Bo, 2 yrs old, has diabetes.

[Bo's Mom]

I am new to this forum, also new to the world of canine diabetes. My 2 yr old Cairn Terrier, Bodacious, was just diagnosed two days ago with type 1 diabetes. He is currently still at the vet while they get his sugar under control. My husband and I are just shocked and scared over this.
He seems so young to be facing this issue. We are very hopeful that he can come home in the next few days. Of course we also know that this changes life for all of us but will do whatever it takes to keep Bo healthy and happy. I just feel, right now, that I am treading through this blind. I don't know what to expect when we get him home. I just wanted to read about others in this same situation for advice.

[jesse girl]

Re: Bo, 2 yrs old, has diabetes.

hi and welcome

you can take two roads one more proactive with management of the disease at home or just go on cruze control with minimal management other than giving shots and feeding every 12 hours. there is no wright way or wrong way it would be your way .

i have been very proactive with my jesse she was very sick in the beginning so i knew she would need allot of help to survive and she did and is doing very well today .

best thing i did for jesse was testing her blood sugar at home she was fairly young also at 5 years so i wanted her to have a full and happy life if that was possible.

you do have a bit of time take advantage of it you can even practice shots at home and get comfortable with the syringe .information will make things much easier . you can get supplies at walmart under the relion brand from insulin to syringes and testing supplies for a big discount most times you dont need a prescription if using nph insulin . i like the syringes with the short needles and with half unit markings to make dosing easier .

now i know vetsilun is back on the market i dont know if your vet is using this insulin designed for dogs. if so you you will need a prescription and may need to buy supplies from your vet. here on the forum for people in the states vetsilun was taken off the market a few years ago so most of us are on nph a humane insulin.

dogs can live a long normal life with some limitations and it does become a
new normal. catching it early can also be helpful without any other complications to getting to a better place

[CraigM]

Re: Bo, 2 yrs old, has diabetes.

Welcome to you & Bo,
Yes, there will probably be a little change to your lives, but nothing that is too much to handle.

As you probably know you will be injecting insulin and watching Bo's food.

First the insulin: There are several brands / types of insulin. For the past few years the most common insulin used were either Novolin-N, or Humulin-N. They are similar (not EXACTLY the same), and some of us have used both at different times over the years - usually based on cost. These insulins at most pharmacies cost $80-$100, but Walmart currently has a contract to sell Novolin-N for only $25. Walmart is also a great place for other supplies like syringes. There is also a vet sold insulin that is just returning to the U.S. called Vetsulin. You might search the forum for comments about Vetsulin.

Food: Food and insulin work together and need to be balanced. There are many thoughts about food. Some vets recommend / sell diabetic formula foods that some use with good results. Others feed quality "standard" dog food, while others homecook. Probably the most important thing is to find a food that Bo will eat 100% of the time and be very consistent with the type and amount. Many use a food scale to weigh out the food because just a little difference in quantity can make control difficult (I swear that just 6-10 kibbles can throw Annie's blood sugar off; maybe not, but it seems so) Between meal treats probably should be discontinued until you really get a handle on Bo's diabetes. If treats are MANDATORY, you might consider a couple pieces of frozen green bean. Remember consistency in whatever they put into their bodies in very important: food, insulin, other medications all need to be as consistent as possible. Its also highly recommended to feed / inject twice a day, 12 hours apart. Yes, you will read on this forum that some have found a different schedule that works for their pup, but that is after months, or years of testing and experience.

Let's see if / what others may have written to you.

Craig

[Abby's Mom]

Re: Bo, 2 yrs old, has diabetes.

Welcome to you and Bo... (I love his name).

A couple of things that helped me in the beginning surrounding giving shots... i remember laying awake a night, thinking how much I hated to do this... but now it is so much a part of our routine, I don't even think about it.

1. Cold Insulin hurts.... so warm it up prior to administering it. I place it between my lips, or under my arm (in the summer)
2. Inject with the flat side of the need up, and at a slight angle. I will pinch the skin, and once it slides in, I then unpinch so hard and inject.
3. Shorter syringes are better, less chance of doing a fur shot. This is injecting in one side and out the other.
4. The thinner the better with syringes as well. Makes it alot easier. The higher the number, the thinner the needle. I use the 31Gauge, short needles.
5. Rotate the area in which to give shots. Scar tissue can develop, so rotations of shots are always a good idea. Right at night, left in the morning. There are many places to inject.... some start in the scruff area, but some end up in the flank, or along the side.

