Announcement

**MattiesDad** · 04-06-2010, 07:52 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Hi, MadMadMom:

I'm still learning about all this myself, but I get the Type N Reli-On from Walmart for about $25.

**Cornspot** · 04-06-2010, 08:01 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by MattiesDad View Post

Hi, MadMadMom:

I'm still learning about all this myself, but I get the Type N Reli-On from Walmart for about $25.

I use the Relion also, and I don't use prescription food (I feed a grainless kibble--chicken & potato based)

This is a great place to get your questions answered!

**MattiesDad** · 04-06-2010, 08:15 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by MadMadMom View Post

Just at this low dosage it is only going to last for 4.5 days and is $42 dollars a bottle.

You may want to check your math-- each bottle is 1000 units. 100 units per ml, each bottle has 10 ml. So you know where to get cheaper insulin, and it's going to last longer than you thought. See? It's getting better already!

**ozzi** · 04-06-2010, 08:36 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

You are NOT over your head at all, and this is exactly the right place for you to be. Every person here understands the overwhelming feeling of hearing your dog has diabetes and then racing to try and get a handle on what to do. It's confusing, difficult to absorb, and in many ways a very helpless feeling. What I promise you is that in a very short time, ALL of those feelings will dissipate, and you will feel much better.

When Ozzi was diagnosed, he was over 600, and he responded very quickly to insulin. After the first injection, I could see immediate, positive changes in his behavior (less drinking, fewer trips to pee, etc.), so I want to reassure you that you will most likely see a quick improvement. It's the regulation that can take a while.

I cannot believe a glucose of 880!! WOW. Given that Brandy's sugar is so high and she weighs 59 pounds currently, I'm surprised her dose is only 12 units twice/day. Generally, the starting dose is about 1/4 unit/pound, which would be closer to 15 units twice/day. Ozzi weighed 65 pounds at the time of diagnosis and his sugar wasn't as high as Brandy's and he was started on 15 units of Humulin N twice/day, and now takes 25 units twice/day. Your vet is right, this is just a starting dose, and how she responds will determine where she ends up. The increases are done slowly to give her body a chance to respond to the insulin, to determine how the food/insulin balance works on her, and to avoid hypoglycemia (the sugar dropping too much, generally below 50).

With a BG of 880, she must have been running about 2-3+ ketones in her urine. Do you know what the value was? It would be a good idea to pick up some ketone sticks (over the counter at any pharmacy, and fairly cheap at WalMart) to at least monitor her ketones now while her sugar is up. With the insulin on board, she will definitely come down from when she was diagnosed, but you don't want her to continue spilling ketones and that's important to report to the vet if it continues. If she is anything other than negative, I would call the vet to ask about increasing a unit or two now, rather than waiting a week.

At the current dose of 12 units twice/day, the bottle of Humulin that you have will last about 6 weeks, however, I suspect that dose will be increased. Relion Novolin-N is an NPH insulin made exclusively for WalMart and Sam's Club. Humulin-N is also an NPH insulin (intermediate-acting). Both work very well and for most dogs, are interchangeable. The difference is that the Relion at WalMart is half the price of Humulin! If you are in the US, you do NOT need a prescription for insulin...it is over the counter. You do need a prescription for syringes, and WalMart sells Relion syringes, which are also half the cost of retail pharmacies and work great. I use them and am very happy with them.

A couple of things about injections that vets sometimes forget to mention: (1) when you take the insulin out of the refrigerator, roll it gently back and forth (about 10 times) to completely mix it. Don't shake it though! (2) after you draw it up in the syringe, warm it by putting it under your armpit or hold it horizontally in your mouth for 30 seconds or so. This will take the sting out of the injection so it is not painful. (3) Always inject with the bevel (the opening at the bottom of the needle which shines when you hold the needle tip to the light) in the UP position. Again this will make it fairly painless for Brandy.

You can cut your costs by half if you use Relion Novolin-N and Relion syringes. You can cut your costs by 100% by learning to test at home and reporting the results to your vet. There are several videos and resources here to help you learn, and I cannot encourage you enough to learn asap. I realize how much info is being thrown at you, but I don't want you to make the mistake of waiting six months to test (as I did) if you are willing to learn. It is cost-effective, and so much less stressful for the dog! I was scared to learn and avoided it, and now am a believer that testing is a necessary, not optional part of Ozzi's treatment.

