Jasper - Advice needed please

[jasper2008]

Hello everyone! I am new to this forum but not new to dealing with a diabetic pet, having home checked & given insulin injections for around 6 years to my cat who sadly passed away in 2011 due to cancer. She was a steroid induced diabetic.

I have a 5 year old Cavalier King Charles Spaniel who underwent surgery last year to have both his ear canals removed due to flaked skin in his eardrum causing infection & rupturing his ear drums. He was given steroid injections & further steroid tablets for around 3 months, I did ask if they could give him anything else but the answer was no, so here we are again with another diabetic due to steroids.

We knew what to look out for and a couple of weeks ago noticed him drinking a lot more water than usual but not urinating anymore than usual then last week his appetite was ferocious so I decided to be on the safe side to check his BG's and they were 25 mmol/I (UK) 450 mg/dI (US)

We went to the Vets today 3.30 pm (UK)who said we should feed him is regular meal before hand which we did. My husband who is good at testing & giving injections but does not understand the disease asked the Vet if we could feed him a light meal later tonight ( I was not in the room at the time) and she said yes, so my hubby is insistent that I give him something to eat now 8.40 pm (UK) I am reluctant to do so but he is getting insistent.

I know there is a difference between a cats metabolism & a dogs but do not know sufficient to be able to put forward a good argument. Apart from the fact I don't think it correct to feed him again.

Tomorrow we will start the regime of 5 units 7am & 5 units 7pm

Please if anyone can give me advice I would be so thankful, I am getting myself stressed now.

I have a lot more questions but this is the important one for now.

Thank You! so much if you can help.

kind regards

Hilary

Name: Jasper:

Breed: Cavalier King Charles Spaniel

Weight 13.8 kg

Insulin: Caninsulin Cartridge

Method: VetPen

Dose: 5 Units Morning & Night

Monitor: OneTouch Ultra

[CraigM]

Re: Advice needed please URGENTLY!

Welcome to the forum.

Usually, two meals per day along with the insulin injection. since you are just starting today, you can probably avoid the debate with your husband tonight and give a small meal, but that is NOT the normal procedure. Get on the normal 12 hour schedule tomorrow.

How much does Jasper(??) weigh?

Craig

[CraigM]

Re: Advice needed please URGENTLY!

By the way, Natalie, the forum owner, will likely be along soon to approve your membership. Until that happens, your posts may be delayed a little before they show up on the forum. We do this to keep the forum free from spam.

Craig

[jasper2008]

Re: Advice needed please URGENTLY!

Thank You! so much for replying Craig. Jasper will be pleased & so will my husband. Just read my post & omitted to say he had an injection of 5 units at the vets which after all is the most important part of my post.

Sorry about that I think that may make a difference to your reply, I thought I had mentioned the insulin doh!

many thanks

Hilary

he weighs 14.8 kg

[CraigM]

Re: Advice needed please URGENTLY!

I still think as long as you get him on a 12 hour routine starting tomorrow things will be fine. Just don't give any more insulin after todays late meal (probably too late for that advice since it's already 10:30pm (2230) there)

14.8kg = 32.6 pounds, so the 5 units is a conservative starting dosage. Every pup / situation is different, but you will likely take him back to the vet in a week and likely increase the dosage a bit.

Many here use the One Touch Ultra and think it reads dog blood just a little low. Of course, the readings seem closest to true down around 5 mmol, and a little higher at higher readings. Many just go by the meter reading, others might add something like 1.4mmol to the meter reading to compensate for the error between dog and human blood. (Example: if I saw 100mg/dl on my One Touch Ultra, I'd add 25mg/dl and record the test as 125). Sure wish the U.S. would conform to the rest of the world!

BTW, if you would ever like to change the title of your thread, just mention what you'd like, and a moderator can change it for you.

Craig

[jasper2008]

Re: Advice needed please URGENTLY!

