Newly diagnosed and not responding to insulin

[Spring's battle]

Help please. Spring is a 6 year old Weimaraner up until recently she was healthy & happy and now to her new Journey which started about a month ago we were having frequent accidents in the house and she was starting to lose weight at first we were frustrated because we didn't understand why she was having accidents so we weren't paying attention to the fact that the urine was sticky and the weight loss I attributed to summer and heat plus running around more outside. Once the stickiness was noticed along with weight loss and excessive drinking I went to Google and all signs lead to diabetes I took her up vet on 5/18/16 and she was diagnosed with diabetes and a UTI as well as dehydrated although she was drinking all the time and her blood sugar levels were 489 and was told she should be around 140ish. They started her on insulin and gave a one time injection of antibiotics and unfortunately on the next draw her levels went up and up and today they switched insulin to the twice a day dose and with the 1st dose at draw her levels are now 549 at that point they told me to do a direct transfer to another emergency facility. The consultation would be free so we went, at that time the consult was that there could be many factors but the cost would be 5-6 hundred a day for keeping her over the weekend and about 2-3K for testing and they don't know if they will even have a answer, unfortunately I can't afford 5 thousand on top of the 600 I spent on the other vet bill and I hate to think I pave a amount on my pet but I have to think of all factors and be reasonable. I did text my vet and asked him if I could bring her back in the morning and try a higher level of insulin and he said yes so that is where we are headed in 4 more hours. Her appearance besides losing weight loss great, she wags her tail and acts normal but based on everything she is sick. I read a few articles and they talk about pork/beef/human insulin and I believe pork is the two they tried also I read about trying to give in different areas to possibly get better absorption... ANY suggestions or IDEAS? I don't want to make a life/death choice over money I want to try ideas any home remedies that may add to assisting the insulin, foods that a beneficial anything. Please and thank you.

[Spring's battle]

Re: Newly diagnosed and not responding to insulin

Spring was about 75lbs or so and now is 52 so she is looking like skin and bones we went back to the vet this morning and they raised her insulin up to 20 twice a day, and we are to go back Monday for a blood draw but they did give the testing strips to use when she goes to the restroom. Unfortunately the levels read over 2000 on glucose levels which I see is bad because it's the highest on the label and the ketones are negative.... ugh I feel so desperate for her that I've had a migraine all day and my stomach is in knots I just want her healthy and to know she isn't in distress.

[CraigM]

Re: Newly diagnosed and not responding to insulin

Welcome to the forum and sorry to read all your problems. Weekends can be slow on the forum, so you might not get much info until Monday.

Do you know the type of insulin they are giving? I understand she is now getting 20 units twice a day. Is she eating OK at the clinic?

The urine test strips are better than nothing, but blood testing is the way most of us do it. In your spare time, I'd suggest you view some YouTube videos of home blood testing. It may sound difficult, but most pups learn to accept the poking (the "parent" has more problems)

Hope she come home soon. Being at a clinic can be stressful on pup and parent!

Craig

[amydunn19]

Re: Newly diagnosed and not responding to insulin

Hi and welcome to the forum! It is slow around here on weekends but hopefully some others will stop by. I know it is very scary to start but I think once you get past the initial shock of it all, you will see that diabetes can be managed and life will return to normal , maybe a bit more structured.

I have a few things to say - first, she doesn't have ketones so there is no immediate danger. There is no reason that she should be hospitalized as long as she is eating. I am quite concerned about the dosage of 20 units twice a day - this is double the recommended starting dose for a 52 lb dog. What dosage was she on at diagnosis? Did you say she was only on one shot a day? One shot a day doesn't ever really work - vetsulin and NPH have about 10-12 hour durations. Can you give kind of a timeline of dosages - when they were changed, how much, etc. ?

Urine testing, though better than nothing, is not very useful in measuring glucose - more so ketones. You can buy a human meter if you really want to start managing blood sugar - much cheaper than the vet's office. My favorite is the one touch ultra - it is very close to the animal meter. I have used it for over 8 years now and it will give you the power to manage your dog's diabetes.

The key to managing this disease is to be consistent - same food, same amount, same time, every day. What are you feeding? Two meals, twelve hours apart is the way to start. In between snacks won't help unless she goes low. I know you are concerned about weight loss - until you get blood sugar lower, she will be unable to gain weight. They eat and their body is not using any of the food - it just passes through without helping. If you try to feed more thinking you will help her gain weight, her blood sugar will go higher and getting her under control is impossible. I know it is hard to see but you can work your way out of this. And you don't have to spend a fortune at this point.

[CraigM]

Re: Newly diagnosed and not responding to insulin

One more question. Is she spayed? Hormones in unspayed diabetics can be a big problem getting the blood glucose regulated.