Finally, post all your questions. There are so many awesome people here to help and support you. The people here have made a HUGE difference for me, and for Ozzi. You will be surprised in a month or so, when you realize what an expert you have become on canine diabetes!!!

My best wishes,
Kevin

**Patty** · 04-06-2010, 08:52 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Brandy's Mom,

Welcome! It is overwhelming at first to try to absorb it all but it does get easier.

Weight loss often comes with the onset of diabetes. When there's not enough insulin, glucose is unable to be used by the cells for nutrition and the body starts using its fat and muscle stores for fuel. As the blood sugar gradually comes down you should start to see her weight stabilize.

With an initial blood sugar of 880 and not receiving insulin until Tuesday, did they test her for ketones? Here's some information on ketones: http://diabetesindogs.wikia.com/wiki/Ketones

You can purchase Ketodiastix at your local pharmacy. They are urine strips that will measure the amount of glucose and ketones in the urine. Anything more than trace ketones is cause for concern and should be evaluated by a vet immediately. Just FYI, my local pharmacy has sold me the ketostix before and I didn't realize it until I'd left the store so be sure you have the Ketodiastix which measure bothe the glucose and ketones.

Humulin N is often a very good insulin for dogs, so I'm glad your vet started you out on this insulin. As the others mentioned, Novolin N is essentially the same insulin made by a different manufacturer and is sold cheaper under Walmart Relion Novolin N brand. You can ask your vet for a prescription for this as some pharmacies will ask for one even if the state doesn't require it.

You can also save a lot of money by learning to home test. It will give you peace of mind to know how her blood sugar is ranging throughout the day. With a dog Brandy's size the OneTouch Ultra2 is a good meter to look at. I have one similar to this an get my strips on ebay so there are other options for making testing affordable. Here's a link to some of the areas you can test: http://www.k9diabetes.com/bgtestvideos.html

Glad you found us. Again, welcome to you and Brandy,
Patty

**MadMadMom** · 04-06-2010, 09:18 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by MattiesDad View Post

Hi, MadMadMom:

I'm still learning about all this myself, but I get the Type N Reli-On from Walmart for about $25.

Thank you, I will check on that!

**MadMadMom** · 04-06-2010, 09:19 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by Cornspot View Post

I use the Relion also, and I don't use prescription food (I feed a grainless kibble--chicken & potato based)

This is a great place to get your questions answered!

Will it be labled as grainless? Or what should I look for to know that it is grainless? Thank you

**MadMadMom** · 04-06-2010, 09:21 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by MattiesDad View Post

You may want to check your math-- each bottle is 1000 units. 100 units per ml, each bottle has 10 ml. So you know where to get cheaper insulin, and it's going to last longer than you thought. See? It's getting better already!

Oh my goodness!!! I feel a huge weight lifted off of my chest. It does say 10ml and 100 units per ml, but the bottle looks so tiny. If I RE-figured this out right ...it is going to last 10 times longer than I thought? Oh Thank You. Thank You!!!!

**MadMadMom** · 04-06-2010, 09:49 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by ozzi View Post

You are NOT over your head at all, and this is exactly the right place for you to be. Every person here understands the overwhelming feeling of hearing your dog has diabetes and then racing to try and get a handle on what to do. It's confusing, difficult to absorb, and in many ways a very helpless feeling. What I promise you is that in a very short time, ALL of those feelings will dissipate, and you will feel much better.