I think that may be enough information for now... but one thing I learned from this forum, and that there are many options on how to deal with this disease with some hard fast rules.

Insulin/Food need to work together.... but we have lots of ideas on how to make that work.

Typically 12 hrs routine for insulin with food.... some have made this work with a different routine.

Just remember, ask any question.. if you need help, we are all here, as we all understand what you are going through.

Barb

[CraigM]

Re: Bo, 2 yrs old, has diabetes.

Here is a link to the AlphaTrak web site. The AlphaTrak is a home testing meter that some of us have. Great meter, but much more expensive to use than normal human style testing meters. You will learn more about meters and home testing in the future. I'm sending the link just because the info and videos can answer many of the questions you might have. Just remember some of the info is selling the AlphaTrak2

http://www.alphatrakmeter.com/index.html

Craig

[cottons mom]

Re: Bo, 2 yrs old, has diabetes.

Hello to you and Bo.. I am also new to this site. My westie was dx in April. I have found great advice that I have put into practice from this site. It is scarey the unknown but folks here are very kind with thier knowledge, no use reinventing the wheel Hang in there it does get easier and these folks are always willing to help with any issues. Cotton and Deb

[nikkismomjill]

Re: Bo, 2 yrs old, has diabetes.

Hi! I am fairly new to this site, too. My Toy Fox Terrier, George, was diagnosed with diabetes in November 2010. We were lucky because we noticed some sticky pee in the house by the fridge. George used to be owned by someone who baby gated him in the kitchen, so we suspected him. (We have three dogs). Thus, we got him in to the vet for testing before he got sick.

Our vet gave us a very informative talk about canine diabetes. He also gave us our first insulin and our first syringes. He explained how to handle the insulin and demonstrated giving shots (using sterile water). He had each of us (hubby and me) practice on George. George is very treat driven and quickly figured out the routine. He is real cooperative.

I am sure your vet will do the same for you. This forum will be here for you. You'll get really good at taking care of Bo. The learning curve can be a little overwhelming at first. Then its simple problem solving and on you go!

[momofdecker]

Re: Bo, 2 yrs old, has diabetes.

Welcome to the forum.

Some things I learned...

If your vet has not already run a complete blood count (CBC) / chem panel, it might be worth considering. Should Bo have any problems down the road, that diagnosing data will provide an invaluable reference point.

Ask for copies of all medical records from here on out. Including what Bo's blood glucose (bg) was a time of diagnosis. How did his vet determine his insulin dose? Ask for copies of any blood glucose testing that was done to come to that conclusion. Should you ever find Bo in an emergency situation, that data and history will be helpful to have on hand.

When a dog is working towards regulation, sometimes their bg runs higher than regulation range numbers. If elevated for an extended time a dog can develop ketones. There are urine strips you can find at most pharmacies that you can use at home to test for ketones. Anything more than a trace can be life threatening and usually requires immediate veterinary care. Water is very important for a diabetic dog and should never be restricted.

Exercise can impact many dog's bg. Some lower with exercise. Some raise if the bg is elevated. Some have large drops. Some have minimal drops. The only true way to determine the impact on your pup is to test before and after exercise. If home testing is not for you, it may be worth carrying a biscuit or packet of honey during extended periods of exercise, just to keep your pup safe. Heck, even if you are home testing, it's better to be safe than sorry and to have something on hand to bring bg up quickly if necessary.

Insulin... If you find that your pup does not eat a full meal you can still give insulin but it should be a reduced amount. General rule of thumb is as follows:
Full meal = full dose of insulin
3/4 meal = 3/4 dose of insulin
1/2 meal = 1/2 dose of insulin
1/4 meal = 1/4 dose of insulin
If a dog is fasted or does not eat at all, often the dog can still receive 1/4 of their normal dose of insulin.

Wishing you the best in this new journey of yours.

Holli

[Bo's Mom]

Re: Bo, 2 yrs old, has diabetes.

I am so thankful I found this forum and even more thankful for the great messages from you all!! How will I know (after he comes home) if his bg drops or elevates in between insulin/meals? My vet has already said that once they get him regulated and send him home, they don't want us "home testing" for the first 2 weeks. They told us that we'll just need to give him his insulin/food and bring him back to them in 2 weeks so they can check him and make adjustments if needed. We both work during the day so he and Cyrus will be alone as usual for 7 1/2 hrs M-F.

