my girl Cari

[mygirl]

My Cari was diagnosed in May 2015. Her sugar tested through the roof and he took her back immediately. She walked in, not blind with a slight cloud in her eyes and 3 days later she could no longer see without being led. The diabetes he said was under control, all I have to do is give her this shot once a day and feed her 1/2c Science Diet W/D twice a day, two treats of 1 tablespoon wet food at a time in between whenever I want. He showed me how to give a shot, and then watched me stick her. I sucked it up, swallowed my fears and stuck her. She did not flinch, she has always made things easy. The guilt and fear of her being blind was far more concerning. I thought the diabetes was regulated now, I just give the shot once a day. I am very happy to say that she did react well and did stay that way, until this week that is. I noticed that she had lost weight. I check her weight often because she is so tiny. She had lost another .6, that was a total of 1 lb in the last 2 months. Even though I had bought the Alphatrak II immediately when I found out, so I could check at home if I needed, I hadn't attempted a curve yet myself. I decided it was time when her weight dropped. I am so glad that I had this site to help me review common topics over the last months of her disease, from food to treats to emergency treatments, I have been here educating and making adjustments. So I started the curve. Unfortunately I had fed and given her injection before I weighed her. I started the curve then, so I did not get a fasting read. The first read was 4 hours after morning food and injection (1/3c pure balance salmon with 1 tblsp pure pumpkin, injection is 6u Novilin N). Here is the 24 hr read, I need help before my next injection which is in 4 hours. Please respond if you need more information and thanks in advance for your help. I am so tired and scared, I just want to get her regulated again before anymore damage is done to her little body.
Wednesday
2p 81
4p 53
6p 62
8p 212
(10p dinner)
10p 403
12a 537
2a 498
Thursday
10a 433 Adjusted injection from 6u Novilin N to 4 1/2u and fed normal 1/3c pure balance salmon and 1 tblsp pure pumpkin
12p 120
2p 120
4p 80
6p 92
8p 53
10p could not get sample from poor little elbow pad
12a 539

[CraigM]

Re: my girl Cari

Welcome to you and Cari.

I think you can see in your readings that one injection per day isn't working very well. The numbers were too low on 6 units during the first few hours, then the numbers went very high (insulin was used up by that time)

The readings on 4 ½ units looked better during the day, but of course the overnight numbers were very high because of only getting a single injection.

To be honest, I've never heard of any pup getting only one injection of Novolin-N!

If Cari were my girl, I'd think about going to 3 units, twice a day. How much does she weigh?

Craig

[CraigM]

Re: my girl Cari

By the way, don't beat yourself up over her vision. Some pups seem to get cataracts very quickly and there just wasn't anything you could have done to prevent them. Some pups can have surgery to correct the cataracts, you might speak to your vet about the surgery, but it can be $$$.

Most blind dogs do well, it's the human that has the difficulty . My Annie has been blind for over a year and still enjoys chasing a bounced ball and going for walks on leash.

Craig

[jesse girl]

Re: my girl Cari

hi and welcome

it even appears the one dose at 4.5 units is to much and it appears your pup was already spiking before the 10 pm feeding without shot and stayed high without any additional insulin

how much does your pup weigh now ?

[Joan]

Re: my girl Cari

Welcome to you both.

I completely agree with the others, dogs cannot be regulated with one injection per day. I would advise immediately go to 2 shots per day, 12 hrs apart and given right after each of the 2 meals.

It certainly sounds as if your girl is getting too much insulin at this point. Especially when they first start out as diabetics, they can be erratic, and caution is the better part of valor on the insulin dose. As time goes on, this can change, but right now even 4.5/day seems too much to me.

I would start with 1.5 Units with each meal, and see how the glucose levels are with that dose. If still low (under 150 at this point is probably low), then go down to 1.0 each time. Your dog is mostly low, which is unusual and certainly indicates a reduction in insulin. If you find at any point she is below 100, I would give small amt of bread, honey, or syrup and monitor very closely.

Congratulations on the testing!! You are on the right track, and doing great. Reading and learning is the best thing to do, and gives you a basis for making decisions on your pups diabetic needs as you go forward.

BTW you are absolutely correct NOT to feed the W/D diet. With a diabetic dog that is losing weight and underweight, they need more nutrition, and your decision there with the pure balance Salmon is so much better than what your vet recommended.

[amydunn19]

Hi, Cari! I hope you have gone to two doses a day. I would encourage you to seek out a new vet if possible to one who understands diabetes better. I am surprised that any practicing general vet would not know that nph is not a 24 hour acting insulin. At most, you get 12 hours, and that has left you and your dog in such a strange predicament. Dangerously low part of the day and sky high the rest. Long term , you need a vet who gets it.

You can fix it with our help and your testing. So glad you found us. It took me quite a long time to seek help online too. Maggie's first vet was not at all familiar with diabetes. She didn't do curves and I didn't know any better. She had me coming in once every two weeks for a single test. Instead of it being her lowest point of the day, it was her highest so they kept increasing her. An 11 lb dog barely eating on 9 units twice a day. Yikes. I think about it now and cringe. They didn't know she was grossly overdosed until finally one morning, she came crashing down and would have died if my other dog hadn't awakened me. That is when I took control. The first vet said I was making a huge mistake and she wouldn't make it 6 months. She is still here 8 years later.

