Diabetes Now Hypoglycemia-Help

[alleng8304]

I am new to this forum. My Norfork Terrier, a rescue dog, is about 9 years old. In January, He was diagnosed with Diabetes and Cushings disease. He weighs 16 pounds and we started him on 4 units of Vetsulin once daily. (January) We titrated him up to 15 units daily until we got some Somogyi effect. He is also no Denamarin for elevated Liver enzymes and Trilosane 7.5 mg daily. I do occasional bld sticks but mostly use Jorvet Urine strips. About a month ago we came up too quickly and too high on Trilosane and I honestly believe we threw him into Addison's.We almost lost him. That has now been resolved.

He eats 3 small meals a day with broiled chicken and white rice , and some Nutra Senior dog food. eats at 10 am, 5pm and 10 pm. I have now switched to twice daily insulin of 6 units in Am and 3 units 10 hours apart with food. Total of 9 units per day. He is starting to get cataracts in both eyes (so much for Ocu-glow) and hair is thinning. His blood sugar by Urine dipstick is done 3x per day. It usually runs about 100 each Am and slowly climbs up during course of the day. It may even spike up to 500 occasionally. Merck, makers of Vetsulin says that insulin levels will wax and wain (??) Yesterday, different scenario. Urine glucose in am was 100 10 am 150 at 3pm and negative at 6pm and 10 pm.??? I decided to do a bld stick and that was 212.(10 pm) Can the Urine test strips be that inaccurate? He has no clinical signs except hair loss and cataract forming. He is drinking less water. Perhaps a ACTH stim may be able to tell me where his Cusings is. If I can get that under control, Perhaps his need for insulin will go down

What am I missing here?? Thank you

[MikeMurphy]

Re: Cannot Get Ollie under Control

Hi and welcome to you and Ollie.

The normal Vetsulin starting dose for a 16 pound dog would be 3 units, twice daily. The normal protocol to follow is to let the insulin settle in for 5 to 7 days, do a 12 hour curve, evaluate the curve and if necessary increase insulin by .5 units, keep repeating this process until you get to a low BG reading around 150. The goal is to get Ollie’s BG readings between 150 and 250 for most of the day.

Most of us here feed our dogs every 12 hours, followed by insulin. Is it possible to feed him every 12 hours and have the same insulin dose every 12 hours?

Blood glucose meters are far more accurate than urine strips. What type of meter are you using?

Even with him having Cushings, his insulin appears to be working. Hopefully some of our members who also have Cushings dogs will chime in, but Cushings can be misdiagnosed in our diabetic dogs, since a lot of the symptoms are the same.

[Raysaint]

Re: Cannot Get Ollie under Control

It's usually hard to regulate blood sugar with 2 different insulin doses. The body gets confused and can't settle in to a steady insulin pattern. Consistency is important.

Tried it with my dog, feeding 2 different size meal portions at breakfast and dinner, with 2 different doses. Didn't work, numbers were erratic.

Urine strips only measure sugar in urine, which is not an accurate indication of blood sugar. It's a broader range. Blood sugar measurements need to be more specific in order to see what pattern is happening, and especially to check the low point in the 12 hour period.

[Daisydog10]

Re: Cannot Get Ollie under Control

Hello!

Raysaint and Mike are correct, blood glucose monitoring is much more accurate than the urine strips and a 12 hour feeding and dosage schedule may be very helpful in regulation.

One problem may be the white rice, it tends to spike blood sugar much quicker than brown rice, quinoa, chickpeas, etc. Weighing out or measuring each meal ingredient is also helpful, that way each meal is consistent as well.

[jesse girl]

Re: Cannot Get Ollie under Control

Its always a good idea to sign up on our sister site K9 cushings and talk to them about your dogs diagnosis

You can receive a false positive for cushing with an unregulated diabetic dog so we here on the forum take a double diagnosis of both diseases at the same time with a grain of salt

[alleng8304]

Re: Cannot Get Ollie under Control

Thanks to all for comments. So should I start over with 3 units of insulin q12 . Do not use white rice but dog food and how often to take blood glucose. Twice a day seems cruel and painful. Thanks

[alleng8304]

Re: Cannot Get Ollie under Control

How often do you do blood monitoring and does your pup have cataracts after years od diabetes

[alleng8304]

Re: Cannot Get Ollie under Control

is NPH give you better control than Vetsulin? How often do you do blood monitoring?