When Ozzi was diagnosed, he was over 600, and he responded very quickly to insulin. After the first injection, I could see immediate, positive changes in his behavior (less drinking, fewer trips to pee, etc.), so I want to reassure you that you will most likely see a quick improvement. It's the regulation that can take a while.
So it wont take until she is completely regulated to start to see and improvement? That is a relief. She seemed to have more energy when we picked her up, but I just chalked it up to her being in a strange place all day and happy to see us
I cannot believe a glucose of 880!! WOW. Given that Brandy's sugar is so high and she weighs 59 pounds currently, I'm surprised her dose is only 12 units twice/day. Generally, the starting dose is about 1/4 unit/pound, which would be closer to 15 units twice/day. Ozzi weighed 65 pounds at the time of diagnosis and his sugar wasn't as high as Brandy's and he was started on 15 units of Humulin N twice/day, and now takes 25 units twice/day. Your vet is right, this is just a starting dose, and how she responds will determine where she ends up. The increases are done slowly to give her body a chance to respond to the insulin, to determine how the food/insulin balance works on her, and to avoid hypoglycemia (the sugar dropping too much, generally below 50).My heart sank when I heard that number. She had a morning appointment and she ate before going there so I dont know if that would have an affect on it. It was the lab that they took last week at 64lbs. They called us with the results that afternoon, but we had to wait til today because they are closed on the weekend and Monday the vet was not in. He said he was starting her at a really low dose and that I he would increase it to get to the right one. I asked why he didnt start with a higher dose and he said it would kill her, its better to start low. All I know is I want to get her to a better place, where her food is actually giving her nutrients and she can gain some weight

With a BG of 880, she must have been running about 2-3+ ketones in her urine. Do you know what the value was? It would be a good idea to pick up some ketone sticks (over the counter at any pharmacy, and fairly cheap at WalMart) to at least monitor her ketones now while her sugar is up. With the insulin on board, she will definitely come down from when she was diagnosed, but you don't want her to continue spilling ketones and that's important to report to the vet if it continues. If she is anything other than negative, I would call the vet to ask about increasing a unit or two now, rather than waiting a week.Okay I will get some. I dont know what the value was. Im not sure what that is. They went over the results today and she stayed in the low 300s except the test 2 hours after given her first dose of insulin. She went to 6 hundred and something. I dont remember the exact number. When I read about it I thought it was supposed to be closer to the low 100s. I didnt ask the vet as I was a little overwhelmed taking everything in and learning how to give the shots. I will go down in the morning and get those before work. I have to read more about the ketones, because Im not quite sure what they do

At the current dose of 12 units twice/day, the bottle of Humulin that you have will last about 6 weeks, however, I suspect that dose will be increased. Relion Novolin-N is an NPH insulin made exclusively for WalMart and Sam's Club. Humulin-N is also an NPH insulin (intermediate-acting). Both work very well and for most dogs, are interchangeable. The difference is that the Relion at WalMart is half the price of Humulin! If you are in the US, you do NOT need a prescription for insulin...it is over the counter. You do need a prescription for syringes, and WalMart sells Relion syringes, which are also half the cost of retail pharmacies and work great. I use them and am very happy with them.I was very relieved to see that I messed up on my math. The bottle is so small, I still am in disbelief that that much could be in there. So are they pretty much duplicates? because it says not to change them off of it without getting regulated on it first. Is it something I should bring up with the vet...if it is slightly different. I dont want to take any chances or hurt her. We were scheduled for her next visit on Monday, then he said "could you make it in on Friday" so we will be dropping her off again then, I think they might up it then

A couple of things about injections that vets sometimes forget to mention: (1) when you take the insulin out of the refrigerator, roll it gently back and forth (about 10 times) to completely mix it. Don't shake it though! (2) after you draw it up in the syringe, warm it by putting it under your armpit or hold it horizontally in your mouth for 30 seconds or so. This will take the sting out of the injection so it is not painful. (3) Always inject with the bevel (the opening at the bottom of the needle which shines when you hold the needle tip to the light) in the UP position. Again this will make it fairly painless for Brandy.He showed us how to roll it but didnt say anything about warming it or the bevel. Thank you

You can cut your costs by half if you use Relion Novolin-N and Relion syringes. You can cut your costs by 100% by learning to test at home and reporting the results to your vet. There are several videos and resources here to help you learn, and I cannot encourage you enough to learn asap. I realize how much info is being thrown at you, but I don't want you to make the mistake of waiting six months to test (as I did) if you are willing to learn. It is cost-effective, and so much less stressful for the dog! I was scared to learn and avoided it, and now am a believer that testing is a necessary, not optional part of Ozzi's treatment.Do you mean testing to regulate them or just the monthly blood draw after she is regulated?

