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  #101  
Old 08-25-2009, 10:27 PM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Patty- very scary! You did a great job to pull Ali out of that hypo.

Before I finished reading your odd-ball injection post, I was going to say something about its being safe to give a second injection if it's so obvious how much is left in the syringe after the first effort.

Also, my vet had mentioned to me that if the injection just wouldn't go, or was very difficult, it was possible I was into muscle. And a few times, I've pulled the needle out and reinserted as you described in your post.

Guess we're lucky; Kumbi hasn't had a hypo yet (dx 1 Sep 2006). I hope he never does.

But you REALLY kept your head and did what was necessary; good for you. Hope Ali is recovering okay now. Thanks so much for your very informative posts.

Tue, 25 Aug 2009 22:26:46 (PDT)
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  #102  
Old 08-26-2009, 10:24 AM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Oh my gosh Patty... how scary!! I'm so glad you're a veteran and knew just what to do. And especially happy to hear that she came through it well.

Sure sounds like it went into something other than SubQ.

I'm thinking that it might be wise for all of us who have diabetic dogs to consider not giving the rest of the injection if something like that happens. Maybe just go on the assumption that it has gone into muscle or a blood vessel and so will have a strong effect and at least wait a while to give the rest.

Since I know you tend to beat yourself up, I want to make doubly certain that you understand that I am NOT criticizing what you did! Not even a little. This is a situation that I never encountered or have seen encountered in five years online with canine diabetes forums. I am sure I would have done the same as you - figured the syringe was the problem and injected the rest.

Looking at what you have written, though - and thank you so much for sharing this experience with everyone here - if I was still caring for a diabetic dog I think I would be more conservative in the future and not give the rest of the insulin just in case it did go into muscle.

I hope Ali's blood sugar is getting back to normal. It definitely could take a couple of days.

Natalie
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  #103  
Old 08-26-2009, 04:10 PM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hey Natalie,
I really did think it was syringe related at the time. I just can't imagine with the skin I had and my short needles I was in muscle, but I had to have been in something to get that fast of a response. Nothing else makes sense.

Being more conservative in the future is a very good lesson! I've also switched back to her left side. I'm a bit nervous about that area now.

I left her on 9u with her bgs being 400. She was 270 this morning so I dropped her a 1/4u. I checked her before I ran errands today at 1:30pm and she was 236. She's 260 tonight.

She's still so itchy. I gave her 1 Benadryl today but really should've given her 50mg. I'll do that tonight. She has all the classic signs of her reaction to other foods, like the oatmeal and buckwheat. Poor girl's practically chewing the pads off her feet. I'm worried it's the rice I'm using and I just don't know what I'll replace it with if that's the case. We've tried so many different things.

We are heading home to visit family next week. I'm hoping things settle down for her by then. She'll be coming with us so her schedule's going to be off for a while.

Never a dull moment!
Patty
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  #104  
Old 08-27-2009, 01:38 PM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hi Patty,

Hoping things settle down for Ali and you can enjoy the visit with your family. Have a safe trip. Hugs to you and Ali.
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  #105  
Old 09-04-2009, 06:09 AM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hi Patty
How scary! I only had one time that Audy had a low blood sugar episode and it was short. That was scary enough. You must have been a nervous wreck. Thankfully, you knew what to do and Ali is is fine. You did great!

I hope you and Ali are doing well and enjoy your Labor Day weekend!
Anna
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  #106  
Old 09-18-2009, 11:01 AM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hi all,
I'm needing some of your experience and thoughts if you don't mind.

We've been busy. Had a trip home to IL that was pretty rough on Ali this time. She started with the "itchies" before we left and they got progressively worse. She's on 50mg Benadryl 4x a day. I had to take out the rice from her food.

We met with the vet who does house calls for an hour a little over a week ago. We again talked about Lantus since we've had such a time finding a food that works for Ali and she doesn't show allergic symptoms to.

We decided now is the time to try it if we're going to while my husband is here to help. If it doesn't work, we can always go back to N and keep trying different foods. But Ali hasn't been stable for more than 2-3 week intervals before she starts her pattern of dropping due to the food-insulin match.

We started yesterday. She seems to get a 16 hour-ish duration out of it.
I did contact Margo for help since her Alex was on Lantus as well as Carla with Grams. It was advised to give her 6 units (she was on 8 of N) with food in am, feed 2nd meal at 4hours as usual, then withhold food in the evening to get an idea of duration of the insulin before bg turns upward - since Lantus has the potential to last 24 hours.

