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(My apologies for length! Actual questions at the end for anyone not in the mood for my novella)
Kermit the Dog: 14 year old neutered male “beagle” though possibly foxhound or mix. Think tall, skinny, athletic beagle with lifelong anxiety issues. Prozac discontinued 5/7.
Prior to May 1, weight 44 pounds. Now down to 41.5. Previously diagnosed with degenerative disc disease and arthritis, chronic airway disease and inflammatory bowel disease. Symptoms of these conditions were managed with 100 mg gabapentin 3x daily and 5 mg prednisone daily. He's been weaned off the prednisone with his last dose 5/8 and thankfully has had no return of his cough. He still takes the gabapentin. IBD has not returned since 30 day Tylan regimen in February.
Kermit first presented May 1 with loss of appetite, heavy (water) drinking, lots of peeing and agitation – panting, pacing, circling. (I had noticed some symptoms prior, blamed the steroids and reduced his prednisone to 2.5 daily). We observed swelling of the lymph nodes in his neck, also suspected UTI, and started a course of amoxicillin and added alprazolam for the anxiety. He did okay that way for a couple of days, but on May 5 began exhibiting some odd neurological signs like standing in corners, leaning against walls and having more trouble than usual moving around in the world. I blamed the anxiety meds, but late that afternoon he vomited up several undigested medications still wrapped in their sausages, so we went running for the vet. We tried a different antibiotic that night – zeniquin – based on my feeling that he had been a little better on the amoxicillin and that I thought his neck was less swollen. Full blood panel ordered that day, and with those results, diabetes (glucose 600+) and pancreatitis were diagnosed the next day. Ultrasound showed enlarged liver, angry pancreas and they thought (at that time) lymphoma because of all the swelling in his neck. He would not eat and refused all oral medications.
His agitation was extreme and these were very difficult days. Probably lots of you have sat with an animal you love that is in distress – so y'all know. We made it through only because Kermit started eating teeny amounts when I begged and praised and babied him. A few small bites and 4 units of insulin, raised to 6 if he ate a little more, and raised to 8 if he ate great. That was last week – good grief, seems like a year ago. I was holding out hope that the enlarged lymph nodes in neck and abdomen were more related to the general inflammation and stressed out immune response of the untreated diabetes and concurrent pancreatitis, and I continued his antibiotic zeniquin. He was prescribed cerenia for the nausea and mirtazapine to stimulate appetite. Kermit got better, started eating more.
He has had two curves so far, at the vet's office. The first one was about 48 hours after starting the teeny 4 unit insulin doses, with all glucose readings registering too high to measure. Five days after increasing to 8 units, second curve had a low of about 360. We increased to 10 units Humulin N, every 12 hours. That is his current dose.
He had been quite calm and doing much better with eating, but two days after finishing the antibiotic zeniquin, he became agitated again. Panting, pacing, refusing to rest, wearing out his poor old back, and labored breathing even when he eventually stopped moving hours later. We ran back to the vet. Cytology of the lymph aspiration does not rule out an “emerging” lymphoma but shows only neutrophilic inflammation. No cancer. We have restarted the zeniquin, a two week course this time. Continuing with cerenia and mirtazapine. That was Friday. $25 (!!!) spot check glucose reading 335.
Today – Kermit is little old man Kermit, not exactly bouncing off the walls, but he is calm, comfortable and is eating on his own. He is still very picky about eating, but today he seems to be okay with boiled chicken, oatmeal and canned pumpkin. I have been cooking for him his whole life, so it is not surprising to me that he utterly refuses any fancy prescription foods – but he also now turns away from lean beef, rice, butternut squash and a few other foods he has never refused before. I know some of these foods are not ideal for diabetics, but for now, I just need him to eat anything and try to settle his poor pancreas.
I got a Relion meter at Walmart today and based on what I had read on this forum about walmart insulin, I spoke to the pharmacist there. She quoted me $24.88 for a bottle. That's a complete game changer for me after having paid $115 at Costco last week, especially being in the hole about $2000 from vet visits, meds and diagnostics to get us here.
