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dctexan
02-09-2009, 08:33 AM
Hi everyone. My name is Emily and my dog Dixon (pitbull or pittie mix...we aren't exactly sure. He was a Katrina rescue we adopted) was diagnosed with diabetes 2 weeks ago. Dixon is (almost) 4 years old and weighs 35lbs (he weighed between 39-41 before he started getting sick...during the height of his illness, he was down to 33lbs). I am baffled as to how/why he got diabetes since he is a young, lean, physically active dog whose diet has always been strictly regulated (1 cup Wellness Venison dry food 2x day plus 3 baby carrots every night before bed. He would occasionally get some people food - leftover egg, rice, veggies, yogurt, etc. but it was never large amounts and it was not something that happened daily). I realize it is useless to ask why, but I just can't help it.

Anyway, here is Dixon's story (sorry it is kinda long...feel free to skip it and go to the data section below. I am not sure how helpful the story is but it makes me feel better to share it). Around Nov my husband and I noticed that Dixon seemed a bit mopey, with reduced appetite, and thinning fur. His weight was still okay (40lbs) and he still seemed to enjoy everything he used to enjoy (walks, playing, doggie daycare, etc.) so we kinda ignored it (which I now feel horrible guilty about!) figuring he was just experiencing a winter-related funk (he has always been sensitive to the winter, even though we live in Atlanta where there is very little winter to speak of. The past two winters he has shown similar symptoms). Then around New Years I noticed that the fur loss was getting pretty bad and his anorexia and depression were increasing. We took him to the vet who asked us if Dixon had been rubbing himself on the carpet/scratching. He definitely had been doing these things so we told her so. We decided to treat it as an allergy (which seemed very reasonable to use since Dixon has demonstrated other sensitivities in the past. For example, metal touching his skin makes him break out in a rash. He also has a "sensitive" tummy and it took us well over a year to find a dog food that didn't give him diarrhea) and put Dixon on OTC antihistimines and to start doing a medicated bath weekly. The itchiness seemed to improve a little bit, but Dixon still just wasn't right so we went back to the vet. This time the vet put Dixon on steroids (which I now know can push boarderline diabetic dogs over the edge. I imagine this is what happened to us). Of course the steroids caused his to be crazy thristy and made him have to pee all the time. Tese side effects were expected so we just dealt with it. However I started to worry when I noticed that even though his steroid dose was decreasing, his water consumption and bathroom needs were increasing. This was definitely not right. Still, I decided to wait until he was off the steroids before doing anything (ack! MORE guilt). Unfortunately once he came off the steroids everything went downhill very rapidly. He stopped eating (and when he did eat he would vomit), he was drinking water all the time, and he could not make it more than 3 hours without having to pee. He also started peeing in the house, sometimes right in front of us (and he had never ever done that before!). He also started looking very very skinny. We took him into the vet and did the usual round of tests (x-rays...thinking maybe he had an obstruction, urinanalysis to check for a UTI, blood work). X-rays showed an enlarged pancrease, urine showed sugar and ketones, blood work showed very high blood glucose (I am not sure how high, I never asked). Dixon was checked into the animal hospital for detoxing/insulin control.

His stay was fairly short (at least from what I have read that other people has to endure), only 3 days/2 nights. Even though he still had some ketones in his urine, the vet decided to release him to me (since she had gotten his fasting blood glucose down around 100 using the short acting insulin and he was keeping his food down). He was placed on 7 units of NPH (his dose in the hospital had been 5 units) to be administered every 12 hours immediately after a meal (meal instructions were to give 1.5 cups of Wellness mixed with a "spoonful" of cottage cheese or plain yogurt every 12 hours).

We are monitoring his blood glucose at home (OneTouch Ultra Smart). Here are the readings obtained so far...

1/31/09
8:43AM - 259 (immed. prior to breakfast & insulin)
10:53AM - 563
12:49PM - >600 (freaked out & called vet. She said that due to his lower levels that morning it was okay to continue to monitor at home)
6:00PM - 415
8:16PM - 468 (10 min prior to dinner & insulin)
10:15PM - 462

2/01/09 (I bumped Dixon up to 7.5 units of insulin)
8:22AM - 106 (immed. prior to breakfast & insulin)
1:04PM - 369
8:13PM - 255 (immed. prior to dinner & insulin)

2/02/09
8:18AM - 119 (immed. prior to breakfast & insulin)
10:30AM - 358
12:30PM - 340
3:00PM - 422
4:55PM - 314
6:55PM - 306
8:28PM - 248 (immed prior to dinner & insulin)
10:29PM - 437

Was told by vet at this point to keep Dixon on the 7.5 units and to recurve on 2/07/09

2-07-09
7:40AM ..... 271 (just before breakfast/insulin)
9:57AM ..... 438
11:48AM ... 449
1:45PM ..... 532
3:45PM ..... 380
6:00PM ..... 317
7:45PM ..... 326 (just before dinner/insulin)
9:59PM ..... 477

2-08-09
7:35AM ..... 397
6:45PM ..... 343

2-09-09
8:20AM ..... >600 (this was 40 minutes AFTER breakfast & insulin)
10:40AM ..... >600

It is clear to me that his insulin needs to be increased. I have sent all of the data into the vet and am waiting to hear back from her.

My questions for you guys are

1). Since starting insulin Dixon has been positively food obsessed. Just completely obsessed (and he was NEVER this way before). Does this ever go away? We are going to have to eventually reduce his ration (the increase was to help his regain weight) and both DH and I are really dreading it.

2). Can diabetic dogs ever get treats? What are some good treat suggestions? Part of Dixon's bedtime routine used to be getting 3 baby carrots. We have discontinued this since the diagnosis (my understanding is that carrots are fairly high on the glycemic index) but would really like to be able to replace it with something.

3). We usually travel cross country 1-2 a year to visit DHs parents. We are now freaking out about how to handle Dixon's medical needs when we travel. Has anyone else dealt with this successfully?

4). We really like our vet as a person (and for generally doggie health issues) but we feel like maybe we should consult with a specialist. Any advice about finding one?

