Newly Diagnosed, having issues

[Neirracul]

Hi everyone,

My pooch, Maura, is an 8 year old Siberian Husky who was recently diagnosed (2 weeks ago). She was in dka when we figured out what was happening and she had a hospital stay, and they released her when her blood sugar came down some. They gave her an initial prescription of 20 units of Vetsulin and we’ve been following all the rules, two meals a day 12 hours apart, insulin directly after. She seemed to be getting more lethargic and our alphatrak 2 came in and I decided to do a blood glucose curve to see what was happening since the spot reading I did was around 400. Her bg only went up from there during the day (I can post the full curve if needed) and came back down into the 400s later in the day. Called the vet with my worries and he was irritated that I’d done a home curve because they don’t recommend owners doing their own curves at home (???). Either way, his solution was to increase her dose to 22 units and see how that works out. Today I did a spot check 8.5 hours after her morning dose and her bg was 655. I am extremely frustrated and not sure what to do at this point. I know it’s early on but the readings I’m getting just keep getting higher, not lower.
Anyone have any ideas? I was doing a lot of reading about insulin resistance and somogyi overswings/ rebound but the vet just brushed me off when I asked about possibilities.

Edited to add:
Maura is 62 lbs
Eating 2.5 cups of Ketona salmon per day



Cheers,

Erin and Maura

[Raysaint]

Re: Newly Diagnosed, having issues

vets try to maintain control, and some don't like owners doing things themselves. Home testing is crucial, doing your own curve is quite ok.

This whole process of regulation takes a lot of time, don't expect changes right away. Increasing insulin willy nilly is not the way.
Starting dose is 0.5 units per kg (2.2 lbs).
Stick with that for a week, do a curve, and increase insulin a unit at a time each week.
The body is going thru lots of changes so it takes time to adjust to changes, and things will sometimes be opposite of your expectations. Stay the course.

Don't get too focused on numbers right now, get the routine down and be consistent.
Patience is your best friend.

[MikeMurphy]

Re: Newly Diagnosed, having issues

Hi and welcome to the forum.

I agree with Raysaint. The starting dose of 20 units is way to high for a 62 lb dog. The normal starting dose should have been 12 to 14 units, twice daily. Then adjust insulin in .5 to 1 unit increments, based on the results of weekly 12 hour curves.
Going beyond the correct dose can cause Somogyi Rebound.

[Neirracul]

Re: Newly Diagnosed, having issues

Thank you guys for your responses! I feel a lot better that my suspicions are being confirmed. I went onto the Vetsulin webpage about dosing and did some math last night about the recommended starting doses and decided to use their starting dose of .5 units per kg once daily and a 25% reduction of that twice daily and started her with 10 units that we will move up from. It’s a bit lower than you said but honestly, she seems to be doing better already. Her 330 PM spot check was ~550 today which is way better than the 650 bg we got yesterday at the same time. As long as she is feeling better it’ll be easy to stay the course and be patient. I expect some bumps in the road but this is reassuring. Thank you!

[Riliey and Mo]

Re: Newly Diagnosed, having issues

hi
thats good news

just wanted to mention the amound of food twice a day is important
it goes by weight also
i would check the mfgs website or the dog food bag to see how many cups per day then divide by 2
looks like 3.5 cups

[jesse girl]

Re: Newly Diagnosed, having issues

I just want add to all the good advice you received has your dog been spayed ?

[Section1]

Re: Newly Diagnosed, having issues

Hope Maura keeps doing better. I'm in a similar position as you and don't have any advice to offer but please post updates on your dog's progress.

[Riliey and Mo]

Re: Newly Diagnosed, having issues

this journey gets easier its just getting it all together at first thats hard but its doable and well worth it

[Raysaint]

Re: Newly Diagnosed, having issues

This is a good read for basic education. Combine that with advice from the good people on here and you'll do well.

https://www.aaha.org/globalassets/02...ines_final.pdf

Believe it or not, I've learned that there are lots of vets out there with little diabetes experience. And we can usually tell based on the initial advice, dose, etc. that they give.

Seems odd that info we can get right on websites from insulin makers, etc., they don't seem to have read it.

