New -- Barb and Harriet

[Barbara Erwin]

Hi, everyone -- My eight-year-old Westie, Harriet, was diagnosed with diabetes in March. She had been on prednisone for a number of years because of atopic dermatitis, a common skin condition for Westies, unfortunately. She was tested for Cushings and the vet says she didn't have it, but I still believe she was showing the early signs of Cushings, probably iatrogenic Cushings (the kind that's caused by long-term steroid use). She is off prednisone now and on twice-daily shots of 6 iu of Caninsulin. I am trying to manager her skin issues with diet (grain-free Orijen) and Omega fatty acid supplements. If that doesn't work, the vet says the only option is Atopica, which is expensive but, more importantly, another drug that I'm just not comfortable giving her.

My question is this: Harriet started out on 3 iu of insulin twice daily and was gradually increased to 6 as a result of blood glucose curves done both at the vets and by me at home, using an AlphaTrak blood glucose monitor. When she was on 5 iu, her highest readings of the day were around 20 mmol/l. The 6 brought her down under 12 for most of the day, which is what the vet was hoping for. However, yesterday I did another curve and she was under 8 most of the day, dropping as low as 3.3 in the late morning (I gave her a Dentastick, which she loves, and that brought her back up to 8.4 within an hour). The strange thing was that, after the 8.4 reading, she dropped down to 7.7 and 7.0 over the next four hours. This was several hours after her insulin shot and well past the point at which she usually bottoms out. Do you think she's starting to produce insulin on her own? I have read that, once dogs with iatrogenic Cushings are off prednisone, their adrenal glands will begin to produce adrenaline and that can reverse some of the symptoms of the disease -- including diabetes that was related to the Cushings. Is this just wishful thinking on my part?

[Busy07]

Re: New -- Barb and Harriet

I'm brand new and I don't know the answer, BUT, we have been told the same thing can happen with Oliver. His diabetes is prednisone induced due to treatment of meningitis. He is now totally off of the prednisone (just finished on Monday); however, he is on Atopica until we're sure the meningitis has resolved. We were told that sometimes within a few months to a year that the diabetes can resolve.

The folks here are much more knowledgeable than I and can certainly give you more information.

Time will tell, and it can happen. I hope that's true in your case.

[BestBuddy]

Re: New -- Barb and Harriet

Hi Barb and Harriet,
Sometimes it is just the body adjusting and using the insulin better. It has only been a few months and I would keep a close watch on those numbers and if it stays too low then I would drop the insulin a little and see how that went for a few days.
Jenny

[k9diabetes]

Re: New -- Barb and Harriet

Hi Barbara! Welcome to you and Harriet!

When did she finish up the prednisone entirely?

How much does she weigh?

Natalie

[eyelostit]

Re: New -- Barb and Harriet

Hi Barbara and Harriet, Welcome

Sorry about the skin problems

I was wondering if you had a recent curve you could post.

Harriet was on 3 units caninsulin at dx 2 x day and now at 6 units.

Can you tell us how long has it been since Harriet was put on 6 units? and also the type of food Harriet is eating.

Has the vet said anything about the readings

Sorry for all the questions but it helps us so much

Dolly

[Barbara Erwin]

Re: New -- Barb and Harriet

Hi, everyone -- Harriet weighs 15.9 pounds (she was close to 18 pounds before being diagnosed but this is a better weight for her) and has been on six units twice a day for about a month. She started at three units twice a day, then went up to five after a curve at the vet's. We did our own curve after a couple of weeks on the five units and consulted with our vet, who advised us to increase it to six units twice a day.

Around the same time we increased her to six units, I switched her from the vet-recommended Purina Weight Management food to Orijen adult to see if the grain-free diet would help her skin problems. I also added a daily Omega fatty acid supplement. We've tried various antihistamines to no avail. So far, her skin has been manageable but she's still itchy and needs to be bathed every couple of days in an anti-fungal shampoo and a colloidal oatmeal cream rinse.

She has been off prednisone since March when she first started exhibiting signs of Cushings and diabetes. I now blame that drug for many of her problems and wish I had done more research on its potential ill effects. My previous vet had said that the side effects were minimal as long as we kept to alternate day dosing -- I now know that he understated the problems with long-term steroid use.

Her last curve was (sorry, the measurements are in mmol/l, which I know aren't the most common on here):

6:45 a.m.: 8.0 -- food and insulin administered right after this reading

8:45 a.m.: 8.2

10:55 a.m.: 5.7

12:50 p.m.: 3.3 -- got nervous and gave her a Dentastick to bring it up

1:50 p.m.: 8.4

3:40 p.m.: 7.0 -- this is the one that surprised me because she dropped on her own without any insulin

6:45 p.m.: 7.8 -- food and insulin administered right after this reading

8:40 p.m.: 4.1

10:10 p.m.: 5.9

This board is such a help to us newbies! Thank you all for your sage advice.

Harriet came from a pet store (I know, bad idea) and has her origins in what is likely a puppy mill in Missouri. In-breeding is no doubt at the root of her skin issues and maybe even her other health problems. But she's now a member of our family and we'll do whatever it takes to make sure she gets the best possible care.

[k9diabetes]

Re: New -- Barb and Harriet

Harriet is such a great name for a Westie!