Finally, post all your questions. There are so many awesome people here to help and support you. The people here have made a HUGE difference for me, and for Ozzi. You will be surprised in a month or so, when you realize what an expert you have become on canine diabetes!!!

My best wishes,
Kevin

Thank you so much for all your info and help. I already feel better and feel more confident in helping Brandy with everyones advice

**k9diabetes** · 04-06-2010, 09:54 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Already some good news!

Definitely go for the Walmart brand. It is Novolin NPH but is packaged as a Walmart house brand called Relion N and it's about $22-25 a bottle.

I sure am glad to hear the insulin got started today... I worry about a dog going even two more days with blood sugar that high.

One way you can save a small fortune is to learn to test her blood sugar at home. Take a look here: www.k9diabetes.com/bgtestvideos.html to see various folks testing in different places. Brandy being a lab might well have an elbow callous, which is a great place to test, and the lip is another good alternative.

Once you learn to do it, you can do the curves your vet is doing at home for about $10 each.

Your vet may not be supportive of home blood glucose testing. Many aren't but more are coming around to it all the time. You can show them this study by UC Davis that shows that a OneTouch Ultra meter is a great meter to use testing on dogs:

ACVIM 2008 Abstract

Evaluation of Six Portable Blood Glucose Meters in Dogs.
T. Cohen, R. Nelson, P. Kass, E. Feldman
School of Veterinary Medicine, University of California, Davis

The purpose of this study was to evaluate six portable blood glucose meters (PBGMs) - AlphaTrak, OneTouch, Elite XL, AccuChek, Precision, Contour - for use in dogs. One hundred fifty-eight venous blood samples were asayed for glucose using all PBGMs in randomized order and by a reference hexokinase method. Results from the PBGMs and reference hexokinase method (HM) were compared.

HM blood glucose concentrations ranged from 41 to 639 mg/dl. There was excellent correlation between PBGMs and HM results (table). Results were consistently low for 4 PBGMs compared with HM results. High and low results were common with the AlphaTrak. The difference in results between PBGMs and HM increased as blood glucose concentrations increased. Difference in results between PBGM and HM were significantly (p<0.0001) less for the AlphaTrak and OneTouch and significantly (p<0.01) higher for the Contour compared with other PBGMs. Problems with correct identification of hypoglycemia (<70 mg/dl), normoglycemia (70-120 mg/dl), and hyperglycemia (>200 mg/dl) varied between PBGMs (table).

Percent Incorrect from Reference Range
AlphaTrak -- 18
OneTouch -- 21
EliteXL -- 45
AccuChek -- 45
Precision -- 49
Contour -- 73

Results of this study support use of the AlphaTrak and OneTouch glucose meters based on significantly closer results with HM.

Besides saving you a lot of money, you can learn way more about your dog's regulation by testing at home because you can spot test periodically and check any time you are concerned about the blood sugar being unusually low or unusually high.

It is the best tool I ever had with Chris.

If you haven't already, take some time to read up on diabetes on the main website for this forum: www.k9diabetes.com.

It's always scary at first but we have all been there at some point.

Natalie

**MadMadMom** · 04-06-2010, 09:56 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by Patty View Post

Brandy's Mom,

Welcome! It is overwhelming at first to try to absorb it all but it does get easier.

Weight loss often comes with the onset of diabetes. When there's not enough insulin, glucose is unable to be used by the cells for nutrition and the body starts using its fat and muscle stores for fuel. As the blood sugar gradually comes down you should start to see her weight stabilize.

With an initial blood sugar of 880 and not receiving insulin until Tuesday, did they test her for ketones? Here's some information on ketones: http://diabetesindogs.wikia.com/wiki/Ketones

You can purchase Ketodiastix at your local pharmacy. They are urine strips that will measure the amount of glucose and ketones in the urine. Anything more than trace ketones is cause for concern and should be evaluated by a vet immediately. Just FYI, my local pharmacy has sold me the ketostix before and I didn't realize it until I'd left the store so be sure you have the Ketodiastix which measure bothe the glucose and ketones.