Hi! again Craig Thank You! so much for all your help. I have a few questions if that is ok?
If I want to post again with questions about controlling Jasper etc do I post another thread or continue to ask in this thread, I have checked the FAQ & can't seem to find an answer to that.
I don't want to start off by doing things wrong lol

Oh! I posted Jaspers weight wrong it is 13.8 kg. My mind was all over the place & still in shock I think at having another steroid induced diabetic .

thanks again Craig

Hilary

[farrwf]

Re: Advice needed please URGENTLY!

If I want to post again with questions about controlling Jasper etc do I post another thread or continue to ask in this thread, I have checked the FAQ & can't seem to find an answer to that.
I don't want to start off by doing things wrong lol

You want to keep posting in this thread, Hilary. That keeps all your stuff together. That way it's easy for members to reference what's going on by reviewing your history of posts..

Whenever you post, it bumps your thread up to the top so most will read what you posted.

[Rubytuesday]

Re: Advice needed please URGENTLY!

Hi Hilary, don't worry about doing things wrong! The moderators are great here and can merge your threads or even rename it if need be.

They usually try to keep all of a dog's history on one single thread. That is why they sometimes move or rename threads.

welcome, Tara

[jasper2008]

Re: Advice needed please URGENTLY!

Thanks! for the replies farrwf & Tara, I thought that may be the case, it is better to keep everything together. I didn't want to start off on the wrong foot as some moderators on other forums can be rather difficult if you inadvertently do something wrong lol. It's getting very late here in the UK & I am up at 6am to feed & give him his injection. I have loads of questions mostly about the difference between a cat & dog's metabolism that are insulin dependent but they are going to have to wait until tomorrow.. thanks for the warm welcome & reassurance & it is great to be here getting help & advice..

see you all tomorrow

Hilary x

[k9diabetes]

Re: Advice needed please URGENTLY!

Hi Hilary,

Welcome to K9D! I have not had time yet to respond to your post in more detail.

I think the species differences relative to diabetes are really interesting! And fortunately, especially with dogs, they tend to work in dogs' favor in that dogs are pretty tolerant of high blood sugar. The main, very common side effect is cataracts.

Neuropathy is actually fairly rare in dogs, usually only if their blood sugar has been very high for a considerable amount of time or if they already have some kind of problem with communication across the spinal cord, in which case the high blood sugar layers over the top of the other problem.

Caninsulin is the starting insulin for dogs in the UK so that's good. Dogs metabolize insulin more slowly than cats (but faster than people) and generally do best on intermediate types of insulin such as Caninsulin and Isophane.

And they are Type 1 diabetics generally as opposed to Type 2 like cats. So they virtually always must have injected insulin for the rest of their lives.

In terms of testing, dogs' ears don't always bleed as well as cats' ears. If you need some other places to test, take a look at www.k9diabetes.com/bgtestvideos.html.

Those are the main differences.

For more information, take a look at the main website, www.k9diabetes.com. There are a number of pages of general information about diabetes in dogs, insulin, etc., plus links to other resources: www.k9diabetes.com/complinks.html.

Natalie

[jasper2008]

Re: Advice needed please URGENTLY!

Hi! again everyone

Deep breath! here goes.

When I used to control my cats diabetes, I tested her BG's before every shot which was once a day & adjusted the insulin according to the reading ie under 10 mmol no insulin 10 -15 mmol 1/2 unit 15-20 mmol 1 unit which I tweaked even further meaning if she was between 8 -9 mmol I sometimes gave her 1/2 unit depending on her demeanor This is just to give you an idea of the regime and the ranges may be slightly out as it was some time ago now. Do you recommend testing before each shot? as my vet said to test him after 5 days, I am not really comfortable with this, how do you know what the glucose levels are & how much insulin should be administered, is it different for dogs? I also had a problem getting blood from the various locations but eventually managed some from his ear.
Do you all adjust insulin (if needed) according to the BG's. Do you test before every shot?
as it is going to be difficult getting blood, I never had this problem with my cat perhaps jasper is just being stingy lol

