Blood Glucose Problems!

[Jules]

Hi Everyone,
3 months ago my 13 year Cavalier dog was diagnosed with Cushings Decease, Diabetes, Sick Sinus Syndrome and a Heart Valve Issue. He nearly went blind at the beginning of the month, due to the diabetes attacking his system so quickly. I was able to have his cataract surgery done and he has done beautifully with his healing. However!! The Vetsulin has not been favorable for him and BG was spiking at odd times (Curve: 8:00am=313 10:00am=537 12:00pm=515 2:00pm=441 4:00pm=264 6:00pm= 255) I think they are trying to keep him in the 300-375 range, so the Internist has switched him to Novolin N and his levels are staying in the 525+ ranges. I am currently in the middle of a curve (Fasting Curve @ 7:00am=530 8:00am=507 10:00am=465 12:00pm=539). This is my first curve on the Novolin N I know we can regulate ourselves with urine strips and blood tests (which he is very tolerant of when I prick his paw). I am however, uncertain, of how much I can increase the Novolin N. I know they were increasing the Vetsulin 1-2 units at a time. Would that be the same for the Novolin N? I am so new to this and am so frustrated with the vets not helping. ALL help is appreciated!!
Thank You,
Jules

[CraigM]

Welcome to the forum.

How much does your pup weigh? What medications is he on in addition to the Novolin-N? Did you switch to U-100 syringes when you switched to Novolin-N?

Craig

[CraigM]

Oops, a few more questions.

What dosage of Novolin-N? Injecting and feeding twice a day, about 12 hours apart?

Craig

[Jules]

Originally Posted by CraigM

Oops, a few more questions.

What dosage of Novolin-N? Injecting and feeding twice a day, about 12 hours apart?

Craig

Hi Craig,
Thank you! I'm very grateful to have found this forum!! Hunter weighs 17.2 pounds. Because of other health issues he is on a number of other drugs + vitamins. So, with the diabetes. He is on Novolin-N (7 units 2 times a day), and yes definitely switched to the U-100 short syringes. His heart conditions demand 2 drugs to keep his heart pumping that is 2.5mg Terbutaline 2x a day, 100mg Theophylline SR 2x a day. His cushings decease is controlled with 250mg on Tuesdays and 125mg on Saturdays. His liver and gallbladder have been diagnosed as "sludgy" so we have to take 150mg of Ursodiol 1x a day. And last but not least, he has 2 herniated discs(long ago injuries) in his back that may or may not be affecting his spinal cord so....he is on 100mg Gabapentin 2x a day. And all the drugs are given 12 hours apart, except Ursodiol that is given at lunch with his vitamins (Petform). I know he is 13 but this dog is so high energy and life loving he doesn't let much get to him. But I have to say diabetes is really nudging his tolerance level right now. This has been a very difficult thing for him to beat. We had the cardiologist at his cataract surgery to externally pace his heart during surgery 26 days ago. His eyesight is back and he is only on Neo/Poly/Dex drops 3x a day, the Neo/Poly/Dex ointment 2x day and the Tacrolimus Tears 2x a day. He is a difficult case, but he has a tremendous love for life!! As always all help is appreciated.
Jules

[CraigM]

Thanks for the additional information. I was lucky that my Annie was “only” diabetic. I’m sure Hunter is more challenging! I’m hoping that others with more experience will check in this evening.

I think I’ve read that Cushings dogs usually require higher insulin dosage? Many on the forum try to maintain 150-250ish range. What meter are you using?

Craig

[Jules]

Originally Posted by CraigM

Thanks for the additional information. I was lucky that my Annie was “only” diabetic. I’m sure Hunter is more challenging! I’m hoping that others with more experience will check in this evening.

I think I’ve read that Cushings dogs usually require higher insulin dosage? Many on the forum try to maintain 150-250ish range. What meter are you using?

Craig

Thank you Craig, I hope that what we are having to go through will somehow help someone else. That is always my prayer. I'm using the AlphaTrack which is the same one they use at the emergency vet here. I really have had great results with it and find it very easy to use. I wish we would have been able to find y'all earlier and have shared time with Annie here in the forum.
Jules

[MikeMurphy]

Hi Jules and welcome to the forum. Hunter has a lot going on there. He’s lucky to have you to care for him.

The process to get his BG regulated is the same for Novolin N as it is for Vetsulin... let his body adjust to insulin increases for 5 to 7 days, do a 12 hour curve, evaluate the results and then, if necessary, increase insulin in 1 or .5 unit increments and then repeat the process until his low(nadir) BG reading is around 150.

Medications can affect his readings. For example, Neo/poly/Dex for his eyes is a steroid, which usually raises blood glucose. But every dog reacts differently. My Lily is on it and her BG doesn’t seem to rise with it.

Mike

[Jules]

Originally Posted by MikeMurphy

Hi Jules and welcome to the forum. Hunter has a lot going on there. He’s lucky to have you to care for him.

The process to get his BG regulated is the same for Novolin N as it is for Vetsulin... let his body adjust to insulin increases for 5 to 7 days, do a 12 hour curve, evaluate the results and then, if necessary, increase insulin in 1 or .5 unit increments and then repeat the process until his low(nadir) BG reading is around 150.

Medications can affect his readings. For example, Neo/poly/Dex for his eyes is a steroid, which usually raises blood glucose. But every dog reacts differently. My Lily is on it and her BG doesn’t seem to rise with it.

Mike

Hi Mike,
Thank you!! Awesome information. It's wonderful to be here!
Jules

[MikeMurphy]

Originally Posted by Jules

Good Morning.
I have a question about monitoring. I use AlphTrack and Novolin N. I am currently using 9 units 2x a day, which was increased from 7 units 2x a day on Monday 10-30-17. I have my next curve set for Sunday should all go well and I do not see a need to do it sooner. During the curve if I see that the levels are not backing down is it ok to adjust the insulin during the curve or should I wait for the 7:00 pm shot?
Any advice?
Jules

Hi Jules,

I copied your question to your thread.

It’s always good to complete the full curve. That way you get to see the full picture... fasting numbers, nadir and everything in between. Then a decision can be made on what to do.

Mike

[Jules]

Thanks for both the info and placing me back on my thread. Still learning to navigate the forum