I know that the Alpha Trak 2 is probably ideal for home glucose testing, but for now I am trying like heck to keep spending down while also keeping Kermit alive and most importantly comfortable. I realize that he is not immortal, but I'll be danged if I will be making an end of life decision for a disease that is treatable. If we fail, we fail, but I'm committed to trying. I do have some experience with nursing/hospice care situations from my 18 year old dog Bonnie who passed in 2013, as well as with several human family members that have also passed. I'm generally familiar and comfy with medical situations, with some knowledge of human Type II diabetes and dietary recommendations.
But, I have a lot of questions. There is just a wealth of information here, some of which I have read through (and I really can't thank everyone who posts here enough, the stories and information here have already made a big difference in MY quality of life, not to mention Kermit's).
My big questions for today are:
--Does anyone have any ideas about this generalized agitation/anxiety or seen similar symptoms in their diabetic dogs? I do have alprazolam to give him, but I have been reluctant to dose him with that for fear of disguising an important blood sugar symptom.
--Does anyone have experience with the Relion glucose meter and how it works with canine blood? I took a spot check reading this afternoon and got 316. Hopefully this week I can get with the vet and do some comparisons with their AlphaTrak, but at $200 a curve, I sure would like to put that off for a week or even two, if Kermit remains this stable and comfy. I am not opposed to getting an AlphaTrak myself down the road if I can get Kermit stabilized, but the cost and delivery time are what made me start with Relion.
--Has anyone had any issues switching from Humulin N to the Walmart brand of insulin?
--How crucial is it that the shots are exactly 12 hours apart? Surely 20 or 30 minutes is an okay margin of error?
--How can I be sure I'm giving the injection correctly? The vet had me 'draw back" a little once I inserted the needle, but I find that very awkward and am not always able to do that. Could I be injecting the insulin into his skin instead of under it? Would I see liquid outside if that were the case? How badly can one possibly give the injection? What if I miss an air bubble? Giving the injection is definitely the part that gives me the most anxiety.
Any advice is welcome and appreciated! I know my Kerm is an old guy with a complicated diagnosis, but I'm not going to give up on him just because he's “old”. There is no expiration date stamped on him. His quality of life is still very good – he jumps in chairs, lays in the sun, takes off out of the driveway gate if you leave it open and bays at a strong breeze. He's more than just this list of symptoms and he hasn't given up on me yet. After last week, it seems like a miracle that he's still with me at all.
Kermit the Dog: 14 year old neutered male “beagle” though possibly foxhound or mix. Think tall, skinny, athletic beagle with lifelong anxiety issues. Prozac discontinued 5/7.
Prior to May 1, weight 44 pounds. Now down to 41.5. Previously diagnosed with degenerative disc disease and arthritis, chronic airway disease and inflammatory bowel disease. Symptoms of these conditions were managed with 100 mg gabapentin 3x daily and 5 mg prednisone daily. He's been weaned off the prednisone with his last dose 5/8 and thankfully has had no return of his cough. He still takes the gabapentin. IBD has not returned since 30 day Tylan regimen in February.
Kermit first presented May 1 with loss of appetite, heavy (water) drinking, lots of peeing and agitation – panting, pacing, circling. (I had noticed some symptoms prior, blamed the steroids and reduced his prednisone to 2.5 daily). We observed swelling of the lymph nodes in his neck, also suspected UTI, and started a course of amoxicillin and added alprazolam for the anxiety. He did okay that way for a couple of days, but on May 5 began exhibiting some odd neurological signs like standing in corners, leaning against walls and having more trouble than usual moving around in the world. I blamed the anxiety meds, but late that afternoon he vomited up several undigested medications still wrapped in their sausages, so we went running for the vet. We tried a different antibiotic that night – zeniquin – based on my feeling that he had been a little better on the amoxicillin and that I thought his neck was less swollen. Full blood panel ordered that day, and with those results, diabetes (glucose 600+) and pancreatitis were diagnosed the next day. Ultrasound showed enlarged liver, angry pancreas and they thought (at that time) lymphoma because of all the swelling in his neck. He would not eat and refused all oral medications.
His agitation was extreme and these were very difficult days. Probably lots of you have sat with an animal you love that is in distress – so y'all know. We made it through only because Kermit started eating teeny amounts when I begged and praised and babied him. A few small bites and 4 units of insulin, raised to 6 if he ate a little more, and raised to 8 if he ate great. That was last week – good grief, seems like a year ago. I was holding out hope that the enlarged lymph nodes in neck and abdomen were more related to the general inflammation and stressed out immune response of the untreated diabetes and concurrent pancreatitis, and I continued his antibiotic zeniquin. He was prescribed cerenia for the nausea and mirtazapine to stimulate appetite. Kermit got better, started eating more.
