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  • Remy Newly diagnosed Diabetes

    I’ve been on the K9 Cushings forum as Remy was diagnosed with Cushings a year ago. Now, almost to the day he has been diagnosed with diabetes. (Blood glucose was 401 and urine 3+) In mid December his glucose was 150 which wasn’t unusual for him when stressed. He suddenly began having seizure or syncope type episodes (he’s had 3) where he falls on side, flails or twitches and then he’s up as though nothing ever happened. We also learned he has some changes to his heart along with mitral and tricuspid degeneration. And, lest we not forget, his previously controlled hypertension had shot to the moon. We were scheduled for an Internal Medicine consult at Louisiana State Univ today but it was cancelled due to the weather. We have however seen a cardiologist and neurologist and we are attempting to figure out exactly what is going on with our boy and how best to treat his various issues.
    Remy is a male Bichon nearly 12 years old. He has always had elevated liver enzymes which were previously investigated by Internal Med. without an exact diagnosis but likely a form of chronic hepatitis. He has always suffered from extreme anxiety as well.
    So, since I haven’t had a diabetic dog in 20+ years I am relearning many things. Back then we mostly used the urine dipsticks. We have a Freestyle Libre sensor on Remy and have the AlphaTrak 2 glucometer as well. Ive checked them against each other and so far they seem on target but I don’t know yet about higher readings since the Freestyle stops around 500. Remy is presently on 3 units Vetsulin twice a day at 10 and 10. He has always been a grazer unless we give him a wet food he really likes so we have switched to that (Nature’s recipe) to keep his meals more consistent. He eats 3x day. Fortunately Remy has been very good about the insulin injections, etc. He doesn’t bother the sensor at all. My biggest concern is the swings from as low as 60 to the upper 400s and if we can gain consistency throughout the day. Whether his episodes of falling over relate to the pituitary tumor (Cushings) or a blood glucose or blood pressure issue we just don’t know yet. Cardiologist didn’t think the heart murmurs were enough to cause this, but he did suggest possibly doing an assessment with a holter monitor for 24 hrs if no other cause can be determined.
    We have one other dog, Angel, a toy poodle is nearly 16 and she has had transitional cell carcinoma for two years (bladder cancer). We are running out of options for treatment as she also has high liver enzymes and the medications eventually effect her bone marrow. So far she is not clinical but I know that will change if we can’t find another treatment she can tolerate. Two years with TCC is really miraculous, especially since she has always seemed to feel very well and has a high quality of life. Also, has anyone used the Sun Tech Vet blood pressure monitors. We just sprung for one and are also learning how to best use it, cuff placement etc. so we can measure both dog’s BP at home when they are calm. I’m reading all the wonderful information here and appreciate any comments as there is nothing like learning from those who have ‘been there’!! Thanks to all, Claire (Remy and Angel’s mom)
    Last edited by RemysMom; 02-17-2021, 09:04 AM. Reason: Misspelled word

  • #2
    Re: Remy Newly diagnosed Diabetes

    Hi and welcome My jesse is well past 16 and close to her 11 year being diabetic
    She also has been epileptic for her entire life and was never put on medication for that . The episodes do sound like seizures and that will spike blood sugar from what I have seen . Cushing may make it more difficult to gain good control and with the other challenges consistency may not be in the cards but that ok dogs can do well without great control .

    Jesse had anxiety especially loud noises than could lead to a seizure but that seemed to go in remission about 4 years back maybe do to her hearing fading . I believe the anxiety of loud noises was part of the epilepsy

    I have taken a different approach that you with less veterinary care and letting her just live her life . Some years back I had a talk with jesse that we would not do any major medical procedure to try to extend life as what we did early in her life with diabetes was quite extreme with not allot of hope but she pulled through . She was young and I thought it was worth giving it a
    go

    Its nice to know the libre compared well to the pet meter . Have not heard a comparison between the 2 . I have used a discount human meter on jesse for her entire diabetic life and has done the job

    Sounds like your off to a good start and prepared to move forward in managing the disease at home which is helpful . Just dont react to individual numbers and be more aware with overall patterns .
    Last edited by jesse girl; 02-17-2021, 10:02 AM.
    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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    • #3
      Re: Remy Newly diagnosed Diabetes