I am sure I have tons of other questions, but I think I have rambled on enough for an intro post. Thanks for listening!

rhodesian46
02-09-2009, 12:45 PM
HI,
I was wondering whether Dixon had a thyroid test along with his blood work? It should say T4 or Free T4
You could give Dixon some frozen green beans Make sure they don't have a lot of sugar in them. I would get the organic ones at Costco or Wal Mart in a bag.
Hunger issue will probably subside when her is regulated.With Pebbles it never did as she also was diagnosed with Cushings right after the DX of Diabetes
Have you compared your meter to the vets lab? This way you would know approximately how much your meter was off.
If you have a gut feeling that something is just not right with your vet or he isn't experienced enough then run Go with your gut. You need to find a Dr that has treated diabetic dogs including using Novolin. An Internal Medicine Specialist would be great. Working together as a team is so important.
Make sure that you get a copy of all Dixons tests,vet notes etc from your vet You wil need all of this when you see another Dr. ALso in case of emergency it is great to have these
When I did weekly curves, I did the first reading at fasting,then 1 hour later ,then 2 hours thereafter till I got to the evening fast. I did these on weekends as I knew that I could be home with her.
Don't freak if you go away. It is the same schedule that you would have if you were at home. many have done this successfully.
I am sure that Nat or Kathy will be sending you loads of links soon. Just want to say welcome. I know this is new It will get better

k9diabetes
02-09-2009, 01:18 PM
Hi Emily,

Just a quick note to welcome you and Dixon. I have to go take care of some other things but will be back to catch up on the two of you later today! :)

Natalie

We Hope
02-09-2009, 01:43 PM
Welcome, Emily!

Before Lucky was regulated, we had something similar happening with the food. He started looking for dinner hours before it was time for it to be served. He was hyperactive in his quest for food. Hard to deal with because I knew giving him something earlier or something extra wasn't in keeping with the diabetes schedule.

After getting regulated, while he was eager to have his meals, it wasn't the obsession with him any more as you've described with Dixon.

When we got him regulated, we did it with two things--pork Lente insulin and a switch to a food which has more fiber in it, Prescription Diet W/D canned.

Dieters are big on foods which have a good amount of fiber in them because eating them lets you feel "full" without eating a lot of calories. Fiber is a plus to those with diabetes because it helps control post-meal spikes (large bg rises after eating), which it looks like Dixon has, and because it slows the system's absorption of glucose.

While eating more fiber hasn't helped people reduce their insulin needs, more fiber has done that with dogs.

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

If you would consider changing Dixon's diet to get more fiber into it, you don't necessarily need to go with the prescription type dog foods. We have people here who are feeding non-prescription "lite" or "senior" diets because of their added fiber and their dogs are doing well with them.

Diabetes meant getting rid of all the old treats Lucky used to get. I gave him a bit of roast beef (no sugar, no carbs) for an after-shot treat in place of them.

Agree with you that Dixon's in need of an increase! ;)

Kathy

k9diabetes
02-09-2009, 07:46 PM
Hi Emily,

Just so you know, I LOVE long posts!! :) The more information, the better!!

Poor Dixon... he's had a time of it. Our dog developed diabetes just after steroid treatment for allergies as well.

What became of the skin and hair problems - did the anti-histamine and steroids clear them up or does he still have issues?

The throwing up was most likely related to the very high blood sugar and ketones. I'm so glad you took him to the vet when you did as ketoacidosis is a life threatening condition.

Given how high his blood sugar has been most of the time, I wonder if the 119 and 106 were accurate readings. Sometimes a strip that's not completely filled will give an off reading...

Then I'm concerned about the large jump in his blood sugar today to more than 600... is it possible that he got into some food or consumed something he shouldn't have last night?

Because the 7.5 units was keeping him at a much better spot - not regulated by any means, but not over 600 either.

If those low readings those two mornings were accurate, he could be going quite a bit lower at night and last night he might have gone low enough to have been hypoglycemic, generating some rebound high blood sugar.

We are monitoring his blood glucose at home (OneTouch Ultra Smart).

1/31/09
8:43AM - 259 (immed. prior to breakfast & insulin)
10:53AM - 563
12:49PM - >600 (freaked out & called vet. She said that due to his lower levels that morning it was okay to continue to monitor at home)
6:00PM - 415
8:16PM - 468 (10 min prior to dinner & insulin)
10:15PM - 462

2/01/09 (I bumped Dixon up to 7.5 units of insulin)
8:22AM - 106 (immed. prior to breakfast & insulin)
1:04PM - 369
8:13PM - 255 (immed. prior to dinner & insulin)

2/02/09
8:18AM - 119 (immed. prior to breakfast & insulin)
10:30AM - 358
12:30PM - 340
3:00PM - 422
4:55PM - 314
6:55PM - 306
8:28PM - 248 (immed prior to dinner & insulin)
10:29PM - 437

Was told by vet at this point to keep Dixon on the 7.5 units and to recurve on 2/07/09

2-07-09
7:40AM ..... 271 (just before breakfast/insulin)
9:57AM ..... 438
11:48AM ... 449
1:45PM ..... 532
3:45PM ..... 380
6:00PM ..... 317
7:45PM ..... 326 (just before dinner/insulin)
9:59PM ..... 477

2-08-09
7:35AM ..... 397
6:45PM ..... 343

2-09-09
8:20AM ..... >600 (this was 40 minutes AFTER breakfast & insulin)
10:40AM ..... >600

It is clear to me that his insulin needs to be increased. I have sent all of the data into the vet and am waiting to hear back from her.

1). Since starting insulin Dixon has been positively food obsessed. Just completely obsessed (and he was NEVER this way before). Does this ever go away? We are going to have to eventually reduce his ration (the increase was to help his regain weight) and both DH and I are really dreading it.

Is he obsessed all day long or mainly first thing in the morning? If it's mainly in the morning, I would again be concerned that he's dropping low at night... with such high blood sugar during the day, it doesn't seem very likely but is something to consider.

2). Can diabetic dogs ever get treats? What are some good treat suggestions? Part of Dixon's bedtime routine used to be getting 3 baby carrots. We have discontinued this since the diagnosis (my understanding is that carrots are fairly high on the glycemic index) but would really like to be able to replace it with something.

The green beans and brocolli are great treats as they have almost no calories.

One time he can have something special is as a reward after he gets his injection - as far as his blood sugar is concerned, it's just part of the food going in with the meal. But if a treat means a lot to him, he will enjoy it. Our Chris always got a mini milkbone after his shot and he could get impatient waiting for me to get done so he could have it!

Otherwise, though, for now it's best to stick to his meal and shots and nothing in between because right now you are watching the interaction between his meals and his insulin and treats (other than some green beans or brocolli (I can't spell brocolli...)) make it difficult to "see" how that interaction is going.

3). We usually travel cross country 1-2 a year to visit DHs parents. We are now freaking out about how to handle Dixon's medical needs when we travel. Has anyone else dealt with this successfully?

Do you take him with or board? We took our blind diabetic dog on a number of cross country trips and he did great! We packed up all his supplies with an ice chest for his canned food and insulin and we stopped all over the place. Gave lots of injections in the back of our Jeep at rest stops and parks! :)

4). We really like our vet as a person (and for generally doggie health issues) but we feel like maybe we should consult with a specialist. Any advice about finding one?

