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  #11  
Old 11-23-2008, 05:38 PM
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Default Re: My Ali girl and question about basal insulins

Thank you all for the welcome!

Kathy, Thank you for the information! You did a lot of work to find all of that! I did know about the difference in potency between dogs/pigs and humans.

I also know Peggy and have talked to her about Molly's use of Levemir. I've been looking for other dogs as well on this insulin. She did say that the potency factor was an issue with both Molly and Kramer. It is about 4x stronger because of the increased concentration.

A few of the differences: Ali is a larger dog, a lot more active and Molly has atypical cushings. I'd like to know how an active dog does on a basal insulin. I know when Ali catches her ball, greets family, or see the UPS man she can drop almost 50 points.

When looking just at Levemir and Lantus: The pros and cons I see...
Lantus I've been told can sting because of the pH factor
Lantus has been used more in dogs than Levemir
Levemir is said to be a more predictable profile than Lantus and more predictable between individuals and their particular metabolism (humans)
Levemir may be harder to find the right dose
Both are expensive!

And you are right, I won't know until the UTI is gone. The 5 nuggets this afternoon put her into the high 200s preshot, then she rises from her meal above that. So I need to keep working on the tweaks. Her pattern changes so easily. We were having duration issues before. Now she is in the low 100s preshot. I may try adding a grain to her 2nd meal to see if that will keep her from going too low late afternoon.

Another question, has anyone here used expeller pressed coconut oil in their diabetic dog? My holistic vet talked to me about this in trying to help Ali gain some weight. I know it needs to be done very slowly. It is one of the 'good' fats that apparently doesn't need insulin to 'unlock the gate' in order to be used by the cells.

Thanks,
Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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  #12  
Old 11-23-2008, 09:55 PM
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Default Re: My Ali girl and question about basal insulins

She gets two injections of NPH, yes?
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  #13  
Old 11-23-2008, 10:41 PM
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Default Re: My Ali girl and question about basal insulins

Hi Patty,

A few thoughts... (congrats on great numbers, by the way - looks like the UTI is clearing!)

Hmmm... the food has some pretty sugar rich foods as its main vegetable is carrot and fruit is watermelon plus little fiber, which it seems like Ali could use. The lettuce and broccoli aren't going to provide much in the way of glucose when they get digested, which probably occurs later in the cycle.

Quote:
Northwest Naturals™ Bison
INGREDIENTS: Bison heart, Bison liver, carrots, romaine lettuce, watermelon, broccoli, Bison kidney, ground Bison bone, flaxseed, safflower oil, garlic, dried kelp, inulin, salt, potassium chloride, fish oil, parsley, apple cider vinegar, ginger, zinc proteinate, iron proteinate, copper proteinate, manganese proteinate, mixed tocopherols (as preservative), rosemary extract, Vitamin E supplement, Vitamin D3 supplement

Guaranteed Analysis (as fed):

Crude protein10.0% minCrude fat8.0% minCrude fiber1.5% maxMoisture72% maxCalories299 kcal per 8 oz. approximately 40 nuggets or 1/2 of a dinner bar
When Chris was on a higher fiber kibble that had a larger share of carbs, he actually got a boost of glucose from that kibble later in the day - something that would help Ali.

On canned food (chicken as the first ingredient and rice as the only grain) he digested the food a lot faster.

You might try adding a complex carb. Again, it's impossible to say what Ali will do with it. Some process oatmeal very quickly. Others slowly. We originally tried adding kibble to get a boost of blood sugar early and got one late instead.

Once we went to the Canidae/California Natural, we were happy with the diet and so we lived with a postprandial rise as all his numbers were still in a very good range.

In the interim, I agree that you should try giving that in-between meal earlier. You want to get it going in before she bottoms out so that it's turning to glucose when she needs it. From this curve, at least, you're waiting until she's well into a drop already. Giving the additional food sooner should give you better balance and less of a rise late in the 12-hour period.

