glucose too high

[Paula Acosta]

Hello, i found out my dog has diabetes about a month ago and we still cant control his levels. We've been using insulin, we started with 2 units in the morning and 2 units in the afternoon. I took him to the vet to get the glucose curve, and was told his insulin needed to go up double. soo 4 in the am and 4 in the afternoon. after a week i starter getting crazy high numbers, numbers higher than what he was diagnose with, so i took him back to the vet because they wanted to see how i was injecting the insulin because maybe i was doing something wrong, they told me i was doing ok and to increase his units in the am to 6. Im doing everything as told and ive been getting crazy results, results up to 680!

I took him for another curve yesterday and they were also getting crazy results (by crazy i mean that before his insulin he would be at 650 and an hour later he would be at 687) they suggested that the bottle of insulin might be bad and to buy a new one ( keep in mind i bought this bottle of insulin at their office for $100! when waltmart sells it for $25)

i bought him the new bottle of insulin injected him with 4 units in the afternoon. went to sleep and about around 5:30am i was woken up by my dog because he wanted to drink water, i let him drink water and he drank for like a minute straight. i checked his gloocose at 6:11 am and he was at 693!! i gave him his food at 6:30am and injected his 6units of insulin at 6:50. at 7:12am i checked him again and h was at 710!!! the highest he has ever been. at about 1:15pm we check him agian and he was at 614, i called the vet to let them know what were results, they took the whole day to call me back. when i finally got called i was told to cut back on the units of insulin, to go back to 2units in the am and 2units in the afternoon. I gave him his insulin at 6:50pm (2units) and just checked him at 10:53 and he is at 705!.

Im really confuse and would like to get some opinion on this, because obviously the insulin is not working, or maybe it was just an overdose?

[Monsters Momma]

Re: glucose too high

My daughter would remind me to 'breathe'. So I'll do the same.

First off, welcome! You've found a great place.

If you read anyone's thread, you will find that it takes a lot of patience and time to get our pups glucose down where it should be. Next, I would ask you to tell us everything you can about your pup...weight, breed, food, insulin (I'm assuming Novolin), etc. Everything you want to tell us....we like to get to know the new pups! Lastly, has your vet diagnosed your pup with anything else? And infection of some kind maybe? Did your vet test for ketones? What kind of meter are you testing with?

The good news is...If you had given an overdose, your pup would go low, not high typically. It took us 6 months+ to get regulated, some take shorter, some take longer. It's the rare pup that just settles in at the starting dose, but those high numbers are concerning.

Through it all, do not forget to breathe...this is a marathon, not a sprint.
Hang in there! You've found a great place!
Mel

[Paula Acosta]

Re: glucose too high

Hi Mel,

My dog is a puggle (half pug half beagle)he is 8 years old. When we found out about his diabetes he use to weight 48lbs, the vet prescribed Royal Canin diabetic, and i feed him 1.5 cup in the morning and in the afternoon, and walk him 30 min every day. He now weights 42lbs. and yes you are right about the insulin is novolin. I know inject him 2units twice a day.

I dont remember the vet mentioning anything about ketones so my answer to that is no.

the reason why i say overdose is because i read something about The Somogyi effect, http://vetmedicine.about.com/od/dise...ogyiEffect.htm

i read that article yesterday morning when his sugar lever went up to 710 after the insulin, and the vet told me bring the dose of insulin down (before yesterday we were giving him 6units in the am and 4 in the afternoon, now the vet told me to bring it down to 2 units.

oh and the meter i use is the AlphaTrack.

Thank you for your advice on breathing, this has been an overwhelming experience for me, for me my dog is my baby so i get worried all the time. Im glad i found this blog while researching for answers

[Monsters Momma]

Re: glucose too high

Ketoacidosis is ketones in the urine when a dog has high glucose. You can get ketostix at the closest pharmacy and if there's more than a trace of ketones, it's a trip to the vet. Fortunately Vinny has never had this but several pups have and it doesn't look like anything I want to experience any time soon.

Hopefully someone with some experience will come along that knows more than me. It certainly wouldn't hurt to get some strips and test him in the meantime.
Mel

[jesse girl]

Re: glucose too high

usually insulin doesn't take affect till about 1.5 hours after injection this is called onset so if you do check at shot time and an hour after shot you could actually see a rise in blood sugar .

have they done a complete curve ( a test before shot and meal and every 2 hours into the next fasting which is before next shot and meal )

if seeing a deterioration of the numbers after an adjustment upward that can be a clue to an overdose situation and reducing the dose may have been appropriate

now early in the diagnosis its possible a dog could still produce some insulin and the need for insulin maybe lower but once that ends the need for more insulin can go up

a starting dose is based on a dogs weight and this is a general consensus that doesn't holed true a 100 percent of the time and some dogs need allot less my jesse was one of them thats why you may need more testing

my jesse could go from 500 to 70 in the first few hours and then by hour 4 and 5 would be back up to 500 again so if i missed testing at that low point i would have just thought jesse was just running high all the time .

now seeing an increase in symptoms as far as thirst and urination seems a bit unusual raising the dose and may point to possibly an infection going on or something else outside of diabetes but most would think the higher sugar as the reason . with this disease you have to keep your mind open to other possibilities

[Riliey and Mo]

Re: glucose too high

Hello and welcome

2 iu seems really low, 6 is low too.