      WOW, 11 years is amazing!! You’ve obviously done a fantastic job keeping Jesse stable and happy. Fortunately except for these three little episodes and the week we knew something was wrong as he was drinking like crazy and peeing in his sleep which he had never done before, he hasn’t acted sick or miserable in the least. Remy was a back yard breeders dog and never socialized. He tends to be afraid of everything....the trash cans on the sidewalk before garbage day, an acorn falls from a tree,car door slams somewhere, a bird hops by. It’s all scary to him. His Cushings has stayed well controlled. We just went up from the original dose a few weeks ago. We were due to go back for a 30 day ACTH retest when he started panting more, drinking and peeing. I thought perhaps we would need to bump up the Vetoryl but the Cushings was fine. It was his glucose that had suddenly shot up. Trying to learn at what point has he gone too low or is he too high? How much food should he have and when? I have so much to relearn and to get up to speed on how things are done now compared to years ago. Big round of applause for the great job you have done keeping your baby happy!!

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      • #4
        Re: Remy Newly diagnosed Diabetes

        Jesse's good living was probably the largest factor . Jesse came from a breeder also . Losing hearing may have been a blessing in disguise . If she cant hear it she is not scared . I did acclimate her with fireworks sounds on youtube for the 4th of july which was helpful during that time. As with you and your pup you probably dont enjoy that holiday very much . Not a problem for jesse anymore

        It sounds like your up to the challenge and will do well for your pup . Just remember there will be ups and downs
        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
          Re: Remy Newly diagnosed Diabetes

          I know a bit off topic but amazing how some dogs are such “wimps” when it comes to sounds ..I say that jokingly. My dog is the opposite. When we have thunderstorms, she runs to the front door so we can go sit on the porch and watch them. It’s hilarious. She also loves to watch fireworks. My mother’s dog s the opposite, if you clap, her dog shakes and hides

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          • #6
            Re: Remy Newly diagnosed Diabetes

            The funny thing is he doesn’t mind fireworks. If he’s in the house he’s OK. But if he’s outside he’s afraid of everything. After five years he’s finally fairly comfortable in the back yard but take him out front on his leash and it’s a different story. He’s especially afraid of women. He adores my husband but me, he could care less about. LOL

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            • #7
              Re: Remy Newly diagnosed Diabetes

              hi Claire and Remi

              just givng some info about the sensor.
              libre sensor reads blood in the fluid whereas the glucose handheld meter reads blood.
              the Freestyle Libre handheld meter reads lower than low and higher than high on a dog meter.
              the libre sensor reads hi when it really isnt.
              so its not that reliablle and am glad you are testing with the alphatrack meter.
              especially do curves with the alphatrack meter and double check the libre readings with handheld meter.
              glad you found us
              Riliey . aka Ralphy, Alice, Big Boy
              20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

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              • #8
                Re: Remy Newly diagnosed Diabetes

                I very much appreciate the information. I’m feeling my way around the AlphaTrak. Worst problem is getting enough of a blood sample. He tends to be so afraid of everything I don’t want to hurt him and the lancet hasn’t worked very well for us. OTOH, I don’t trust the Freestyle Libre since it isn’t calibrated for dogs. I would like to schedule an appointment with one of the vet techs to go over getting a good sample for the Alpha Trak and making sure of the proper placement of the BP Cuff for taking his blood pressure. If we can do those things competently I will feel much better about the accuracy of the test results. Getting readings at home where Remy is calm will help us to improve our plan of care. Tomorrow we have our consultation with Internal Medicine at LSU. Hoping to get some answers so we can better help our boy!!
                Thank you so much for the information. The Freestyle is great but, within limits apparently.

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                • #9
                  Re: Remy Newly diagnosed Diabetes

                  getting blood was hard for me. The vet techs I helped weren't much help either because they are used to drawing blood at the office, they don't always use the lancets like we do.

                  Hopefully you will get some good help. Otherwise there are some good tips on here.

                  Judi
                  Jenny: 6/6/2000 - 11/10/2014 She lived with diabetes and cushings for 3 1/2 years. She was one of a kind and we miss her.

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                  • #10
                    Re: Remy Newly diagnosed Diabetes

                    I was going to bring in my equipment and see if they could help me. I’ve had better luck just using a small gauge hypodermic needle. Just have to be careful not to poke too deep. So far with the lancet I haven’t had much luck. You’re right though, they are used to veinipuncture blood draws. Hopefully I can get it right.