Once again, thank you all so much for your messages. I will be checking on Bo around 3:30 today, but I bet they don't let me bring him home until tomorrow or Saturday morning. We all miss him like crazy.

[jesse girl]

Re: Bo, 2 yrs old, has diabetes.

technically bo will not be regulated when he gets home from the vet they will just determine what a safe dose to start with

i always thought it was funny that the vets do allot of testing at the clinic but once home they say dont test

i can understand that people can be freaked out by the numbers and may want to make adjustments on there own with little knowledge and vets take this into account but my opinion because its so early in the diagnosis you cant be sure how your pup will react to insulin especially if going to low which is where home testing will tell you before it becomes a problem

do you understand the symptoms of low blood sugar and how to respond most dogs are started off at a low dose as not to enter the area of low blood sugar but some dogs can need a very low dose to start my jesse was one of them home testing caught that before it was a problem .

[jim maceri]

Re: Bo, 2 yrs old, has diabetes.

The answer is simple......home testing is the ONLY way you will be able to monitor his BG. I have my dog somewhat regulated...as good as I believe he can be and I still test him at least 4 times a day. Before each meal and again before his 2 walks. In almost 2 years of diabetes Spirit has never had a hypo incident BUT he has come dangerously close to some very low numbers after walks. 2x a month we do a full curve and honestly I believe spirit LOVES being tested. He comes running when he hears the snap of the cap on the test strips, sits down and won't leave my side until he is tested.

Home testing really does give you peace of mind.

[Judi]

Re: Bo, 2 yrs old, has diabetes.

a lot of vets don't want people to home test because they are worried we will change the insulin dose constantly. It takes a dog's body 4 or 5 days to adjust to a different dose so while it is tempting, you have to stick with a dose unless they have scary life threatening low blood sugar.

Jenny is the Queen of low blood sugar. I didn't test for awhile, she has other issues and whoops, low blood sugar.

So now I only adjust her dose if she is under 100. Otherwise I stay the course.

At the end of the day Bo is your dog. Because he is so young, he is probably pretty active and exercise can really cause fluctuations in sugar levels. I'm going to jump on the band wagon and encourage you to test.

Once your vet realizes you aren't going to go nuts, he or she will adapt.

The more people you can involve in learning how to give the shot and test, the better your life will be. The biggest hassle for us has been making sure someone is home every 12 hours for her shot. My Mother In Law has helped us out on numerous occasions and it has been a godsend.

My hairdresser also has a grandpuppy who is diabetic and knows a pet setter who will give shots. Options are wonderful

Please keep us updated. Judi

[CraigM]

Re: Bo, 2 yrs old, has diabetes.

The vet will start Bo at a low conservative dosage and he will be OK. At the next vet visit the vet will likely increase the dosage, and so on.

The best procedure (in my mind) would be for the vet to do a "curve". Testing every two hours from breakfast to dinner. Most vets don't do this because their clinics aren't open for all those hours and just take a single reading. Single readings leave a lot to be desired! Say the reading at 1pm was a very nice 150, what would the reading have been at 11am, or at 3pm? Blood glucose isn't a static number and can easily have a 100 point swing throughout the day - see the potential problem?

For many reasons, home testing is the best course and you don't need the vets permission. You might not want to make any adjustments on your own without consulting with the vet, but the info you get from home testing is very valuable.

Yes, working away from home will make proper testing a weekend affair and the vet would probably aim for slightly higher numbers than we stay-at-home folks aim for due to safety concerns.

Concern is good, but don't worry too much. Just move slowly and things will probably be fine.

Craig

[Abby's Mom]

Re: Bo, 2 yrs old, has diabetes.

Some vets feel that home testing, will cause human intervention and you may want or feel the need to raise the insulin dose and be frantic when you see high numbers.

Initially the dosage that they may want you to keep Bo on will be lower than what he may end up.. but it takes some time to settle into that dose, as once the body get use to the insulin, his BG levels may decrease. High BG levels, even though we never like to see them, will never kill a dog, but lower BG levels will. So it is good to play it safe.

With saying ALL of that... I think that home testing is a wonderful tool, so instead of guess when Bo is have a Hypoglycemic attack, you can test and find out for sure.

Honey should always be used or possibly Karo Syrup, if blood sugar is too low. Followed up with some carby treats. I use some that have 8 calories in them, so I can control the amount better, than breaking it up. Nutro I believe have some, and I use three if I need to intervene, with a lower number than I would like a specific time of day...