With the severe allergies and possible IBD and diabetes... I'd probably at least consult with an Internal Medicine Specialist. You should have quite a few choices where you are. Ask your vet for a referral. A good vet will encourage you to take advantage of specialty care.

Our dog had a LOT of health problems. Before he passed away last year, he had an ophthalmologist, a cardiologist, and a dermatologist and had seen a neurologist!! Most dogs don't need all that but Chris benefitted greatly from their specialized expertise and I don't think he would have survived to 14.5 years of age without that extra care. Our vet was great about referring us any time he felt Chris could benefit. The trip to the neurologist was an emergency, for example. The vet examined Chris and felt there were potential neurological problems so sent us to an expert right awy.

The vet may want to explore those low numbers with a few more days of testing. And if he stays at 600+, he should see the vet in case he's picked up an infection or the treatment that reigned in his allergies has worn off and they are coming back up strongly. Either one could drive his blood sugar up.

Let us know what the vet says!

Natalie

bowens2
02-10-2009, 06:32 AM
Emily

Sounds like you have a better handle on things than most newbies. I know I was a mess and it took me a few months of trial and error and a lot of Natilie's help.

Monkey was diagnosed in September 2006. He seems to be different than most dogs. He is on Lantus which is expensive as far as insulins go but he does well on it so I have not switched him YET. He gets 14 units 2x a day. The only reason I keep him on Lantus is I work a lot and from the posts of other caretakers, it seems I have more play with Lantus as far as time goes. Recently when I boarded him at the vet. They gave him a shot a 8am then again at 4pm and he seemed fine. I usually do a 8:30am and 6:30pm because he is hungry at that time. I usually follow with the brocolli but sometimes I hold off an hour or two. My schedule is very erratic so this works for him and us. Lantus is what my vet started Monkey on. It is said on these boards that a lot of dogs do not do well on Lantus but he does and like I said before it is expensive.

TREATS
I give Monkey a cup of brocolli steam in chicken broth and then add more chicken broth after it has cooled every evening. This helps some what with the hungry part. Monk gets 2/3 cup of RD (high fiber) and 1/2 can RD (of course also high fiber) twice a day and he weighs about 28 lbs. I also found a chicken strip (at Target - Vitality with vitamins) that does not affect his glucose. I stick one of those down in a medium size Kong a couple of times a day.

Just recently, I took the big stocks of brocolli and sliced them into tiny chips and steamed them in chicken broth. Monkey loved them (he usually will only eat the florrets and they have to be soft). I have thought about getting a dehydrator to make them crispy. I think I would be able to use these like regular treats several times a day.

Just suggestions - Like Natalie told me in the beginning every dog is different. Monk has no other known medical issues to deal with.

Like they say the important thing is to get his numbers regulated then add the treats.

I love the so called bully breeds and my maiden name was Dixon!

dctexan
02-10-2009, 07:33 AM
Thank you everyone for the warm welcome and support!

Just to give you the rest of the data from yesterdays readings...

2:10PM ..... Dixon threw up a small amt, water and some food.
2:11PM ..... I started thinking "crap, we are so going back to the vet today" as I cleaned up the vomit
2:19PM .... 421 (sigh of relief as I decided that we did NOT need to go to vet)
7:25PM .... 418 (just before dinner & insulin)
9:53PM .... 489

I tried to get a readintg this morning, but after 3 sticks and 2 wasted test strips (Dixon is NOT a bleeder) all while my toddler was pitching a fit I decided to skip the testing. Dixon seemed much better last night and he went from 11PM-6:15AM without needing to potty (also water consumption was more normal).

He is at doggie daycare today :)

As for the accuracy of the "100" readings....I am pretty sure they are accurate (although, obviously, there is always room for error). The blood wicked completely and the general trend seems to be for his BGL to be lowest first thing in the morning. The going hypo overnight is an interesting theory (although I don't think it has been an issue lately). I will keep it in mind though if we start getting morning 100 readings (and maybe test him at some point in the wee hours of the morning?)

As for the >600 readings I have no idea what is going on there. It is unlikely that he got into anything extra (he is in my bedroom at night and doesn't roam the house. He was with me all morning...he is a velcro dog who won't let you leave the room without shadowing). One possibility is that he may have gotten some Cheerios (I have a 17 month old human child who has been known to drop food...although never large quanities). Hopefully the vet will have some suggestions/ideas (still haven't heard back from her which is kinda making me grrrrr)

The other weird thing I am noticing is that his curve is the inverse of what I expect to see. It seems like most dogs curves are U-shaped. Dixon's seems to be an inverted U (with the peak in the middle of the day). Any idea what is going on?

Maggie's Mom
02-10-2009, 07:52 AM
No advice, because I'm new to doggy diabetes too. But, wanted to let you know that this board is awesome!! I wouldn't have survived without it!

dctexan
02-10-2009, 07:54 AM
Woohoo avi worked!

To answer the rest of the questions...

I really do not know if Dixon's thyroid was tested. I was so freaked out over the original diagnosis and the implications that I didn't ask for a copy of the blood work. I am going to guess that they did NOT do a thyroid test though because (as I recall) there in house regular blood panel does not assess thyroid function and they only ran the blood panel (or at least that is all they charged me for and I am pretty sure they wouldn't leave extra tests off of my bill). I DID specifically ask the vet about the possibility of Cushings (growing up, I had a schnauzer with Cushings) and whether any of the bloodwork indicated a need for further testing and she said no.

The food obsession is pretty constant. It is just like he is starving ALL.THE.TIME. He can (and does) settle down and take naps and such (so he isn't pacing in the kitchen all day) but anytime anyone goes anywhere near the kitchen he is there is a heartbeat and anytime anyone has any food he is following and begging. If I put him in a down stay he will whine/woof/inch forward because he is so antsy about the food. He was NEVER like that before.

The skin problems cleared up completely on the steroids (figures) but are totally back now. Maybe a little bit less intense (still rubbing fur on the carpet but not as frequently). Fur is still looking thin, but I imagine it will take him quite a bit of time for it to regrow.

He typically boards when we travel because I cannot stand the idea of flying with my dog (it makes me WAY too nervious to think about them in the cargo hold. I just do NOT trust the airlines enough to hand my dog over to them. Also, I am not sure that airlines will allow bully dogs to fly anyway). Driving from GA to OR isn't a sane option for us. I am pretty sure that his curent kennel will let him stay with them (it is also his doggie daycare) but I feel all freaked out about what if they miss a shot (or even worse, double inject him?!), what if his meals are evenly spaced? How do we handle the schedule differences between the kennel and home? Things like that. I guess you just have to have some faith. Maybe that will come as Dixon becomes more stable and his diabetes treatment more routine? Right now it just feels like the biggest issue in the whole world.

