Losing Marley

[marleyman]

5 year old Marley was diagnosed over a year ago with Diabetes. Because he's so young our Vet is convinced that he still manufactures some of his own insulin - how much and when we never know. This has made regulating Marley an absolute nightmare.

Over a year later, and he's still not regulated. He still collapses on me when his sugar drops - it's the most frightening thing ever....and really sad to watch.

We do regular curves which are awful - sticking Marley in the ear sometimes a dozen times before we can get a good blood droplet...I usually end up in tears at the end.

His readings are all over the charts - 475 - 200 - 57....never consistent.
Just yesterday he collapsed 3 times on our afternoon walk...I was no where near my car and we had to make our way across the entire park to get to it.

My partner Karla and I are at our wits end.
Now on top of all of this - Marley has developed cataracts and his vision is really bad. We were already told by an Eye Specialist that they won't do surgery on Marley until his sugar is regulated - great.

So here we are- Marley has unregulated Diabetes, our Vet raises and lowers his insulin doses - we start from scratch - we do more curves - he's OK for a couple weeks - then his levels drop - he collapses again - our Vet changes his insulin dose again - we start from scratch again - over and over and over.

We feel absolutely lost - and no where near regulated our poor boy who's suffering all this time.

We're emotionally (and financially) drained.

Any words of wisdom would be greatly appreciated.

[k9diabetes]

Re: New Member = At our wits end

Hi and Welcome!

I moved your post here as this is the best place for discussions like Marley's.

I'm sorry to hear you are upset and frustrated.

There are many reasons why a dog is difficult to regulate and, frankly, I'd consider Marly still producing his own insulin pretty far down the list. It is possible... my dog "honeymooned" - went back to producing insulin after he was diagnosed - for six months. But our experience was very very different from what you describe with Marley and he's been diabetic quite a while.

Cushings disease is one possibility, high triglycerides have been a current topic of discussion and are definitely another possibility. It could be that the insulin isn't being absorbed and metabolized properly in Marley.

So...

I'd like some more information about Marley and then I'd appreciate it if you could post the results of his curves - some or all, recent ones, depending on how many you have done.

Please let us know Marley's:
- breed
- weight
- neutered or intact
- diet
- how often he gets insulin
- how many units of insulin
- the kind of insulin

Even if his blood sugar goes high as a result, I would reduce his insulin to a point where he never ever goes too low. Hypoglycemia destabilizes the entire blood glucose / hormonal system.

And I would give up exercise at least for a few days until we can sort these kinds of issues out.

Exercise nearly always drops blood sugar, sometimes dramatically. Since you're already having problems with lows, I would just skip the exercise at least until we can talk more and hopefully you can reduce the insulin enough to put a stop to any low blood sugar for at least three to five days.

In terms of testing, there are other places to test where you are likely to have better luck and less crying! Ears are one of the more difficult places to test on a dog. Check out the tutorials page - www.k9diabetes.com/bgtestvideos.html for picture and video tutorials of the lip, back at base of tail, dew pad, and callous. Some of the videos are big so give them time to load.

I truly think we can help you sort this out - my dog was difficult to regulate and we got pretty good at analyzing curves in the process.

Very anxious to hear more,

Natalie

[Soaphie & Sydney's Mom]

Re: New Member = At our wits end

I'm so sorry for all you are going through. We went for about 5 months before getting regulated......and the reason we are FINALLY regulated is because of this board (no thanks to our FORMER vet)!!!

Just remember to breathe and vent to us and ask questions - alot of knowledgeable people are here to help!

Tami & Soaphacles (Dog Philosopher)

[eyelostit]

Re: New Member = At our wits end

Hi there and Welcome !

I think I'd lower the dose of insulin also, with getting the lows and exercise can factor into all of this. I'd rather see highs at this point then seeing those lows in the mix. A Hypo-Low is worse than having a high bg, you cannot tell where it is coming from right now until we have more info.

Hang in there !

Dolly & Niki

[marleyman]

Re: New Member = At our wits end

I am so very happy for finding this Website/Forum...and I am very upset.

We have asked our Vet several times, "We feel like when Marley exercises, when we run him, that his sugar goes low, and he has another episode...does exercise effect his sugar levels at all?" - Our Vet just dismissed it.
Augh, that makes me so mad.

