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-   -   Ollie's Over the Rainbow Bridge (http://k9diabetes.com/forum/showthread.php?t=7889)

oliversparents 09-29-2016 01:01 PM

Ollie's journey
 
Our dog Ollie was diagnosed with diabetes a month ago. He's a 66 lb lab mix. Our vet started him out on 10 units Novolin.

We wasted time with the first bottle by not handling it properly, so his blood sugar was still testing high 600's to low 700's midway between meals. Took the Alphatrak to the vet to compare with his two meters, and yes, it reads a bit high, but not so high to be defective.

Tried a new bottled of Novolin, handled properly this time, and waited a week. Still no change. Then I went online, found out by weight, his dose should have started at 15 units! Went up to 12, then 14, and today he's still testing at 702 midway between meals.

We are boosting it to 15 tonight. I am wondering if it's normal to see no incremental decrease in blood sugar as you increase the insulin? Is there a threshold or something?

It's possible that for some reason he's resistant to the Novolin. When should I try something else? How long can we keep increasing the Novolin before we know it isn't working?

He drinks and pees more than usual, is lethargic, but comfortable. Also we are 2 hrs from the nearest vet.

Thanks...we need some experienced advice. It's so frustrating not knowing what is causing the insulin to be ineffective.

CraigM 09-29-2016 01:27 PM

Re: New and needing advice
 
Welcome to the forum. Sorry to hear you are having a little trouble with Ollie.

Many of us feel .2 units per pound is a good STARTING dosage (twice a day injections). So, a 66 pounder might be started around 13 units. The key word is STARTED at 13 units. A few may do OK on the starting dose, but many (most?) will require more. Just as an example, my 18 pound dog would be started at 4 units, but she has been getting 9 units for the past several years. Every dog / situation is different.

Sounds like you are doing things right. Monitor, small increase, and then monitor for about a week before possibly another increase.

Craig

CraigM 09-29-2016 01:30 PM

Re: New and needing advice
 
Before I forget. Are you getting your Novolin-N from Walmart? Walmart sells Novolin-N for $25/bottle, MUCH less expensive than other pharmacies! Syringes are pretty low cost there also.

oliversparents 09-29-2016 02:29 PM

Re: New and needing advice
 
Craig,

Thanks for your quick reply.

Yes, we've been getting the insulin from Walmart. It's good to know that dosages can be quite a bit higher than the starting dose once they start working. I had no idea.

Would it be normal to see a gradual reduction in blood sugar as the dose increases? I am hoping he doesn't have a uti on top of things, making the insulin less effective, or non-effective. In the past few days, he's urinated on his bed while sleeping. Before that, if he had an accident, he would get up and do it somewhere away from his bed.

Plus I have a vet tech friend of a friend who says Novolin does not work. I have a hard time believing that, since it's sold as a human insulin as well. And there can be so much human error in administration (speaking from experience!).

But the hardest thing is knowing what high blood sugar can do to our little guy, and standing by helplessly trying to help with no change yet.

Mary

CraigM 09-29-2016 02:50 PM

Re: New and needing advice
 
Quote:

Originally Posted by oliversparents (Post 157485)
Craig,

Thanks for your quick reply.

Yes, we've been getting the insulin from Walmart. It's good to know that dosages can be quite a bit higher than the starting dose once they start working. I had no idea.

Would it be normal to see a gradual reduction in blood sugar as the dose increases? I am hoping he doesn't have a uti on top of things, making the insulin less effective, or non-effective. In the past few days, he's urinated on his bed while sleeping. Before that, if he had an accident, he would get up and do it somewhere away from his bed.

Plus I have a vet tech friend of a friend who says Novolin does not work. I have a hard time believing that, since it's sold as a human insulin as well. And there can be so much human error in administration (speaking from experience!).

But the hardest thing is knowing what high blood sugar can do to our little guy, and standing by helplessly trying to help with no change yet.