He has had two curves so far, at the vet's office. The first one was about 48 hours after starting the teeny 4 unit insulin doses, with all glucose readings registering too high to measure. Five days after increasing to 8 units, second curve had a low of about 360. We increased to 10 units Humulin N, every 12 hours. That is his current dose.
He had been quite calm and doing much better with eating, but two days after finishing the antibiotic zeniquin, he became agitated again. Panting, pacing, refusing to rest, wearing out his poor old back, and labored breathing even when he eventually stopped moving hours later. We ran back to the vet. Cytology of the lymph aspiration does not rule out an “emerging” lymphoma but shows only neutrophilic inflammation. No cancer. We have restarted the zeniquin, a two week course this time. Continuing with cerenia and mirtazapine. That was Friday. $25 (!!!) spot check glucose reading 335.
Today – Kermit is little old man Kermit, not exactly bouncing off the walls, but he is calm, comfortable and is eating on his own. He is still very picky about eating, but today he seems to be okay with boiled chicken, oatmeal and canned pumpkin. I have been cooking for him his whole life, so it is not surprising to me that he utterly refuses any fancy prescription foods – but he also now turns away from lean beef, rice, butternut squash and a few other foods he has never refused before. I know some of these foods are not ideal for diabetics, but for now, I just need him to eat anything and try to settle his poor pancreas.
I got a Relion meter at Walmart today and based on what I had read on this forum about walmart insulin, I spoke to the pharmacist there. She quoted me $24.88 for a bottle. That's a complete game changer for me after having paid $115 at Costco last week, especially being in the hole about $2000 from vet visits, meds and diagnostics to get us here.
I know that the Alpha Trak 2 is probably ideal for home glucose testing, but for now I am trying like heck to keep spending down while also keeping Kermit alive and most importantly comfortable. I realize that he is not immortal, but I'll be danged if I will be making an end of life decision for a disease that is treatable. If we fail, we fail, but I'm committed to trying. I do have some experience with nursing/hospice care situations from my 18 year old dog Bonnie who passed in 2013, as well as with several human family members that have also passed. I'm generally familiar and comfy with medical situations, with some knowledge of human Type II diabetes and dietary recommendations.
But, I have a lot of questions. There is just a wealth of information here, some of which I have read through (and I really can't thank everyone who posts here enough, the stories and information here have already made a big difference in MY quality of life, not to mention Kermit's).
My big questions for today are:
--Does anyone have any ideas about this generalized agitation/anxiety or seen similar symptoms in their diabetic dogs? I do have alprazolam to give him, but I have been reluctant to dose him with that for fear of disguising an important blood sugar symptom.
--Does anyone have experience with the Relion glucose meter and how it works with canine blood? I took a spot check reading this afternoon and got 316. Hopefully this week I can get with the vet and do some comparisons with their AlphaTrak, but at $200 a curve, I sure would like to put that off for a week or even two, if Kermit remains this stable and comfy. I am not opposed to getting an AlphaTrak myself down the road if I can get Kermit stabilized, but the cost and delivery time are what made me start with Relion.
--Has anyone had any issues switching from Humulin N to the Walmart brand of insulin?
--How crucial is it that the shots are exactly 12 hours apart? Surely 20 or 30 minutes is an okay margin of error?
--How can I be sure I'm giving the injection correctly? The vet had me 'draw back" a little once I inserted the needle, but I find that very awkward and am not always able to do that. Could I be injecting the insulin into his skin instead of under it? Would I see liquid outside if that were the case? How badly can one possibly give the injection? What if I miss an air bubble? Giving the injection is definitely the part that gives me the most anxiety.
Any advice is welcome and appreciated! I know my Kerm is an old guy with a complicated diagnosis, but I'm not going to give up on him just because he's “old”. There is no expiration date stamped on him. His quality of life is still very good – he jumps in chairs, lays in the sun, takes off out of the driveway gate if you leave it open and bays at a strong breeze. He's more than just this list of symptoms and he hasn't given up on me yet. After last week, it seems like a miracle that he's still with me at all.
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