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  • #1

    KoKo - New diagnosis

    Hello all... KoKo was diagnosed about a month ago and has been on Novolin N since 5/15/2013. KoKo is a 4 y/o 43 lb American Eskimo Dog. We started him on 8 U suggested by the vet and we got a ReLion Confirm glucometer. I tested his brother, a normal eskie, about 5 hours after a meal and got a BG of 79 for comparison sake.

    Although the vet wanted me to feed him W/D, I flatly refuse to feed by-products, that's just me. I chose to go with Premium Edge Weight Control II food (8-10% fat) as his amylase and lipase were high fasting and his triglycerides were 1100! His urine was negative for ketones.

    I have seen fasting and spot check sugars all over from 80 - 350 and I am a bit concerned that a) I'm a crappy injector, b) he has episodes of rebound or c) he absorbs the insulin differently some days. Today I decided that I'm going to do the following - please comment, either positively or negatively I really would love some input:

    1) Decrease his dose to 7 Units for a week in case there is some rebound going on,
    2) Buy some 5/8" needled syringes so I can inject him at a 90 degree angle - this 45 degree stuff is wreaking havoc on my confidence and I'm a Med Tech for heaven's sake !
    3) Do a curve at the end of the week.

    KoKo was born here 4 years ago May 22nd (the 5th of 6 pups) and went to live with his new family on 8/6/2009. They called me a month ago to tell me that he had been diagnosed with diabetes and they wanted to know what they should do with him as they couldn't take care of him... I took him back... OF COURSE!
    Last edited by Juulz; 11-29-2015, 09:08 AM.
    Tags: None
  • #2
    Re: KoKo - New diagnosis

    Welcome to the forum!

    It would be nice to see your readings. Have you done a "curve", blood tests about every two hour from before breakfast to dinner? Great that you are home testing, and even greater that you have a "control" pup to compare readings. As you probably know, human meters usually read dog blood low, so that 80 reading is likely closer to 110-120. (I'll look back through my notes later and see if I have the approximate difference).

    Your current 8 units sounds like a good starting dosage and I wouldn't think you would need to reduce it. A "curve" is the way to tell: we make adjustments based on the lowest number, so it would be great if you could do a curve and post the results.

    We are about to have dinner, but I'll check back later this evening, and I'm sure others will welcome you.

    Craig
    Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

    Comment

    • #3
      Re: KoKo - New diagnosis

      Originally posted by CraigM View Post
      Welcome to the forum!

      It would be nice to see your readings. Have you done a "curve", blood tests about every two hour from before breakfast to dinner? Great that you are home testing, and even greater that you have a "control" pup to compare readings. As you probably know, human meters usually read dog blood low, so that 80 reading is likely closer to 110-120. (I'll look back through my notes later and see if I have the approximate difference).

      Your current 8 units sounds like a good starting dosage and I wouldn't think you would need to reduce it. A "curve" is the way to tell: we make adjustments based on the lowest number, so it would be great if you could do a curve and post the results.

      We are about to have dinner, but I'll check back later this evening, and I'm sure others will welcome you.

      Craig
      Thanks! I will run a curve within the next week and post the results.

      Comment

      • #4
        Re: KoKo - New diagnosis

        Annie & I just ran a comparison between our ReliOn Confirm and AlphaTrak2 meters. As you probably know, the AlphaTrak2 is a dog validated meter that many vet clinics use. Great meter, but the normal retail price for the meter is pretty expensive (about $150), but is sometimes found on sale. In addition, the test strips are very expensive, about $1 each. A few of us have the AlphaTrak2 and less expensive human meters like the Confirm, and use the less expensive meter for most tests. We can get a fairly accurate comparison by testing the same blood droplet with both meters and determine a percentage difference. Here is what I recorded a few minutes ago:

        Confirm = 78
        AlphaTrak2 = 126

        I would divide the Confirm reading by the AlphaTrak2 reading to get a conversion factor

        78 ÷ 126 = .62

        I would then divide any readings from the Confirm by the .62 factor. Normally I would do several, maybe 10, comparisons and take the average. I'll do another comparison for you in the morning.