Also, thanks for the snacks/diet suggestions. Sounds like fiber is going to be key for Dixon. I will mix up some greenbean puree for him tonight :D

k9diabetes
02-10-2009, 08:26 AM
Diabetic dogs have been successfully boarded. Sometimes folks leave them with the vet to board but a good conscientious kennel (having a day care makes me think they are more interactive and participatory than a plain old kennel) can do it right. You would want to have his regulation pretty well in hand if you can.

We also had a pet sitter stay at our home with Chris when he was young, before he was diabetic, so that may be another option. She went to work during the day but spent the evenings and nights with Chris.

But one step at a time. Unless you're on the verge of travelling, there's lots of time to work out a plan for that. Hopefully by the time that comes up you will be past the freaking out stage that we all go through at first.

Ask the vet for a copy of all of Dixon's test results - it's great to have them at home to refer to. I have the vet fax over the results of all tests done as soon as they are available and keep a file of them here.

Since the skin cleared up on steroids, it sounds like allergies alright. Is he still taking an anti-histamine?

I hope the hunger will settle down as he regulates. He really is literally starving right now - without insulin, that food just washes out through his blood stream and he doesn't get the benefit of it! So he undoubtedly is very very hungry. But as his insulin dose comes up, he will feel better and I expect that the hunger will abate.

VERY exciting that the urinating is already coming under control. That's how Chris was - he didn't start drinking a lot of water until his blood sugar was sustained above 450. So thirst and urination generally wasn't an issue with him.

You're making progress! Just know that the "first part is the worst part." It will all get better and easier and less stressful with time.

Natalie

bowens2
02-10-2009, 10:19 AM
I do know here in Cincinnati I could never find a kennel that would take a diabetic because of liability even though I told them he was regulated.

So I always board at my vet which is cheaper for me any way and Monk can't stand all the noise at a kennel.

Monk isn't as starved as he use to be but he very seldom seems 100% satisfied. Still he is not as nearly as bad as he was in the beginning.

dctexan
02-10-2009, 11:55 AM
Vet just got back to me. We are increasing insulin to 9U and will re-curve next Tuesday.

k9diabetes
02-10-2009, 12:54 PM
Meant to add earlier today that Dixon's curve is an "upside down" one. Which I actually LOVE because you can test premeal and know that virtually all of his readings the rest of the day will be higher than that.

You always set the insulin dose based, essentially, on the lowest blood sugar for each 12 hours. Whatever number of units takes him down to the best BG he can achieve while keeping his BG safely always above 90 to 100. In your case, you'd want him to start at 100, knowing he will go up from there, and return to about 100 at his next meal.

eyelostit
02-10-2009, 11:08 PM
Hi Welcome Emily an Dixon :)

I recently had to take Niki for a stay at my Aunts house for about 5 days, that went well as far as food and shots.

Years ago I used to board my 3 dogs, I taught the man at the Kennel how to do insulin shots, and gave him all the info, as to how much to feed etc, and I called the Kennel everyday to see how she was doing.

I see your vet increased the insulin to 9 units, down the road if you are still seeing highs, another thought is the food, I worked with a member who was using the Wellness Core, problem was not enough carbs , I don't know if you are using the grain free or not, but once the diet got changed abit using the Core with some green beans or brocolli and a bit of other dogfood the bg went down. It just all depends on how your dogs handles the food and insulin.

I was using Orijen for awhile 70% protein 30% carbs, but this did not work out until I added some other kind of dogfood in the mix with veggies.

I hope all goes well with the 9 units.

Niki's 1st vet before the diag of diabetes assumed she had urinary incontinece so gave her Detrol, what a mistake, my dog was taking this and was diabetic. Niki was DX at 5 yrs old. She will be 12 in summer and has had diabetes for over 6 yrs now, she's doing well. Hang in there it takes some time at first, and alot of patience.

Again Welcome and ask anything, no question is a silly question (we have already asked them ;))

Oh where to in OR, I used to live there.:)

Dolly

dctexan
02-11-2009, 09:13 AM
Thank you so much for the information everyone!

So we started the 9U last night. Fasting BGL was like 489 this morning :(
I re-tested him an hour after breakfast and 9U insulin shot and he was at 523 (which I guess is better than the spikes I had been seeing, of course Dixon already started off the morning with high sugar).

Questions (and I just know I am going to have a ton of them for quite a while...thank you for being so patient with this newbie)

1). How long does it take for dogs to adjust to new insulin doses? Shouldn't the 9U have brought his fasting BGL lower than they had been previously? Vet wants me to give the new dose at least a week (and re-curve next Wednesday). Is a week between dosage assessments typical?

2). I feel myself becoming a little obsessed with the BGL numbers. I would curve Dixon every single day if I had the time and money (those little test strips are crazy expensive!) - such is my nature. What is the "normal" amount of testing during the pre-regulation period? I want to make sure that I am paying attention and getting the data I need without crossing over into crazy testing territory.

3). When do I worry about ketones and how should I be checking for them (should I be checking for them?). My vet feels that as long as Dixon is eating/drinking well (no anerexia, no vomiting) then we shouldn't get too freaked out about ketones. Is this true?

4). Diet. I am so confused! I have done quite a bit of reading about diet for a diabetic pet. The most typical recommendation is high fiber & low carb. What about protein & fat? Also, doesn't increased fiber just make for more (ahem) waste? The typical recommended diet for healthy dogs is mostly meat based and minimal to no grains. Looking at the available prescription diets for diabetic canines I have to say that the ingredients look like (in my opinion) crap. Tons of corn and other grains. Very little high quality meat. What is the reasoning behind this? I agree that Dixon might need a new food but I am loathe to change without having a solid scientifically based rationale for WHY I am doing so. When we first adopted Dixon it took us almost a year to find a high quality dog food that worked well for him. Other foods we have tried but that caused loose stool, frequent stool, gas include Pedigree Lamb & Rice (this is what he was eating when we adopted him), Innova Evo (small bites? maybe the big bites. I can't remember), California Natural (Lamb & Rice), & Wellness Super Mix (Chicken). I am pretty sure that part of his reactions to those food was food sensitivity/allergies (Lamb = BAD! probably a few other things too), but maybe also too much protein (Evo?) or fat (pork fat or duck fat = very, very bad)? What exactly should I be looking for in terms of finding a high quality dry food suitible for a diabetic? His current diet (Wellness Venison) is 21% protein, 12% fat, 3% fiber and 420 cal/cup.