Craig

[Spring's battle]

Re: Newly diagnosed and not responding to insulin

Good evening and thank you both for responding. She went to the vet initially on 5/18 @ 4pm and they ran blood tests which showed her blood sugar levels were 449 and she she was high in ALT (not sure what that is 284 says range is low 10/high 125) her cholesterol levels were high 456 low is 110/high 320. and her LIPA was high 5604 low 200/high 1800 and TBIL high 1.0- low0.0/high 0.9. CI was low at 103 low109/high 122. At this time they gave vetsulin 12 units @6:20pm and gave IV fluids 75mls/hr.
5/19- Gave convenia 80mg (which I believe is an antibiotic for a UTI)
Glucose test at 7:44a- her level was 517 and noted ketones in urine
8am gave 12 units vetsulin
Glucose test 5:44p level was 521
6pm gave 12 units vetsulin
5/20-
7:45a moderate ketones7:47a- glucose 531
8:20 gave novolin 12 units
4:12p-Glucose 549.....

At this point is where they sent me to the emergency hospital for a consult and I ended up taking her home around 7pm she stayed home all night seemed ok except tired.
5/21- went back to regular vet and they didn't do any blood tests just changed back to vetsulin and went to 20units as well sent us home with the strips to use until Monday when we go back at 8am to see how she did over weekend. They put her on 1cup dry purina pro plan rx dual fiber control and 1/3 can of royal canin glycobalance.

We gave her 20units of insulin at 9:40am @ vets office, they gave her a shot of liquid under skin to absorb since she seemed dehydrated still, we used a test strip at 11:28a and light trace of ketones and glucose was off the chart it's colored (dark brown) which shows a range of 2000
11:45 fed her 1 cup dry 1/3 can wet
3:10p-Strip test no ketones and same glucose levels
She just ate same amount of food and will be getting the insulin soon
After she just ate her spirits seemed higher, she ran outside to pee instead of walk and she kissed our other dog on the way


-also she is typically fiesty and protective doesnt like the vet and needs muzzle and she was fine with everyone no growling anything. On the way home from vet today and stopped at store and I went in son stayed with her in car and she growled and barked at a stranger (I'm trying not to get over excited because she hasn't responded so far but I feel happy about that progress?)

[Spring's battle]

Re: Newly diagnosed and not responding to insulin

Btw: yes she was spayed as a puppy.

[amydunn19]

I am a bit worried. To go from 12 to 20 units is a huge increase. Would it be possible to get a human meter so you can test? Around here, we typically see a one to two unit increase at a time. It is best to do a curve prior to increases. A curve is a series of blood glucose tests starting at the first meal of the day, testing every two hours until the evening meal. I understand the 12 may not have been enough but there is no way to know how low she may go with urine strips. You may have gone past the dose with an 8 unit increase. Hypoglycemia is the biggest threat your dog faces - being high is uncomfortable and you don't want ketones, but please be on the lookout for signs of low blood sugar.

[Spring's battle]

Re: Newly diagnosed and not responding to insulin

I can find out tomorrow if I can get a meter anywhere being this is new to me I am unsure of everything. I just went to check on her and she was laying down, once I went in the kitchen and opened the fridge she came running with tail wagging....

[amydunn19]

You can pick up a meter at Wal Mart if you have one close. Their brands (Relion) are cheap but not quite as accurate but will keep her out of immediate danger. If you have more money in your budget, a One Touch Ultra is more reliable with dogs. The strips are more expensive but you could get a bottle then order more from Amazon or ebay for much cheaper. I order the ones that are still sealed in original packaging but near expiration. The strips are good way past expiration plus I use 4 or 5 a day.

I always worry about overdosing because my dog was horribly overdosed in the beginning.

[peony]

Re: Newly diagnosed and not responding to insulin

I can find out tomorrow if I can get a meter anywhere being this is new to me I am unsure of everything. I just went to check on her and she was laying down, once I went in the kitchen and opened the fridge she came running with tail wagging....

My Kirby went from 32 pounds to 17 pounds. He was drinking constantly and acted starved. The good news is 5 months later he weighs 22 pounds and is drinking normally. He gets 8 units of Novolin N twice a day. He has been increased slowly and we always wait two weeks and do a curve before we increase again. My vet lets me test at home and I email her the curve results. I use an AlphaTrac 2 that I purchased on Amazon for $51 (it included 25 test strips.) I bought 26 gauge lancets because I couldn't get blood with the 31 gauge. I tried the Relion meter but it kept timing out before I got enough blood.

I was very nervous when I first started testing Kirby but as time goes on it becomes more and more routine. We also used the strips and at the beginning it always read high ketones and 2000+ glucose. I still check him periodically although he is much harder to catch now My vet said the strips were most useful in showing ketones and low glucose, otherwise they aren't very accurate.