        Here's a photo of most of my meters! I'm always looking for something better / cheaper.
        https://www.dropbox.com/s/uncfbu5tmzsbnwb/P4100002.JPG

        Here's a link to the AlphaTrak2 system. I'm not pushing the AlphaTrak, but their website has some good information, just remember they are trying to sell their meter http://www.alphatrakmeter.com/alphat...sy-to-use.html

        Craig
        Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

        Comment

        • #5
          Re: KoKo - New diagnosis

          Welcome and thank goodness you took Koko back from those people who wouldn't take care of him. I say wouldn't because once you get a routine down, diabetes is manageable and besides a little extra expense, your life only changes minimally.

          I think doing the curve first will tell you more about what is going on. Good start for you to begin testing this early - I didn't start until I was about two years along on this journey.

          There are many good foods out there but the most important thing is to have a food your dog eats willingly and consistently(hopefully enthusiastically). Vet prescription food is certainly not required.

          I give both of my dogs salmon oil because I have a schnauzer(not diabetic) and I have heard it will lower triglycerides since they are prone to those and diabetes. My diabetic dog Maggie is allergic to the world so it helps her with her coat and skin.
          Maggie - 15 1/2 y/o JRT diagnosed 9/2007, Angel status on 6/20/16. Her mantra was never give up but her body couldn't keep up with her spirit. Someday, baby.......

          Comment

          • #6
            Re: KoKo - New diagnosis

            Just popping in to welcome you, and glad that you took Koko back, and taking care of him.

            Barb
            Barb & Abby 12/24/1999-12/31/2013 ~ dx 5/10/2011 ~ Forever in my heart ~

            Comment

            • #7
              Re: KoKo - New diagnosis

              Morning comparison between the ReliOn Confirm and AlphaTrak2:

              Confirm = 88
              AlphaTrak2 = 131

              Finding a conversion: 88 ÷ 131 = .67 conversion factor

              As I mentioned, I'd do several of these same blood droplet tests to get an average. Meters / blood samples are not 100% accurate, and minor differences are to be expected (take back-to-back tests with your meter and I'd bet the numbers would vary). So far we have: .62 and .67 for an average .65.

              As Amy said, probably the biggest diet requirement is to feed something the pup will eat 100% of the time. The diabetic formulas may not sound very appetizing to us, but some dogs do very well on them. I had not heard of Premium Edge Weight Control II, but I looked it up and it had some pretty good reviews. One minor thought (remembering I'm just a "parent" and certainly not a dog food expert) is the fiber content. Some think higher fiber content helps to moderate big swings in blood glucose. Some add additional fiber to their pups meals. I add a bit of Benefiber (sugar free) and a tablespoon of black beans to increase the fiber. You might not need any additional fiber, but something to keep in mind if KoKo has very wide glucose swings.

              Craig
              Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

              Comment

              • #8
                Re: KoKo - New diagnosis

                Thanks for the welcome, and the meter comparisons!!

                I will leave the dose at 8 Units for now and get some shorter needles - I think I'll feel better if I can give the insulin at a 90 degree angle to the skin.

                I'll do a curve after I get the new syringes and use them for a couple of days.

                I picked the food as its carbs were all low GI types: barley, oatmeal and brown rice, as opposed to potatoes or white rice. The protein and fat were at least close to where I wanted them. I used the recommendations of Linda Freeman's "Beyond Insulin Therapy", University of Queensland when looking at food formulations.

                Can you tell I used to do medical research for a living?

                Comment

                • #9
                  Re: KoKo - New diagnosis

                  Originally posted by Juulz View Post
                  2) Buy some 5/8" needled syringes so I can inject him at a 90 degree angle - this 45 degree stuff is wreaking havoc on my confidence and I'm a Med Tech for heaven's sake !
                  I'm not sure what trouble you are having with your syringes. Do you think the needles are too long? Many of us use 5/16" (8mm) needles from Walmart.
                  http://www.relion.com/diabetes/syringes
                  I'm using the ReliOn 3/10ml capacity, 31 gauge, 8mm length syringes. They are about $12 for 100. I've seen advertisements that BD has an even shorter 6mm needled syringe, but that would be almost too short for me. BTW, I use a small battery powered grooming razor weekly to thin out a strip in Annie's fur to inject into. I like to be able to see skin when I inject.