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                    • #11
                      Re: Remy Newly diagnosed Diabetes

                      Originally posted by Remy’sMom View Post
                      I was going to bring in my equipment and see if they could help me. I’ve had better luck just using a small gauge hypodermic needle. Just have to be careful not to poke too deep. So far with the lancet I haven’t had much luck. You’re right though, they are used to veinipuncture blood draws. Hopefully I can get it right.
                      you might have a better time jabbing with the lancet only.dont use the device.

                      i tested on the upper lip theres a good blood droplet.

                      your doing great
                      Riliey . aka Ralphy, Alice, Big Boy
                      20 lb male. 5 1/2 nph insulin. 1/2 cup fromms. black cockapoo, dx Apr 2012 . 5 1\2 yrs diabetic. 2000 to 2017

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                      • #12
                        Test post for upcoming update

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                        • #13
                          Hopefully I will do this properly. Remy, a Bichon soon to turn 15 yrs was diagnosed with Cushings in Feb 2020 and Diabetes Feb 2021. He’s been on 15 mg. (10mg and 5 mg) until December 2023 when he was found to be low cortisol. After a couple of weeks vacation they put him back on Vetoryl 5 mg once a day. His PCP and I decided to do every other day as we were concerned about him going to low again. ACTH Stim 2/14/24 showed him low cortisol again so Vetoryl was discontinued 2/17/27.Remy has never been well regulated. Tried PZI and Vetsulin. Since I was most comfortable with Vetsulin we’ve stuck with it however it generally is very very slow to take effect and doesn’t last long enough. He is fed and gets his Vetsulin at 10 and 10. He’s up and down like a roller coaster most of the time. We started to move the evening Vetsulin dose up an hour or so earlier if he was already high. Remy has had a Libre sensor since the beginning and while they are sometimes inaccurate we have had fairly good luck with it but use the AlphaTrak to confirm glucose as needed. He is generally comfortable if under 400 but when he gets higher he is drinking, peeing, pacing, miserable. Endocrinologist at University has recommended Degludec which is a basal insulin. His private care Internist and PCP are hesitant because they are not familiar with Degludec insulin and concerned about who will be able to help us during an emergency say on the weekend or late at night if no one is really familiar with this insulin. Meanwhile I haven’t gone more than 15 minutes from home in years. I live in fear of him becoming hypoglycemic if he’s alone even though we have yet to ever see any clinical signs. With the sensor we always catch it as soon as he starts to read below 80. One suggestion was to have some fast acting insulin on hand for those times when Remy becomes hyperglycemic and miserable. He is only 14 lbs so it would be a very small dose. I also realize it can carry some risk but having him reading over 700 isn’t good either. I’m afraid my anxiety level is sky high with all of this. Perhaps the Degludec would work wonderfully for him but then again, it might be a disaster. I want to have a recheck ACTH done in case his cortisol has gone up again and is affecting his glucose levels. It seems like the lessened sensitivity to the Vetsulin coincides with taking him off Vetoryl. We did start a new vial of Vetsulin just in case even though the old vial was only opened 2/27/24. Remy does not get any treats unless his glucose is going low. He eats a canned food which we feed him on a spoon. Started that two years ago when he wouldn’t eat and although time consuming he eats all his food and is done when we finish the bowl. He has always been a picky eater and this works. So he gets the same amount of food and similar content. The protein varies since he spits the food back at us if we try to give him the same thing breakfast and dinner. Since we’ve been hand feeding he hasn’t had pancreatitis again, and his weight has been stable. We just can’t get his glucose to a reasonably stable range. I also haven’t wanted to change insulin until we get the cortisol situation resolved. If anyone has had experience with Degludec (also called Treshiba I think) I’m interested in how it worked for you. I’m so utterly confused at this point I really don’t know what to do! I’m open to any advice and suggestions!! Thanks to everyone in advance!!

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                          • #14
                            Claire, YAY!! I see you and Remy made it back here again. I’ll be following along, and will try to offer any Cushing’s-related suggestions that may be of any help along the way. But I’m soooooooo glad you’ll be back here to talk with the K9D folks about Remy’s diabetes. Best wishes to you both!

                            Marianne
                            Last edited by labblab; 03-09-2024, 08:28 PM.

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                            • #15
                              Thanks a bunch Marianne! So thankful for your help!! not sure I did this right, so much information to try to condense but hopefully I can get some advice. I’m about ready to look for a therapist to help this anxiety ridden dog mom LOL!!!
                              Claire

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