Cadbury was diagnosed today and we're having a rough start!

[JustinJ]

Short Story;

3/18: Took Cadbury to vet for a consultation, suspected diabetic after exam.

3/19: Confirmed Diabetic (High glucose in blood and urine)
- Signs of potential kidney issues or dehydration from diabetes causing it
- Prescribed 9u NPH insulin 2x daily (12 hours apart, 1/2 hour after feeding)
- Prescribed a Kidney-friendly diet (have not looked into yet)
- Scheduled glucose curve for next Friday (25th) w/vet
- Ordered the AlphaTrak w/same day delivery (thanks Amazon)
- Found Novolin N @ Walmart for $25/vial (thanks Walmart)
- Fed Cadbury at 5:45p (mix of dry & canned - roughly 2 cups)
- Administered first insulin shot @ 6:15p
- AlphaTrak came at 6:30p...would have liked to taken a pre-meal reading
- Cadbury threw up (what looks like) all of his dinner @ 8p
- Frantically setup AlphaTrak and got our first reading @ 8:25p = 566 mg/dL

Needless to say, day 1 of treatment is not going as planned and we're a bit freaked out! I expected a high reading but we're worried about what's to come. We didn't consider the throwing up scenario and it's Saturday night. The insulin is not near it's "peaking" hour and we're worried it's going to bring his numbers really low now that his food is no longer in him! I plan to take another reading around 10:30p and set an alarm for a few hours after that to get another reading and monitor his condition. I don't really want to attempt to make him eat again and he hasn't puked his food up like this in a very long time.

Any other suggestions or am I on the right track?

This community looks awesome and I have been reading for hours...Thanks to all who is part of this!

- Justin, Alex & Cadbury


Cadbury's History:

Name: Cadbury
Breed: Chocolate Lab
Age: Will be 9 years old next week
Medications: Was on Temaril-P for 9 - 10 months in the last year. Stopped mid Feb 2016. (was for lick granuloma)
Healthy eater - Blue Buffalo 4 cups day (no human food)

Cadbury's symptoms;
- Noticeable increase in water intake over the last 30+ days.
- Weight loss was evident although food consumption was somewhat normal (3-4 weeks)
- No longer pulling during walks/bike ride, now is trailing (~2 weeks)
- Has become very lethargic and sleepy (~2 weeks)
- No longer jumping on bed/couch (~1 week)
- Loss of interest in all of his toys except ball (~1 week)
- Can not run (~1 week) - was running 30 days ago...

3/18: Vet visit ahead of scheduled annuals (due in mid-Apr). We took him in early because he hasn't been himself lately
- Weighed in at 73 lbs (last weight in was 96 lbs 4/2015)
- Vet took some samples and did physical exam
- Vet suspected he was diabetic which we had not even considered
- Left freaked out

[Joan]

Re: Cadbury was diagnosed today and we're having a rough start!

If you have given him 9 units of insulin, and he threw up the entire meal, you will need to get some food into him. Corn syrup will work, it is very quick, can raise the blood glucose in 15 minutes. If you have some of that, you can wait till his bg is under 250, but I would not wait that long. Maybe a tsp every half hr and monitor him. You need to know before he gets too low, if that will work for him and he will keep it down. it is important because he WILL go low after insulin and no food to counter balance.

Honey also works but a bit slower. Also if you can get the syrup/honey into him, then a bit later some protein, maybe bread? Or meat so that it will last. The syrup brings them up (or prevents a big dip) but it wont usually last for more than an hr or so.

Very good that you are testing, you can see how it is doing.

[Joan]

Re: Cadbury was diagnosed today and we're having a rough start!

Sorry did not welcome you to the forum, wanted to get that info to you re food etc.
Yes this is a rough start for sure. It will get better i promise! You are doing so well to have purchased the glucometer already and testing too. If not you would have been spending the night at the emergency no doubt.

As an emergency measure, you can rub the syrup on the gums if they are not swallowing. he is still pretty high, but I would expect he will drop pretty rapidly in the next hr or less. So getting an idea of how to administer what ever quick carb you have on hand is a good idea. It is quite likely that he may eat a bit and keep it down, something bland like chicken & rice if you have it, oatmeal, bread nothing spicy or harsh...some canned foods are pretty rich.

[WRoberson]

Re: Cadbury was diagnosed today and we're having a rough start!

You found the place for the help you need. Great people and really great support group.

