Kumbi died uexpectedly June 8 2010

[Patty]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Carol,
I do hope the meds help Kumbi's liver! When is he scheduled for a recheck?

Sore tonsils and throat from coughing...poor Kumbi, no fun

Patty

[Noodle]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Poor Kumbi has had a lot going on lately. I hope his liver is able to heal and that once his cough is gone and his teeth are taken care of, that everything else can return to normal.

[Margaret Boyle]

Re: Kumbi's BGs while on liver support meds

Carol,

Hope Kumbi is feeling better I am thinking about you.

Hugs to you and Kumbi

Marg

[CarolW]

Re: Kumbi bloodwork - out-of-range values

First, thanks to my very dear buddies here, for your replies. We're going along. Kumbi LOVES his meds! Hates Procedures, but is adapting to frequent Pricks from Mama Prick.

Here are Kumbi's out-of-range values, from
Kumbi's geriatric blood panel, Tue, 23 Mar 2010
------------------------------------------------------

Submission Date: 2010-03-23; 21:22:10
Completed Date: 2010-03-24; 03:29:12

exam and blood draw at Saseenos clinic
by Dr. Julia Harrison

Out of range values

BIOCHEMISTRY
Test Results Reference units
Glucose 11.0 high 3.0 - 7.0 mmol/L
Bicarbonate 16 low 17 - 24 mmol/L
Anion Gap 27.4 high 10 - 22
ALP 4630 high 10 - 150 IU/L
Verified
Chemistry run on a 2x dilution
ALT 264 high 5 - 60 IU/L
GGT 75 high 0 - 14 IU/L
Cholesterol 10.61 high 3.00 - 8.00 mmol/L
Glucose(Grey) 9.0 high 0 - 6.1 mmol/L


HEMATOLOGY
Platelets 446 high 170 - 400 x10E9/L

Hem Micro Comm*

Platelets were clumped; this will interfere with the accuracy of the
platelet count and underestimate the number of platelets present
Platelet numbers are adequate
Lipemic artifact is present in RBCs

Differential: % abs
---------------------------------------------------------------------
Eosinophils 17.0 1.564 high 0.000 - 1.231 x10E9/L

Comment:

presx diabetic dog adequate control gross mouth coughing
Chemistry sample is slightly hemolyzed and lipemic

[end report]

Fri, 9 Apr 2010 11:45:41 (PDT)

[CarolW]

Re: Kumbi BGs - update to now

Kumbi's BG readings from Wednesday 7 April thrugh now

Wed, 7 Apr 2010 07:00

06:59 - 22.1 mmol/L = 398 mg/dL
Insulin - Novolin-NPH, 7.0 units, 07:00 (holding dose)
15:02 - 25.3 mmol/L = 456 mg/dL
17:01 - 18.7 mmol/L = 337 mg/dL
18:30 - 17.6 mmol/L = 317 mg/dL
19:03 - 19.9 mmol/L = 359 mg/dL (food spike is 2.3 mmol/L = 41 mg/dL)
Insulin - Novolin NPH, raised 0.5 units to 7.5 iu, 19:04


Thursday, 08 April 2010; 07:29:41

06:31 - 17.4 mmol/L = 314 mg/dL
07:00 - 20.8 mmol/L = 375 mg/dL (food spike = 3.4 mmol/L = 61 mg/dL)
Insulin Novolin NPH, holding at 7.5 units, 07:01
10:54 - 17.1 mmol/L = 308 mg/dL
14:58 - 19.4 mmol/L = 350 mg/dL
17:01 - 18.4 mmol/L = 332 mg/dL
18:34 - 14.2 mmol/L = 256 mg/dL
19:00 - 16.9 mmol/L = 305 mg/dL
Insulin - Novolin NPH; 7.5 units; 19:01


Friday, 09 April 2010; 03:08:21

02:03 - 20.4 mmol/L = 368 mg/dL
06:31 - 16.9 mmol/L = 287 mg/dL
07:00 - 22.1 mmol/L = 399 mg/dL (food spike - 5.2 mmol/L = 94 mg/dL)
Insulin - Novolin NPH - 7.5 units; 07:01

I'm REALLY tired, after Hunt Day - going for a nap. Also, I'm working really hard on charting (Hi, Carolyn and Gretel) - learning more, gradually - that wears me out, too!