I never fed my cat with carb ridden dry after dx as per FDMB. I notice in one of your sticky's that you say dogs process carbs different from cats? does that mean you recommend carbs in foods for dogs? as I read the following on the internet:-
What is the glycemic index?
The glycemic index is a scientific measure of how easily a particular food can be converted to blood glucose (sugar).
Dog foods with a low glycemic index exhibit less of a tendency to raise a dog’s blood glucose (sugar) level than others.
What type of dog foods have a lower glycemic index?
In general, dog foods with the lowest carbohydrate content exhibit a lower glycemic index.
Since most kibbles are carbohydrate based, low-carb canned foods should be given serious consideration when selecting candidates for diabetic pets.
Jasper has always been on canned food, so please may I ask what your recommendation is for feeding

From reading it sounds like it is more difficult to control a diabetic dog than it is a cat?
I know there are loads more questions but brain fog has set in & as soon as I press post I will remember something.

Please bear with me as I had a stroke last year & new information is hard to retain.
Could someone please explain how the food is converted to glucose and how it reacts with the insulin. I read the sticky on this subject but not too sure I understand the process.

You eat & food is converted to glucose,you give an insulin shot when the food has converted after x amount of hours it peaks with the insulin & then drops this is the danger if it drops too low, sorry I am lost it just wont sink in the relationship between food & insulin, I am really trying & getting myself upset now, I never had this problem before my stroke & it is really important that I grasp this in order to help my boy.

I feel so useless & stupid in tears now

Hilary x

[Riliey and Mo]

Re: Advice needed please URGENTLY!

Hello and welcome Hilary and Jasper

Your Jasper is sooo cute

The regime most of us do is test at fasting morning and night and at the 6 hour mark
Feed then inject right after testing

You need to collect data on your dog by doing curves. These will tell you how the food is meeting up with the insulin. Changes can be made only after a curve has been done.
A curve is done every 2 hours starting with the morning fasting then testing every 2 hours for a 12 hour period.

If your up to it this would be a good starting point for you doing a curve.

Patients is the key, same food, same amount ,same insulin, same exercise.

[Eddie]

Re: Advice needed please URGENTLY!

Hello Hilary and welcome!

I don't know much about the theory of it all and will leave that for more expert people to explain - but on food generally, the conclusion seems to be that different dogs do well on different foods. Some have "diabetic" foods, others carry on with their original food, others home cook and everyone finds something that works for their particular dog.
The main thing is that it must be food that the dog will eat reliably day after day. Some people (including us) keep their dogs on whatever food they had before diagnosis and regulate on the basis of that food. Our dog has another digestive problem so we were reluctant to change his food in case it upset that problem. We were feeding Orijen but that became difficult to find here in the UK so we did have to change - but only to Canagan which is very similar - just fish and vegetable and no grain.

On testing it is a good idea to do some 2 hour interval curves (ie testing every 2 hours to see the general trend) and see what is going on generally. We then test also before each meal. Our dog tends to be at his lowest at fasting and we just see where he is then tweak the dose accordingly - but only within a narrow range. We find he is quite sensitive to very small changes. As Mo says, when you are still trying to find the optimum dose it is helpful to keep everything the same for about 5-7 days. We only started "tweaking" when we were fairly sure about the sort of dose he needed.

We test him on his inner lip. We tried other places including ears but it was difficult to get enough blood from anywhere else. I didn't like the idea of it somehow but Eddie is fine and will come up and paw at me to get on with his test so that he gets his treat afterwards.
The vet did not suggest testing. I found out about it on this site and just started doing it then told the vet afterwards. He is now supportive and prescribes insulin on the basis of our numbers (Eddie has only ever had 1 curve done at the vet in 15 months).

If you have a curve then you can see how your dog processes food and insulin a bit. Ours processes the food faster at first so his BG rises then the insulin gets going and starts taking the sugar out of his blood so his BG drops down towards his next meal. (he hasn't read the instruction manual very well as most dogs drop after food and injection then rise towards the next meal - but either is ok; you just need to know which sort of curve your dog tends to have).