And one key thing to remember, one my vet reminded me of the other day, it's how the dog is doing clinically that matters, not just his specific numbers each day. That's something us human diabetics focus on, and it delayed my dog's regulation.

[Neirracul]

Re: Newly Diagnosed, having issues

Hi everyone, thank you! I think we are in a much better place now with a dose of 10 units twice daily. She’s fully transitioned to Ketona salmon, 3.25 cups per day for a 60 pound dog with treats of either frozen broccoli cubes or small apple slices when we have to give her eye medicine. She’s had pannus since age 4 and has been on and off Optimmune 2-4 times daily (currently on). Tear production has improved slightly. I was worried about giving her a steroid but three separate vets have claimed that the medication is nonsystemic and stays primarily in the eyes. She gets two walks per day, one right after her morning meal and one either right after her evening meal or within 2 hours of it. She’s a lot perkier now and the excess lethargy has seemed to go away. Clinically, it appears she is doing fine. No accidents or excess urination. She drinks a good bit more but I think that is more the result of switching to a kibble from a hydrated food. We are going to start measuring her water intake so we can stay on top of things.

Our spot checks have been in the 400s since lowering her dose. We had one reading of 311 after a long midday walk but that was a special event. We are going to do another glucose curve tomorrow and see how she’s doing. Will most likely be moving up to 11 units on Sunday.

I’ve been doing a lot of reading about different insulins and financially we are having difficulty affording the Vetsulin (it’s 75 bucks a vial from our vet). I was considering switching to the Walmart branded Relion (Novolin N?) since it seems like a lot of dogs do well on it. Any tips here? I just bought a months worth of Vetsulin so we are good for a little while and can focus more immediately on finding her ideal dose.

P.S. Maura is spayed!

[jesse girl]

Re: Newly Diagnosed, having issues

All good news and making progress !

Usually a transition from vetsulin to relion n insulin from walmart sees a similar response for most dogs . So the transition is usually uneventful but some dogs came up with allergic issues with the human insulin but that seems to be very rare .

As far as dosing it works out to close the same in units between he 2 insulins . Now they use different types of syringes so actual volumes of insulin is different

My Jesse started on vetsulin over a decade ago and it was removed off the market at that time so she was not regulated on vetsulin because I Told the vet at the time that since vetsulin was coming off the market why regulate jesse on it . They told me they had plenty of vetsulin but I said we still have a problem with it coming off the market and they agreed to transition to relion N . She was the first to do it at that facility. Now a couple week latter I took over the management of her diabetes and have not had a vet involved with her diabetes since then .

I still have that original vial of vetsulin in the fridge . I thought they were going to pay me back for it but that never happened so it just sits there

[sibhus]

Re: Newly Diagnosed, having issues

Neirracul, im also new on here as my 7yr husky was also diagnosed with diabetes. Ive gotten some great help here as well.

As to the insulin, I also was advised by my vet to use vetsulin but realized the Novolin n can be had for 24.88 at Walmart whom you can always count on to have on hand and never run into issues as to availability or price fluctuations. A lot of vets are trained by the pharmaceutical industry so will only endorse what the industry offer. Also the reli-on needles are about $12 and use the 30unit 8mm style needles.

I believe the profile curves are slightly different between vetsulin and Novolin n however, the dosing is similar.

[Neirracul]

Re: Newly Diagnosed, having issues

We did a glucose curve today and her results were:
441
356
549
518
467
388

It looks rather suspicious when plotted out. Readings were taken every two hours, starting at 7 AM and ending at 5 PM. By 11 she was very sleepy and did not want to get up. I imagine this is what was happening all week, but I’ve been working so it’s hard to say. My partner said she was a lot less active during the late morning/ afternoon. It would explain why our 3 PM spot check are always in the 400s. What do you guys think?

[MikeMurphy]

Re: Newly Diagnosed, having issues

Good morning. Not a bad looking curve there. You should be able to safely move up one unit and do another curve in one week. Once you start to get closer to the 150 - 250 range for most of the day, then you can increase in .5 unit increments.

Good work!

[Riliey and Mo]

Re: Newly Diagnosed, having issues

good job this curve is good.
the lowest number is 388
your okay to up one unit to 11.
keep up the good work regulation is just around the corner.