I give Kirby his shot on his side. My vet said it's the best site for absorption. I alternate sides morning and night so I don't keep giving it to him in the same place.

The people here are wonderful and helped me save Kirby's life.

[Auddog]

First off, welcome to the forum to you and Spring!

Wow I've never seen such a huge increase so fast from a vet! 12 to 20 makes me nervous too. I'd try to get your hands on a human meter as soon as you can. I was sent home with some pee sticks a couple of times to test my boy's glucose, among other things, and I could never get the hang of looking at it right when I was supposed to. I find them to be a bit tricky because they continue to change color until it's as dark as it can get.

Bazzle and I were also one touch ultra users, and most pharmacies will have starter kits you can buy that include the meter, some testing solution, a few lancets, and a travel case (though walmart is usually the cheepest). Personally I never got enough blood to test using the lancets that come with the kit (typically 30 or 31 gage), so when you go to pick up your starter kit it may be worth your while to pick up a box of thicker lancets. Lancets and needles are counterintuitive like sheet metal in that the larger the gage, the thinner the needle. If you decide to head to Walmart, their Relion Brand Lancets that are labeled "thin" are 26 gage lancets, and that worked great for us.
I noticed how you said Spring can be a bit fiesty, so I hope you can make home testing work.

I understand how stressful this can be in the beginning, but try to take a deep breath. Regulating diabetes is a slow process. We often say this disease is a marathon, not a sprint; and like Amy said, do long as you don't see any ketones in her system, she's not in any danger. I would encourage you to ask your vet how many diabetic patients they've treated, because making that big of a jump makes me think they don't have a lot of experience in this area. Also, infections have a tendency to make blood sugar go up, and can also cause a bit of insulin resistance, so if she's not over the UTI, that could be part of the reason they're having a tough time getting her sugar down.

Even though it can be slow on weekends, there are a number of us that check in (myself included), so you certainly don't have to feel alone. We're here for you, to offer advice and share our experiences .

You got this!

Audrey

[Spring's battle]

Re: Newly diagnosed and not responding to insulin

I am so happy to hear about everyone's journey and all the advice I'm getting and now I too am worried that her dose is high and I live in Florida I think we have plenty of walmart stores here so I will go see if I can buy one. Where do you poke her for reading? I was sick to my stomach giving the shot of insulin, and the insulin is being given in her side kinda above her back leg and yes I'll rotate sides also she is not fiesty with us she just is very protective of the house and doesn't like strangers so when she didn't bark at anyone I knew that couldn't be good.
Last night she went out to potty at 10:45p and no accidents in house and I went in to get her up and she is in bed with my son and they are both being their normal lazy self and not ready to get up so I feel good about that. She woke up stretched looked at me, rolled over and went back to sleep. (That is how she used to always be)

I'll update after food, potty, test etc. THANK YOU FOR THE RESPONSES

[momofdecker]

Re: Newly diagnosed and not responding to insulin

Good evening and thank you both for responding. She went to the vet initially on 5/18 @ 4pm and they ran blood tests which showed her
high blood sugar levels were 449
high ALT (liver value) 284 (range 10 - 125)
high cholesterol 456 (range 110-320)
high LIPA 5604 (range 200 - 1800)
high TBIL (total bilburn - liver value) 1.0 (range 0.0 - 0.9)
low CI (blood chloride level) 103 (range 109 - 122)

Hello and welcome to the forum. I edited your dog's values a bit so they are easier to read. The ALT value is a liver value. Diabetic dogs, especially uncontrolled diabetics, can have elevated liver values and high cholesterol values. Given the high LIPA value, I wonder if the vet checked for pancreatitis at all? There is a SPEC cPL blood test that can check for pancreatitis. The reason I mention it is because pancreatitis can cause insulin resistance in diabetic dogs.

Infections of any type can also cause insulin resistance in a diabetic dog - so if your pup does indeed have a UTI - her blood glucose (bg) may be running higher than normal until the UTI is resolved. Diabetic dogs are prone to developing UTIs and for some the unexplained elevated bg is the first sign before any other symptoms develop.

Diabetes in dogs is quite doable - and you are off to a great start. There is a wealth of experience on this forum - you are in good hands. Hang in there an don't hesitate to ask lots of questions.

Wishing you the best in this new journey of yours.

Holli

[amydunn19]

Re: Newly diagnosed and not responding to insulin

Videos of blood testing:

http://www.k9diabetes.com/forum/showthread.php?t=2243

Bigger dogs tend to have calluses and those make it easier, give good blood and don't cause any pain. Also, skin tags have no nerve endings so if your dog has any, they are great places to use.