Sweet Bob the Yorkie has passed 08.08.13

[SeattleCraig]

Dog's name, breed: Bob the Yorkie, 10 years old
Dog's weight: 8 lbs.
Diet: Hills A/D critical care and Pedialyte (pushing it right now with a baster-type thing, as he won't eat on his own.)
Insulin: Humulin
Number of units per injection and injections per day: 3 units, twice per day
Brand of BG meter if home testing: ReliOn Confirm right now, because I didn't know what I was doing.

Bob was just diagnosed last week. It's been a rough week. He got very sick, very fast, and was diagnosed with hypothyroidism, diabetes, and possible renal failure all at once. After 4 intense days of subcutaneous fluid therapy at home, his BUN's, creatine, and phosphates have all returned to near perfect levels, and now I'm just working to get his diabetes well managed.

I have a lot of questions, but I'll just use the search function and read until I can gather my thoughts.

This is a wonderful resource.

[SeattleCraig]

newbie needs some input

Good morning, people.

Bob (Yorkie, 8 lbs.) was diagnosed last week, and he started 3 units Humulin 2x per day last Saturday. His BG was over 500 at the time. On Monday afternoon, the vet checked and he was in the 380's. She told me to increase to 4 units 2x per day.

Yesterday AM he had a mild seizure, and I took him in. His BG was 70 on the AlphaTrac, and 53 on the follow up blood work. The vet gave him a couple shots (as in shot glasses) of Karo to up him a bit, and told me to lower him back to 3 units.

Last night his BG was 74 at 6:00 pm and 76 at 8:30 pm. He ate his dinner (he's being fed by a baster at the moment because he won't eat--Hills A/D and pedialyte--and I gave him his 3 units (with misgivings--I'm really new to this, and I was worried about giving him 3 units when he was already at 76 at the end of a curve, but I'm just not experienced, and I don't know how much his meal offsets the insulin dose).

Anyway, at 11:30 pm (bedtime) his BG measured 32. I gave him a shot of Karo and a shot of food (again, as in shot glass, not injection), then slept on needles with the Karo syrup on the nightstand.

He seemed to do pretty well through the night.

His BG just measured 91, pre-breakfast and shot.

Should I be giving him the full 3 units when his BG is already so low at the tail end of the curve?

I have more questions, of course, but this is the most pressing at the moment. I'd sure appreciate some feedback.

Thank you,

Craig (& Bob)

[k9diabetes]

Re: newbie needs some input

Hi Craig,

In my opinion, 3 units was too high of a dose to start with an 8 pound dog - I would have started him on 1 or at most 2 units. I hate to see a dog started on more than 1/4 unit per pound. Even 1/4 unit per pound is often too much.

Are you home with him today?

I think another low blood sugar episode is likely if he was given 3 units and I would feed him another meal to keep that from happening.

If his blood sugar is under 100 tonight at dinner, I wouldn't give him any insulin at all to bring his blood sugar up. Then at breakfast, if his blood sugar is above 200, I would start with 1 unit of insulin and see how he does with that.

You want to find a place where you can give him a consistent amount of insulin and have no low blood sugar even if it's higher than you would like it to be. Once you find that level, you want to wait at least five days for his body to develop a longer term response and then any increases should be in half unit increments at home. Ideally maybe get the syringes with half unit marks and then you can increase in 1/4 unit increments.

Is he eating a normal amount of calories?

Is the eating problem from changing to a prescription food for the diabetes?

Natalie

[SeattleCraig]

Re: newbie needs some input

Thank you for the response, Natalie.

I already gave him his morning dose, albeit about 2.5 units. I just couldn't pull it to 3. I wish I'd read your response first, but he was due, and I didn't know how long it would take to get some feedback.

He hasn't eaten on his own volition for 8 days. He just got very sick, very fast. The high BG--although crucial--was kind of second priority to the high BUN's, as the vet was very concerned that his kidneys were shutting down. Fortunately, we caught that early enough, and his kidney indicators are all back to normal.

So now the full focus turns to regulating the BG.

I'll watch him closely this morning. I'm testing every 2 - 3 hours today, and I've got food and Karo at the ready.
(I'm very fortunate to work from home during the week.)

Thanks again for the great feedback.

[CraigM]

Re: newbie needs some input

Craig & Bob,
Wow! You guys have had some excitement (understatement).
Just wanted to say "Hi" and welcome you to the forum. Lots of good info, and people here. I read all the posts everyday, and will follow Bob's thread.

[k9diabetes]

Re: newbie needs some input

I would go ahead and feed him a mid-day meal - better to pre-empt the low blood sugar than to set off all of the crisis hormones that go with a low.

Every time low blood sugar occurs, the body draws on some of its glucose reserves to help reverse it. Repeated low blood sugar can exhaust those reserves, leaving his body unable to respond to lows in the future, and the hormones involved can make the blood sugar unstable.

Do you think he would take some more food now?

With this very scary episode he went through, he could either need a lot less insulin as he recovers or even need none for a while. There are rare instances where a case of severe pancreatitis, for example, can cause diabetes temporarily that resolves once the pancreas heals up.

I think I would give him a couple of shots of food today until dinner time since he had a nearly full dose of insulin. Maybe about the same interval as you're checking his blood sugar.

Natalie

[SeattleCraig]

Re: newbie needs some input

That's exactly what I'll do. Thank you.

I think he'll allow another baster-full of food right now.

