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  #21  
Old 03-19-2016, 05:25 PM
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amydunn19 amydunn19 is offline
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I am concerned if your dog doesn't look like a cushings dog, he probably isn't. The majority of cushings dogs have the physical characteristics of the disease. Many cushings tests are false positives in unregulated diabetics. You might want to visit our sister site, k9cushings.com and run the results past them.

The hunger can be related to unregulated diabetes - most diabetic dogs are very hungry until they reach a dose of insulin that controls their blood sugar.

Also, I have never heard of stopping insulin while treating for cushings. That is an incredibly bad idea and could send him back to DKA.
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  #22  
Old 03-20-2016, 10:31 AM
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Vanessa Vanessa is offline
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Default Re: Need help with Ben

Thank you for your helpful replies.

To CraigM: Yes, I am waiting for the Alphatrak kit. I need to discuss dosage again with my vet - especially why he is not increasing dosage or increasing the frequency of insulin injections. Apart from my constant fear of a dka relapse, I am also worried that the fact that Ben is spending so many hours with high glucose levels in his blood is eventually going to lead him to blindness (already has cataracts). I am going to wait a couple of days more for the metre, and then get a human one (I hope they come with lancets too, as that is what worries me most).

To amydunn19: I just posted on k9cushings. I already got the same advice as you gave me, not to stop giving Ben insulin, which is exactly what I will see to.

Just to be prepared for home testing:

- is there a need to disinfect with surgical spirit the area from which blood will be taken?

- I will be trying to test first near the tail area as in one of the you tube videos on this site (Ben has a very low pain threshold!). He is short-haired - do I need to shave the area or it doesn't make any difference?
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  #23  
Old 03-20-2016, 11:15 AM
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CraigM CraigM is offline
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Default Re: Need help with Ben

Quote:
Originally Posted by Vanessa View Post
Just to be prepared for home testing:

- is there a need to disinfect with surgical spirit the area from which blood will be taken?

- I will be trying to test first near the tail area as in one of the you tube videos on this site (Ben has a very low pain threshold!). He is short-haired - do I need to shave the area or it doesn't make any difference?
i know the instructions for human diabetics recommend to wash their hands (finger) before testing. To tell the truth, my wife & I are type-2 diabetics and don't always wash just prior to testing. I would think trying to clean a dog would be difficult most of the time and not required.

I test Annie on her ear and do shave a strip where I normally test. I use a small battery powered grooming razor, but any razor (your husband's?) would work. I'd think a hair / fur free area is needed or the blood might flow into the hairy area. I shave the strip every week or two. Btw, I also shave the area where I inject the insulin so that I can see the needle enter pink skin. Annie is a longer haired dog, so that might not be required for you.

I do use alcohol wipes (little individual squares of tissue soaked with alcohol bought at the pharmacy) to clean Annie's ear flap after cleaning them with an ear cleaning solution. Annie gets "goopy smelly" ears and needs them cleaned every 2-3 months. The cleaning solution is sticky and I need to clean it off with the wipes before blood testing from the ear. Of course if you test near the tail, this wouldn't be a problem.

Craig
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  #24  
Old 03-20-2016, 05:15 PM
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k9diabetes k9diabetes is offline
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Default Re: Need help with Ben

Hi Vanessa,

I imagine that the Cushing's folks are also telling you to hold off on worrying about Cushing's at this time. That would be my strong advice. Dr. Peterson, a veterinary endocrinologist, has written about working on the diabetes first and worrying about Cushing's later:

http://endocrinevet.blogspot.com/201...e-in-dogs.html

If there is any "good" news about your dog's diabetes, it is that it can tell you whether your dog has Cushing's disease.

If he does, he will need a very high dose of insulin for his weight. If his insulin dose is normal and his blood sugar regulates, he does not have Cushing's disease. It is something far too many vets jump to at the first sign of any rise in liver enzymes. Really no need to test for it right now and absolutely no reason to treat for it since his diabetes would likely skew any tests for it now.

