Diagnosed today - lots of confusion and questionable veterinary visit/info

[Beau1]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Unfortunately, Laika has been at her worst today. She's been more lethargic than ever before - and not just in the morning, like in previous days, but all day today.

We picked up the antibiotic for her UTI today, and tonight I gave her 1/2 tablet hidden in bits of the Rx food. She did eat that.

But she didn't really want to eat her dinner today. It's the first time she didn't want to eat. She didn't want the Hills Rx w/d Chicken that she eagerly ate the past few days. We mixed them with vegetables, and she didn't want any of it. She did eat if I fed a bit of veggies to her by hand. We tried warming up the food and adding veggie broth, but she still won't touch it. We tried separating the Rx food from the veggies, but she still didn't want it. She really wanted the chicken dish we had - and when we gave her bits of the chicken, she scarfed it up. She's not supposed to have that type of salty, oily, spicy, processed food, though.

Since she hardly ate anything tonight, we didn't give her the insulin. I heard insulin shouldn't be given if your dog didn't eat. She did eat a little - and I read you can give her half the amount of insulin if she ate half her food. But giving her .5 unit just seemed too little and unnecessary.

She's getting thinner everyday. She's a lost a patch of fur where her front leg meets her body. Her ears, gums, and skin on her underside are often reddish. Her tail is always down, when it used to be always curled on her back. Her rear paws started turning white a few days ago, and have been getting whiter everyday. Her muzzle is getting whiter, too, though it started getting a bit whiter some time ago. She's 7 years ago. She seems so sick, listless, and low in energy, just lying down most of the time.

We're pretty worried about her. I guess we should call a vet again. The ones we went to were unacceptable in many ways towards us, and I feel they've compromised the health of our dog, and caused us a lot of stress and work - self-educating instead of getting answers/help from them.

[MikeMurphy]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

I’d get her to a vet as soon as you can. If you don’t trust your current vet, find a new one.

Insulin should be given, even if your dog doesn’t eat. Just so you know, here are the guidelines for giving insulin:

If your dog doesn’t eat or if she eats 1/4 of her meal... give 1/4 insulin.
1/2 meal... give 1/2 insulin.
3/4 meal... give 3/4 insulin.
Full meal... give full insulin dose.

[Riliey and Mo]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

He needs to eat seems he wants chicken
If its dry food try moisening it abit
Put a topping of lean no fat cut up chicken or salmon on his food see if he eats it
If he doesnt scoff it up try another food
Still not eating he needs to see a vet.

[Raysaint]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

A 14 lb dog probably should be on more than one unit of insulin. A starting dose would be 3 - 4 units. If her insulin is not enough, then her sugar will be very high, and that will cause her to lose weight and be lethargic.

Get a meter asap and start checking sugars. Once you establish the general sugar level, you'll probably be able to increase the dose. Then, wait a few days, do a curve, determine when nadir time is and the sugar level at that time, then increase dose by one unit, wait a week, another curve, increase again, until nadir is at an acceptable range.

This will take some time but that's Ok. Only increase insulin one unit at a time each week until sugars come down. Then probably a half unit at a time as nadir gets lower, as determined by each week's curve.

Find a new vet that encourages home management, and get the uti cleared up.

[Beau1]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

A 14 lb dog probably should be on more than one unit of insulin. A starting dose would be 3 - 4 units. If her insulin is not enough, then her sugar will be very high, and that will cause her to lose weight and be lethargic.

Get a meter asap and start checking sugars. Once you establish the general sugar level, you'll probably be able to increase the dose. Then, wait a few days, do a curve, determine when nadir time is and the sugar level at that time, then increase dose by one unit, wait a week, another curve, increase again, until nadir is at an acceptable range.

This will take some time but that's Ok. Only increase insulin one unit at a time each week until sugars come down. Then probably a half unit at a time as nadir gets lower, as determined by each week's curve.

Find a new vet that encourages home management, and get the uti cleared up.

We increased her insulin dose from 1 to 2 units this morning. She had been taking 1 unit twice a day for a week - that's what the vet said to give her. I did call the vet office we went to, and said we increased to 2 units this morning, and the vet tech said we shouldn't increase the dose without the vet's permission.

But I read everywhere online that a starting dose should be about .2 for every pound of weight. She's at 12 pounds today, and was 14 pounds just a couple of days ago. I feel her 1 unit starting dose was too low, so she wasn't improving under the insulin - just getting sicker every day, in fact. That's why we increased to 2 units this morning.

