Who took their dog to a specialist? Advice?

[anotherk9lover]

Do what exactly? The curves? I felt like the specialist gave me very little info on diabetes in general. All she said is to just lower her to 5 units and recheck curve in 3-4 weeks before bringing her in for a follow up. I'm not going to do that, bring her back in that is. What kind of insulin did you guys use? She seemed to think that 6 units for Daisy who is 4.9kg is too high, but she also mentioned that NPH N from Walmart that we use is a weaker insulin, so maybe that's why daisy needs a bit more of it. How did you guys go about dosing, and what type of insulin?

[Judi]

we used nph from walmart because of the cost. most people around here use that.

in US terms my dog weighed 7 lbs. We started at 1 unit twice a day. Did a curve every week to 10 days. It. Took. Forever.

What was Daisy's last curve at 6?

[anotherk9lover]

Her last curve 12/23/19 at 6 units was: 386 (fasting 6am), 458, 178, 198, 221, 320, 445. That's from 0600 to 6pm every 2h. And then I checked again at 11pm just to see what the peak was, and it was 94, which the specialist seemed to not like that it's pretty low, so that was part of the reason why she lowered it to 5. But the previous curve on 5 units was higher: 446, 450, 391, 367, 416, 410, 502. It never even went lower than 300's at the peak which is really weird. The curve 2 weeks before that looked better, on 6 units, but it went low at one point which is why my vet wanted her back on 5: 94 (fasting), 157, 59 (at peak 11am), 198, 405, 539. As you can see her curves are just all over the place.

The best curve we had was back in end of sept, it was on 5 units: 349, 415, 190, 161, 200, 189, 133 (before 6pm feed). I'm not sure how to interpret these really, and the specialist didn't tell me anything in depth about it either, she mentioned that maybe increasing the dose makes her compensate by creating higher sugar, not sure how that works. Anyone experience that?

[anotherk9lover]

Did any of your pets suffer with uti's or skin infections? Daisy gets yeast infections around her urethra because she has folds there that collect moisture and turn into infections. Have you found any helpful products for it? I imagine now with diabetes things will get even more aggressive, although strangely this has ben her longest stretch without an infection yet.

Maybe there's already a thread on that here, i'm not too sure how to navigate it still.

[jesse girl]

cushing meds could have caused the instability .

people do curves every one to two weeks until the dog is regulated and that can mean different types of regulation . i am happy for jesse to be from 100 to 250 . she has had very good sugar and at times not so much in her almost 10 year career in diabetes

usually a starting dose is multiplying weight by .2 now my jesse need less than a starting dose so nothing is perfect . all dogs have a unique way of processing injected insulin . my jesse is on nph from walmart

[k9diabetes]

[QUOTE=anotherk9lover;167938]

Originally Posted by Raysaint

I don't know, i'm genuinely confused because I was under the impression that low carb and high protein is what's recommended for diabetic dogs.

Pet store owners in particular, pushed by pet food manufacturers, are always trying to sell low-carb high-protein food for diabetic dogs and freak out if you tell them you need your dog a food with corn in it.

But here's the thing.

Most of what the people selling the food know about diabetes they know about human diabetes and, in particular, Type 2 diabetes, which is heavily influenced by diet.

Canine diabetes is basically always similar to Type 1 in humans but there are important species differences in how they process these insulins.

Dogs typically process NPH faster than humans do. And process Vetsulin fairly quickly as well. So we have seen over the years - I've been involved in this and a preceding forum since 2004 - is that dogs need some carbs to go with the fairly quick effect they get from their insulin. And that high protein and mostly meat diets generally have not worked well for diabetic dogs.

Every dog is different - in the end, I think the best advice is to feed the food that gives your dog the most level blood sugar.

The flatter the blood sugar, the better you can regulate their diabetes. Because you have to base the insulin dose on their LOWEST blood sugar, not their highest. All levels drop if you increase the insulin so you can only increase it so long as the LOWEST blood sugar isn't too low.

Some dogs who really get a quick response to the insulin have actually had to have really carby food and/or a delay in injecting the insulin so that the insulin and sugar from food got delivered together. Like crackers carby!!

I know you posted your curve and when I have a bit more time I will take a look at it.

But if the blood sugar never goes below 300 or 250, that's indicates that more insulin is needed.

Natalie

[k9diabetes]

Originally Posted by anotherk9lover

Do what exactly? The curves? I felt like the specialist gave me very little info on diabetes in general. All she said is to just lower her to 5 units and recheck curve in 3-4 weeks before bringing her in for a follow up. I'm not going to do that, bring her back in that is. What kind of insulin did you guys use? She seemed to think that 6 units for Daisy who is 4.9kg is too high, but she also mentioned that NPH N from Walmart that we use is a weaker insulin, so maybe that's why daisy needs a bit more of it. How did you guys go about dosing, and what type of insulin?