Fri, 9 Apr 2010 12:00:26 (PDT)
zzzzzzzzzzzzzzzz

[Patty]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Ok Carol, I'm curious...what's the difference between glucose and glucose (grey)? Also, did they list triglycerides since his blood was lipemic?
Patty

[CarolW]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Patty - I have no idea! I didn't see a listing for triglycerides. Never heard of Glucose (Grey), either!

Fri, 9 Apr 2010 12:31:21 (PDT)
going for that nap, before I wreck my computeroperations by falling asleep at the keyboard!

[ozzi]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Carol,

The reference to "grey" in glucose (grey) refers to the tube that was used to draw the blood. Glucose can be drawn in a tiger-top tube (serum separator tube) or a grey-colored tube which contains sodium flouride to protect the integrity of the glucose in the blood by preventing red blood cells from metabolizing the glucose in the blood. Flouride inhibits glycolysis so loss of glucose does not occur in a grey-top tube. In general, grey top tubes are only used for transport of blood from a drawing site to a lab, and the serum separators are used for on-site lab testing where the blood is drawn and tested at the same location.

So the value associated with "glucose (grey)" just means the glucose value, and that it was drawn in a grey-top tube. Essentially the "grey" is just to document the tube it was drawn in, and there no difference between 'glucose' and 'glucose (grey)' as far as the number itself is concerned.

I didn't read your entire thread (due to time), but I noted that your dog was coughing and that the eosinophil count was very high. An eosinophil is a type of white blood cell, and an elevation of eosinophils often refers to an allergic process or possibly a parasitic infection. When the count is high, it can cause liver or spleen enlargement. I just wondered if all of this was connected? Did your vet mention the possibility of allergies or parasites? Has Kumbi had an ultrasound to see if she has liver cirrhosis? I apologize in advance if you already covered these topics, but as I mentioned, I haven't had a chance to read the whole thing yet. I just wanted to throw out a few thoughts that I had and clear up the glucose (grey) issue!

Kevin

[Patty]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Thanks for the explanation Kevin.

[CarolW]

Re: Tracking Kumbi's readings with liver meds

Kevin! Fabulous post! Thanks SO MUCH for the information on glucose, and glucose (Grey).

You'll notice the two values are different, but I imagine the plain "glucose" value is incidental, a standard value, while, going by what you say, the "glucose (Grey)" is a specific measurement as would be done with a vet's lab machine.

I also appreciated your other remarks. We can schedule an ultrasound if need be, which we'd probably do after Kumbi finishes his course of meds to support his liver.

The BG-tracking I'm doing right now is to make SURE Kumbi doesn't hypo - and - with the reading I got right after his walk this afternoon, just after three p.m., I'm about to do another reading, which I'll tack on here, along with the other stuff since this morning.

Next week, Dr. Amanda Booth and Dr. Julia Harrison will get together to go over what is going on with Kumbi, and do some kind of planning.

Meantime, I'm beginning to feel a bit as though Kumbi is turning into a pincushion, though he's handling it well. (Marie and Bruno, take note!)

I must absolutely prevent a hypo; we'll see what readings I get in a few minutes, and then at fasting, and then pre-insulin this evening.

I'll post this, and follow up very shortly.

Fri, 9 Apr 2010 16:56:45 (PDT)

[CarolW]

Re: Kumbi - feeding the peak helps! More BGs

Here's my promised report for Kumbi's 17:00 reading:

Friday, 09 April 2010; 03:08:21

02:03 - 20.4 mmol/L = 368 mg/dL
06:31 - 16.9 mmol/L = 287 mg/dL
07:00 - 22.1 mmol/L = 399 mg/dL (food spike - 5.2 mmol/L = 94 mg/dL)
Insulin - Novolin NPH - 7.5 units; 07:01
15:06 - 9.0 mmol/L = 162 mg/dL (feed peak snack follwed; 15:08)
17:00 - 14.4 mmol/L = 259 mg/dL

The only good walk-time for us is around 3 p.m. Kumbi's nadir usually runs anywhere from 3 p.m. to right before his supper (18:30). Because I really can't get emergency vet care for him, I MUST prevent him from having a hypo, so I let him run with higher BGs than I'm necessarily really comfortable with.

Here's an amusing aspect to this: Kumbi is on those Chinese herbs, which COULD lower his insulin requirements, so I had dropped his dose quite sharply when, the day after I first gave the herbs, he was running much lower than usual. Then I began to raise the dose again, because he started running even higher than usual. More checking required, to make sure there's no rebound going on!

I think its pretty funny for me to half-panic at a mid-afternoon reading of 9.0 mmol/L (162 mg/dL). As Natalie has remarked, and Branka also (BrankaVinni), when you're used to high readings, getting nice ones can be scary!