Actually, he has no choice in the matter. He's in diabetes boot camp at the moment, and I'm the drill sargeant nightmares are made of...

okay, not really, but I'm trying real hard. I'm usually a total pushover.

[k9diabetes]

Re: newbie needs some input

LOL... with a face like Bob's, who wouldn't be a pushover!

[Margaret Boyle]

Re: newbie needs some input

Welcome,

Craig and Bob You certainly have had some excitement and stress the last few days

Bob is a right wee cutie, I have not a lot of input Craig as you are getting plenty of advice..........this is the best forum on the internet.

Natalie Peggy and Patty are all great with their support and a wealth of wisdom on diabetes...... as are a lot of the others so you have certainly came to the right place

I will be following your thread and once again a nice big welcome.

Marg

[Patty]

Re: newbie needs some input

Just wanted to say hi and welcome to you! What a totally adorable picture of Bob

I'm also impressed you're home testing already. It's obviously been invaluable!
Patty

[buddingartist]

Re: newbie needs some input

Welcome Craig and Bob.

He is one sweetie little thing and so very cute. I too would be a pushover for such an adorable little face.

I too am impressed that you are testing already.

Good luck
Louise

[MaryLea]

Re: newbie needs some input

Welcome to the forum, Craig and Bob. Yup, I join the others in saying I'd be a pushover for that cutie, too.

We were fortunate to find this site just before our vet advised a change from 4u to 8u, twice a day. Everyone here went bananas--Natalie, Peggy and Patty led the bunch (pun intended). We had given two shots at 8u before reading the responses here. Ruffles BG dropped about 200 points overnight! We backed off to 4u for two injections and then upped to 5u. Her progress has been slower, but I'm convinced if we'd continued on the 8u (2x day), she would have had an episode like you experienced.

The leaders here have much good information and are more knowledgeable than many DVMs. Seems like the DVMs are not given much training with diabetic animals; they learn by experience (meaning they may "practice" on our pets). The people here have also learned by experience, but since they are the dog owners, they live with the situation day in and day out. They have a personal, invested interest in doing what's best for the dog.

We have the extra excitement of having another issues to deal with for a few days, as you will see in my signature. I'm using turkey-and-gravy baby food (step 2) on kibble to get her to eat; also using about 1/2 to 1 Tbl. of the baby food to crush the pills into, and mix; she thinks it's a treat! (She licks it out of the spoon.) Don't know if Bob would eat it, but the idea was given to me by someone on this forum.

Fortunately for us (You, Bob, me and Ruffles) the folks here are a great resourse!

[SeattleCraig]

Re: newbie needs some input

Thanks, everyone, for the warm welcome.

As I mentioned in my first post this morning, Bob's BG was at 91 pre-breakfast and pre-insulin. I hesitantly gave him 2.5 units, as I wasn't sure how long it would take to get a response here.

After Natalie posted with such good advice, I fed Bob some more (to prevent another low BG event), and monitored him closely throughout the morning.

His 12:15 pm test came in at 30. I gave him Karo and fed him again, and he seemed much better, and rested comfortably for the rest of the afternoon. I even got a couple of wags out of him, which he hasn't done much since being so sick.

His pre-dinner/pre-insulin BG was 102 this evening, so I fed him well and gave him just 1 unit. I'll test him again in a couple of hours (before bed), and then again in the middle of the night, and see how he does with that.

Thanks again, and a special thanks to Natalie for her great advice. I'll report back in the morning.

Craig (& Bob)

[k9diabetes]

Re: newbie needs some input

I sure am glad that you are there with him to monitor and that you dived right into testing at home!

I'm hoping that your meter is reading the blood sugar somewhat lower than it actually is. I still wouldn't change what you're doing - I just hope he's not truly having blood sugar in the 30s. I have had blood sugar in the 50s before and it's uncomfortable. He's certainly not rebounding in response either - another good thing.

I'll be very anxious to hear how he does on 1 unit.

Hope you have an uneventful night!

Natalie

[CarolW]

Re: newbie needs some input - Bob, Yorkie

Craig - after seeing your name SOMEWHERE here, I was looking for you and Bob, and finally, I found you! What a fabulous picture of Bob!

Speaking of fabulous, you are doing a fabulous job with Bob in these very early days. Fifty million cheers for Natalie, Patty and Peggy, and the other forum members who contribute.

And fifty-one million cheers for you, for being brave and dedicated, and getting under way with testing Bob's blood glucose levels yourself. It's that steady monitoring that will REALLY help get Bob stabilized - finding, eventually, the right dose of insulin for him.

I really regret it when veterinarians so blithely prescribe such-and-such a dose of insulin, and so often, it's too large and sends the dog into hypoglycemia, making things a lot more difficult - dangerous for the dog, very tough for the human DogParent.

The operative principle seems to be, Start Low, Go Slow. Simply because it DOES take numbers of days for the dog's body to adapt to using injected insulin. So we can't know the efficacy of a particular dose right away, but must needs track with this glucose testing.

The time and energy put in by the Human Dog-Parent, I'm glad to say, generally pays off extremely well, and the stress and strain won't go on forever. With your particular dedication and careful attention, I'm betting that a month or two down the road will find Bob doing really well, and you, well-settled into the routine.

Lucky you can work from home! Yep - Bob is one lucky dog - and what a great face!

So, a big, fat welcome from Kwali and Kumbi at the Bridge, and Camellia and me here on Earth.

Fri, 19 Nov 2010 22:32:34 (PST)