                  I know you are using the Walmart ReliOn Confirm meter, but are you using the ReliOn branded Novolin-N insulin? That's about $25 at Walmart, compared to $80+ at other pharmacies.

                  Craig
                  Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

                  Comment

                  • #10
                    Re: KoKo - New diagnosis

                    Originally posted by CraigM View Post
                    I'm not sure what trouble you are having with your syringes. Do you think the needles are too long? Many of us use 5/16" (8mm) needles from Walmart.
                    http://www.relion.com/diabetes/syringes
                    I'm using the ReliOn 3/10ml capacity, 31 gauge, 8mm length syringes. They are about $12 for 100. I've seen advertisements that BD has an even shorter 6mm needled syringe, but that would be almost too short for me. BTW, I use a small battery powered grooming razor weekly to thin out a strip in Annie's fur to inject into. I like to be able to see skin when I inject.

                    I know you are using the Walmart ReliOn Confirm meter, but are you using the ReliOn branded Novolin-N insulin? That's about $25 at Walmart, compared to $80+ at other pharmacies.

                    Craig
                    Yes, I am using Novolin N from Wal-Mart

                    The vet recommended 29g 1/2" needles... I think these are my problem. I'm going to get some 3/8" 8mm needled syringes when I go to get more lancets as I'm almost out of those.

                    Question: on a human, you bunch the skin and inject perpendicular to go subQ... on a dog, is the subQ layer attacked to the skin when you

                    The fur is long enough to part to see skin so I don't think I'll have to shave him. (I sure hope not, because Eskie fur never grows back quite the same if shaved to the skin!)

                    Comment

                    • #11
                      Re: KoKo - New diagnosis

                      Hi!

                      My dog has loose skin, so I just pull up the skin, and stick the needle under the area I've pulled up, dispense and pull out. I don't worry too much about hitting a particular layer, but I try to avoid hitting any meat.
                      Zoe: 12 yr old Black Lab/shepherd mix. Diagnosed 6/1/11. Currently on 15 units Novolin NPH 2x day, and hopefully as close to regulated as possible. Feeding merrick Grain Free Salmon and Sweet Potato. Weight 63lbs.

                      Comment

                      • #12
                        Re: KoKo - New diagnosis

                        I sort of change technique from time-to-time. I'm currently pulling up a bit of skin (a tent) and inject vertically straight down into the top of the "tent". Other times, I make the "tent" and go through the side at a slight downward angle (using a 8mm needle). I remember a few years ago when we were using long needles, I went through the tent and squirted on Annie's side / back a few times.

                        Craig
                        Last edited by CraigM; 06-13-2013, 08:36 AM. Reason: added "8 mm needle"
                        Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.

                        Comment

                        • #13
                          Re: KoKo - New diagnosis

                          here is a picture I've copied and saved from someone else. I know Natalie posted once that her Chris didn't like the feeling of skin being "tented" so they just did a perpendicular thing with him.

                          whatever works. just avoid a vein. Patty had a horrifyingly scary experience with Ali when the insulin went right in.

                          Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.

                          Comment

                          • #14
                            Re: KoKo - New diagnosis

                            Thanks for the tips... So many years taking blood, I always had something to aim for, I guess this feels so blind.

                            Comment

                            • #15
                              KoKo... Curve in progess

                              KoKo's curve... in progress:

                              Glucose tested with ReliOn Confirm glucometer.
                              KoKo 43.5 lb
                              1 cup = 305 kcal

                              19:05 245 1 cup food
                              19:30 8 Units Novolin N
                              20:54 144
                              21:56 196
                              23:05 444
                              .
                              .
                              .

                              07:42 259 1 cup food
                              08:15 8 Units Novolin N
                              10:28 221
                              11:39 229
                              12:25 320
                              14:27 287
                              16:50 121
                              18:30 148 (Normal dog: 86)
                              19:27 128 1 cup food
                              20:10 8 Units Novolin N
                              21:09 332
                              22:46 308
                              Last edited by Juulz; 06-20-2013, 08:11 AM.

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