Humulin N is often a very good insulin for dogs, so I'm glad your vet started you out on this insulin. As the others mentioned, Novolin N is essentially the same insulin made by a different manufacturer and is sold cheaper under Walmart Relion Novolin N brand. You can ask your vet for a prescription for this as some pharmacies will ask for one even if the state doesn't require it.

You can also save a lot of money by learning to home test. It will give you peace of mind to know how her blood sugar is ranging throughout the day. With a dog Brandy's size the OneTouch Ultra2 is a good meter to look at. I have one similar to this an get my strips on ebay so there are other options for making testing affordable. Here's a link to some of the areas you can test: http://www.k9diabetes.com/bgtestvideos.html

Glad you found us. Again, welcome to you and Brandy,
Patty

I am going to get those strips tomorrow morning. Thank you for the video links. I am going to look into the OneTouch Ultra 2 also. Thank you again for all the explanations of stuff. I am in disbelief of how much this site helps and how much great info that everyone has and shares...Thank You!!!

**MadMadMom** · 04-06-2010, 10:06 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by k9diabetes View Post

Already some good news!

I sure am glad to hear the insulin got started today... I worry about a dog going even two more days with blood sugar that high.

One way you can save a small fortune is to learn to test her blood sugar at home. Take a look here: www.k9diabetes.com/bgtestvideos.html to see various folks testing in different places. Brandy being a lab might well have an elbow callous, which is a great place to test, and the lip is another good alternative.

Natalie

Yes, it was very hard not doing anything for 3 days...that is what made it a long hard weekend. I felt helpless and knowing nothing could help her til the visit was disheartening. She does have a callous on her elbow. I am a little nervous about doing the testing myself, but it is something I am willing to learn. Just knowing the medicine will last 10 times longer than I thought is a relief. Thank you

**k9diabetes** · 04-06-2010, 10:13 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

If you give the videos time to download, there is one of Killian tested on an elbow callous and one of Chris being tested on the lip.

Both videos are valuable as much for the fact that the dogs couldn't care less about having their blood sugar tested as they are for the instruction on how to do it!

Chris was tested at least three times a day every day because he got four injections a day - very unusual you will be happy to know!

Did the vet say anything about ketones?

I see you are off the beaten path a bit - do you go to the vet in Reno or have one closer?

We have a warm spot in our hearts for Reno because of the incredible dog park space they have there up on the hill. Of course where you are, you may not need a dog park!

It all gets easier one day at a time.

Natalie

**MadMadMom** · 04-06-2010, 10:33 PM

Re: Brandy...Yellow Lab, Just Diagnosed

Questions

Originally posted by k9diabetes View Post

If you give the videos time to download, there is one of Killian tested on an elbow callous and one of Chris being tested on the lip.

Both videos are valuable as much for the fact that the dogs couldn't care less about having their blood sugar tested as they are for the instruction on how to do it!

Chris was tested at least three times a day every day because he got four injections a day - very unusual you will be happy to know!

Did the vet say anything about ketones?

I see you are off the beaten path a bit - do you go to the vet in Reno or have one closer?

We have a warm spot in our hearts for Reno because of the incredible dog park space they have there up on the hill. Of course where you are, you may not need a dog park!

It all gets easier one day at a time.

Natalie

I watched the one on the lip test this weekend, he did so good. I dont remember anything specific about ketones, but it was so much I could have just missed it. It was an overload of info that come as fast as possible and a crash course in how to give shots...kind of a blur looking back on it. I will be more prepared Friday with anymore questions that I have. I do believed I got more info here that I would ever from the vet, but people that are and have gone thought it personally...and am extremely grateful.

We have a vet in the North Valleys, so its not all the way in town. Unfortunately this is a new vet because when I called our vet in Lemmon Valley, the receptionist said that she (the vet) not longer takes care of large breed dogs, but she would talk to her after she got out of surgery since she had already taken care of her. We just decided to find another one, which might have been a good thing.

I think I know where you are talking about...the hiking trails on Peavine? We dont need a dog park where we are at....lots of open space...where Brandy and the boys are always on the go & exploring

Have a great night! Thank you again!
Amber

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