- breed:
We found Marley abandoned on St. Croix, USVI. People always tell us he's a "Soft coated wheaten Terrier" or "is that a Labrodoodle?" but he's a mutt.

We did perform a DNA Test for his Breed and all that they could find positive traces of were, German Shepard and Lhasa apso - and he doesn't shed.

- weight: 55 lbs.

- neutered or intact: neutered

- diet: Hill's Prescription Diet® z/d® Low Allergen Canine (he has food allergies)

1 cup at 5AM
1 cup at 1PM
1 cup at 6PM

- how often he gets insulin:
twice a day, 1. after he eats his 5AM meal, then after he eats his 6PM meal

- how many units of insulin: Our Vet just changed his dose AGAIN.
He now gets 9 units in the AM and 9 units in the PM

- the kind of insulin: Vetsulin

Insulin History (now you'll see why we're so upset):

8/13/09 - 8/25/09: 10 units AM and 9.5 units PM

8/26/09 - 9/20/09: 9 units AM and 8 units PM

9/21/09 -9/22/09: 9 units AM and 9 units PM

9/23/09 -9/27/09: 9.5 AM and 9 units PM

9/28/09: (1 day only) 10 units AM and 9 units PM

9/29/09: 10/4/09: 10 units AM and 9.5 units PM

10/5/09: 10/25/09: 10.5 units AM and 9.5 units PM

10/26/09: 11/3/09: 10 units AM and 9.5 units PM

11/4/09: (1 day only) 9.5 units AM and 9.5 units PM

11/5/09: 9 units AM and 9 units PM (this is where he is today).

*NOTE: Marley also has epilepsy (diagnosed 4 years ago) and is on phenobarbital. Since he's been on phenobarbital, he hadn't had any seizures, up until Oct. 25th, just a couple weeks ago...his blood level dropped to 41 and made him go into seizures - we took him to the Emergency Vet Clinic. Then our Vet changed his insulin on Oct. 26th again because of this.

Curve History:

9/20/09:
7AM: 294
12:30pm: 360
3pm: 442
8pm: 458

9/27/09:
7AM: 417
12:20pm: 304
3:20pm: 395
7:30pm: 470

9/28/09:
6:30pm Spot Check - 240

10/2/09:
7:30am Spot Check - 407
6pm Spot Check - 258

10/4/09:
7am: 353
12:10pm: 314
3:15pm: 127
7:40pm: 474

10/11/09:
6:20am: 241
12:05pm: 89
3:30pm: 162
7:40pm: 237

10/18/09:
7:03am: 303
12:15pm: 154
3:18pm: 86
7:15pm: 184

10/25/09: Taken to Emergency Vet Clinic at 3:25pm = 41
This brought on a series of petite seizures.

11/3/09: Marley collapsed again.
12:30pm: 58

11/5/09: Marley collapsed again.
I was alone in the park with him and couldn't get a reading.

Just typing all of this has blown me away. Even though we know our Vet personally - as you can see - Marley is a mess even after all this time.
Our hearts break for him and all the suffering that he's had to endure, because we can't get him regulated.

I thank you so much for even taking the time to read this mess and to maybe give us some advice to help our boy.

Janel

[pgcor]

Re: New Member = At our wits end

Dear Janel - OMG! You have all been through the wringer! I just wanted to say that I have been to six different Vets over the past 2 years when my Pip was diagnosed. I have been given every strange piece of advice out there. Don't test at home - don't go on the Internet - negative or 100 on the urine check - 500 on the urine check is okay - 80 blood glucose is too low - 80 is okay.......aarrrgghh

It's very confusing and I believe that many of the Vets we have seen have their hearts in the right place - but just don't understand the complexities of the disease. Only a fraction of their education is devoted to diabetes management. It was a huge wake up call for us. So for now I come here, read what I can to educate myself and have been successful in eliminating some of the bad advice I've been given.

I believe you have come to the right place. Natalie and others on the board are very astute in dealing with this disease. There's so many things that will help you, but for now...step by step.

I've been managing my Pip for two years and am hardly an expert - but I truly believe you will find some peace here.

Welcome, welcome, welcome - we're all here for you!

Pam and Pip

[marleyman]

Re: New Member = At our wits end

Thank you for your kind words Pam...both my partner Karla and I are already so grateful for having found this site.