Cara's Mom
02-11-2009, 09:57 AM
Welcome Emilie and Dixon!
Finding the right food is rather important and took me a long time.
You should be looking for low/no carb and fat and lots of fibre. Yes, fibre increases "waste", but it also slows down absorbtion, which helps keeping BG down!
There are a lot of different kinds of fibre. Maybe talk to your vet to find out what he recommends and take it from there.There are a lot of very good dogfoods out there for our sugarbabies. But to find out which will work for your dog could be a chore!
Cara is now on IAMS Vetererinary Formula Weight Control D and is doing great!

Best wishes

We Hope
02-11-2009, 10:00 AM
Adjusting to new insulin dose: This depends on the individual dog. It takes from 2-3 days to possibly 5-7:

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

Page 10

"the size of the insulin depot makes it necessary to allow 2-5 days of adjustment before achieving a new equilibrium."

When we were having problems with Lucky and high bg's at the start, we would increase based on testing done on day #3 or possibly day #5 since the last increase. This depended on how bad his numbers were at the time.

Everyone has his/her definition of what's "normal" for their home testing and I'll let people tell you what's normal for them. Just don't get into the habit of "chasing numbers" because it can bring you more harm than good. Chasing numbers can give you an "itch" to either increase insulin doses too rapidly or do too large of an increase. "Scratching" it can lead you into Somogyii rebound where the bg's go up and down like a roller coaster ride.

The fix for that is actually LESS insulin rather than more, because when you hit a low, you activate the counter-regulatory hormones which are in all of us and their job is to keep the body from dropping too quickly. So the signal goes out and the body releases these counter-regulatory hormones, cortisol among them, whose job is to RAISE blood glucose levels. Adding more insulin when this is happening just keeps the vicious circle going.

Ketones:

You should be checking for them now because Dixon is still in the higher bg ranges.

http://k9diabetes.com/forum/showthread.php?p=6111&highlight=ketones#post6111

Since you use a meter for blood testing, you don't need to have the Ketodiastix which test for both glucose and ketones, but can get Ketostix, which test urine for just ketones alone.

With the diet, I would want to stay away from fat, because diabetics are prone to getting pancreatitis, since they already have a medical condition which affects the pancreas. We have people here who are feeding types (canned/dry) of the various prescription diets for diabetes, and people who are feeding non-prescription foods with an eye on the fiber and fat in them.

Some people have not had luck with one particular prescription-type diet but have with another; the same is true for those using non-prescription foods. When you do have a food Dixon does well with, the insulin can be adjusted to "cover" it if it's not the "perfect" food for diabetes.

HTH! :)

Kathy

k9diabetes
02-12-2009, 10:23 PM
So we started the 9U last night. Fasting BGL was like 489 this morning :( I re-tested him an hour after breakfast and 9U insulin shot and he was at 523 (which I guess is better than the spikes I had been seeing, of course Dixon already started off the morning with high sugar).

Questions (and I just know I am going to have a ton of them for quite a while...thank you for being so patient with this newbie)

1). How long does it take for dogs to adjust to new insulin doses? Shouldn't the 9U have brought his fasting BGL lower than they had been previously? Vet wants me to give the new dose at least a week (and re-curve next Wednesday). Is a week between dosage assessments typical?

Yes, a week is very typical.

2). I feel myself becoming a little obsessed with the BGL numbers. I would curve Dixon every single day if I had the time and money (those little test strips are crazy expensive!) - such is my nature. What is the "normal" amount of testing during the pre-regulation period? I want to make sure that I am paying attention and getting the data I need without crossing over into crazy testing territory.

It is easy to do! Good thing they make the strips a little expensive, huh? :)

While they are in such high numbers, there's really not a lot of advantage to curving frequently. Premeal BGs and spot checks to see whether the new insulin dose is having an effect and how much of an effect are good. That way, if there's suddenly a huge drop in blood sugar, like Maggie had the other week, you can drop the dose back down.

I have done quite a bit of reading about diet for a diabetic pet. The most typical recommendation is high fiber & low carb. What about protein & fat? Also, doesn't increased fiber just make for more (ahem) waste? The typical recommended diet for healthy dogs is mostly meat based and minimal to no grains. Looking at the available prescription diets for diabetic canines I have to say that the ingredients look like (in my opinion) crap. Tons of corn and other grains. Very little high quality meat. What is the reasoning behind this?

The standard for diabetic dogs has been those prescription diets that are typically corn based and have a fair amount of carbs in addition to a lot of fiber. And in truth, particularly with NPH, those diets have often worked well in concert with the action of the insulin.

BUT many vets are seeing food more flexibly these days and I've seen diabetic dogs do well on just about every diet imaginable - from junk food to home cooked and everything in between.

I would start with what you want to feed and see how that fits with the insulin. I especially prefer this approach with a dog who has problems with lots of diets.

If the food and insulin do not work well together, then you can consider changing foods to see if you can get a better fit. You can also supplement what you want to feed with fiber or grain... sometimes a diabetic dog needs some carbs to go with a strong surge from the insulin whereas protein can be digested too slowly.

Chris started out on WD and then was switched to half canned Canidae and half cottage cheese (Canidae was digested so quickly that we needed something that went through a little slower and cottage cheese worked really well for him). He did well on both. The curves on those two very different diets did not look the same but it doesn't mater what "shape" the curve is as long as the range between highest and lowest blood sugar is good.

I don't see any reason why you can't leave Dixon on his current diet and see how he does. If his blood sugar is swinging through a huge range, he might need a diet change or an adjustment to it by adding something.

Chris was very sensitive to various ingredients. We eventually determined that he was sensitive very heavily to soy and seemed also to be sensitive to barley and to eggs if given too much, plus some weird fiber sources caused him problems. That was why we liked California Natural chickena and rice canned food, which he got along with Canidae for a while - it's a simple food - chicken and rice only.

Natalie

dctexan
02-13-2009, 07:53 AM
Thank you so much Natalie (and everybody!) for answering my questions.

Dixon seems to be feeling better these days. he is actually playing with his toys and running around the yard :D

Since the insulin dosage increase to 9U we have seen number between high 500s and low 200s (in general he is hanging out between 350-450). We are planning to do a curve tomorrow and then again on Tuesday or Wednesday.

We might also do some overnight testing, just to make sure that nothing "weird" is going on at night, but haven't committed to that idea completely. We will probably make a decision based on how Saturday's curve looks.

It sounds like we can just keep Dixon on his diet for now (the vet was on board with this plan). I have taken to adding a bit of green bean puree, 1/2 tbs of pumpkin, and some cottage cheese to his dry food just to try to spread food metabolism out a bit. He has been a bit gassy the past 2 days, I am thinking maybe it is the pumpkin? I will stop giving that tonight and see if it helps.

I am also going to pick up some ketone pee sticks tomorrow. Can I just get those at CVS or do I need to plan on searching? Also, what is the recommended protocal when urine is positive for ketones?

