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  #231  
Old 10-04-2008, 06:39 PM
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Default Re: Cara - Need a shoulder!

does that mean her fast acting part of the insulin cannot handle it at the moment....so...indications of infection?
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Last edited by Cara's Mom; 10-04-2008 at 06:40 PM. Reason: typo
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  #232  
Old 10-04-2008, 07:11 PM
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Default Re: Cara - Need a shoulder!

Marion,

Right now, what you may be seeing is the point where the fast-acting semilente insulin peaks--around 10 AM--and the second peak at about 4 PM is that of the long-acting ultralente.

http://www.ncbi.nlm.nih.gov/pubmed/9...gdbfrom=pubmed

Pharmacokinetics of a porcine insulin zinc suspension in diabetic dogs.
Journal of Small Animal Practice-1997

"Ten dogs with naturally occurring diabetes mellitus were injected with a highly purified porcine insulin zinc suspension at a dose according to their expected requirement. Plasma insulin and glucose concentrations were measured at two-hourly intervals over 24 hours following injection. There were either one or two peaks in plasma insulin concentration: one at about four hours (mean 4.3 +/- 1.3 [SD]) and another at about 11 hours (mean 11 +/- 1.85) after the injection. The second insulin peak was seen in only eight dogs. Persistence of elevated plasma insulin concentrations ranged from 14 to 24 hours (mean 17.4 +/- 3.65). These results compare favourably with those published for other intermediate-acting insulin preparations used to treat canine diabetes mellitus and suggest that this preparation has useful properties for the successful management of many canine diabetics."

Taking this apart a bit, they say that the first peak at about 4 hours after insulin is plus or minus 1.3 hours. That means it could be 1.3 hours sooner or 1.3 hours later. Then you see them talk about the second peak at 11 hours--plus or minus 1.85 hours later. Meaning that it could be close to 2 hours earlier or later than 11 hours.

These numbers are an average of the times noted for the 10 dogs tested, with 8 of the 10 showing evidence of the second, later peak.

All Lente insulins "operate" like this, in the respect that there are two Lente family insulins combined to produce the insulin--30% fast-acting semilente and 70% slow-acting ultralente.

http://petdiabetes.wikia.com/wiki/Lente

But what's shown as a time activity profile is all of this nicely "smoothed" out:


People who continue to use Lente insulin (beef only now--imported from the UK) and those who formerly used it when it was more widely available would have also had the possibility for the two peaks because no matter what one makes or made the insulin from, it still works in the same fashion.

It may be that you will continue to see two peaks from Cara. When her bg's were so high, it would have been difficult to impossible to have seen it.

Lucky did not show two peaks but just the one later in the day, so he was still keeping with his tradition of not going by the book.

Does this help any--sure hope so!

Kathy
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  #233  
Old 10-04-2008, 07:33 PM
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Default Re: Cara - Need a shoulder!

Hi Kathy, so again she is doing what she's supposed to be doing!!!!! Smart doggie!
I believed it to be an indication of an infection. Never realized there could be 2 peaks ( Twin Peaks ). Just got my head around "nadir" or "peak" and doing my own curves on Vetsulins webside. Boy, still got a lot to learn
The urine test at the Vet was called "inconclusive" (don't like that word !), little to "murky"( scientific word?!?) and that's why it was sent out. There were no ketones, but Bg's were present, ofcourse.

Thanks Kathy, you are the bestes!
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  #234  
Old 10-04-2008, 08:06 PM
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Default Re: Cara - Need a shoulder!

Marion,

If you look at this (another "grab" via Google cache from caninsulin.com), noting the blue lines for insulin, you'll see the faster semilente peaking at about 10:00 in the example. Then you see the slow ultralente peaking between 14:00 and 16:00--


Keep in mind that the higher the blue line goes, the harder the insulin is working--the red line is the blood glucose.

Now--let's have a look at another fast-acting insulin--this is R, Regular, or Neutral. This is used to cover meals and to bring down high bg's; it has roughly the same time activity profile as semilente.


See how much that looks like the semilente blue line from about 8:00 to 12:00 on the Caninsulin example?

And now, we take a look at ultralente:


Have a look at this one at about 12 to 14 hours after injection; the "bump" is the tallest--this is the peak of ultralente. Now look back at the Caninsulin example at about 14:00 to 16:00--this is where the ultralente starts working hardest.

I used to watch that show, "Twin Peaks". I agree with you re: inconclusive, but there are times when it's really the only way to describe where we are at this point--what we've done up to now hasn't ruled in anything or ruled it out either.

Nice to know that something that looked worrisome really isn't, right?

Kathy
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  #235  
Old 10-04-2008, 08:13 PM
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Default Re: Cara - Need a shoulder!

RIGHT!
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  #236  
Old 10-05-2008, 06:50 AM
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Default Re: Cara - Need a shoulder!

Have other question: Re: those "Twin Peaks"
With the first peak being at 10 AM, around the same time of our walk, will it not be more benificial to change walktime? Let's say more towards the "Valley" time? As a boost for the insulin?
Just thinking
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  #237  
Old 10-05-2008, 08:20 AM
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Default Re: Cara - Need a shoulder!

Marion,

I think this is worth a try!

http://www.bddiabetes.com/us/main.aspx?cat=1&id=389

"Managing your dog’s diabetes also means managing its activity level. Exercise ‘burns up’ blood glucose the same way that insulin does."


You may find that in changing the time of your walk, the exercise could be more helpful at keeping those bg's down after the 10 AM insulin peak is over.

Quote:
Boy, still got a lot to learn
I think you're doing GREAT at this!

Kathy
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  #238  
Old 10-05-2008, 09:24 AM
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Default Re: Cara - Need a shoulder!

Just came back from our walk.....so will try this to-morrow !
I do have lot to learn yet, but with things slowing down a little....my brain starts working again and I seem to able to "reason" better
Thanks Kathy
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  #239  
Old 10-05-2008, 10:29 AM
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Default Re: Cara - Need a shoulder!

You're darn tootin' you're learnin' those ropes!

Kathy
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  #240  
Old 10-06-2008, 10:20 PM
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Default Re: Cara - Need a shoulder!

Sounds like you are taking good care of Cara.

Re: UTI's, Niki has never had this problem, but earlier in her diag she was constantly high and I notices by her PP little crystals hanging from her hair, the doc said it was from the sugar in the urine, so I gave her a wash with my summers eve, went over the area with a tucks pad.

So I wash her PP once a week, sometimes I forget, but I think from the urine with the sugar in it and then sometimes they are laying on the floor leaking the urine that is how they get a UTI, thats just my thought on it.

Niki does seem relieved when I do this, especially when I wash the area behind her PP where the urine would drip on, on the fur.

Maybe I'm just nuts, but she hasn't had a UTI yet.
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