hind leg weakness

[Raysaint]

Hello everyone, my bio will tell you the basics of my dog's situation right now. I have questions and am interested in feedback, however, being newly diagnosed we are just getting into the routine and haven't did our first curve yet, so I won't barrage the group with all my questions now. Some things may iron themselves out. Being from Canada I use the mmol/L but I'll put the U.S. numbers in brackets.
My first curiosity though, is his overnite sugars. He had some high pre- supper fasting BG for 3 nights, 25/30/28 (450/540/510), he ate a full can, I gave him a full 4 units of NPH (which may be a conservative dose right now) and his pre-breakfast BG next morning was not bad, low teens (216-300) The last 2 nights, pre-supper BG was 19/22 (342/400) and his morning fasting BG was unchanged. Why no decrease? I can't believe it was Somogyi, so a liver dump maybe, but why not the previous nights. History doesn't seem to be a good predictor of future BG. p.s., his daytime BG he usually ends up higher at supper than what his morning Bg was, but a curve or 2 will figure that out.
Looking forward to being a part of this great forum and all working together to keep our pets healthy.
How do we add a photo of our pet beside our forum name?

[jesse girl]

Re: Forum newbie, new diagnosis

hi and welcome

my jesse has been diabetic for 7 years and i still could not guess for certainty what her numbers would be before i test sugar . now her sugar is adequate and is good for her health but its a bit unpredictable and always has been and i think people that do test sugar everyday can see similar results

maybe just maybe your pup will be very predictable as far as sugar . some just give a shot and sugar is just super steady but i think thats kind of rare

My personal opinion i think many dogs end up on a dose thats maybe to much but the body is able to compensate for that .the only evidence you might see is a higher fasting or spike off a lower trend but thats ok as long as the body can keep up with active insulin supplying sugar to calm the strength of insulin you dont need to find that perfect amount . its possible one days need for insulin maybe different from another . from what i see the body does a good job at keeping our dogs safe and actually on the forum its rare to see a hypoglycemic event in any of the dogs here .it is a testament to the care they get but also the body and the natural process working to preserve life


think about how difficult this must be for the body to adapt to this new reality of injected insulin far different from the natural process

if the body dumped sugar and hormones into the system off a lower number or maybe just not comfortable with the dose you could see some resistance to insulin for a couple days until the sugar and hormones are depleted and injected insulin starts working on sugar again . at first its seems to have no pattern but looking closer you may see the pattern maybe happen with resistance for 2 days than resistance broken on the third day with numbers moving lower then bounce back up and the cycle begins again

sounds like your off to a good start everything out there is just a theory or opinion we cant know whats really going on in the body but we can test and make educated decisions on how to move forward. the key is keep your mind open and dont get to ridged in your thoughts what you may believe today may not what you will believe tommorow

[Raysaint]

Re: Forum newbie, new diagnosis

And being diabetic myself, I am looking at his situation thru my perspective and experience, and I'm learning I can't do that.
Thanks. It's good to hear others feedback as it helps me broaden my knowledge and perspective. I guess I want this to be too scientific, I'm a guy.
(BTW, I figured out the signature thing, but profile photo of my dog won't upload))

[Riliey and Mo]

Re: Forum newbie, new diagnosis

hi and welcome

can you tell us what meter your using?
how much does your dog weigh?

I think I have an extra alpha track 2 dog meter around. I.all go look for it.

food feeding goes by weight also. maybe check the mfg feed guide. a full can of food might be too much for a multiple.

my dogs a cockapoo 20 lbs eats 1/2 cup twice a day followed by 5 units of mph

your doing great

mo

[Raysaint]

Re: Forum newbie, new diagnosis

Using alpha track 2. He eats a can in the morning and one at supper time. He weighs about 22lbs., he lost a couple pounds a few weeks ago.
Doing his first curve tomorrow, and I think we'll find he is under dosed. 4 units was a conservative starting point.
So far, his pre supper bg is always higher than his starting bg for the day in the morning. And overnite, he only comes down a few points when I give him slightly more than 4 units. But that isn't the case during the day, so his daytime dose probably needs a bigger increase than night does. Insulin resistance, maybe, he is hypothyroid.
I'll get back to everyone after his curve tomorrow, that should start to tell me a little bit.
thanks.

[amydunn19]

Re: Forum newbie, new diagnosis

Welcome to you! Sounds like you are off to a pretty good start. Dog diabetes is not going to be one of those things that makes sense most of the time. I found even after almost 9 years, I still could not always explain some of the highs and lows. If our dogs could tell us how they feel, it would be real easy to figure out. So, we have to rely on supposition and sometimes we have a tendency to make connections that might not always be there. At least, that is what I have found. Since you are just starting out, keep in mind that his body may still be in an adjustment period.

Consistency is key to success and home testing is really necessary to figure it all out. So, you already are ahead ! You can go ahead and do a curve at home with the meter you are using. It is never too early to gather information.

Four units would be a standard starting dose.(1/5 unit per pound) - conservative is the best approach. The hypothyroid issue is a contributing factor to resistance so why is there a delay in starting meds? The problem with delaying is that when you do start thyroid meds, the insulin dosage may dramatically change. You are seeing some change in bg, which is a good sign. Resistant dogs usually just stay high all the time. Night time numbers will be different as activity levels are so different. Maggie always got more insulin at night than during the day.