Watching Marley suffer all this time has been incredibly hard for us. And it's been a constant roller coaster ride with no end in sight...meanwhile, the clock is ticking away with his eyes and they get progressive worst with each day...it would be so much better to have his eye surgery now, before his eyes get much worst and develop problems...

The stress from this has been hard...but we're much for sad for our guy then we are stressed.

So grateful to have found you all.

[Margaret Boyle]

Re: New Member = At our wits end

Hi There, Welcome

I feel your frustration as I was 1/ 1/2year before I got anywhere near regulation with my Lucy and we still have up's and down's.

All I can say to you-----you have came to the right place for support.
It is a disease with so many variables. You are certainly having a time of it

I can assure you there is light at the end of the tunnel. Natalie will give you plenty support she had been through it all with her Chris and is very knowledgeable as regards regulating.

One piece of advice forget trying to test on Marley's ears they are very bad for getting blood, there are other places you can try. I test Lucy's inner lips and her dew pads up at the back of the front legs.

You will get plenty of advice here, just take your time and study it all.

It will get better.

[CarolW]

Re: New Member = At our wits end

MarleyMan - I agree with Natalie that quitting the exercise for a time would be helpful - till you get dosages straightened out. My Kumbi easily drops 100 points (in mg/dL) on a SHORT, relaxed walk!

I'll be watching and cheering you on. Gotta run! My computer-calendar just told me it's time to feed Kumbi, NOW! (I lose track of time when I'm here! haha!)

Sat, 7 Nov 2009 06:26:22

[marleyman]

Re: New Member = At our wits end

Thanks for your support and words....

Marley is only 5 so he has no callouses and we tried once to stick him in his pad but it was painful for him - so we kept with his ear.

And you're right - testing his ears sucks! God love him...sometimes we stick him 10 times before we can get a good droplet of blood for that meter!

I am planning on watching all of the videos on the website for sure!

[peggy0]

Re: New Member = At our wits end

Welcome to you and Marley. You sure have had a go of it. I sure wouldn't be going higher than 9 for awhile, maybe even 8.5 and leaving it there for a few weeks and then going up if necessary 1/2 unit at a time. Maryley may just need a snack at the lows of his curve to get him through to meal time. Higher is better at this point especially since his vision is already going. My dog also had cataracts and I managed his BGs from 120 to 250. He had cataract surgery 9 months after being diagnosed and can see now. He was all over the place in regards to readings for many months if you read my posts 200 to high 400's. I got his curve right mostly by ignoring my vet and learning my dog and then worked with his food. Its very frustrating I know and heartbreaking. I also checked for ketones on the high readings and he never had any. You need some peace of mind until he evens out.

[marleyman]

Re: New Member = At our wits end

MarleyMan - I agree with Natalie that quitting the exercise for a time would be helpful - till you get dosages straightened out. My Kumbi easily drops 100 points (in mg/dL) on a SHORT, relaxed walk!

I'll be watching and cheering you on. Gotta run! My computer-calendar just told me it's time to feed Kumbi, NOW! (I lose track of time when I'm here! haha!)

Sat, 7 Nov 2009 06:26:22

Thank you for your words too!

But if we stop his exercise for now and somehow regulate him - then wouldn't he just get all messed up again once he goes back to exercising?

[marleyman]

Re: New Member = At our wits end

Welcome to you and Marley. You sure have had a go of it. I'd be dropping to 8 and leaving it there for a few weeks and then going up if necessary 1/2 unit. Maryley may just need a snack at the lows of his curve to get him through to meal time. Higher is better at this point especially since his vision is already going. My dog also had cataracts and I managed his BGs from 120 to 250. He had cataract surgery 9 months after being diagnosed and can see now. He was all over the place in regards to readings for many months. I got his curve right and then worked with his food. Its very frustrating I know and heartbreaking. I also checked for ketones on the high readings and he never had any. You need some peace of mind until he evens out.

Thank you..that is good advice - we just talked this AM about doing what we think is best at this point, since our Vet isn't helping at all...and at times, is honestly very short with us about Marley - almost like she's sick of dealing with our situation....or, maybe she's just frustrated with herself and has no idea of what SHE'S doing!

[CarolW]

Re: New Member = At our wits end

Oh, MarleyMan,

Thanks for your support and words....

Marley is only 5 so he has no callouses and we tried once to stick him in his pad but it was painful for him - so we kept with his ear.

And you're right - testing his ears sucks! God love him...sometimes we stick him 10 times before we can get a good droplet of blood for that meter!