Natalie

Quote:
Originally Posted by Vanessa View Post
Thank you for your helpful replies.

To CraigM: Yes, I am waiting for the Alphatrak kit. I need to discuss dosage again with my vet - especially why he is not increasing dosage or increasing the frequency of insulin injections. Apart from my constant fear of a dka relapse, I am also worried that the fact that Ben is spending so many hours with high glucose levels in his blood is eventually going to lead him to blindness (already has cataracts). I am going to wait a couple of days more for the metre, and then get a human one (I hope they come with lancets too, as that is what worries me most).

To amydunn19: I just posted on k9cushings. I already got the same advice as you gave me, not to stop giving Ben insulin, which is exactly what I will see to.

Just to be prepared for home testing:

- is there a need to disinfect with surgical spirit the area from which blood will be taken?

- I will be trying to test first near the tail area as in one of the you tube videos on this site (Ben has a very low pain threshold!). He is short-haired - do I need to shave the area or it doesn't make any difference?
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  #25  
Old 03-26-2016, 12:04 AM
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Vanessa Vanessa is offline
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Default Re: Need help with Ben

Dear all,

I finally managed to get a curve with a loaned pet glucometre. Ben cooperated all the way through. I took blood from the base of the tail, and Ben hardly noticed.

I am copying the figures here as I cannot find a way of copying the curve proper here. I have converted the values to US ones already.

Time of day - Glucose Levels
at 7.15 - 129.6
at 9.45 - 82.8
at 11.50 - 68.4
at 14.20 - 156.6
at 16.20 - 140.4
at 19.20 - 154.8

We had a walk at 7.00 (10 mins), 8.30 (30 mins), noon (10 mins), 16.30 (20 minutes) and 19.45 (10 mins).

Insulin injection was at 7.30 am and 7.30 pm, preceded immediately by feeding, in our case, 0.14 pounds of Royal Canin for diabetics for each meal (62 gr). We are still using Insulatard, 5iu x2 / day.

I am suspecting the lower figures might have been an error, as Ben was not hypo at the time, though he looked a bit tired. Still, I am now eliminating the long morning walk and will try doing it in the afternoon, where we seem to have the higher figures.

I will be repeating the curve once I get my own glucometre (hopefully next week!).

I still have not managed to come to the bottom of the Cushing's issue.

To Nathalie: Following your comment, I asked my vet if the dose we are giving Ben is high in relation to his weight. The answer I got is that he would like to have him on a lower dose - so nothing definite so far. From my calculations, we are at 0.63 / kg (or 2.2 pounds) of weight.

My worry is now that on Monday when Ben was at the vet's in the morning and had his glucose levels tests and some routine blood tests taken, while glucose was at 120.6 in the morning, his Alk ph were 759 (range 23 - 212) and ALT 138 (range 10 - 100) .

All I can conclude now is that the insulin is working, but I am not sure if dose given is excessive.
Peeing and drinking back to normal.
There is also fur growing on the shaved patches.

Many thanks for any guidance or advice!

Last edited by Vanessa; 03-26-2016 at 12:07 AM. Reason: I would like figures to appear in columns. Trying to fix the problem for ease of reading.
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  #26  
Old 03-26-2016, 12:12 AM
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Vanessa Vanessa is offline
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Default Re: Need help with Ben

One further general question please - as it is tick season, given that the dog is getting daily injections, do you still use chemical repellents or is there some other natural solution?

Thanks.

Vanessa
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  #27  
Old 03-26-2016, 04:39 AM
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amydunn19 amydunn19 is offline
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I don't think Ben has cushings. A cushings dog would never, ever see those lovely numbers without treatment for cushings. I would not pursue it at all.

