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  #31  
Old 07-13-2010, 09:16 PM
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Default Re: why does jesse need less and less insulin all of a suden

thanks for the information patty the standard way has had no success she doesnt understand the word routine and normal way of doing things shes a great girl work has been slow so i have been able to put alot of time into her and love to do it the spike occurs more so after the shot begins acting and not the food timing it seems when the insulin is working for an hour you can almost set your clock by it and thats when the spike begin the spike in the morning happens at the end of the cycle that just started with less insulin she has had some nice flat times where she didnt move much but it didnt last usually the dose that was working became to much and had to drop and she would be to high It would be nice to just be in the 200s instead of below 100 or 300 an above where is that happy medium it must be out there some where
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  #32  
Old 07-13-2010, 10:28 PM
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Default Re: why does jesse need less and less insulin all of a suden

This is potentially an incredibly complicated picture... the possible influences on Jesse's blood sugar include:

- recent hysterectomy and question about whether ovaries were removed with changing hormone levels or hormone-generated high blood sugar.

- fairly recent diagnosis with potential insulin resistance from the high blood sugar that now could be starting to fade so less insulin is required.

- recent pancreatitis that can affect blood sugar in multiple ways - insulin production could return when pancreatitis resolved or inflammation of the pancreas generated a need for more insulin at first and less is needed now.

- honeymooning with recurrent insulin production unrelated to the pancreatitis.

All of these influences could be behind her need for less insulin and are creating whatever her current diabetes status is now.

If you can find a place where you can hold everything constant for four or five days with no low blood sugar and ignore the higher levels, no changes in timing of meals and injections, no changes in food... that will give you the clearest picture of her current food/insulin balance and status of her diabetes. And of course find out whether she could still be producing hormones.

If she could stay at the levels you got at 1.5 units, that would be great as they are in a decent range - not terribly low or terribly high. A good place to settle and wait for a longer-term response.

Natalie
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  #33  
Old 07-14-2010, 08:10 AM
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Default Re: why does jesse need less and less insulin all of a suden

I'm going to type within your post to share some thoughts I have...
thanks for the information patty.

The standard way has had no success. She doesnt understand the word routine and normal way of doing things. I do understand this. My girl is a bit of an anomaly herself. Natalie's Chris didn't process insulin the same way many dogs do either. And Joan's Bella is on a more unusual shot schedule that works for her. Shes a great girl. Work has been slow so i have been able to put alot of time into her and love to do it. Your dedication to her shows. I realize you've done a lot detective work before having come here so we don't have the same picture in viewing past curves. I did have a friend give me some advice when I was struggling with Ali before. She said when things go haywire, go back to the basics.

That's essentially what I would do. I like Natalie's thought here:
Quote:
If she could stay at the levels you got at 1.5 units, that would be great as they are in a decent range - not terribly low or terribly high. A good place to settle and wait for a longer-term response.
Maybe we could help sort things out, but I really think you need a stable baseline to work from again. There are potentially a lot of variables to consider at this point.

The spike occurs more so after the shot begins acting and not the food timing. It seems when the insulin is working for an hour you can almost set your clock by it, and thats when the spike begin. Every dog responds differently to food and can metabolize insulin differently as well. It may be that cutting back on some of her regular food while adding a different carb or protein source would even things out. Margaret is having do to this with her Lucy to eliminate a food spike. And Tricia's Lily is getting a very different response to the same food Daisy's Noodle is on. But a new baseline should help make these decisions.

The spike in the morning happens at the end of the cycle. That just started with less insulin. Unfortunately less insulin can also mean a shorter duration. So tweaking the food to even things out may be key.

She has had some nice flat times where she didnt move much, but it didnt last. Usually the dose that was working became to much and had to drop and she would be to high. Every time I make a change with my girl, she shows a nice flat even response . Then 3 days later shows her true colors and starts dropping or rising on me .

I have a friend whose dog would do a 3-day wobble. And Kevin was finding that Ozzi did this about every 2 weeks. He'd be fine for a while then have a very low day and have to "reset" things.

A temporary insulin resistance can also do this. The dose today can be too much in a few days. Conversely, a dose today that looks too low can settle in and be just right in several days. Dogs usually have some residual insulin working in the background that can accumulate and overlap the shot times. Over time, the build up can drop numbers a bit.

