Bailey got his wings... June 26, 2014

[Geoff]

Re: Regulating Bailey

Goodness how time flies! Well, Bailey seems to be back to his normal dose of 15 units of protaphane and 4 units of Humalog after he changed from 4 drops of pred forte per day to 2. Initially he went quite low but now he seems to be back to what it was before changing to 2 drops meaning I need to give him 15 units again to bring his levels down. Also recent curves have not been good, I am getting some more insulin today as after 28 days it really does seem to lose effectiveness. Even after 2-3 days past 28.

I would of thought the levels would of stayed the same after stopping the morning eye drops (meaning less insulin to bring him down) but it seems not.


Apart from that he is ok I think. He seems to be having trouble coming down the stairs, he is ok with the first 2-3 then he jumps the rest onto the floor and lands (mostly!) ok. I am not sure why he has started doing this. There is only 4 steps in total. He walks ok, runs up the hills with me and jumps up onto me with his paws on my thighs so not sure if he has a sore back, legs or just wants to come down the stairs differently!! I have phoned the vet to get some advice and may need to take him in for a checkup.

Hope everyone is well.

Geoff

[Judi]

Re: Regulating Bailey

glad you are figuring him out and hope it is just a pulled muscle or something

[Geoff]

Re: Regulating Bailey

Hello well the new insulin didn't do much. I find it hard to keep up with him! His body and his BG levels are continually changing, sometimes he goes low, other times he stays high, so if I give him more insulin I might drop him too much. I might raise him 1/2 an IU and see how he goes. I am afraid the vet will want me to start the Cushings meds if I go too high with the protaphane dose.

[jesse girl]

Re: Regulating Bailey

this disease can create it own patterns and cycles

it could be as simple as dropping to low at 2 am in the morning which may give sustain higher numbers for a day or two

my jesse has epilepsy and her blood sugar can correlate with that disease creating different patterns i do understand them on most occasions and adjust to them but we will never be 100 percent sure.

[Geoff]

Re: Regulating Bailey

Goodness, all these poor poochies!! My Bailey has epilepsy also, is on drugs for it and hasn't (touch wood) had a seizure in years. So yes, he sometimes, as I believe most dogs do, throw some curve balls into the mix, we all want low BG's 24/7 dammit with no variations!! :-)

[Geoff]

Re: Regulating Bailey

Hello all, time certainly is flying isn't it! I am still juggling Bailey's insulin however I have finally got a cable for his blood glucose meter which makes it easier to upload the information, doing it manually took too long! His levels are OK, I am really leaning towards giving him a midday shot of 4 units of Humalog as his morning readings stay high until noon and the protaphane insulin seems to kick in around 3pm (starts to peak at least).

Do people do this with their pups or is it usually 1 shot in the morning and one at night? I would think whatever works, humans take insulin all day to regulate their BG so why not dogs?! His is sitting between 10-20 (180-360) every day. At dinner time he is around 13mmol and morning around 16mmol. But midday/afternoon he sits around 17-20mmol hence my leaning towards a midday shot.

I am hesitant to raise him from his 16units of protaphane as I figure sitting between 180-360 is not terrible. He used to be 450+ so he is "stable" to a point. My concern is does he have cushings? He was on the threshold 12 months ago after a stim test but his hair is ok. He is strong, barks strong, plays with the kids, loves his ball, loves walking, his hair is ok, looks a bit funny in places due to my amateur grooming skills but other than that he is great!

I am scared to be honest taking him to the vet for an opinion as I really don't want to put him on Cushings meds if I can help it but is more insulin bad for him AND is the cushings doing him damage (assuming he has it?!)

Hope everyone is well, getting cold over he in Australia as winter slowly creeps in!

Regards,

Geoff

[CraigM]

Re: Regulating Bailey

Annie was sort of like Bailey. Annie could have a fasting in the mid 100s mg/dL, and climb into the high 200s within an hour or two. She would stay in the high 200s / low 300s through about 6 hours, and then start to come back down, having her lowest number just prior to the next meal / injection. This was on NPH.

I now sometimes mix a little Novolin-R (short acting) to counter that food rise. I believe Novolog / Humalog (quick acting) has been used by some as you described.

The advantage of "R" insulin to me is that it lasts a bit longer than Humalog, others find the longer duration a problem. Another minor advantage of "R" is that it and NPH can be mixed in a single syringe. Also, in the States "R" doesn't require a prescription, and is inexpensive bought at Walmart.