We Hope
02-13-2009, 08:23 AM
Emily,

You can easily get the Ketostix at CVS or any other pharmacy. You might need to ask the pharmacy desk for them because I've seen a lot of them keeping things like that which might walk out the door "free" behind the counter. At our local pharmacies, some of the diabetic supplies are behind the counter for that reason.

When you're checking for ketones, if there's more than a trace, it can be a serious problem. Still, even if you see a trace, I would contact your vet because he/she may order an insulin increase which could take care of the trace ketones problem. There are signs when the ketone problem is a bad one at this link:

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

While I think Dixon may still need to have his insulin increased along the way, I think you are on the right track with him! :)

Kathy

k9diabetes
02-16-2009, 07:19 PM
His socks, white tipped tail, his expression, and the way he folds his paws remind me a lot of Jack, our smooth coated border collie. He sure is a handsome guy and those are wonderful pictures!!

I do have a thing for black and white dogs... cats too actually... someday I want to have a tuxedo cat.

Natalie

eyelostit
02-17-2009, 03:18 AM
I'm glad Dixon is feeling better, it will take 5-7 days to see results with the insulin.

At the beginning of our journey we tried various diets till we found one that worked with the insulin.

You're off to a good start, with insulin adjustments it takes time, baby steps actually, it'll all work out. ;)

dctexan
02-18-2009, 07:10 AM
Here are our numbers after starting 9U of insulin

2/11/09
7:10AM 396 (immed prior to food & 9U)
6:48PM 564 (food & 9U given at 7:20PM)
9:35PM 228
11:29PM 310

2/13/09
7:23AM 308 (immed prior to food & 9U)
7:25PM 103 (gave dinner but withheld insulin)
7:56PM 168 (gave all 9U after recheck)
10:12PM 417

2/14/09 First Curve on 9U
7:55AM 329 (immed prior to food & 9U)
10AM 227
11:20AM 267
1:30PM 295
4:23PM 234 (stole a graham cracker from Benjamin at 4:45ish)
6:18PM 315
7:50PM 405 (immed prior to food & 9U)
10:47PM 376

2/15/09
7:49AM 289 (immed prior to food & 9U)
7:39PM 374 (immed. prior to food & 9U)

2/17/09 Second Curve on 9U
7:40AM 217 (immed prior to food & 9U)
9:30AM 181
11:30AM 400
1:30PM 388
3:30PM 285
5:30PM 389
7:30PM 387 (immed prior to food & 9U)
9:29PM 294


I have sent the info to the vet and am awaiting her instructions. Presumably we will be bumping up to 10U

We Hope
02-18-2009, 07:31 AM
Emily,

I believe you're going to increase also, based on the 300's and at times, some 400's. We're all waiting for Dixon's "magic number!" :)

Kathy

dctexan
02-18-2009, 01:36 PM
Heard back from the vet. Bumping up to 10U and recurving next week.

eyelostit
02-19-2009, 06:10 AM
Hi Emily,

Glad he is coming down some.:)

I was wondering is Dixon still on the Wellness Food, which type is it ? How much does he weigh?

Dolly

dctexan
02-19-2009, 07:49 AM
Hi Dolly,
Dixon is still on the Wellness (Rice & Venison dry food). He gets 1.25 cups 2 x day. We are also mixing in some green bean puree (between 1/8-1/4 cup), 2tbs cottage cheese, & 1/2 tbs pumpkin. So far that diet seems to be working for him so I think we will stick with it. Weight last Sunday was approx 36lbs. we are trying to get him back up to 39-40ish.

Emily

Soaphie & Sydney's Mom
02-19-2009, 01:21 PM
We use the Wellness Venison & Rice as well - Soaphie (and Sydney) LOVES IT.

If anyone is looking for a good place to get this, check out www.smartpak.com. Order as much as you want and the shipping is $7.95 TOTAL and it typically arrives in 2 days....we usually order 5-6 26lb bags at a time....and the shipping is still only a flat $7.95.

Tami

dctexan
02-20-2009, 12:58 PM
So we started the 10U. Yesterday was okay (started out great in the morning with readings in the 150-250 range) but by the evening he was up to 350ish (just before dinner and injection). Two hours after dinner he was back down to the 200s. This morning he was in the 500s! Do you think he might have sunk too low during the night and rebounded (there is no way he snuck any extra food since he was in our bedroom - door shut - all night). Probably too early to tell but I am freaking out a little.

eyelostit
02-21-2009, 11:27 PM
When I look at your current curve posting and look at your previous one I do see some bg reading down in the 170's, my thought is a slight food change either adding something and taking something else away. Just a thought.:)

You on using NPH correct?

k9diabetes
02-22-2009, 10:48 AM
Hi Emily,

It's certainly possible. Sometimes a 1 unit difference is a big difference when they get down into those numbers.

I'd go back to 9 units and give him a few days to stabilize and see what happens.

There are other possibilities... UTI, other infection, bad insulin (is it a new bottle?). Consider those as well.

If he stabilized on 9 units (after a few days to settle what we're assuming is rebound) and went back basically to the levels of the curve, I'd assume 10 units was too much and try 9.5 units.

We used syringes with half unit marks, which was cool because it allowed us to adjust insulin by quarter units and I often did that. Chris was on an average of 7 units so a 1/4 unit could make quite a bit of difference.

How's his blood sugar now?

Natalie

dctexan
02-23-2009, 07:43 PM
Dixon's number since starting 10U

2/18
7:29PM 317 (immed. prior to food & insulin. Had received 9U @7:30AM)
10:04PM 120
12:00AM 235

2/19
7:45AM 185 (immed. prior to food/insulin)
7:15PM 348 (immed. prior to food/insulin....was at doggy daycare all day playing. Had 1/4 cup dry food some time between 12-1PM per vet's instructions on daycare days)
8:58PM 201

2/20
8:00AM 511 (immed. prior to food/insulin. We all woke up a bit late)
11:30AM 376
4:50PM 249
7:50PM 422 (immed. prior to food/insulin)
11:38PM 313

2/21
7:45AM 436 (immed. prior to food /insulin)
9:22AM 386
7:28PM 280 (immed. prior to food/insulin)
9:33PM 97
10:22PM 82 (gave 2 Wellness Peanut butter Treats)
11:10PM 127

2/22 FIRST CURVE ON 10U
7:50AM 395 (immed. prior to food/insulin)
9:25AM 450
11:58AM 341
1:37PM 291
3:45PM 158
5:58PM 189
7:45PM 210 (immed. prior to food/insulin)
9:50PM 119
11:07PM 142

2/23
7:25AM 279 (immed. prior to food/insulin)
7:44PM 71 (eek! freaked out & gave dinner. Waited to give insulin)
8:15PM 149 (gave all 10U...hopefully made the right choice. Will monitor)
9:56PM 118

k9diabetes
02-24-2009, 02:43 PM
I think I'd cut back to 9.5 and see how that goes - if no scary numbers, let it settle for a week.