It would be nice to just be in the 200s instead of below 100 or 300 an above. Where is that happy medium? It must be out there some where Some dogs achieve this so easily it make the rest of us green with envy . Others are a lot harder work but I'm hoping we can help! I know it's hard and you've been doing a lot of work for your girl, but personally I'd like to see if you can hold steady on 1.5u with food/insulin timed together and exercise consistent for 4-5 days. See what this "clean slate" so to speak has to offer then post your curve. It may be that despite all your hard work there are things going on at a cellular level (as Natalie mentioned, like honeymooning or hormonal changes from remaining ovaries) that you may have to just "react to" for a time.

Hoping we can help!

Take care
Patty
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  #34  
Old 07-14-2010, 08:41 AM
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Default Re: why does jesse need less and less insulin all of a suden

we have been going in the upper 400s havent been there in awhile I do use r insulin at these times with good results I dont want her at these levels Patty i believe you may be right with the lower dose of insulin the staying power is not there maybe this brief honeymoon is over for now it appears the lower dose is not enough I have incorporated some r with n at shot time an hour after her meal the r starts in a 1/2 hour so time start is the same if i just gave some n at food time it takes her into the 200s and gets her out of those high ranges I went 2 units n 1unit r walk up at 5am she was at 238 checksd at 6 am 368 went for walk came back at 7 am 497 the pattern is the same but higher ranges with less insulin natalie your right this is very complicated we've been doing this since march and ive learned alot from you guys and trial and error her shots may have to be customize if given an hour after mealtime it gives me flexability the schedual is great for both of us we will keep workinf at it and thanks I will keep you posted
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  #35  
Old 07-15-2010, 02:27 PM
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Default Re: why does jesse need less and less insulin all of a suden

july 14 th

5pm 238
6:10 360 fed 3?4 cup bb
6:50am 439 after 45 minute walk used to drop on walks no insulin in system
7am shot 3 unit n 1 unit r
8 am 295
9 am 189
9:30 213
10 am 251 gave 1/2 unit of r
12:10 106
12:46 138
1:31 149
3 pm 172
4 pm 144
5 pm 167
5:53 188
6:15 312

with the r insulin during the ris up just a 1/2 unit will keep her flat all day at the number she settled at just today

8:53 am 355 gave 1/2 of r
9:25 am 319
10 am 221
10:41 226
1:30 225

last 3 hours 5 point fluctuation once the r insulin takes affect and drops her to the low point she stays flat for a long time its beautiful does this give you wonderful people any information this can be done with alot of monitoring and probably have to be home to see where bottom is but it shows it can be done the spike at 10 i still i believe this is sugar from the food at higher doses I could eliminate it but she went to low then she appeared to have a brief honey moon period that may come and go and she seems to need more insulin now the spike in the morning this wasnt here when using more insulin and did not go this high with less insulin in the past. this may be her body released sugar she even rose after her walk quite a bit and thats unusual lately but did happen in the past at the end of her cycle which made walks easier it appears there is no influence of insulin at this time maybe the lower dose is exhausted or her body is dumping sugar at the end of her cycle and overwhelming whats left r insulin works well to get alot of the excess sugar out and working together with n keeps her pretty flat the problem is developing a program out of this to anticipate the rises before they happen can be dangerous so you must let them at least begin and rise to at least 250 to be comfortable as you can see doses are small with great effect work is slow so i can do these thing the future may be different and may be working more I guess with the food thing the only way ime going to see when this will occur is not give her shot test and see the rise and give some r insulin to keep it under control its a little scary but shes high at times anyway and I can bring it back down any thoughts. what would a rise from food look like is it fast and strong is it slow and moderate I need to know if the rise is from the food or just a natural rise with no insulin in her system. ttanks if you have any ideas if you dont thats ok to havent called the em vet about her ovaries I really dont wont to talk to them it wasnt a pleasurable experience.
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  #36  
Old 07-15-2010, 06:04 PM
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Default Re: why does jesse need less and less insulin all of a suden

patty your over lap suggestion does make sense at the end of her cycle she would drop off pretty good at higher doses these doses weren't given for fairly long and the numbers were pretty good and then things went hay wire and she dropped a lot and no signs of rising without intervention so I lowered the dose dramatically and that worked for a little bit so overlap may have played a part in this as i stayed at the higher dose we had build up and you could see dropping after the 12 hours which carried into the next shot and it took some time to clear that at the lower dose which intern become not enough and numbers rose dramatically at the end
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  #37  
Old 07-15-2010, 08:16 PM
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Default Re: why does jesse need less and less insulin all of a suden

I'm afraid that I really have not been following your thread closely so don't know if this may even apply or if it has already been touched upon....