So, you can do this - you can learn everything and do it all while you find a good vet to help.

[mygirl]

Re: my girl Cari

Okay, let's get to know each other later, but let me start this second post by saying thank you, thank you, thank you!! You don't know it, but you have been with me since the beginning. Anything that was an emergency or suspicious was handled by my vet AND this website. You and the vet have always differed on the amount of injections, but frankly he was her savior when she needed him so I did spot checks and watched closely. . .
Now I have (by Divine intervention) started to do research and take on the responsibility of a perfect curve. (We just got really settled in to blind, oh I had a hard time adjusting, she did great!!) I think I caught her in Somagyi rebound due to overdose for a sustained period.
Per my vet: Cut her back to 5, I read here and cut her back to 4.5 (25%). I called him the next day with the numbers of that and he said to hold at that. I have and she dipped below 100 again today. I have a lot more stats if someone here can help me. I am very afraid now!! I don't like the lows!!!

[CraigM]

Re: my girl Cari

Didn't you try 4.5 units in your first post and that gave some low numbers, and a very low 53?

How much does she weigh?

Still think twice daily injections will be needed. Are the overnight numbers still very high?

Craig

[mygirl]

Re: my girl Cari

Yes, that was before my next feeding and my vet said to hold at that. He said to do 5, I chose to do 4.5. When I posted in the wrong place and didn't get a quick response in time I went ahead and followed his advice. I have been monitoring her and his advice was obviously, while correct to reduce the dosage, not as sophisticated as I would like it to be. Cari is a 12 yr old Cairn Terrier. She is 10.4 lbs. She gets 6U NovolinN at first feeding. She started on Science Diet W/D and I was told my other dog could eat the same-they both developed tumors on their legs within 4 mos. I am not saying it is causal, but. . . She eats 2/3 c. Pure Balance (open to suggestions, as I believe food is life) twice a day with a pinch of Benefiber and a tblsp of pure pumpkin. I do this on a timer at exactly the same time. Frozen green beans about 4 times a day. Frozen pumpkin cubes once a day around mid first 12 hours. This is what I have settled on by studying diet when bg is under control which I thought it was. I don't know what to do now. I am baffled by this new information that I am trying to assimilate. Any help before her next feeding at 10p.m. is so greatly appreciated! Her last two numbers were 61 and 91, respectively. She has now had a dental bone, which is her favorite, I figured if her sugar was low then I would make her carb her favorite. This plus the rice and eggs.

[jesse girl]

Re: my girl Cari

a staring dose for a 10 pound dog is max at 2 units twice a day and sometimes a starting dose is to much as with my jesse

the vet at the time my jesse was diagnosed did well saving her but not very good with managing diabetes . basically reading what we need to do out of his medical book informing us our goal is normal blood sugar. which for most is not attainable so the perfect curve is usually not going to happen . you would like the best that you can do but it doesnt need to be perfect for a dog to do well and sometimes not even close to perfect

it really is quite simple raising the dose to higher sustained numbers and reducing the dose with number below 100 or unstable blood sugar with spreads above 200 points from low to high for the day

[Rubytuesday]

Re: my girl Cari

Hi there, I know your scared and it is hard to trust information that contradicts the doctor, but once daily is rarely the way to go and only after a lot of experience.

The insulin you are using just isn't designed to work on a once daily dosing.
I know it is easy for me to say but here goes: I would start her out at a twice daily dose of 2 1/2 units. This is a pretty standard starting dose.

I treated my dogs diabetes myself with a lot of hand holding from folks here. Not to say that you shouldn't have a doctor with a good understanding of diabetes handling Cari's care, but I don't think this particular doctor has a good understanding of diabetes care. Unfortunately this is more common then you would think.

Tara

[mygirl]

Re: my girl Cari

Thanks so much for breaking it down. I realized that I wanted to avoid those lows for sure, but still confused as to what a second dose tonight at feeding time would do since she already got the initial overdose of 4.5 this morning. I supplemented with the rice and bone when she was low, she is already back up to 395. I tested the Alphatrak and it was a normal 165. Why did it lower itself last night without a 2nd dose if there isn't some kind of half life?
These are her numbers for yesterday at 4.5:
Fasting was 589, OMG!!!!
however this is the rest of the day:
at 1 hr instead of 2 hr intervals:
1 hr- 235
3hr- 125
5hr- 159
7hr- 120
20 hr-542
24hr- 350?????

[mygirl]

Re: my girl Cari

Thank you so much for the kind words of understanding. I know that I have not done very well by my girl. I am trying to fix that now.

[mygirl]

Re: my girl Cari

Oh and finish the Super Bowl, her last numbers were high (394) after the bone and rice. Ugh!! At least crisis averted? She eats again in 2 hrs. I will update post with her numbers in 1 and 1/2 hours if anyone can figure this out. Her numbers today after the 4.5 dose.
fasting= 350
3 1/2 hrs- 181
5 1/2 hrs- 61 OMG!!!
fed rice and eggs and dental cleaning bone
6 1/2 hrs 97
8 hrs 394

and she is running from me again because she hates this testing!!

[CraigM]

Re: my girl Cari

I would do as Tara suggests, 2.5 units starting tonight. The morning dosage will be pretty much out of her system by then.

Craig