It can be difficult to aim for tight control AND be able to leave them alone / avoid feeding interim small meals. Ultimately, sometimes... and I'm not saying Ali is there yet... it's just better to run their regulation a little looser. We had the benefit of mostly being home with Chris but definitely on days we couldn't do that we would let his numbers run higher for his safety. There comes a point with some dogs where they just can't be kept at really tight regulation cuz they bounce around, throwing a low day not once a year but once a week or two weeks without any warning.

I'm not sure what Ali's curves looked like on other foods... that may give you some clue to how tweaking the diet would affect things.

Natalie
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  #14  
Old 11-23-2008, 10:42 PM
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Default Re: My Ali girl and question about basal insulins

Is there scheduled exercise in the curve somewhere? That could make a big difference in the levels.
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  #15  
Old 11-26-2008, 01:26 PM
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Default Re: My Ali girl and question about basal insulins

Hi Natalie,
Sorry it's taken me so long to get back. A lot going on here.
Some answers:
You're right. She is on 2 injections

I keep a really detailed journal of exercise, food, potty times, etc. It's actually a bit overboard, but I started it when we were having trouble and it's helped me sleuth out some issues. She typically gets some exercise in the way of catch, frisbee, or a walk in the morning and early afternoon before her insulin has worn down. No heavy sprinting with this though. And I try to keep it pretty consistent.

Lately, she's been running high. My husband is home (long story...we've been waiting for housing on a military post and have been apart for a bit) so what with traveling into and out of town to visit family, her schedule's a bit off.

I have been looking into BRAVO's formula for food. They have the option of getting the basic meat, organ meat and ground bone. Then you add the veggies and carb/fiber. I know of another person feeding this food and it's been working really great for them. I just can't get it around here. Once we move I should be able to get it in NY though.

I really hate to go back to kibble. The Wellness reduced fat CORE worked for us for a while but her ears were flaming red on it. I really think it's the grain proteins she doesn't handle well. I will keep tweaking things 'til we get it! But I also know this next month will be a bit rocky as we'll be moving soon.

Thank you for your input. Once she's out of the woods with the UTI and we are settled, I am going to try to regulate with what she's currently on. If that doesn't work then I'm going to try the BRAVO so I can get away from the higher glycemic carrots/watermelon in her food. If I can't get that tweaked, I may consider the Levemir. I really think the raw food is a huge benefit for her allergies and it just seems like it would work better with a flatter profile insulin.

Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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  #16  
Old 11-28-2008, 11:03 PM
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Default Re: My Ali girl and question about basal insulins

The Bravo sounds good.... the way I understood it, you could customize the carbs and vegies with it, which would be ideal with a diabetic dog, being able to experiment to find what combination works best.

Journals are worth their weight in gold! Glad you're keeping a detailed one.

Sorry there's so much turmoil in your life at the moment... I know everyone will be happier when things settle a bit.

Natalie
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  #17  
Old 03-07-2009, 12:11 PM
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Default Update on Patty's Ali

Hi all. I haven't posted on Ali in quite some time. This was our previous thread for some background http://k9diabetes.com/forum/showthre...hlight=levemir when I was looking into changing insulins.

We are still using Humulin N and have had some tweaking going on with Ali’s food/insulin match. She’s on a raw food diet that is 85% pheasant 15% produce with strict no grains (they all left her miserably itchy) to help her allergies, so it’s a challenge to match the insulin without the typical carbs to carry her through. I found that pumpkin didn’t carry her through the low and left us with 300-400s preshot.

She has had times where she dips too low during the peak of her insulin. If I back off ¼ unit, she runs too high for most of the day. If I move up her second meal so it’s there to prevent the drop, she starts running in the high 200s consistently. She’s quite a bouncer. So I’ve been playing around with what will keep her more on the level.

I’ve found blueberries seem to be the magic food for us. I cut them in half when I give them to her or she swallows them whole and they come out looking the same way they went in

Here’s some of our playing around when she’d dropped low:
2/28
156 6:00p Food/insulin
74 10:20p Next meal + 4 blueberries
71 10:55p
99 12:20p
244 6:15a
4 was too much

3/4
195 6:05p Food/Insulin
163 10:00p 2nd meal + 1 blueberry (1 was not enough, too low in the morning to inject)
3/5
99 6:10a Food – waited to inject
194 6:43a Insulin
156 10:30a 2nd meal + 2 blueberries (2 seems to be the magic number)
148 4:40p
202 6:20p Food/insulin

I’ve been able to duplicate these numbers without the previous low. I’m hoping they continue!