We got the AlphaTrak2 meter. Can you please explain what you wrote: "Once you establish the general sugar level, you'll probably be able to increase the dose."

Do we really need to wait a few more days to do a curve? We went to the vet last Thursday, and following their orders, we gave her 1 unit insulin twice a day, spaced 12 hours apart. We were supposed to come in to the vet's today so they could do her glucose curve all day, but I cancelled that appointment and said we'll do it ourselves.

[Riliey and Mo]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Okay glad you got the animal meter. You can now control Beau blood sugar
Start slow start testing before he eats and injection
Then wait 2 hours test again
Post his numbers here okay along with what he eats. How much. When u walk him but not far at first
Start a log book for him
Keep it simple starting your journey

Ps. You just changed the dose so wait a week to do a full curve
Spot check and post here for now

[MikeMurphy]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Do we really need to wait a few more days to do a curve? We went to the vet last Thursday, and following their orders, we gave her 1 unit insulin twice a day, spaced 12 hours apart. We were supposed to come in to the vet's today so they could do her glucose curve all day, but I cancelled that appointment and said we'll do it ourselves.

Glad you’re home testing now and yes, you need to wait a week before you do a 12 hour curve. It takes a dog’s body 5 to 7 days to adjust to any change in insulin dose. Remember that getting a diabetic dog regulated is a marathon, not a sprint. It takes time and patience. Don’t be tempted to increase too early.

Also... it is recommended that you only increase insulin in .5 unit increments for a small dog.

If insulin is increased too quickly or in big increments, you could inadvertently go beyond the proper dose and go into Somogyi Rebound (big swings in BG).

As Riliey and Mo suggested, post your spot checks and curves here. Especially with the curves, we can help you interpret them.

[Raysaint]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

By general sugar levels, I meant the range between highs and low. If the whole 12 hours is on the high side, you’re safe to increase.

Vets here in Canada start the dose at 0.5 units per kilogram of weight. A kilogram is 2.2 lbs. And starting doses are usually pretty conservative.

The 2 units is very conservative I would expect.

[Beau1]

Having trouble drawing enough blood w/o hurting her; how do I curb her hunger?

Thanks for your responses.

We've had a lot of trouble using the Alpha Trak 2. I've looked online and watched several YouTube videos. We're still having trouble getting enough blood without my hurting our dog.

I saw a video where the guy drew blood from his dog's upper paw pad - one that doesn't touch the ground. That's the only time I was able to draw enough blood from my dog - but she looked very hurt. Her reading that time was almost 600. So we've increased her insulin dose to 2.5 units twice a day, spaced 12 hours apart.

My AlphaTrak's lancet device seems broken - whenever I push the button, the little top area falls out. So I've been trying to just use the little lancet freehand.

I've tried piercing Laika's ears - but she always looks hurt. I try to push the lancet in just a bit to minimize the hurt, but then not enough blood comes out.

I do always try to warm up the area with a heated rice bag or by rubbing her ears between my hands. But I've still been unable to draw enough blood, and she still looks hurt.

-------

Her health seems greatly improved from before. She's taken all 21 days of her UTI antibiotic.

She still seems hungry all the time, though. Another question - what can we feed her that's good for her, but that can curb her hunger? She's been getting Taste of the Wild canned food in the morning and at night, her old premium kibble throughout the day, and some healthy human food, like vegetables or a bit of fruit.

[jesse girl]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

If blood sugar is high there wont be any amount of food that will subdue hunger as food is not processed very well into the body with high sugar

Its best to stay the course and do a complete curve once a week and adjust the dose based on the lowest number within that curve

I test jesse on her inner lip and at the beginning jesses vet at the time thought i was cruel but letting her suffer through high sugar is much worse than the small discomfort from testing

Now jesse gives me a kiss after testing her inner lip and probably have done it 10,000 times or more

There are simple protocols to follow and not doing them prolongs the regulation process . Once regulation is complete than you may have a bit more flexibility

[DebEsco]

Re: Having trouble drawing enough blood w/o hurting her; how do I curb her hunger?