Can you post any curves done? This will help gather more data on your dog.

[CraigM]

Re: glucose too high

Welcome!
As you can imagine, it's really hard to diagnose a good starting dosage for some pups. There is general consensus that a starting dosage may be .2 units per pound of weight. So a 40 pound pup might be started with 8 units of Novolin-N injected twice a day. I know this is quite a bit higher than you've been.

Does he have any other medical problems going on? Any other medications? Are you feeding ANY treats / snacks between meals (not that you can never give a treat, but we need to know if that might have a bearing on the high numbers).

Craig

[k9diabetes]

Re: glucose too high

An overdose of insulin at 2 units is extremely unlikely, and most dogs your boy's size would have been started at more than 6 units twice a day.

My personal feeling is to start at about 1/5 of a unit per pound at most. In his case, that would have been 8 units and I would have liked to have seen him started out on at least 6 units.

So I think there is very little chance that your dog has somogyi and instead probably simply needs more insulin than he's been getting.

He could easily need as much as 15 units twice a day, possibly more - that's a dose that would still be well within "normal" for a 42 pound dog.

He's certainly at risk of ketoacidosis with such high blood sugar.

I would start immediately giving him 8 units twice a day to see if it moves his blood sugar at all. And would probably take it up to at least 10 units twice a day before starting to consider that he might not be responding to the NPH.

Very rarely - as in I have only ever known one dog for sure in 10 years - a dog is not responsive to the human insulin molecule in NPH. But it's so rare that I always put it way down the list of likely problems. Far more likely is that your dog just isn't getting nearly enough insulin.

Sounds like you may need a new vet... one with more diabetes skill. Many of us have had to change vets in response to a diabetes diagnosis.

Please do get some Ketostix or Ketodiastix and test his urine for ketones. Anything more than mild ketones is a crisis. Mild ketones calls for stepping up efforts to get the blood sugar down with perhaps some faster acting insulin and more insulin than he's been getting.

Natalie

[Paula Acosta]

Re: glucose too high

Hi all, thank you for answering.

when we first found out that he had diabetes he was at 537 on February 1, 2014. a week after giving him 2units of insulin twice a day i took him to the vet for a glucose curve on Feb 10, they told me to not give him food or the insulin that they would do it there, i was told he didn't want to eat when the food was offered to him the results were

Before Insulin 7:45am: 430
they injected the 2units of insulin at 8am

10am- 399
12pm-369
2pm-377
4pm-373

with this results they told me to bring up his units of insulin to 4units twice a day. that same week i bought the alpha trak and started to do the test the results were as follow

on 2/13/14
6:47am- 692
7:41am- 514
1:44pm-601
6:54pm- 513

on 2/14/14
7:28am- 609
1:50pm- 610
9:27pm-604

i called the vet with this results and was told to go in because they wanted to see how i was giving him the insulin. i was doing everything ok so they told me to bring his morning dose up to 6, so he was with 6units in the morning and 4 in the afternoon.

I kept getting crazy results the highest been 687 and the lowest was 350. when i took him on monday for his glucose curve they told they kept getting weird results too, so they thought the bottle of insulin was a bad bottle. so i bought a new one.
yesterday i checked him and the results were
6:11am- 693
7:12am-710
1:15pm 614
10:53pm- 705

i called the vet and they told me to bring his dose of insulin down back again to 2units. My husband and i have noticed that he has been more active with more energy while walking, like he is himself again. before with the 6units and 4 units of insulin he would walk slow, and seemed tired.


what do you guys think?

[k9diabetes]

Re: glucose too high

Can you post the results of the last curve the vet did?

Looks like the curve on 2 units was with no breakfast. And curves at the vet aren't all that "natural" as they are often in a kennel all day with little activity and a lot of stress. Our dog's blood sugar tended to go lower at the vet than when he was at home.

I honestly think he's just not on enough insulin. Somogyi rebound isn't all that common.

There are other possibilities too - like a UTI or other infection or inflammation.

But I personally would compromise and give him 5 units morning and evening and give him a few days to adjust to the larger dose and then see if his blood sugar "moves"... not that it will necessarily be 300s all day but to see if it drops during the day even if it is high at meal time.

Also, make sure the AlphaTrak is properly coded, strips seem good.

What do they use for the curve at the vet?

If it's a human meter, it could have read the blood sugar quite a bit lower than the AlphaTrak. And if the vet used an AlphaTrak, they could have miscoded it - the codes for dogs and cats can be different.

Natalie