You probably know the insulins available in the States better than what we know about insulins in Australia. Here is a quick list of some of the insulins:

http://www.ehow.com/about_5385391_ty...n-insulin.html

http://www.dlife.com/diabetes/insuli.../insulin-chart

In addition to the small amount of "R", I've also been adding extra fiber to her meals. Don't know the brands you might have, but we are using a generic version of Benefiber (sugar free, non thickening, grit free). I really think the extra fiber has also flattened her curve.

Craig

[Geoff]

Re: Regulating Bailey

Thanks Craig, exactly. At the moment Bailey seems to "almost" be at his peak at next meal time. Then dinner brings him up to 20 again even with Humalog, without I would imagine 25+ I find he still comes down to low teens (12 ish) without Humlaog but it's much quicker with.

I have to get all this through my vet, the vet does the prescription then I go to chemist to purchase the Humlaog ($40AU) which ATM is around $40US so not cheap, but so worth it. I am not sure about fiber intake, the US foods are different to Oz foods although similar brands. Overall I am pretty happy. I am after thoughts on midday insulin shot of Humalog which seems to last 2-2.5 hours at best.

It's funny, I guess he eats, which raises his BG, then I insulin him, which drops it, after 2-3 hours the Humlaog wears off and his BG goes up again before the Protaphane can "kick-in fully" His food rise must last 4-5 hours or more! Which to me is weird but perhaps that is how it all works. I "expect" his BG to drop and stay dropped but no, the food must be turned into glucose for hours, albeit less than the initial spike.

Geoff

[CraigM]

Re: Regulating Bailey

It's funny, I guess he eats, which raises his BG, then I insulin him, which drops it, after 2-3 hours the Humlaog wears off and his BG goes up again before the Protaphane can "kick-in fully" His food rise must last 4-5 hours or more! Which to me is weird but perhaps that is how it all works. I "expect" his BG to drop and stay dropped but no, the food must be turned into glucose for hours, albeit less than the initial spike.

Geoff

Yep, that is pretty much how Annie would work.

The slightly longer lasting "R" might help Bailey?

Craig

[Geoff]

Re: Regulating Bailey

Hello, latest curves for Bailey along with spot checks.
According to the software that came with the meter he was within target (71%) of the time (between 10-20 mmol) in the last 30 days
Between 10-15 44% of the time
Glucose Average 16.2 which I think is not too bad?!


Date Time mm/ol mg/l
1/05/2013 22:17:44 21.59 388.62
1/05/2013 16:25:58 13.49 242.82
30/04/2013 20:02:54 11.93 214.74
30/04/2013 18:14:15 12.32 221.76
30/04/2013 16:33:39 23.15 416.7
29/04/2013 17:29:29 12.77 229.86
28/04/2013 19:58:20 13.21 237.78
28/04/2013 15:52:06 15.43 277.74
28/04/2013 10:59:04 18.87 339.66
27/04/2013 19:47:24 12.99 233.82
27/04/2013 17:25:10 12.21 219.78
27/04/2013 15:53:01 14.32 257.76
27/04/2013 13:54:18 15.49 278.82
27/04/2013 12:26:49 19.54 351.72
26/04/2013 19:38:26 15.04 270.72
26/04/2013 17:42:38 9.27 166.86
26/04/2013 16:15:39 11.71 210.78
26/04/2013 11:33:08 21.81 392.58
25/04/2013 15:50:33 11.05 198.9
25/04/2013 11:44:19 18.82 338.76
24/04/2013 19:58:48 14.76 265.68
24/04/2013 18:14:10 10.99 197.82
24/04/2013 16:25:18 8.83 158.94
24/04/2013 12:55:14 21.65 389.7
24/04/2013 12:35:49 23.2 417.6
23/04/2013 19:56:05 13.32 239.76
23/04/2013 17:27:03 14.93 268.74
23/04/2013 13:35:03 20.54 369.72
23/04/2013 12:21:57 20.43 367.74
23/04/2013 10:31:30 16.21 291.78
23/04/2013 8:37:00 19.32 347.76
22/04/2013 18:04:47 11.05 198.9
22/04/2013 16:15:53 15.76 283.68
22/04/2013 12:22:54 13.49 242.82
21/04/2013 22:40:08 21.15 380.7
21/04/2013 18:25:27 17.76 319.68
21/04/2013 17:03:52 14.82 266.76
21/04/2013 15:26:54 11.27 202.86
21/04/2013 14:14:32 14.38 258.84
21/04/2013 12:24:53 19.26 346.68
21/04/2013 10:12:16 19.04 342.72
21/04/2013 8:29:20 20.93 376.74
20/04/2013 22:26:37 18.82 338.76
20/04/2013 18:36:48 16.43 295.74
20/04/2013 15:05:12 19.21 345.78
20/04/2013 9:31:18 14.65 263.7
20/04/2013 8:23:15 12.82 230.76

[Rubytuesday]

Re: Regulating Bailey

Hi Geoff, I was just wondering about how you and Bailey were doing. Nice to hear all is plugging along.