The numbers around 1150 are not considered hypo so you probably wouldn't see symptoms. A true hypo would not occur until the numbers drop to 20 or 30. But, we don't want to see that. Those numbers might be a little tight for any leeway and super tight regulation is tricky - you don't want a sudden burst of energy and exercise to drop to unsafe quickly. So, I agree that raising those numbers by putting off exercise might be useful. Or consider dropping the dose 1/2 unit.
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  #28  
Old 03-26-2016, 06:02 AM
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Auddog Auddog is offline
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Hi there,
I just wanted you to know that I used to live in a tick problem area (lots of horse pastures, and right up against some mountains full of sage brush). Anyway, I've always just used the powdery tick collars instead of gell kind you put on their backs, and they worked great. When Bazz became diabetic, i didn't want to use those anymore because I wasn't sure how it would effect his blood sugar.
I knew that prevention is the best way to avoid those little blood suckers (I always kept Bazz on a leash when we were out exploring back country, to stop him from going into tall grass and brushy areas off the path we were on), but it's always nice to have that extra sence of security. So now I keep a spray bottle that's half full of water, half full of apple cider vinegar, and has 3 or 4 dried cloves in the bottom; and i spray it on him right before we hit the trails.
I'm not sure if it's the avoidance of brushy and grassy areas, or the AVC mixture, or the fact that we don't go out at often or as long as we used to but we haven't seen any ticks since using our method. If you're not a fan of the smell of AVC, I've also heard that rubbing a little bit of coconut oil on their fur acts as a natural repellent to ticks (and mites and fleas too); but we've never tried coconut oil.
I hope that helps

Audrey & Bazzle
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  #29  
Old 03-26-2016, 09:28 AM
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Vanessa Vanessa is offline
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Default Re: Need help with Ben

To amydunn19: You really hit the nail on its head, as vet also suggested today that we will need to drop insulin dosage by 1/2 a unit, at least for the morning dose . We skipped the morning walk today and had it in the afternoon. Upon vet's suggestion, I am now doing a curve for the night, as yesterday I did only a 12-hour cycle.

To Auddog: Many thanks for the tip. I have prepared the mixture, ready for tomorrow. Ben likes to walk along paths and fields (I always follow him closely) and inevitably, he picked a couple of ticks over the past few days. I am actually going to use it on my other dog too!
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  #30  
Old 03-06-2019, 11:50 AM
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Vanessa Vanessa is offline
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Default Re: Need help with Ben

Dear all,

I had to return to this website to ask for advice.

Recap: Ben, a 12-year old small dog (cross-breed but looks like a Toy Manchester Terrier) was diagnosed with diabetes in late 2015 (if I remember correctly).
Vet struggled to find a way to control diabetes and, in fact, never did. The dog had 2 episodes of ketoacidosis, one at the beginning and the other one last week. The latter wasnít as serious as the first one and required only some 16 hrs on the drip.
Ben weighs 6.8 kgs (15 pounds).
Glucose levels have never been controlled. This morning the machine couldnít even register a count. This afternoon it is at 26 (468 in the US).
Caninsulin didít work for Ben and we had switched to Insulatard early on. Heís on 5 international units in the morning and in the evening, following a meal of 82 g of Royal Canin diabetic food (portions are sometimes bigger if dog is terribly hungry).
With such high glucose levels, Ben is emaciated - just skin and bones. At least this week he feels like running and being his old self.
Eyesight almost completely gone.
I wish I could help him but donít know where to start. I read Chrisí story and can see so much of it in what is happening to Ben.
The vet doesnít have much experience with diabetes and is now dithering to change his insulin. In my mind, Insulatard isnít working.
I asked pharmacies here but theyíre at a loss too.
A) I asked on the availability of Humulin R (which worked for Chris). They have Humulin I or Humulin S. Does anyone have any experience with these?
B) if you change from a lente insulin to a more rapid acting one, how do you determine the doses? (I will do it with the vet, of course, but Iím afraid I have to propose it - as I had to do last time to change to Insulatard and to not treat the dog for the supposed Cushingís disease which he didnít have...)?
C) any experience of Actrapid or Mixtrapid on dogs? Again, how to determine the doses pls?
D) any suggestions for intermediate/ fast-acting insulins on dogs?

Apologies for throwing out all these questions... Iím trying to put together some information that may help me save Ben before more damage is done.
Thank you for any help you can give us!
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