I'll just add the U.S. numbers as it's easier for me to think about it that way...

6:45 a.m.: 8.0 = 144
-- food and insulin administered right after this reading

8:45 a.m.: 8.2 = 147.6

10:55 a.m.: 5.7 = 102.6

12:50 p.m.: 3.3 = 59.4
-- got nervous and gave her a Dentastick to bring it up

1:50 p.m.: 8.4 = 151.2

3:40 p.m.: 7.0 = 126
-- this is the one that surprised me because she dropped on her own without any insulin

6:45 p.m.: 7.8 = 140.4
-- food and insulin administered right after this reading

8:40 p.m.: 4.1 = 73.8

10:10 p.m.: 5.9 = 106.2

I think only time will tell whether she's going to start producing insulin again or whether this is just a matter of breaking down some resistance to insulin that she had built up when her blood sugar was high.

Except for the lows, which are too low for safety, it's a beautiful curve.

Have you reduced her insulin a tad?

You can do half units and if you convert to U100 syringes you can get syringes that measure in quarter half units and eyeball a quarter of a unit. With a tiny dose like this, a quarter unit can make a big difference.

But you could start with 5.5 and see how that goes.

Chris, when honeymooning cuz he started to produce insulin, had flatter curves than this. All within a normal 70-100. Still, every dog is different and I don't think any of us can say what's up with Harriet until she tells us.

We really thought for a while that Chris might go off insulin altogether. When he was down from 14 units per injection to 1!!! But after six months, he lost the ability to produce insulin at all.

Five or six units would be a pretty common dose for her size.

Natalie

[Barbara Erwin]

Re: New -- Barb and Harriet

Thanks, Natalie. I have reduced her over the past couple of days to 5.5 units and will do another curve or at least some spot testing on the weekend.

[Patty]

Re: New -- Barb and Harriet

You can do half units and if you convert to U100 syringes you can get syringes that measure in quarter units. With a tiny dose like this, a quarter unit can make a big difference.

Natalie,
You meant half units here, right? I would LOVE a syringe that measured quarter units so I didn't have to eyeball it!!

And Welcome Barb and Harriet!

Patty

[k9diabetes]

Re: New -- Barb and Harriet

Yes, thank you Patty!! I amended the post... if only syringes came with quarter unit marks... of course they'd have to be fat like a big marker!

[eyelostit]

Re: New -- Barb and Harriet

Thats not a bad curve, I'd decrease the insulin a wee bit also to offset the lows.

You're doing a good job.
Dolly

[debbie]

Re: New -- Barb and Harriet

Hi Barb
My buster got diabetes I would say about February as Harriet. Busters was also prednisone induced. He was given it on and off for his skin and then the vet thought he had ibd and it stopped his vomiting. Anyway, I feel you pain. I changed vets now. Buster has been completely off the prednisone and is fine. I was never told this could have happened to buster while on prednisone. Busters insulin went up to 21 units and now we are at 16. I of course have hope that the diabetes can resolve itself but the vet tells me no. Cats can but not dogs. Now you seem to know more than I do on what is going on witht he curve thing and everything. I do the diastix. I ordered one touch to check his blood like everyone else does but have not received it. I do get very frustrated. I am still very new at this too.
Debbie

[Barbara Erwin]

Re: New -- Barb and Harriet

It has been a long time since I've posted here. I can't believe it has been almost six years since my first worried post after Harriet was diagnosed with diabetes. I'm happy to say that she's still with us, despite some ups and downs. She's had a couple of corneal ulcers, has been diagnosed with an underactive thyroid and, last February, the vets said she had bladder cancer after several persistent UTIs. If that is indeed the case (her biopsy came back "inconclusive" but an ultrasound definitely shows a mass of some kind on her bladder), it is not a rapidly advancing form of cancer. She's now 13 1/2 years old and on quite a few different medications, but her blood sugar has been pretty stable throughout it all. I just wanted to post again to give anyone with a recent diagnosis hope that you can have a long-term positive outcome. Barb

[amydunn19]

Re: New -- Barb and Harriet

Thanks for updating - it is so good for new people to see that their dog can live with diabetes. My Maggie has had corneal ulcers too and we can't get her last one completely back to normal, even after surgery. But, life would be boring without ups and downs, right?

[Monsters Momma]

Re: New -- Barb and Harriet

It has been a long time since I've posted here. I can't believe it has been almost six years since my first worried post after Harriet was diagnosed with diabetes. I'm happy to say that she's still with us, despite some ups and downs. She's had a couple of corneal ulcers, has been diagnosed with an underactive thyroid and, last February, the vets said she had bladder cancer after several persistent UTIs. If that is indeed the case (her biopsy came back "inconclusive" but an ultrasound definitely shows a mass of some kind on her bladder), it is not a rapidly advancing form of cancer. She's now 13 1/2 years old and on quite a few different medications, but her blood sugar has been pretty stable throughout it all. I just wanted to post again to give anyone with a recent diagnosis hope that you can have a long-term positive outcome. Barb

Wow! Six years is an awesome feat! Especially with everything else that you've had happen. Congrats! And thanks for posting!
Mel and Vinny <---1-1/2 years