You are still really early in the process - regulation takes time. Just try to stay as consistent as possible with food times, amounts, shot times and units. Don't try to use intermediate insulin in a reactionary way. Some people see high numbers and will try to tweak their doses to accommodate and you can get on a roller coaster. It is best to weather those high numbers until you can establish whether it is a real pattern with a curve or a one time thing.

[Raysaint]

Re: Forum newbie, new diagnosis

thanks for your encouragement. Yes, expectations don't seem to add up.
Doing his first curve today, started at 9.2 (170)this morning, rose to 25.4 (450) by 10, 16.5 (300) at noon, 20.5 (365) at 2. So he seems definitely under dosed during the day.
A tad over 4 units brings him down a few points overnite, from pre supper bg to morning, which seems odd, knowing that there should be a nadir during the nite and then a slight rise. This morning being at 9.2, I wonder if he went lower than that overnite, seems more like a slow steady decrease after post prandial rise.
So far his daytime curve seems more like a bowl, we just have to get it all lower. But a tad over 4 units during the day doesn't do the same as overnite. So he may need a different daytime dose than night dose.
The internal medicine specialist said he knew of no link between hypothyroid and insulin resistance, we will see. Starting the meds tomorrow, so I will be careful with the vet's recommendation for insulin increase. The meds can take a while to change their metabolism.
Anyway, we'll get there.

[MikeMurphy]

Re: Forum newbie, new diagnosis

Hi and welcome to you and Riley.

It looks like you are on the right path to regulation. After each increase in insulin, let his body adjust to the change and then reevaluate with a curve after 5-7 days. Some dogs can take up to 2 weeks to adjust to a change. Also, many of our forum dogs have different am and pm insulin doses.

As far as the hypothyroidism goes, just be aware that once on the thyroid meds, his insulin requirements may go down. My Lily is also hypothyroid and her insulin dose went from 29 to 18 units of Novolin N after only a week after starting her thyroid meds.

It doesn't look like Riley is insulin resistant because, based on his current BG numbers, the insulin is working, even with him being hypothyroid. Our IMS pointed out to me that hypothyroidism can indeed cause insulin resistance in diabetic dogs. Here's an article by Dr. Peterson on the subject...

http://www.endocrinevet.info/2012/07...esistance.html

[Riliey and Mo]

Re: Forum newbie, new diagnosis

i.m thinking its the food big swing from 9.2.

could be overfeeding. could be the wellness disagreeing and not matching up with the insulin. i.ve seen the wellness brand not working and peeps changed food.

theres alot of food choices low fat. low protein.

i test my dog half hour after feeding to c how high his bg goes then an hour and a half after his shot to c if the food meets uo with insulin.

[amydunn19]

Re: Forum newbie, new diagnosis

I think insulin doesn't have the same action over night because the activity level and anxiety level are possibly different. But, we have dogs on the forum that are higher in the morning. Maggie typically started her day a bit lower than one would expect. You would expect after 12 hours the insulin would be long gone but that is where the dog's individual metabolism might come into play.

Many times, we see unexpected curve shapes and people tend to worry if it is not standard textbook curve. But, dogs don't all go by the book. As Craig always says, they can't read those books.

[Raysaint]

Re: Forum newbie, new diagnosis

yes his post prandial rise today, from 9.2 to 25.5 2 hours later is big, and then he dropped to 16, now he's back in the 20's at 4:00p.m.
But at dinner time, his bg can be in the teens, he'll have that big post prandial rise (maybe up to 30?) but then he seems to slowly continually decrease and have bg of 10 or 11 in the morning. That doesn't happen at all during the day, as you can see in my first sentence above.
Daytime insulin probably needs to increase.

[Raysaint]

Readings don't make sense

His first curve last Sunday showed he was too high all day so we have increased daytime insulin to 5 units. I was afraid to increase overnite dosage because generally overnite he comes down a few points from his pre-supper BG the day before. His morning BG isn't great so I want to increase it a bit; it's about 4.2 units now. But if his pre-supper BG gets better, then 4.2 might be sufficient.
But this morning his Bg was 26.1 (460), up from last evening pre-supper of 18 (325). That warrants a good increase, but how can I confidently increase his overnite dosage when these inconsistencies happen. Most nites he comes down, but some he goes up or remains the same.
Somogyi? dawn phenomenon?

[jesse girl]

Re: Readings don't make sense

hard to tell what to do without a full curve displayed . my jesse early in her dx could go from 500 down to 70 and back up to 500 in 6 hours . if we only tested say at fasting and at mid day we would have increased the dose but actually we should have been reducing it

you could do an overnight curve to see exactly whats going on

[Raysaint]

Re: Readings don't make sense

I would worry about just doing one overnite curve, being that his overnite bg is so inconsistent. If their is no predictability or consistent insulin action, it is hard to determine a regular overnite insulin dose.
And then, with his morning bg all over the map, it makes it hard for his daytime dose to do it's job, and maintain good pre-supper bg. Whoa is me.

[Raysaint]

AlphaTrak false reading, beware

Doing a curve yesterday, our dog is still high as we haven't finalized his dosage. Anyway, at one point I checked his bg and the meter said 5.6 mmol. I thought that odd, so did another with better blood drop and it said 18.2, which seemed right.
I know the meter needs a small drop but if it beeps and starts its reading, it should only do that if there is enough blood, and if there is enough blood to make it start, it should be able to give a correct reading.
So now I'm nervous about future readings. How do I know if the blood drop is big enough for a correct reading.
Kind of scary. Is this normal?