all day BG testing to see if there is anyway to get out of some of the costs because this was something done out of our hands and from medication they prescribed, of course in the most kind way possible I will ask : )

Anyways, so now she is on NPH, which quite frankly I'm a little glad because I hear it is cheaper. Right now I got the Humulin N from Walgreens because it was the closest/fastest option, but (and I'm going to address this to her doctor) I hear that I can get the SAME exact thing at Walmart seeing as they have a contract with the Humulin distributer but just under a different name, I guess ReliOn? I'm just worried at what elements are going to change if I change to that brand (i.e., dosage, syringes, calculating different things based on the generic brand to what my vet is prescribing?) My hope is that switching over to WalMart brand (after I use up this bottle from Walgreens) will save me money each month. I also DO WANT to start BG testing on my own, but quite frankly it scares the beejeezus out of me. My vet said there are several ways to get the monitor for free and that it is really the test strips that are going to run me a high price. Do you guys recommend I do that on my own if I am working/going to school full time and am not home during the day? Or would it be more to my benefit, after she gets stabilized, to just leave that for the occasional vet visit?

Whew! Quite a mouthful for such a long break I've taken (which I apologize about but I had a busy summer with school and work which will finally take a temporary break this Christmas break, thank god). Anyways, I see all the concerns/posts over Vetsulin, which I'm glad to see affirming that I'm not on my own on this. Nevertheless Princess seems to be doing fine, just with a lot more thirst and the frequent potty breaks, she's still a chipper little girl who has quite the energy when need be. On top of that she's cute as a button so it makes it all worthwhile.

Let me know anything you think! Any suggestions/advice are welcome with open arms (and paws!) :)

k9diabetes
11-19-2009, 08:33 PM
Hi!

I was smiling, sympathetically of course! :), reading your post today. It was worth the wait! :)

I'm hoping Princess does really well on the NPH as it will save you a lot of money long-term on insulin and probably syringes. And actually your vet has given you what sounds like some good advice about home testing.

Okay, so Relion N at Walmart is the insulin you want to get. You can also get syringes there for a good price and there is a large variety of syringes for U100 insulins like NPH - the needle size goes down to 31 gauge and you can get syringes with half-unit marks too.

So the vet switched Princess to NPH... did he have you get new syringes too?

Relion N is Novolin N and everyone I have ever seen switch between Novolin N and Humulin N could not tell any difference in the action of the two. So you can switch back and forth between the two as they are interchangeable. Novolin N makes Relion N as a "house brand" for Walmart. It is actual Novolin N, just packaged under a different name.

Same syringes, same dose, totally interchangeable.

I totally agree with the vet that you can usually get a good deal on a meter and over the long run you will spend more on strips than on the meter if you get it for a good price.

For a small dog, you might try a Freestyle meter. They take a very small drop of blood. Walmart makes a meter but their meters do not have as good a track record for accuracy in pets as Freestyle and OneTouch do. So I always recommend Freestyle or OneTouch if you can.

Then you can order strips online. I used to use www.hocks.com (http://www.hocks.com) for a lot of Chris' diabetes supplies. There are cheaper places but you have to watch for expired strips, etc.

Once you learn to test, you can do a curve at home for less than $10 worth of test strips so it's way cheaper than having the vet do it.

Plus, I like curves at home because they reflect real life. Your dog goes through her normal routine during the curve rather than stressing at the vet and being stuck in a kennel all day. So I think they more accurately reflect your dog's daily blood sugar.

Whether you wind up doing them just depends on how you and Princess do with home testing.

I suspect that if it's not too difficult to do with Princess, you will wind up wishing you had learned to do it a long time ago. Knowledge is power and with home testing comes solid information about your dog's blood sugar.

We are getting quite a mob of Min Pins around here! :) Nice to hear from you and yours,

Natalie

ladygirl
11-20-2009, 04:45 PM
Thanks Natalie! (I was secretly hoping you'd be the first to reply! ;) )

Anyways so Princess is doing fine, same 'ol girl with just a little more peeing. But she was shaking (out of being nervous) going to the vet today. That and it was a little cold out, and everytime someone came in the door would bring in a gust of wind. She always reminds me of a litttle kid that you take to get their shots and how sad and reluctant they look. She usually warms up though pretty quickly.

They do have her there all day today for her glucose curve, and her vet just called me to let me know that she didn't really want to eat her food this morning (even with the low fat cottage cheese I gave them), but that they gave her some baby food which she joyfully ate (she's a clever one that girl). Since the vet is closing early today at 6 PM today, her doctor did say he was debating whether to have me come back for a FULL day of BG testing, but that he didn't want to make me have to come again, so he will just take advantage that she is there today and get the most from the readings and try and get her lowest point to see how she is reacting to the insulin and eating. He said for right now it's probably best to keep her at the 1.8 IU and then in some time (he didn't specify how long, I'll ask that when I go there to pick her up) we will gradually increase her.

I did ask him about the WalMart brand of the Humulin N (am I saying that correct? or is it Novolin N? I'm confused on that :confused:) to see if that was a good option for me to change to after I use up this bottle of the NPH from Walgreens. He said he had heard something about WalMart distributing the same exact thing just under a contracted name for a cheaper price, which he said he would find out the details for me before I got there today but he wouldn't see any reason not to , especially considering the price.

Are there any additional questions I should ask when I go after work to pick up Princess up? (I swear this board is like my go-to bible, and I'm not even religious, for diabetes. Beats any reference manuals! :) )

pgcor
11-20-2009, 07:27 PM
Just wanted to chime in here....I was getting Novolin at a Wal-Mart near our home and except for one time, the insulin was always, always bad. It must be the way they pack or transport it. I went to a different Wal-Mart and had better luck. It's well worth the effort as the Humulin N is $45.00 at our Walgreens and the Novolin is $27 at Wal-Mart.

Pam