I'd talked to Natalie about this the other day...I recently spoke with Ali's vet about doing the ACTH stim test (full adrenal panel) on Ali to tell us where her reproductive hormones are. Ali has had vulvar itchiness ever since soon after she was spayed. It was always considered part of her allergies as this is where she comes in contact with everything, but it has been suggested perhaps the enlarged vulva is due to another endocrine disorder or maybe even an ovarian remnant.

It is an issue because she wants to scoot when outside and lick if I’m not watching. And, now with the diabetes, this can create big issue with UTIs. I actually have to put a T-shirt on her when we leave the house to keep her ‘quiet’. The question becomes if she tests positive, what would we do about it? Melatonin is one suggestion that may help. Our vet didn't think she wanted to go with the typical drugs just looking at her. She doesn't have any of the typical symptoms of a cushnoid dog. If there’s an ovarian remnant, surgery is the only option to remove it and I won’t put her through that. She’s been on just about every antihistamine out there. We’ve changed foods numerous times. She’s on fish oil to reduce inflammation. I’ve decided it would be worth it to rule out a hormonal issue. My vet is going to call us Monday to hopefully set it up for the following Monday.

Natalie, I know Chris was sensitive to many things. Did he or do you know of other dogs that have had an adverse/allergic reaction to the ACTH stim gel? We were planning to use the gel intramuscularly as I've heard there is less of a chance of reaction than doing it IV. Any long term effects anyone knows of?

Thanks,
Patty
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Patty and Ali 13.5yrs 47lbs diagnosed May '08 Ali earned her wings October 27, 2012, 4 months after diagnosis of a meningioma ~ Time is precious ~
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  #18  
Old 03-07-2009, 01:11 PM
Ginny Dudek Ginny Dudek is offline
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Default Re: Update on Patty's Ali

Looks like you're doing a fine job of tuning Ali. I know that home testing made a world of difference for my Starz. Starz had a very healthy lifestyle living with diabetes for many years, and then suddenly died from stomach cancer. Today I'm watching a friends diabetic dog. With 2 babies in the house, they've been overwhelmed. I used to lip test my dog, because she was easy to test that way. Sherpa is not so easy, so I'm testing calused spots on him.
Ginny
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  #19  
Old 03-07-2009, 03:10 PM
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Default Re: Update on Patty's Ali

Hi Patty,

I'm gonna merge your two threads after I post this - we like to keep everything together!

Chris did not have any reaction to the ACTH stim other than significantly elevated blood sugar for about three days afterward. It seems to me that some folks have had concerns after the test with their dogs but I am not certain about that.

The better place for your question about ACTH reactions is the Cushings forum...

www.caninecushings.net

I don't think there's a delay there in signing up and posting. But if there is let me know and I will post the question for you. There's tons of experience there with ACTH tests so they could be much more helpful.

Natalie
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  #20  
Old 03-07-2009, 03:40 PM
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eyelostit eyelostit is offline
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Default Re: Update on Patty's Ali

Hi Patty,

I did have success with Orijen adult with putting some weight on Niki, I've been using it for quite some time, it has potatoes and sweet potatoes in it, but i use veggies and turkey with it, and prev maybe some br. rice or other dog food.

If you look at my last post today I was weaning Niki off some Orijen and adding Nutro Senior (her old standby food), I believe the Orijen is good and I think we needed abit more insulin for that with the potatoes and fruit in it.

Sorry Ali has allergies, just a thought, I don't know if Ali would be allergic to this.

Take care
Dolly
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Dolly & Niki passed 2010, 45 lb Border Collie Mix 8 yrs as diabetic, 13yrs old. Blind N 10.5 U 2 X * Dog is God spelled backwards*If there are no dogs in Heaven then when I die I want to go where they went. Niki's food Orijen & Turkey & Gr. Beans, See you at the bridge my beloved & cherished Niki, I miss you everyday
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