I wonder if the 71 was accurate... it went down and back up awfully quick. But why take chances.

Natalie

dctexan
02-26-2009, 12:06 PM
More data to report.

2/23 (continued)
10:54PM 41 (I totally freaked out. Gave 2 Wellness snacks + 1/4 carrot +4 pieces of cucumber. Dixon seemed fine)
11:26PM 95

2/24
7:28AM 184
7:01PM 118 (after day of doggy daycare...received 1/4 cup food at 1PM)
dinner given at 7:10PM. Waited until 7:45PM to give 10U insulin
8:48PM 339
11:10PM 82

2/25
7:25AM 42 (immed prior to b'fest. Held off on insulin)
8:12AM 129 (gave 10U)
8:56AM 237
10:49AM 150
6:39PM 56 (fed dinner at 7:03PM)
7:13PM 119 (gave 10U)
gave Wellness treat at 10:30PM
11:26PM 82 (gave 2 more Wellness treats)

2/26
7:33AM 53 (gave b'fest)
8:04AM 85 (decided to give only 9U)

Dixon is currently at doggy daycare. Apparently he is doing well (playing, acting normal). He had 1/4 cup food at 1PM.

I sent all of the reading obtained since starting 10U to the vet. I am waiting to hear back from her. I suggested that we drop down to 9.5U and see how we do.

peggy0
02-26-2009, 12:09 PM
I would definately be dropping this

k9diabetes
02-26-2009, 12:57 PM
Yeah, that's way too scary. I would cut back at least half a unit and I'd still monitor carefully in case it needs to drop further. You might find now that 9 units is enough.

Cara's Mom
02-26-2009, 01:08 PM
Scaaaaary....:eek:! Maybe the increase in activity and excitement at doggydaycare?
Would definitly lower his dosage on his "daycare" days.

eyelostit
02-26-2009, 04:39 PM
I'd stick with the 9 units also and see how that goes.;)

dctexan
02-27-2009, 01:01 PM
Vet agreed to the 9.5, but said that sometimes when glucose toxicity reverses you need to go cut back the dosage so she said to keep an eye on him and drop back to 9 if I feel like I need to (I already did last night...but this morning he seemed high enough for 9.5). I am supposed to recurve in a week. She also implied that maybe I needed to back off on the testing (did not overtly say this but did say "Let's curve him ONLY in a week" which I took to mean chill out about the testing). Not sure if I agree. I definitely feel like I need to test him before his shots (because if he is down at 41 the last thing I want to do is shoot him full of insulin), but maybe that is over thinking it? I mean clearly his food always brings him back up. Presumably waiting to give the shot messes with the food/insulin metabolism. Hmmm. When we were down at the lower insulin doses we were giving the shot as soon as Dixon finished a meal. Now that the dose is higher (and his numbers lower) I've been waiting 30-45 minutes (so that I can re-test after his meal). What is the typical wait time between meal consumption and insulin injection?

Cara's Mom
02-27-2009, 01:26 PM
The only time I might wait 15 min with insulin is when Cara has very low fasting BG. All other times she gets her shot as soon as she is finished eating.

peggy0
02-27-2009, 03:21 PM
Forbin has very low last BG and i wait 30 minutes and retest

dctexan
04-29-2009, 12:58 PM
Quick update (work has been CRAZY and it significantly cuts into my internet time, darn it!).

Dixon still isn't stabilized. We have played around with a variety of doses but we just cannot get him to maintain any sort of steady pattern (other than 400-600s when his dose is too low). The best we have done recently is 10U 2 x day, but he is still all over the map (as low as 50 and as high as 400). Weight has been up and down (currently a bit down, but this week has been a fairly decent for BGLs so he is gianing again). Had a good talk with the vet today and she is making the referral to an internal medicine specialist.

k9diabetes
04-29-2009, 01:21 PM
Hi Emily!

Nice to hear from you and Dixon. Sorry his BG has been so erratic! Is there a general pattern to his use of food and insulin... like he's always low at about the same time of day and highest at the same time of day?

I hope the IM can help you - that would be very very frustrating!

Natalie

dctexan
04-30-2009, 01:56 PM
Internal medicine scheduled us for tomorrow morning!
Woohoo! I am seriously hoping for some answers and a better formulated treatment plan.

eyelostit
04-30-2009, 04:39 PM
Hi Emily, :)

Glad to see you, I hope you get some answers tomorrow.

dctexan
05-01-2009, 09:45 AM
Back from IM.

Vet feels pretty strongly that the bouncing around is because Dixon is crashing and then rebounding. So, we are going to switch him to 8U once per day of Vetsulin (was on 10U of Humulin BID) and reassess in a week.

Also did a thyroid panel just to make sure things were okay on that front. Those results won't be in until Monday.

Am feeling nervous about the once a day dosing, but am willing to try. I just want to get the boy stable.

We Hope
05-01-2009, 10:51 AM
Trying the once daily dosing will only be for a week. It will give you both the chance to see if Dixon responds better to the Vetsulin. Personally don't know anyone who was able to go with the once a day insulin, but do know plenty who were successful when they took the once daily to twice daily.

Hang in there! ;)

Kathy

eyelostit
05-01-2009, 01:33 PM
I'm hoping all goes well, a few pets do better with the vetsulin, its all trial and error. We'll be able to see from your bg numbers.:)

dctexan
01-29-2010, 12:03 PM
UPDATE and VENT after a long time away from the board.

So my bizzaro dog just refuses to regulate. Here we are, almost a year exactly since diagnosis, and we can not get him to stabilize. Numbers are all over the map regardless of dose :(

We switched over to Vetsulin (quickly went to the twice a day dosing) and had some luck getting him more stable (so staying above 100 and below 350) but it always just seemed to depend on the vial (and ha ha, we find out in December that it WAS the vials) with "bad" vials causing BGLS to crash or go sky-high. But then we'd get a "good" vial and think that all was well. It was crazy. His standard dose was 11U Vetslin, but we basically got by using BGLS as a indicator of the dose we should use (so BGL below 100 ---> 9U, between 100 - 200 --->10U, between 200-350--->11U, and over 350--->12U)

Anyway, we have since switched back to Humulin N and are once again seeing BGLS ranging between 60-500 (this is on a 10U dose, twice daily).

Bloodwork/urinanalysis is normal (other than BGLS) and not indicative of Cushings.