I have used the humalog in the way you describe and have also used the R to cover the entire food rise as Craig was describing.

If you try humalog I would start very conservatively. I think 4 units might get you into huge trouble. I would start with 1/4 unit and see where that gets you. You can't based the afternoon/midday dose on the morning dose because the morning is working along all the food and midday the food will not be there. Once you start with 1/4 it will give you an indication of what that amount will do to the readings at that time of day. Then you can better ballpark an approximate dose.

But.....when you say midday, do you mean noon or in the afternoon like 3:00ish. 3-4 is when I need to check Ruby to see if she needs a shot. if you were giving it earlier say three hrs. after the first humalog, to take care of the tail end of the food rise, you could probably do more then if you did it at 3ish.

On the other hand, what Craig is talking about with the R may carry Bailey through the whole food rise, not needing the extra shot and monitoring that will come with adding the additional fast acting injection.

Either way, giving an additional shot, adding R or fiber will have a ripple affect and I would be prepared to back off following fast acting insulin doses as you see the fastings come down.

What meter are you using that the low is reading 180? Have you compared it with a lab analyzer or an Alphatrack? If not, a true animal meter or lab result would probably be higher. If so I might increase the protophane and see if that would keep him in a good enough range to avoid the midday shot.

I also like Craig's suggestion of adding some fiber. I think that would be ok with the pancreatitis that he is prone to?? I really don't know that much about pancreatitis other then it makes things very difficult. Fiber would slow down the digestion of his food. Possibly the fiber and a slightly higher protophane would get you where you want to be rather then adding another time that you have to be home to test and inject.

Tara

[Geoff]

Re: Regulating Bailey

Hello Tara, I hope you are all well
Thanks, yes I agree, I would rather not ask my wife to deliver another dose at 12:00 midday. I have tried 4 units of Humalog on some weekends and it seems to work nicely (at midday or so) But as I said in the other post, I am scared that raising his insulin from 16 units is a lot?! And is the cushings real and if so what is it doing to him? He appears fine though, but I raised him from 15 units of protaphane to 16 back in:

20/01/2013 7:59pm 15.9 Fasting & Raised Protaphane to 15 Units at 8pm
24/03/2013 21:59:14 20.59 Increased Protaphane to 16 units

So every 2 months he goes up (well, based on those last 2!!)

I am trying to avoid cushings drugs, what does increased insulin mean anyhow? Apart from the $$$ which I don't care about (given that cushings drugs are going to set me back $150p/month at least, plus tests etc)
I mean does too much insulin cause problems?? How much is too much? Given he is "supposed" to be only on 0.5 IU per KG = 6-7 IU. Plus he uses Predneferine Forte eye drops which causes some resistance, plus his epileptic drugs, so really perhaps he is "normal" ha-ha. But what causes dogs to keep needing more insulin? Age? Other factors? Cushings?? Resistance??

oh the meter is a one touch verio. Reads below 4

Thanks!

Geoff

[Rubytuesday]

Re: Regulating Bailey

Here is a good article that goes over the questions you're asking:

http://tinyurl.com/cptn4v3

Got to run. Be well!

Tara

[CraigM]

Re: Regulating Bailey

How much is too much? Given he is "supposed" to be only on 0.5 IU per KG = 6-7 IU. Plus he uses Predneferine Forte eye drops which causes some resistance, plus his epileptic drugs, so really perhaps he is "normal" ha-ha. But what causes dogs to keep needing more insulin? Age? Other factors? Cushings?? Resistance??

The 0.5 unit per KG formula is, I believe, just a recommended starting dosage. Annie weighs 18 pounds / 8.2KG. So in her case 8.2 X .5 = 4.1
Annie has been getting 8.25IU in the morning, and 8.5IU in the evening. Just an example, every dog / situation is different and dosage can vary widely.

Craig

[Geoff]

Re: Regulating Bailey

Yeah I understand and that was my way of thinking. Every human is different, different weight/height/food intake etc etc so why not dogs...

I guess my concern is he is going rather high in his dosage of protaphane but I might try that benefibre which it looks like I can buy here in Australia. If you think some more fiber might help then why not?