Honey - Newly Diagnosed - Advice?

[HoneyMae]

Hello all, My dog Honey, a 10 year old 22 pound pug, was recently diagnosed with diabetes. She also has high liver levels that the vet thinks could be connected to Cushing's Disease, but she wants to get Honey's blood sugar under control before the Cushing's is considered.

Honey is on Humulin N insulin, currently 5 units. She was started on 5 units and her blood sugar was tested approximately 5 hours after getting her morning dose and her sugars were high, around 430. Her dose was then increased to 7 units and one week later she went into the vet for a glucose curve. The vet told me her glucose curve is upside down. She started the day soon after eating at 79 and then her sugars rose throughout the day to about 380. The vet explained this is a somogyi effect and determined 7 was too much, so we've gone back down to 5.

The vet wants to do another glucose curve at 5 units. She is scheduled for one in a week but this doesn't make much sense to me since we already know Honey's levels were very high on the 5. Any advice? Possibly try a different type of insulin? I'm worried the vet is needlessly having us do a curve on 5 for the money.

Honey's accidents and excessive thirst has all but disappeared on both doses, and it seems she has much more pep in her step, feeling more like herself again. She is a trooper and has not once fussed over her injections.

[k9diabetes]

Re: Honey - Newly Diagnosed - Advice?

How long ago was she diagnosed? Did her blood sugar start dropping at some point before the next injection?

I think it's *possible it was a somogyi rebound on 7 units but not necessarily.

The books always shows the curve as a bowl with high blood sugar at meal and injection time and lowest blood sugar at around 6 hours. But dogs don't read the book or even care much about what it says, and their curves come in all different kinds of shapes.

Regardless, I think it was too much of an increase to go to 7 units unless she was taken up slowly in half-unit increments.

5 units is about 1/4 unit per pound and 7 units is more like 1/3 unit per pound, which is quite a bit more insulin than many dogs need. If 5 clearly isn't enough, I would raise it half a unit only.

It makes more sense if you think in terms of percentages. With a small dose like 5 units, 7 units is almost 150% of 5 units! So that's a big increase.

Have you considered testing blood sugar at home?

Natalie

[jesse girl]

Re: Honey - Newly Diagnosed - Advice?

hi and welcome

i am a little confused where you say your pup was tested 5 hours after insulin and it was 430 . was there a complete curve done this day or just one test ?

[HoneyMae]

Re: Honey - Newly Diagnosed - Advice?

Thanks for the advice!

Honey was diagnosed 3 weeks ago. She wasn't increased by half units, the vet told us to jump from 5 straight up to 7. When she was tested on the 5, it wasn't a curve it was just bringing her to the vet for a one time check.

I'm a little concerned our vet isn't knowledgeable on canine diabetes.. she keeps saying she will have to "read up on it" or "call a specialist" to find answers...

[jesse girl]

Re: Honey - Newly Diagnosed - Advice?

the problem with raising a dose based on one numbers thinking this is the high point in the day ( nadir) is not a very safe way to raise the dose especially such a large amount at one time . sounds like a knee jerk reaction to the 430 which is not how this disease is managed its a patient methodical process using full curves to evaluate a dose up or down or keep it the same

my jesse ealy in her DX would start at 500 drop to 70 and be back up to 500 by mid day if we just tested her at fasting ( before insulin and shot) and tested 6 hours later we would think she needs allot more insulin but in reality based on the 70 and the big swing in sugar she actually needed less

[Joan]

Re: Honey - Newly Diagnosed - Advice?

Welcome to you & Honey. Another pug!! I have 10, one current diabetic.

Yes Natalie is absolutely correct, 7 units is way too much for Honeys weight, this early on without testing. 5 may even be too much. FYI if your pug goes too low or drops bg too fast after the insulin shot, then she will compensate and raise her own blood glucose as a defense. So this is why we say that raising to 7 units from 5 without a complete picture of Honeys "curve" is inadvisable.

I think you should search for a new vet that IS up to speed on diabetes. The first few months are critical, and knowledge/experience is needed. You can do the curves yourself, and many will help you with advice on that here.

I had my diabetic pug in for surgery on Tuesday, vet checked him with his Alpahtrak meter (same as mine at home) every little bit, and charged me $20 each test. I am not complaining as recovery from anaesthesia for pugs is tricky, but so you can see the difference, I could do the test at home, same result for about 40 cents. The initial cost of the meter on amazon about $50.

[Monsters Momma]

Re: Honey - Newly Diagnosed - Advice?

Welcome to you and Honey!

You've been given some great advice already regarding insulin and testing. I'll echo their thoughts on testing at home...I have more than paid for my AlphaTrak2 just by testing at home instead of taking Vinny to the vet. Also, I feel better about the numbers because he gets so excited going to the vet, his numbers would definitely be skewed.

Can you tell us a bit more about Honey? We love to get to know our new members! What type of food, exercise, brother's and sister's...anything you want to share. One more question, if you don't feel your vet is up to the task of taking care of Honey, do you have other vets in the area, or specialists that deal with diabetes in dogs? If not, maybe some questions you can ask your own vet will help you gauge how well versed they are with diabetes. I found these http://www.defeatdiabetes.org/questi...pets-diabetes/ and I'm sure you can find others. You have to feel that you have a good team in place to help Honey and you need to have confidence in your vet.

Hang in there, all of this will become quite 'normal' in no time!
Mel and Vinny

[HoneyMae]

Re: Honey - Newly Diagnosed - Advice?

Yes from what you all have said the jump from 5 to 7 seems inappropriate! I will be looking for another vet well versed in treating diabetes, although I'm not sure where to start with that.

I've also started looking into the Alphtrack on Amazon. There are several reviews saying the readings can be as far as 100 points off and it's inaccurate. What has been your experience?

Honey is a brindle pug and she has two brothers, Jasper, a 12 year old black pug and Baby, a 17 year old Siamese cat. They all love each other! Honey is eating 1/4 can of Nutro Ultra Senior wet food mixed with 1/3 cup of the nutro ultra dry food, twice daily. We take her on 3 walks with Jasper every day, though it's somewhat slow going because poor Jasper is almost blind and it takes him awhile to get along now. She's a real sweetheart, but a little timid, other dogs scare the daylights out of her!

[lobosmom1]

When I received my alphatrak2 I made sure to calibrate it with the control solution / test strips , royal canin makes a prescriptive dog food specifically for diabetes , americandiabeteswholesale.com is where I ordered my meter from and they have excellent prices cheaper than I found on amazon as well as any veterinarians , also I save $20 a box on strips through them vs any other websites or vets offices ) , I called alpha track directly and they referred me to that website , also the technical support for alphatrak 2 is also great !
I had trouble getting the control solution sample to read, and the lady on the phone walked me through the entire process ! ❤️

[stylynjm]

Re: Honey - Newly Diagnosed - Advice?

Welcome,
It sounds like you are not testing yet. The Alphatrak2 is great and made for dogs. However, it is expensive, the strips are, and in the beginning you could use a lot of them!!! You can use a human meter, I use the relion confirm meter from Walmart. It and strips are much cheaper.They do read lower, but it gives you a good idea of range and highs and lows. So you get a guide of what pup is doing.
Regarding vets, just start checking around, call and ask questions. Also, an Internal Medicine Specialist can be of some help. I used one for awhile and still have her as a backup if I have a question... I found her not to be much more expensive than regular vet , and actually lower for some tests.

I found ADW to have the best prices...I also use them


The knowledge and experience on here is unsurpassed!!!!
Best of Luck, it takes time and lots and lots of patience