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  #1  
Old 01-03-2017, 03:51 PM
ScottW ScottW is offline
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Default BG Curve help

I have been reading through many of the posts, and this forum is very informative, I have learned quite a bit already. It appears as though every animal is different, and what works for one may not work for another.

We have a 7 year old min pin who has was diagnosed about 4 months ago with diabetes. Our vet does not seem to have a lot of experience with diabetic dogs, and I'm hoping someone here can offer some advice.

We have done several curves, and the vet has also done a 2.
We feed her raw food twice per day- with fibre. About 8oz per day (4 oz per meal). She weighs about 15 pounds, and is a large min pin.

We give her 3.5 units of canine insulin twice per day - 12 hours apart and just after she finishes eating.

We are not sure if she is suffering the symogi effect, or if she needs more insulin, or if she needs a snack in between meals. I've also read about the dawn phenonenom, so that adds even more to take into account.

I'll give you her basic BG curve -taken with the Alphatrak 2

9am BG 666, then food and 3.5 units of canininsulin
11am BG 324
1 pm BG 216
3pm BG 216
5pm BG 540
7pm BG 612

the vet did a curve a month ago using 5 units:

9am 594 - before food or injection
11am 342
1pm 108
3pm 59
5pm 306
7pm 441

I want to thank everyone in advance for any responses. I am thinking about reducing her dosage to 2 units twice per day and doing another curve. Within the last 5 months she's lost the sight in 1 eye almost completely, and the other eye is starting to cloud over - so I appreciate all of your help
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  #2  
Old 01-03-2017, 04:28 PM
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CraigM CraigM is offline
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Default Re: BG Curve help

Welcome to you and your pup.

Looking at your curve at 3.5 units of Caninsulin, I'd say you could increase a little to maybe 4 units. Of course the curve at 5 units is a little "scary" with the 59 reading.

I'm assuming you are in Canada because of the Caninsulin? Are you using an AlphaTrak with a readout in mg/dL, or converting from mmol/L? If converting, are you dividing the mg/dL readout by 18, or by a printed chart? Just want to be sure your reported readings are accurate

One thing I'd like others to comment on is the raw diet. I'm not sure (meaning I have NO knowledge) if a raw diet is appropriate. Seem to me (again, no knowledge) that a diet with some carbohydrates might be more appropriate? Comments anyone??

Craig
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Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.
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  #3  
Old 01-03-2017, 04:44 PM
ScottW ScottW is offline
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Default Re: BG Curve help

Thanks Craig,
We are feeding her carbs in addition to her raw food. We were having similar BG Curves when we had her on prescription food from the vet.

Our real concern is the morning BG level. It was 666 with 3.5 units, before food or insulin. When she was given 5 units, it was too much, however she still measured 594 in the morning before food or insulin - so my concern is that going with 4 units may land her somewhere in between those 2 numbers - but it still seems way too high compared to recommended levels.

By the way, you are correct, I am from Canada.
I am using an app to do the conversion - and I double check the numbers. Actually we got our Alphatrak from the US, so I have to convert those numbers into numbers are vet works with. So the numbers I've reported on this thread are actual readings from the meter - without conversion.
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  #4  
Old 01-03-2017, 05:03 PM
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jesse girl jesse girl is offline
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Default Re: BG Curve help

working with a raw diet maybe challenging with insulin . my thought pet insulin is developed with the prescription food in mind

Now i give my jesse a partially raw diet and it works for her . I dont think a exclusively raw meat diet is appropriate to work with injected insulin

What i have found with jesse she needs some highly digestible carbs to calm the strength of insulin without it she can bounce around a bit high and low and vice versa

the problem with the curve is the large drop and more than likely the body is responding to that drop with higher sugar later on

If you can slow that drop everything else may become more stable . The problem as you said what works for one may not work for any other dog
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Jesse-26 lbs - 16.5 years old ,11 years diabetic, one meal a day homemade and a vitabone snack . 3 shots of Novolin( under the Relion name ) a day . Total insulin for a 24 hour period is 6.5 units of NPH insulin .
Jesse earned her wings on 6/21/2021
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  #5  
Old 01-03-2017, 05:34 PM
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farrwf farrwf is offline
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Default Re: BG Curve help

I'm with Craig on the insulin increase, to 4, then possibly 4.5. Looks like the insulin is having a nice impact, just need to zero in on the right dose. Given your raw diet, you can always increase fiber as another tool.

Welcome, Scott, what's the little lady's name?
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Otis Farrell dx'd 12/10, best friend to his dad, Bill, for over 14 years. Left this world while in his dad’s loving arms 10/04/13. Sonny Farrell dx'd 1/14, adopted 5/15/14. Left this world while in his dad's loving arms 9/06/16. Run pain free, you Pug guys, til we're together again.
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  #6  
Old 01-03-2017, 06:13 PM
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CraigM CraigM is offline
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Default Re: BG Curve help

Guess if you wanted to stay with the current diet, I might give something like a standard (not a diabetic) treat as dessert after the meals. My theory is that the treat might prevent the big drop mid day.