[jesse girl]

Re: Cannot Get Ollie under Control

I test jesse before every dose of insulin . I test her on the inner lip above the canine tooth for over 8 years . Maybe 10,000 tests or more . I heard a similar thought from jesses original vet thinking it was cruel for testing her the way i was doing and i thought thats odd because the discomfort from uncontrolled diabetes is not pleasant

Come to find out dogs are very tolerant of pokes and pricks . They are not human even though we may think of them that way . Jesse gives me a lick after just about every test i do on her inner lip . Same with her shots no big deal

Life just changes to a new normal . Dogs can still have a very enjoyable dogs life with some limitations

[Scooterspal]

Re: Cannot Get Ollie under Control

I know you have other issues do deal with but if cataracts are in the early phase you might want to consider eye drops. They can help control/slow their development into full blown stage and blindness.

Google Lanomax.

I'd also consider providing eye related nutrients on a daily basis. I use spreadable sharp cheddar cheese to hide them in. Scooter cannot resist : )

Check my signature for what I'm using.

Good luck!

[alleng8304]

Re: Cannot Get Ollie under Control

Scooterspal-

Thank you. I use Ocu-GLO which has all of the support vitamins for the eyes. What type of drops do you use? I believe that most people use normal saline drops. The cataracts in Ollie just seemed to appear in the last week or so, did not notice prior. Has been receiving Occu-Glow for 6 months. It is a shame that Kinostat drops has not come out yet. Thats the FDA for you-cannot get their act together

[alleng8304]

Re: Cannot Get Ollie under Control

Jesse Girl-
Thank you. I guess I think of all my dogs as human. I give 6units of Vetsulin in the morning and 3 units in evening. His glucose stays in the 200-300 range. Should I do a fasting in the morning and then adjust. How would one do the adjustment? Thanks

[jesse girl]

Re: Cannot Get Ollie under Control

My jesses routine is far from standard and it took allot of trial and error to get it right and its not perfect . The 12/12 routine did not work for her . I think because of her other challenges

Its hard for anyone to know whats best for your dog because they all can respond so differently to the disease .

Actually a range in the 200s and 300s is not so bad . What my goal for jesse is 100 to 250 and in reality your not that far away from that and most dogs do quite well from 150 to 250 .

The range you are talking about is pretty stable ( no big swings in sugar ) that may give you the opportunity to slowly raise the dose maybe a half to one unit depending on the size of the dog

Now having 2 different doses You may have to curve both periods to see what insulin is doing to blood sugar . That means staying up at night to do a curve from time to time

How did you end up having different doses of insulin ? Now if you have some curves you can post them . Ranges are ok but it doesnt give the nuts and bolts of the regulation and specific times and blood sugar amounts is helpful .

[Raysaint]

Re: Cannot Get Ollie under Control

Starting a consistent 12 hour regimen, with same food amount and same insulin dose is the way to go. Do not make daily adjustments based on testing, it's important to keep the dose the same for at least a week. Then do a 12 hour curve, see what the numbers are, and adjust insulin dose.
Then repeat each week until numbers are getting better and nadir is still in a safe range.
Trying to always correct sugar with different insulin doses does not work in general.
Being diabetic myself, I was adjusting his dose slightly here and there for a while early on and just prolonged his regulation.

Hard to say if NPH is better, you'll have to see what kind of progress you make with Vetsulin. Give it some time.

As for testing, I always test before each meal. I don't think it cruel, I think it important in managing diabetes. For you being early in the diagnosis, you might also spot check around his nadir time, to make sure he's not going too low on a regular basis. But don't adjust insulin based on one low on one day. Only if it's on a regular basis.
You'll get surprising numbers all the time, it's the nature of the disease, bodies aren't machines. Strive for numbers in a good range, on a somewhat regular basis.

[Scooterspal]

Re: Cannot Get Ollie under Control

I use Ocu-GLO which has all of the support vitamins for the eyes. What type of drops do you use?

I'd still consider the additional supplements I use, but your call.

Google Lanomax.