Now stand back take a breath, slow down, inhale exhale.
Just remember:

Do not chase the numbers, always allow time to pass before making big changes.

Watch for very low numbers, very high numbers aren't good but they take time to do harm. Low numbers on the other hand are not as forgiving.

Over the next few week this all will become second nature and routine, Just hang in there, it will get better.

[CraigM]

Re: Cadbury was diagnosed today and we're having a rough start!

Welcome to the forum.

I don't think you have anything to worry about tonight. He is 73 pounds and only got 9 units of Novolin-N which is a very low dosage. Many think a starting dosage of .2 units per pound (14 or 15 units in your case). To be super safe, you could try feeding again and basically start over tomorrow.

Btw, most inject right after the meal so that the food doesn't get too big of a head start on the insulin. Is vomitting a frequent thing with Cadbury?

Craig

[JustinJ]

Re: Cadbury was diagnosed today and we're having a rough start!

First, thanks all for the prompt replies! and warm welcome!

We do have some honey and corn syrup on hand for emergencies.

The throwing up is not normal which added to our worries but the canned food has only been introduced in the last 24 hours, so maybe that's it...however he kept last night's dinner and this mornings breakfast down w/out issues and both had 1/2 can of the canned food.

I'm going to take another reading around 11-11:30, which will be about 5 hours since the insulin was given. I'll see if he wants to eat a small snack, thinking a little serving of brown rice and 1/2 cup of dry food.

Thanks again all, very helpful!

[CraigM]

Re: Cadbury was diagnosed today and we're having a rough start!

First, thanks all for the prompt replies! and warm welcome!

We do have some honey and corn syrup on hand for emergencies.

The throwing up is not normal which added to our worries but the canned food has only been introduced in the last 24 hours, so maybe that's it...however he kept last night's dinner and this mornings breakfast down w/out issues and both had 1/2 can of the canned food.

I'm going to take another reading around 11-11:30, which will be about 5 hours since the insulin was given. I'll see if he wants to eat a small snack, thinking a little serving of brown rice and 1/2 cup of dry food.

Thanks again all, very helpful!

Sounds like a good plan. I'll be checking the forum off & on for the next couple of hours.

Did you get your syringes at Walmart too? Pretty low priced

Craig

[JustinJ]

Re: Cadbury was diagnosed today and we're having a rough start!

11:30p update

5:45p - Dinner
6:15p - 9u injection
8:00p - Threw up dinner
8:15p - 1st test = 566 mg/dL
11:15p - 2nd test = 521mg/dL

I think the dose is low enough to where we aren't going to see a massive drop, regardless of his vomiting. It is his first dose, so we'll continue with the prescribed plan over the next week. Next step is breakfast!

I did buy the syringes w/the insulin at Walmart as well, I think my total was around $37 for a month's supply...Paid about $60 for the AlphaTrak 2 w/25 strips on Amazon.

[amydunn19]

Hi and welcome! That is a rough start but with his low dose, I think you will be fine. Maggie, in her early years, was famous for this kind of stunt. She Would either not eat at all or throw up. They keep you on your toes.

I am wondering why the vet started at such a low dose.

The kidney food may be at odds with diabetes - sometimes it is hard to get a good balance with that food and insulin. I would want to reassess that kidney issue to make sure he needs that food or if it was dehydration.

You are doing great so far. I was such a mess. Stay organized and consistent with all you do. Remember that this disease will take patience to get the results you want. It can take some time to get there.

[CraigM]

Re: Cadbury was diagnosed today and we're having a rough start!

You will be needing more test strips! I usually bite the bullet and order 3 boxes at a time for the quanity discount.

I use the Walmart ReliOn Prime meter for most daily testing. The meter is under $20 and the test strips are $9 for 50! They are sold as a single container of 50 for $9, or a box that contains two containers for $18. Yes, the readings won't be correct because of the differences between human and dog blood, but you can do some comparisons to get an idea of the difference. In my testing, the Prime reads about 35-40 points lower than the AlphaTrak in the low 100 range (prime 90 might be close to 130 on the AlphaTrak). The difference increases as the numbers go higher. If someone can afford the AlphaTrak test strips that's great, but I couldn't afford all the testing at $1 per strip

Craig

[CraigM]

Re: Cadbury was diagnosed today and we're having a rough start!

Any news / update on Cadbury?

Craig

[JustinJ]

Re: Cadbury was diagnosed today and we're having a rough start!

Been meaning to post the latest, thanks for checking Craig.