I am planning on watching all of the videos on the website for sure!

Natalie's video showing her lip-prick on Chris is excellent. I think people feel strange about "pricking a lip." *I* certainly, did; in fact, when I was gearing up to learn to test Kumbi, I spent a whole WEEK considering whether some other prick-site would be better.

Then I talked it over again with my vet. She said they use the lip-prick because it seems easiest for the dogs!

Well, SURE ENOUGH! Of course, that's for dogs who can learn to accept it.

It's not the lip, in fact, that my vets and I prick; it's the inner lining of the mouth - the lip gets folded back against the upper jaw (see Natalie's video).

Also, there are detailed descriptions here:

http://www.coherentdog.org/vek/bgtest.php

I really need to add one more piece of information to those pages, because Kumbi doesn't bleed all that easily, especially on his left side. People who do Ear-Pricks usually warm the site first. That can make all the difference.

I never bothered, with the lip-prick, but later, I learned it makes all the difference even on the "lip"! So now, I wet a paper towel in hot tap-water, wring it out, and fold Kumbi's lip down over that, holding it there about a minute. THEN I prick. Whew! Here comes the sample!

There are other excruciating details in the pages I referred you to, any of which might make your testing easier, so I suggest you read through the text on those pages.

Before I go shoot Kumbi in the back (8 minutes from now), let me add that I believe one of the most common problems is using lancets of too fine a gauge. I need at least a 25-gauge lancet to get blood from Kumbi. I prick by hand, and I sink the needle all the way - to its full depth.

The higher the number, the THINNER the needle. I think I'm going to look for 24-gauge lancets. That would make Kumbi's and my lives easier.

But the warming will do about as well.

I think ten pricks are too many before giving up, and considering where in the procedure something isn't working! So, I suggest, check the gauge of your lancets, check whether you're warming the site enough; check whether another prick-site would be easier.

My vets choose the "Lip-Stick' because ther are so FEW nerve-endings there - the dog doesn't feel any pain.

Kumbi's shot-time! Bye!

Sat, 7 Nov 2009 06:56:14 (PST)

[marleyman]

Re: New Member = At our wits end

Oh, MarleyMan,



Natalie's video showing her lip-prick on Chris is excellent. I think people feel strange about "pricking a lip." *I* certainly, did; in fact, when I was gearing up to learn to test Kumbi, I spent a whole WEEK considering whether some other prick-site would be better.

Then I talked it over again with my vet. She said they use the lip-prick because it seems easiest for the dogs!

Well, SURE ENOUGH! Of course, that's for dogs who can learn to accept it.

It's not the lip, in fact, that my vets and I prick; it's the inner lining of the mouth - the lip gets folded back against the upper jaw (see Natalie's video).

Also, there are detailed descriptions here:

http://www.coherentdog.org/vek/bgtest.php

I really need to add one more piece of information to those pages, because Kumbi doesn't bleed all that easily, especially on his left side. People who do Ear-Pricks usually warm the site first. That can make all the difference.

I never bothered, with the lip-prick, but later, I learned it makes all the difference even on the "lip"! So now, I wet a paper towel in hot tap-water, wring it out, and fold Kumbi's lip down over that, holding it there about a minute. THEN I prick. Whew! Here comes the sample!

There are other excruciating details in the pages I referred you to, any of which might make your testing easier, so I suggest you read through the text on those pages.

Before I go shoot Kumbi in the back (8 minutes from now), let me add that I believe one of the most common problems is using lancets of too fine a gauge. I need at least a 25-gauge lancet to get blood from Kumbi. I prick by hand, and I sink the needle all the way - to its full depth.

The higher the number, the THINNER the needle. I think I'm going to look for 24-gauge lancets. That would make Kumbi's and my lives easier.

But the warming will do about as well.

I think ten pricks are too many before giving up, and considering where in the procedure something isn't working! So, I suggest, check the gauge of your lancets, check whether you're warming the site enough; check whether another prick-site would be easier.

My vets choose the "Lip-Stick' because ther are so FEW nerve-endings there - the dog doesn't feel any pain.

Kumbi's shot-time! Bye!

Sat, 7 Nov 2009 06:56:14 (PST)

Thank you so much for all this information....you all have given us more helpful advice then our own Vet has in the last year and a half....

...now I'm crying from joy instead of sadness :-)