So, I am feeling very frustrated and I am just not sure what to do next. The vet is perplexed as well (IM vet has pretty much dropped the case, so we are back with our regular vet who at least responds to our calls and emails and is making an effort to figure this thing out with us).

Any ideas? Things I am considering are:

1). switching from 2 meals/day to 4 meals/day. this would be slightly tricky since I work out of the house and the dog is home alone. I am guessing a feeder with a time would do the trick?

2). Figuring out a combo of insulins that work? Maybe Humulin N just isn't working by itself? Not quite sure what else to add in.

3). Doing the stepped dosage based on daily BGLS. This is harder with the Humulin due to the fact that it is not as dilute and changes in dose have a more drastic effect than they did with Vetsulin.

Anyone else have any input?

ETA: Dixon is approximately 40lbs (so at least we got him back up to his pre-diabetes weight! Hooray) and eats 1.25 cups of Natural Balance Vension dry food mixed with 1/4 cup green beans and 1/4 cup full fat cottage cheese twice a day.

peggy0
01-29-2010, 02:53 PM
Hi Emily

Sorry to hear you're having some issues. I'm just switching my dog from vetsulin to NPH and seeing some very strange swings as well but it's only been a week. When did you switch back to Humulin? Have you done a curve to see where the highs and lows occur and what does your dog eat? If we get some more info, I bet the board can help you out!! Welcome back and I'm looking forward to seeing your next post.,

AlisonandMia
01-29-2010, 04:44 PM
I am myself of absolutely no use to you and Dixon but this is a link to Natalie's Chris's regulation story. He was initially very difficult to regulate too: http://www.k9diabetes.com/k9diabetes.pdf

The chances are that Dixon's "answer" will probably not be Chris's "answer" but it may be useful for you (and your vet) to read.

Alison

k9diabetes
01-29-2010, 08:05 PM
Could you post your last curve of Dixon's BG on NPH?

Does he basically swing between those extremes every day fairly consistently?

I need more detailed information to offer much input but am more than happy to see what things look like from over here if you can post your curves on NPH.

If you look at Chris' BG, you will see that on Humulin L, which was similar to Vetsulin but with human insulin, Chris swung through big differences in his BG. In his case, he tended to be slow to absorb all insulins and then he tended to put them to work quickly when he did. So his blood sugar would start low and go up and up and up and then plunge back down on that insulin.

But on NPH he got a very different response, much more level.

So it's really important to see when exactly Dixon's blood sugar is dropping.

Among the options, depending on what the curves say, are:

-- more frequent meals using a timed feeder - there are several available that might work for him

-- possibly using some faster acting insulin with the NPH if the sharp drops are occurring late in the day when he has lots of insulin still working but no food. The Regular insulin would go to work faster and be gone faster so could potentially cut off a late drop in blood sugar.

-- a diet adjustment

-- a trial of Lantus insulin if you haven't done that already

-- changing the timing of meals and injections somewhat.

So bring on Dixon's curves and let's see what we can figure out!

Natalie

dctexan
02-01-2010, 08:28 AM
Thanks for responding. Will post data tonight after I get home from work. Of course Dixon has been running high over the past couple of days. I just can not figure that dog out.

ETA: So, in response to your question Natalie, Dixon usually swings wildly across days not within a single day. That is part of what is so frustrating. Because if we look at a curve on Day A is may be between 300-450 (suggesting we should increase his dose), but then if you look at Day B he might be 100-300 (which is a good day! Dose seems about perfect). Of course then there are C days were he drops below 100 and seems to rebound the next day with numbers in the 400s. I will post a bunch on data to let you see the complete picture. One curve isn't going to be reflective of what is going on.

Dixon is a very reactive dog. Food shoots his BGLS up very quickly (even just a small snack). Exercise (usually, but not with 100% reliability) can bring him way down.

Patty
02-01-2010, 10:18 AM
Hey Emily,
I definitely understand the roller coaster frustration.

I was just thinking about your boarding post and the fact that Dixon goes to daycare 1-2 x per week. Do you see a pattern to his bgs and the days he's at daycare? That might help sort some fluctuations out.

Patty

eyelostit
02-02-2010, 08:48 PM
UPDATE and VENT after a long time away from the board.

So my bizzaro dog just refuses to regulate. Here we are, almost a year exactly since diagnosis, and we can not get him to stabilize. Numbers are all over the map regardless of dose :(

We switched over to Vetsulin (quickly went to the twice a day dosing) and had some luck getting him more stable (so staying above 100 and below 350) but it always just seemed to depend on the vial (and ha ha, we find out in December that it WAS the vials) with "bad" vials causing BGLS to crash or go sky-high. But then we'd get a "good" vial and think that all was well. It was crazy. His standard dose was 11U Vetslin, but we basically got by using BGLS as a indicator of the dose we should use (so BGL below 100 ---> 9U, between 100 - 200 --->10U, between 200-350--->11U, and over 350--->12U)

Anyway, we have since switched back to Humulin N and are once again seeing BGLS ranging between 60-500 (this is on a 10U dose, twice daily).

Bloodwork/urinanalysis is normal (other than BGLS) and not indicative of Cushings.

So, I am feeling very frustrated and I am just not sure what to do next. The vet is perplexed as well (IM vet has pretty much dropped the case, so we are back with our regular vet who at least responds to our calls and emails and is making an effort to figure this thing out with us).

Any ideas? Things I am considering are:

1). switching from 2 meals/day to 4 meals/day. this would be slightly tricky since I work out of the house and the dog is home alone. I am guessing a feeder with a time would do the trick?

2). Figuring out a combo of insulins that work? Maybe Humulin N just isn't working by itself? Not quite sure what else to add in.

3). Doing the stepped dosage based on daily BGLS. This is harder with the Humulin due to the fact that it is not as dilute and changes in dose have a more drastic effect than they did with Vetsulin.

Anyone else have any input?

ETA: Dixon is approximately 40lbs (so at least we got him back up to his pre-diabetes weight! Hooray) and eats 1.25 cups of Natural Balance Vension dry food mixed with 1/4 cup green beans and 1/4 cup full fat cottage cheese twice a day.

I think I'd stick with 9 units, with activity thats lowering the bg and perhaps some rebound is showing up. Niki weighs about 45 lbs and is on 10 1/2 to 10 3/4 units and she is not as active as she used to be, years ago her steady dose was 9 1/2 units.

You know your dog and how he is reacting on a daily basis.

I am not saying that all dogs of this weight should get this amount of insulin, all dogs are different and handle food and insulin differently but with an active dog the dosing will be different.

There's a very active dog who is on 6 1/2 units, I have not been in touch with her but her dog's bg looked like what you are seeing, the dose was decreased and the bg came back to 150-200's range.

Hope this helps;)
Dolly