Cadbury slept well through the night, can't say the same for his parents! We're trying...

I set an alarm for 7a as I'd like to get on a solid schedule. He's never really eaten at a consistent time in the morning. I fixed 1 cup dry + 1/2 can of the B.B. he's been on for a while now (the dry food anyway) but he was not interested. He took a few bites but didn't even eat 1/4 of what I served. He just went and laid down.

I tested his BG around 7:30a to get a reading and he was at 429 mg/dL. This was approx 13 hours after his first insulin shot.

I wanted to make sure he got his insulin so I decided to cook up some brown rice and boiled eggs to feed him. He ate a serving of 1/2 cup rice + 1 egg without any issue. The vet said to cut his insulin in half if he didn't eat a full meal so after eating that I gave him his 2nd shot with 5u. Eating/Insulin was given 10-10:30a.

He then had another serving of the exact same portion of rice/egg at 12:30. I want to make sure he get enough quality calories to work with the insulin.

He's been drinking more of a regular amount of water today. Stool is a little hard still but bathroom breaks aren't out of the ordinary. Still very tired and sleepy.

I've emailed my vet our notes so far so we can have a chat early in the week. I just took his BG @ 4:30p and he's at 458 mg/dL.

Not exactly sure how to take these results though, they're obviously still high but he has only had 1.5 doses of the insulin, which sounds like is a low dose anyway.

Is it good that the BG is 100+ mg/dL less (average) today than the readings from yesterday? I'd assume so but I'm still only 24 hours in to my life as a diabetic dog owner, so I question everything

Thanks again for the information and support!

[JustinJ]

Re: Cadbury was diagnosed today and we're having a rough start!

You will be needing more test strips! I usually bite the bullet and order 3 boxes at a time for the quanity discount.

Craig

Ouch! I just checked out the price for the 50 pack of AlphaTrak strips on Amazon and they're $57! Exact price I paid for the meter + 25...I'll look into your suggestion, thanks!

[CraigM]

Re: Cadbury was diagnosed today and we're having a rough start!

I know you want to get food into him so that you will be comfortable giving the insulin. Unfortunately, the meals really need to be repeatable. This is the hard part, getting them to eat when they may not want to for various reasons. When Annie was giving me eating problems, I'd mix in some baby food which she really liked. I was using the tiny 2.5 oz jar of Beachnut chicken and chicken broth from Walmart at just under a dollar a jar. I used just enough to mix with the dog food, so the tiny jar was good to "Doctor" 4 or 5 meals. Others will recommend other toppers to get their attention. It's tough. They may not want to eat because they don't feel well.

Sure, lower numbers today are better than high numbers yesterday, but without full meals and standard insulin dosage you are basically just giving random food + insulin.

Hope the vet advises you to increase his insulin. Just as an example, my Annie is 18-19 pounds and is getting 8 1/4 units per injection. Every situation is different, but 9 units is undoubtably way to low.

Craig

[k9diabetes]

Re: Cadbury was diagnosed today and we're having a rough start!

Welcome to you and Cadbury!

This is a low dose to start - perhaps partly because you may have caught the diabetes quite early?

Since with almost no food the blood sugar does not seem to have gone much below 400, I think the dose should be increased if you get him to eat and he should receive the full 9 units if he doesn't eat.

A pretty normal starting dose with food would easily be 12 units. Even that's a bit on the conservative side. But if he only recently became diabetic, it can be wise to start conservatively. So depends on how long he's had symptoms.

You don't necessarily want the blood sugar to plunge immediately down into the 200s or lower as long as he doesn't have ketones - did the vet mention ketones?

And throwing up plus lack of appetite is fairly common when the blood sugar is very high, such as in the 500s. Once his blood sugar gets down even into the 400s, he should start to feel a bit better. Dogs are fairly tolerant of high blood sugar so they often start to feel significantly better even by the 300s.

The ideal is to start with somewhat less than he likely will need and work UP to the right dose in small increments over a month or so.

I would talk to the vet about a will-eat and won't-eat dose of insulin with 9 units at least when he won't eat. Getting his blood sugar down some is key to getting his appetite back. The body uses about half of its insulin supply to maintain basal blood sugar between meals and most dogs can use anywhere from 1/4 to 1/2 of their usual with-food doses if they eat nothing at all.

Sorry you freaked out... I totally understand. But diabetes is very manageable and doesn't have to impact your dog's life at all. It just takes a little time to get things sorted out in the beginning.

Natalie