I highly recommend the Genteel lancing system. Costs about $100 on Amazon, and there are videos of dog owners using it. You shave a tiny area on each side of base of tail (see their videos). Heat the area with beans tied in an old sock, which has been heated in microwave till comfortably warm not hot. You could use a heating pad as well. Use the Genteel, which has a plunger and tiny vacuum pump. Vaseline on the plastic rim helps make a good seal. It helps draw a drop to surface. Other than jumping a bit when lancet lets go (I think it’s the noise of that, not pain) my dog is comfortable while I count to 20 and let the vacuum do it’s work. And I always get a drop using this. On the ears, it’s a guessing game if I will get a drop or not.

One thing my diabetic cousin taught me: not all lancing devices, nor lancets, are equal. I have about a dozen lancets that I experimented with. I like the blue AlphaTrak lancets the best but did not like their device. I use the Care Touch device on ears. I also use the orange lancets that come with the PetSure strips that work in AlphaTrak but are half the price of the AlphaTrak strips, and come with 100 orange lancets. Whatever testing strips you use, make sure you adjust the AlphaTrak for the strip numbers. PetSure number is 20.

I’ve also used the sock to heat the ears before drawing there, but don’t use Genteel on that, just a normal lancing device. After heating, holding a flashlight with a wide surface behind the ear helps to see the blood vessels. I hold it there while I draw the blood. Stick to the blood vessels around the outside margins if you can, those work best and are least painful for the dog. The closer you get to the ear canal, the more painful. If I’m doing a two hour curve for a day, I rotate the sites between two sides of butt and two ears.

I experimented with saliva test strips, hoping I wouldn’t have to draw blood, but it was not reliable and ranged about 50 points different from blood test. My vet discouraged testing urine bcuz the sugar in urine would be a few hours behind where the dog is currently.

My dog won’t let me do lip and there are not big enough pads on his tiny feet. I would think pads would be most painful site.

The more practice you get the easier it will be. I give a diabetic friendly treat after, a tiny bit of freeze dried meat or all turkey jerky (no sugar). Good luck. Let us know how it goes.

Deb

[Raysaint]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Another place to get blood is on either side of the base of the tail, on the haunches. You may have to freehand lance it, or buy larger size lancets. And you can buy just a better lancet device. I use the Softclix by Accu Chek.
If you contact them they may send you one. Just email them and tell them you lost yours. They've sent me devices, caps, anything I requested.

I agree the Alpha lancet device is pretty basic. They use the same one even for their human meters.

[Beau1]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Laika seemed to be doing better for awhile. But in the past couple of days, she started urinating in the house again. And this time, her urine is sticky - before she got the insulin, her urine was clear and not sticky at all. What does this mean?

Also, I'm afraid her urinary tract infection might be back - I see her licking her genital area, and there seems to be something like pus or clear stuff coming out of it.

We've been having a heat wave the past couple of days - it's usually cool year-round here. She's been panting a lot, but she's not drinking that much water. Maybe it's because of the very hot weather, but she's not hungry as she usually is. She's breathing rapidly and panting a lot right now. Her tongue and gums have turned a little purplish. Her underside is purplish-reddish, when it's normally not much of a color at all .

We just did her glucose, and it was 593. She got her 2.5 units of insulin just 20 minutes earlier. Then I gave her another .5 units of insulin. Is it safe to increase her insulin by a full unit, or should we just increase by .5 unit?

She's 12-14 pounds and she's a chihuahua mix.

[jesse girl]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Insulin adjustments should only be done based on complete curves

Urination without drinking water may not be caused by high sugar because you should see both . Puss could point to a uterus infection which can be life threatening if your dog is intact female . My jesse was rushed for emergency surgery with this diagnosis when this all began over 9 years ago

It does sound like you are seeing some sort of infection . if not drinking with high heat and urinating more can lead to dehydration and that something to be concerned about

[Beau1]

Re: Diagnosed today - lots of confusion and questionable veterinary visit/info

Insulin adjustments should only be done based on complete curves

Urination without drinking water may not be caused by high sugar because you should see both . Puss could point to a uterus infection which can be life threatening if your dog is intact female . My jesse was rushed for emergency surgery with this diagnosis when this all began over 9 years ago

It does sound like you are seeing some sort of infection . if not drinking with high heat and urinating more can lead to dehydration and that something to be concerned about

We still hadn't done a complete curve because we've had so much trouble getting enough blood from her to do a reading. She always struggles when I try to prick her, and she shakes, too.

Today was extremely hot, maybe well over 100 degrees outside. It's normally a high of 50-60 degrees outside in my area. I think we were able to get enough blood from her ear today because it was unusually hot.

She's a spayed female.