Are the meals very repeatable? With our smaller pups a small difference in either ingredients, or quantity might make a difference. I'm currently using a combination of canned and dry kibble, but I weigh each part on a kitchen food scale to keep the meals as identical as I can.

Come to think about it, your pup's curve is about the polar opposite of my Annie's. My Annie's blood glucose may rise 100+ points after her meal / injection, topping out at around the 5th hour, and then slowly comes down to the lowest shortly prior to the next meal / injection. Of course, "every dog is different".

Craig
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Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.
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  #7  
Old 01-03-2017, 08:00 PM
ScottW ScottW is offline
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Default Re: BG Curve help

Thanks for all your help,
We use a kitchen scale to measure her (Georgie's) food.

We have been thinking the same thing as you just mentioned Craig and Jesse Girl. The raw food may be an issue. Either changing her food, or supplementing with a snack may help. I just assumed giving a snack would raise her BG levels, but I'm learning from this website that its not always the case. If her insulin is outlasting the food, it may be causing her body to raise the sugar level through hormones......., so adding a snack, or changing her diet to a food that takes longer to digest may help. Its gets very confusing when there are so many factors affecting insulin and blood glucose levels. Much of the info seems to defy logic - but it makes sense once you really try to understand how the body operates.

Are any of you familiar with the dawn phenomenon? Is it possible that her high BG levels in the morning are caused by this? I've read that testing glucose at 3am is a good way to tell if an animal is affected. If the 3am level is high than it may be 'dawn' and insulin should be increased. If the level is low than it could be 'somogyi' so decrease insulin.

again - I thank all of you for your help.
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  #8  
Old 01-03-2017, 08:30 PM
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CraigM CraigM is offline
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Default Re: BG Curve help

Quote:
Originally Posted by ScottW View Post
Thanks for all your help,
We use a kitchen scale to measure her (Georgie's) food.

We have been thinking the same thing as you just mentioned Craig and Jesse Girl. The raw food may be an issue. Either changing her food, or supplementing with a snack may help. I just assumed giving a snack would raise her BG levels, but I'm learning from this website that its not always the case. If her insulin is outlasting the food, it may be causing her body to raise the sugar level through hormones......., so adding a snack, or changing her diet to a food that takes longer to digest may help. Its gets very confusing when there are so many factors affecting insulin and blood glucose levels. Much of the info seems to defy logic - but it makes sense once you really try to understand how the body operates.

Are any of you familiar with the dawn phenomenon? Is it possible that her high BG levels in the morning are caused by this? I've read that testing glucose at 3am is a good way to tell if an animal is affected. If the 3am level is high than it may be 'dawn' and insulin should be increased. If the level is low than it could be 'somogyi' so decrease insulin.

again - I thank all of you for your help.
Annie gets a little higher insulin dose at dinner time. I've thought it was needed because she is less active in the evening / overnight. It goes something like this:
Very active like, trip to vet, trip to groomer, or a "busy" house = a little less insulin
Home alone or a lazy day / night = a little more insulin

Craig
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Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.
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  #9  
Old 01-19-2017, 12:14 PM
ScottW ScottW is offline
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Default Re: BG Curve help

Thanks for all your helpful suggestions.
We've taken her off raw food, and started her on royal Canine diabetic food. The adjustment to her food has made a huge difference in her BG readings. The highs are still very high, but now the lows are also quite a bit higher.
As per your suggestions, and our research, we upped her to 4 units and did a blood glucose curve:

4 units
9am 36
11am 24
1pm 17.5
3 pm 28
5pm
7pm
9pm 33
Insulin given
11pm 26

We did a follow up test on her Nadir to confirm the numbers and her nadir read 19

After contacting our vet for approval we upper her dose to 4.5 units. We have not done a BG curve yet, but we have tested her nadir. This time, at 4.5 units she is at 15

Do you think it would be ok to up her to 5 units, or do we need to do a full BG curve? At this point we've done quite a few curves and spot tests, so I think we can safely up her to 5 units at this time based solely on her nadir readings - of course we would monitor her closely.

any input would be much appreciated.
Scott
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  #10  
Old 01-19-2017, 02:03 PM
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CraigM CraigM is offline
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Default Re: BG Curve help

Looks like you are getting there!

Tough decision about raising to 5 units without a curve. Most will say you should do the full curve because the shape of the curve (nadir point) might shift a little with more insulin, and you've also changed the food. To be honest, I think you would be OK with the small ½ unit increase. You've been on 4 units, and the new food, for several days? You might feel more comfortable if you were to test at least twice: once an hour before your anticipated nadir, and again an hour after the expected nadir?

Craig
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Annie was an 18 pound Lhasa Apso that crossed the rainbow bridge on 10-5-17. She was nearly 17 years old and diabetic for 9½ years.
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