Don't worry about feeling overwhelmed - I think most of us on here have been through that. As you probably know from having looked after your cat, it does all become much more routine and easier as you get used to it.

Antonia

[amydunn19]

Re: Advice needed please URGENTLY!

Hi and welcome! There are differences between cats and dogs relating to diabetes. Cats generally are type 2 diabetics as dogs are almost always Type 1 diabetics. Thus, the differences in their treatment and protocols would be different.

As far as diet, everyone here has a different food it seems from partial raw, dehydrated, freeze dried, commercial kibble, prescription kibble, canned and home cooked. The possibilities are endless. Each dog is different in the way they process insulin and food and many dogs have other conditions which necessitate their food choices. You can balance insulin with food.

As far as the carb content of food, it is important to have a carb IMO. If you are feeding a food without carbs, say one of those mainly protein foods with no carb, the insulin will have virtually nothing to slow it down and the insulin will be used up very quickly. The dog will go much lower quickly and then may go up quickly because there is no insulin until the next feeding. Another possibility is the dog could go too low and stay there because they may not use up all the insulin at once but they don't receive another meal until much later and risk a low if they are actively playing or stressed out or if they have any activity. Plus, low blood sugar makes them feel very bad with no energy. Different dogs react differently in this scenario but neither result is good. A complex carb will slow down the action of the insulin so that it will be balanced throughout the 12 hour period. The goal is to have the blood sugar levels as flat as possible throughout the day.

I feed one of the low glycemic foods but it is not without challenges. I have a dog who had pancreatitis and she is very picky, too. Her current food is the only one that hasn't caused digestive problems for her. If you choose to feed one of the low glycemic foods, you should be prepared to supplement it with something else and test a great deal. Her food alone just doesn't have enough to keep her from going low, so since she is with me all day, I always check her at noon and give her a mini-meal.

Also, with dogs, adjusting the insulin dosage based on the blood sugar reading is not a good idea at all. This goes along with keeping that food and insulin in balance. You should resist any temptation to change insulin dosage especially early in the process until you have done a 12 hour curve AND not made any changes to food or insulin for 5-7 days. Dogs need time to give the doses a chance to settle. The process is a long and frustrating one but well worth it. If you try to rush it, it can only put you further behind.

The only time I break the rule about not adjusting dosages is if i test before meal/shot time, and my dog is below 100. Her food doesn't raise her a great deal so if i wasn't testing, and I fed her and give her the full dose of insulin, she could go very low. If she is low, I feed her and wait one hour and test her again to see what kind of rise she got and then inject accordingly. I know her tendency so I can anticipate how she will react. That is what testing before meals gives you - knowledge to make decsions for safety. If Maggie is high before her meal and shot, I make a note of it in her journal but I do not change her dosage. If there is a pattern that develops, then that needs further investigation or a curve to make any dosage changes.

[k9diabetes]

Re: Advice needed please URGENTLY!

Just quickly, the difference in cats being Type 2 style and dogs Type 1 style diabetes means that there is no remission that is sometimes achieved with cats.

And, in addition, a dog's insulin needs don't vary wildly like a cat's can because dogs don't make any more insulin of their own. With cats, you are constantly having to balance the insulin they may be making themselves and their sensitivity to insulin so the dosing of injected insulin can vary a lot.

I actually think it's easier to maintain a canine diabetic than a feline one.

We don't generally constantly vary a dog's insulin dose. You can usually find a dose to stick with that gives good regulation and it may need occasional adjustment but you don't work each premeal blood sugar level and insulin dose.

And the carb issue is different too since dogs aren't obligate carnivores as cats are.

In a sense, you almost need to forget a lot of what you did with your cat. The approaches are very different.

The same often applies with human diabetics... there are enough differences between them that they are almost different diseases.

Natalie