So once I see 2 tests with increasing numbers, I'd know the insulin is wearing off. Then if that occurs before hour 15, feed the evening meal and give a reduced dose of insulin (by maybe 1 unit because of the delay) and start with twice a day shots the next day. Well she lasted until hour 16 so we rode it out until morning.

Our vet initially recommended giving 1 shot and feeding all her meals on time as a "normal day" to see what duration was. But I would have had to wait through a possible rise to see if, once the food was digested, several hours later the insulin still brought her down. And, if it didn't, she'd continue rising all night even higher than she did. I couldn't put her into the 500s.

Here were our numbers:
Thursday
247 6:30 a.m. fed 4.5 oz Pheasant injected 6 units Lantus
359 7:40
345 8:48
375 10:15
10:40 fed 6-5/8 oz Pheasant + supplements
367 12:40 p.m.
341 2:42 Hour 8
330 4:50
318 5:43
301 6:40 Hour 12
283 7:42
286 8:23
283 8:47
264 9:45
304 10:42 turning upward Hour 16
369 12:35am
405 3:56 (3am - very uncomfortable, lip smacking rest of morning)

Friday
406 5:27 ketones negative, Fed an hour early and 1/4 of 1st meal (1-1/8oz) with 6 units insulin to avoid high into the 500s
394 6:39
7:00 fed rest of 1st meal (3- 3/8oz)
382 9:40 Fed 2nd meal
345 1:40 Hour 8

We've determined she needs 2 shots. Now the question is with the lower numbers in the evening and extended duration through hours 11-15,
Do I give her a reduced dose at 6:30pm tonight (my vet and I were thinking 6u may be too much with the overlap)?
How much? Like 3 or 4 units?
Then start with 5u am and pm tomorrow to avoid so much overlap and let her settle into that dose to start?

I don't think she'll get the rise she did the first day again as long as there's some overlap going on. She was working off of little to no insulin that morning.

Any thoughts? I know the trick with Lantus is balancing any overlap. Hopefully we can get it worked out. Despite the difference in this morning's start, hours 4 and 8 have lined up well.

Thank you,
Patty
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Last edited by Patty; 09-18-2009 at 11:06 AM.
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  #107  
Old 09-18-2009, 05:23 PM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Well, she was 340 at shot time so I gave her 6 units. An hour later she was 339. So far it doesn't appear the overlap question is an issue nor a big rise. She's just running high after last night. Hopefully that will come down as she settles into the dose.
Patty
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  #108  
Old 09-18-2009, 09:16 PM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

The overlap may not be an issue but if it is you could actually do a 16 hour schedule. I worked it out on paper and it's not too bad since every three days the pattern would repeat and you don't have to do any really awful times.

Like you could do Day 1 - 3pm, Day 2 - 7am, Day 3 - 11pm.

And then repeat that pattern keeping track of it on a calendar. So one injection every 16 hours.

It's a really nice flat response!

Natalie
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  #109  
Old 09-19-2009, 06:03 AM
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Hi Patty,

Sorry to hear that Ali is having some problems. I don't have any advice for you - we never used lantus but hoping you get it all sorted out. Hugs to you and Ali.
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  #110  
Old 09-19-2009, 11:32 AM
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Patty Patty is offline
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Default Re: Patty's Ali - Happy 10th Birthday Thursday July 9!

Thanks Lynne and thanks Natalie for working that out. That's the part I have a hard time wrapping my head around.

So far it hasn't been an issue but when we get to the point of increasing we may have more of a problem with the overlap. It's definitely uncharted territory.

Here's how we look Fri and Sat. She's still riding flat in the 300s.

Friday
406 5:27 ketones negative, Fed an hour early and 1/4 of 1st meal (1-1/8oz) with 6 units insulin to avoid high into the 500s
394 6:39
7:00 fed rest of 1st meal (3- 3/8oz)
382 9:40 Fed 2nd meal
345 1:40 Hour 8
339 5:50p (working back into our 6:30 schedule) Fed, Gave 6u
340 6:50p
285 9:50p Hour 4 Fed 2nd meal
290 10:40p
362 1:58a Hour 8
Saturday
338 6:30a Fed, Gave 6u
370 8:15a
341 10:40a Hour 4 Fed 2nd meal
1:30p - Ketones neg, Glucose 2000+ mg/dL
367 2:30p Hour 8
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