Here are some questions that I armed myself when I went to pick up Abby after she was at the vet for three days.

How will the diabetes and insulin interact with other conditions my pet has or with other medications my pet is taking? provide your vet with a list of any dietary supplements, even herbal ones.

What other health problems should I watch for? Sometimes urinary track infections are prevelent. What are the signs for those.

What kind of records should I keep to help you to evaluate my pet's condition? We do alot of record keeping, and will note BG levels once testing, but even if there was any changes. Jot down time and how long a walk was for example. Did they eat all of their food. Did they appear hungry, etc.

How should I monitor my pet's condition at home? For example, measuring water consumption, watching for excessive thirst, urination, hunger, weight loss or gain, lethargy (lazy or sleepy), urine glucose or ketone monitoring results, home blood glucose monitoring results.

Ask how long you will stay with that insulin if it doesn't seem to be working. Sort of ask what their game plan is. If they are not prescribing Novolin (which you can get at Walmart for $25, you may want to ask why they specifically chosen this one).

How frequently will the vet want to monitor your pet's condition? Weekly, every other week, once a month?

What information will the vet use to determine how well your pet's diabetes is controlled? Your daily observations, blood glucose curves done at the vets?

Will the vet perform blood glucose curves (testing the blood glucose every hour or two for a full day)? How often will this be done? Can you test at home?

After your pet's diabetes is better controlled, how frequently will the vet monitor your pet's condition? Monthly, every 3-4 months? And what information will be used (bg curve, general health check, fructosamine test (we rarely suggest these if the BG curve is done at home... this is a waste of money).

Can you give me some idea of the expenses involved for testing, checkups, etc.

How important is it for me to give the insulin injection at a certain time? We typically give insulin every 12 hrs. Also, if needed, I normally will move Abby by 15 mins intervals for each feeding/schedule, so 1/2 hr each day, until I reach my new scheduling timing.

How many minutes or hours late can I give the shot and not have to adjust the dose?

If I am later than that (the answer to the previous question) what do I do?
Do I skip this shot or do I give less insulin (how much less)?
Do I give the next shot at the regular time?

What do I do if I think I missed a shot or gave an incomplete shot but I'm not sure? Do I give another shot? We typically suggest NO to skip it... but it is a good idea to see how your vet answers. Trick question


What should I do if my pet vomits his meal after I've already given the insulin injection?

How much insulin should I give if my pet refuses to eat?

How much insulin should I give if my pet only eats part of his meal?

I fed my pet, but forgot to give the insulin shot. What do I do?

I found my pet eating extra food, candy, or garbage. What should I do?

My pet looked sick last night and this morning she just doesn't look "right". Do I give the usual amount of insulin?

Be sure your vet explains hypoglycemia (low blood sugar) and how serious it is.
Be sure you know how to treat hypoglycemia - and try not to panic.

Be aware that many pets do not show any signs of hypoglycemia, even when their blood glucose is very low.

What are the physical signs of hypoglycemia? What might my pet do when she is hypoglycemic?

How do I treat hypoglycemia based on behavioral observations.
My pet looks sleepy and is lethargic. What should I do?
Do I give food or Karo? How much?


My pet is stumbling....What do I do?

My pet is having a seizure, or my pet is unconscious. What do I do?

How do I treat hypoglycemia based on home blood glucose monitoring results.
The bg is 50 and I think it may go lower.
Do I give food, or Karo? How much?

The bg is 50, but I think it will go higher soon. What do I do?

The bg is under 50, what do I do?


For all these hypoglycemia situations: when do I call the vet, or when do I immediately take my pet to the vet or emergency clinic?


What do I do if I can smell a strange chemical smell on my pet's breath? This is a sign of ketoacidosis and is potentially life threatening.


Can my pet keep up with his or her usual physical activities (walks, running, swimming, hiking)?

I know this is a long list, and some of this is scary stuff, but it is good to get an idea from your vet on how he would like for you to handle this. I bought a similar list to my vet, and he failed to answer all of my questions or gave flippant answers. Then I knew that I had to find another vet, in order to have a good working relationshp with them.

Probably more information that you had wished for. I'm not normally so long winded.

Barb

[Judi]

Re: Bo, 2 yrs old, has diabetes.

that is a great list Barb. I think it should be posted on one of the resource threads!