Hope you mistunderstood the vet about NPH being a "weaker" insulin as there is no such thing. There are "weaker" solutions that deliver less insulin molecules than other solutions. But NPH isn't even that!

At 4.9 kg, she weighs about 10.75 pounds. So 6 units is within the normal range but on the high side of normal.

To be honest, I wouldn't put much stock in a specialist's knowledge of regulating your dog's diabetes... we took our dog to the guy who literally wrote the book on canine endocrinology used to teach up and coming vets and he was an idiot. We wound up regulating our dog ourselves using home testing. And we never used a high protein diet.

You can learn a bit about our dog's journey at www.k9diabetes.com/k9diabetes.pdf

Whether she should be on 6 units depends on how long she's been on insulin. I will go check.

[k9diabetes]

Originally Posted by anotherk9lover

Her last curve 12/23/19 at 6 units was: 386 (fasting 6am), 458, 178, 198, 221, 320, 445. That's from 0600 to 6pm every 2h. And then I checked again at 11pm just to see what the peak was, and it was 94, which the specialist seemed to not like that it's pretty low, so that was part of the reason why she lowered it to 5. But the previous curve on 5 units was higher: 446, 450, 391, 367, 416, 410, 502. It never even went lower than 300's at the peak which is really weird. The curve 2 weeks before that looked better, on 6 units, but it went low at one point which is why my vet wanted her back on 5: 94 (fasting), 157, 59 (at peak 11am), 198, 405, 539. As you can see her curves are just all over the place.

The best curve we had was back in end of sept, it was on 5 units: 349, 415, 190, 161, 200, 189, 133 (before 6pm feed). I'm not sure how to interpret these really, and the specialist didn't tell me anything in depth about it either, she mentioned that maybe increasing the dose makes her compensate by creating higher sugar, not sure how that works. Anyone experience that?

I would be concerned about a 94 reading at night because it could have been lower before or after that.

The answer could be to give less insulin at night than in the daytime.

Also, keep in mind that going up or down between 5 and 6 units is a pretty large change. A 20% increase by adding 1 unit when giving five units.

So 5 could be not enough and 6 too much. You can eyeball half units on the syringe or get syringes with half unit marks - that's what we used.

.......

My advice: Do 5.0 units for five days, do a curve at home from morning until bedtime and see what you get. Post the numbers here and we can help you interpret them and decide what would likely improve the curve.

Natalie

[k9diabetes]

Take a look at the main website for general information on regulating, testing, effects of things like Cushings, etc.

In particular, look at honeymooning, which can mean that a dose of insulin that was too high six months ago is too low now.

http://www.k9diabetes.com

http://www.k9diabetes.com/dogdiabeteshoneymoon.html

http://www.k9diabetes.com/insulinfood.html

Natalie

[Raysaint]

Studies show that curves are usually slightly different even one day apart. It can depend on what the fasting is, as sometimes bodies compensate differently as the day wears on.
If my dog starts high, his nadir can be 8 points lower than fasting. If he starts good, he might only be 2 points lower. (a point Canadian is about 20 points U.S.)
My vet always tells me that any reading is one point in time and may be different other times, so myself, I wouldn't worry about a 94 unless they were consistent. That's why when playing with doses, might be good to do more than one curve once you settle in to one dose. And changing doses often is going to affect curves.
Looks like 5.5 units might be the dose to try for a couple weeks. Half unit increases are normal for small dogs.

As for yeast, our chihuahua also gets them, and had them bad when we got her. So my vet prescribed me some Surolan, but now it's Otizole. I keep a small bottle handy for the odd time she gets a bit yeasty (she licks more and the skin gets blackish.) I clean the area with hydrogen peroxide, then apply the ointment every 12 hours for a few days.

Your specialist didn't help much because there is no magic bullet to regulation. The people on here have learned that it's methodical and consistent. Same dose for at least a week, curve, adjust, repeat. Stick with the same food while doing that. If that seems to not produce results, a food change may be tried, but then you should start back at a smaller dose just in case. Then curve, adjust repeat.
And most agree that high protein is not the norm for any diabetic. You need carbs to balance and work with the insulin pattern.

It can take a while. Just when things start to look promising, something will surprise you and you think thru what might be happening.

It took me 2 years to get my dog where he is now. Don't panic, stay the course.