Mary

Uncontrolled urination is a byproduct of high blood glucose. The body tries to rid itself of glucose through the urine. Guess it can sneak up on the pup.

I can't remember if I saw a gradual lowering in numbers, it's been over 8 years. I do remember I had big swings in readings the first year or so, but things finally stabilized.

Are you feeding two similar meals per day? No, or highly restricted, between meal snacks? Any other medications?

Craig

oliversparents 09-29-2016 03:17 PM

Re: New and needing advice
 
We are feeding 2 meals, the same amount and type of dry kibble, 12 hrs apart. He doesn't get anything in between. He's a good eater, and has been lethargic enough that we are pretty sure he's not sneaking a cat poo in between meals! He's not on any other meds, and so far isn't displaying any of the other signs of a uti.

About the urine, that's good news. It was just a change from him trying to pee discreetly somewhere else when he had to at night. We've put towels down on his bed and the cleanup is actually easier that way. I'm hoping that goes away when he becomes regulated.

amydunn19 09-29-2016 05:52 PM

Re: New and needing advice
 
Vets have their bias sometimes regarding insulin. They sell vetsulin so naturally, nothing else works as good in their mind. What they don't mention is that Vetsulin was off the market for several years and dogs used human N insulin because vetsulin was not stable. Some vets really push Humulin N(same type as Novolin n) but Eli Lilly has reps that visit the vets like the doctor's offices and I guess that is where that comes from. Maggie used both Humulin and Novolin and even though I saw very little difference, I noticed two things that made me favor Novolin. For Maggie, the duration was longer - she seemed to run out of Humulin at about the 9th hour of the day, Novolin would last 11-12 hours usually for her. Also, the bottle of Novolin stayed potent for at least 30 days - my Humulin never lasted a full thirty days without her numbers creeping up. Others get more time out of their bottle and I don't know if living in a humid climate made any difference but there was something, a preservative, in Novolin that caused it to last longer for us.

jesse girl 09-29-2016 08:08 PM

Re: New and needing advice
 
Walmarts relion n insulin has saved me about $4200 in jesses 6 year run of diabetes ( thanks walmart ) . Now i don't know if vetsulin was better choice as it was coming off the market 2 weeks into jesse's diagnosis so i cant give much of an opinion but when jesse did make the change her pattern remained the same . She used both humulin and novolin she also dabbled in lantus and has used novolog and r insulin

After all that we ended with nph or n insulin and has worked well for jesse . I do think the insulin for dogs that we do have is not optimum for a dogs metabolism but its adequate for a dog to live a happy dogs life with normal lifespans

Now of coarse i would not celebrate the savings for jesse to suffer as far as less than adequate regulation . So if i thought there was something better i would probably move to that even if its more money

oliversparents 09-30-2016 09:49 AM

How fast should I increase doses to avoid ketoacidosis
 
Here's a related question regarding Ollie, who was diagnosed 1 month ago, and whom we're still trying to regulate. His blood sugar has been in the high 600's to low 700's midway between meals since diagnosis, as far as I can tell.

His keytones have increased to a trace (5). We are continuing to increase his dose of insulin (novolin n): he started at 10, and now we're at 16.

How long to wait between increases? Both vets I've spoken to say a day or two, but here I've read a week or two.

Seems like we don't have a lot of time, and the faster increases would be more prudent in this case, to avoid ketoacidosis. But I don't know.

Any thoughts?

Mary

jesse girl 09-30-2016 10:45 AM

Re: How fast should I increase doses to avoid ketoacidosis
 
that's a difficult question to answer . usually takes about a week for a dose to settle and know its true colors. some could take 2 weeks .there are times that 3 days maybe ok but to make a change every day or 2 is really pushing it When resistance is broken it can be dramatic and all of a sudden and a dogs body may not have enough sugar to slow down the strength of insulin do to building to much insulin in the body to fast

What is the weight of your pup ?


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