For a time I gave Mildred R along with her NPH. I worked and struggled with it and in the end found that R just lasted too long in Mildred's system as in reading I found this was true with others who used it.

I then switched her to Humalog at the suggestion of another who had trouble with R and found Humalog to have a much shorter duration so there was no insulin overlap.

Using Humalog now it controls her post prandial spike but is gone from her system in about 5 hours, this when her NPH is then peaking which then carries her thru to her next injections.

I give Mildred Humalog about 15-20 minutes before feeding followed by her NPH immediately after.

Forgive me if this bit of info is useless in your situation, just thought I would throw it out there to give you Mildred's situation when trying to use R.
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  #38  
Old 07-15-2010, 08:48 PM
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Default Re: why does jesse need less and less insulin all of a suden

every tid bit of information can help it may not apply today or never or maybe some one else was reading your post and said thats what i need for my dogie my dogies digestion appears to be slow to get going so i have to weight a bit and her food spike is much later . the r is just a temp fix it usually last at least i can tell at 5 hours I just use it mostly to clear some high numbers it may work combined handling the onset of food and the nph may handle the possible food spike that seems to come later hmm let me think about that . I appreciate your advise
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  #39  
Old 07-16-2010, 02:34 PM
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Default Re: why does jesse need less and less insulin all of a suden

here are some numbers for today I dont know where she will end up at the end of the day she may be alot higher and this question wont matter so much so here we go at 2:00 am she was at 377 from a dose at 7pm of 3.5 of n insulin gave a 1/2 unit of r at this 2 am time

5:45 191 this number was influenced by the r insulin
8:50 am 215 after !/2 hour walk not strenuous 238 usually can drop pretty good on any exercise so this is good not alot of influence of insulin
7 am 3.5 units of n and 1 unit of r
7:30 am 238
8 am 168 influence of just r insulin
9:10 am 113 influence of n and r at same time
9:30 am 137 brief food spike usually goes much higher just using n isulin
10:00 am 146
11:00 am 204 another spike up usually will keep going up
12 pm am 140 maybe the above number may be glitch in meter it does happen
12:45 138
2 pm 177 this rise may end in an hour and start going down but we shall see

my question could someone give me there opinion ive been down this road before good numbers but became to much insulin and things spiraled down the difference this time i may be using the same amount of insulin as before a total of 4.5 units but less at the top range of 5.5 but I have incorporated r with that total so all that will be remaining at the end is the 3.5 of n now if my ending point is in the low 200s should I give the same amount of insulin each of r and n if im lower than that should i reduce the dosage of r or n or both my logic behind this is the r to do the early work and the n for the longevity of the cycle 3.5 of n seems to work so far but cant do the early work and more of it can get her pretty low at the end of her cycle this is very early in this program so any suggestions or opinions would be great thank youits about 4 hour to shot time

quick question on exercise last time i took her this morning she did not drop maybe the duration of the insulin is just about finished any influence of insulin and exercise can provide a steep drop but maybe we hit a number on isulin that maybe ending its hot out but I hose her down before she goes so she is a wet mop and when we get back she is dry any thoughts would be nice Of coarse I have my own thoughts but ill see from you talented peaple what you may do in these situations aditional number 3:16 pm 173

Last edited by jesse girl; 07-16-2010 at 03:26 PM. Reason: added information
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  #40  
Old 07-18-2010, 09:19 PM
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Default Re: why does jesse need less and less insulin all of a suden

I'm sorry to be slow to get back to you. I have been away from desk most of the weekend.

Unfortunately, it is hard to make predictions when a regimen is changing all the time. The best advice I can give is to find something you can stick with for a minimum of five days, test and observe, and then look at the data you have collected for that entire time to see what kinds of trends you come up with.

Every dog is different. Plus it is normal for blood sugar to vary some day to day. You can't control those variables but you can control variables of food, insulin, and exercise.

The best information comes from common themes you see as they develop over an extended period of testing where none of the controllable variables changes.

What you did the other day looks promising. Try sticking with that plan for a week and then we could review all of the data you generate during that week.

Natalie
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