Two more readings to come for today - p.m. fasting (about 18:30), and pre-insulin (Dr. Amanda wants those, and it's a good idea right now!).

Kumbi did NOT like being disturbed for the 17:00 reading; he went outside, stayed a bit, reluctant to come in - then finally, wanting to rest overcame him, and he's returned to his favorite indoor-Sentry bed, from where he can monitor all that I do!

Fri, 9 Apr 2010 17:29:07 (PDT)

[overfiffty]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Dear Carol,

I am so sorry to read that you dog is sick. However after seeing some of his readings I just wish my Bruno was some where in that area. His sugar is still very high. Over 350 and every day we do a urine stick and it's never moved from +2000 with ketones in the negative. He's completely blind now and we have to lead him around. So far all the meds for the Cushings don't really seem to have done anything yet. But we are hanging in there. I shall do another curve tomorrow to see what his #'s are since I cannot do a curve while working. He just eats and sleeps. Not much quality of life anymore. He doesn't do anything just eats and sleeps can't go for walks because his hind legs are weak and he can't really see where he's going.

Doesn't even go near Starr to bug her. Enjoy your time with your four legged one. Bruno is just existing right now with what I can actually say is no quality of life. His back legs are still weak and he takes more medication than anyone in the house. I hope your doggie does a lot better and gets to a place where he was before becoming sick. Hang in there you certainly know a lot more than I do and I know you are doing an absolute great job.

Keep up the good work!!!

Marie and Bruno

[CarolW]

Re: Kumbi - more BGs - gosh!

Hey, Marie - thanks for your good wishes. Kumbi's BGs are just all over the place, which is what, it is said, happens when a dog has an infection or is on antibiotics - or, of course, both! Which is what is going on with Kumbi right now.

I nearly freaked this evening; see these readings:

Friday, 09 April 2010; 03:08:21

Insulin - Novolin NPH - 7.5 units; 07:01
15:06 - 9.0 mmol/L = 162 mg/dL (feed peak snack follwed; 15:08)
17:00 - 14.4 mmol/L = 259 mg/dL
18:32 - 22.3 mmol/L = 402 mg/dL
19:00 - 29.3 mmol/L = 528 mg/dL (quite a food-spike!)
Insulin - Novolin NPH - 7.5 units, 19:01

I might or might not take another reading this evening. Kumbi is definitely stressing over the repeated readings - getting up and going away now whenever I move, just about!

Better to run too high than too low, and I'm not really afraid he's going to drop to hypo level overnight, so I may just make do by keeping a very close eye on him, assessing how he's feeling.

Marie - I'll drop in on your thread, too. And try to check out your thread on the Cushings forum as well, if I don't fall asleep first - badly needing more sleep now!

At the moment, Kumbi seems to feel okay, and he's not drinking unusual amounts of water, so I'm tempted to think the BG swings really are the kind of fluctuation one gets with infection-with-antibiotics.

Catch you later!

Kumbi - glad to see you resting now! And thanks for your garden-song a few minutes ago - Garden-singing (barking) in the evening is a specialty of yours - and your throat seems better!

Fri, 9 Apr 2010 19:41:07 (PDT)

[ozzi]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Carol,
You're doing a great job watching Kumbi! I have my fingers crossed that Kumbi's BG will be back on track very soon after getting rid of the infection and finishing the antibiotics. I really do understand how you feel about getting a normal reading when they have been so high! I got nervous on Ozzi's last curve when his insulin peaked and his BG was 188...not where I want to be, but just a little startled to see a better number!! It really can be scary sometimes to get what you ask for! Hang in there and I think Kumbi will be just fine. I'm worried about you though...you need to get some sleep! But I also understand the sleepless nights. When I increase Ozzi's insulin, I'm a wreck for the first 2-3 nights worrying about a hypoglycemic event. I'm glad you're such a great mom to Kumbi!!
Kevin

[ladysmom06]

Re: Kwali (ndd), Kumbi (dd) and me (Carol, ndh)

Hi Carol,

At the moment, Kumbi seems to feel okay, and he's not drinking unusual amounts of water, so I'm tempted to think the BG swings really are the kind of fluctuation one gets with infection-with-antibiotics

Sorry to hear that your having problems with Kumbi. Whenever Lady had an infection her bg's would rise but once the antibiotic started working she would get back to normal. Hoping that's all it is with Kumbi. Hugs to the two of you.