BG Curve help

[ScottW]

Re: BG Curve help

Thanks Mike.
I did read that article that Natalie wrote, and its excellent.

If you look at the very bottom of Natalie's article you'll see a BG curve. That is how our dog's curve looks. The article does not specific how to fix that curve. She writes:

"In this curve, the blood sugar falls sharply because there is more action from the insulin in the first three hours after the injection is given. The food isn't keeping up with the insulin. And then the insulin runs out (because it was used up so quickly) and the blood sugar goes high again.

The food isn't keeping up with the insulin. Does this mean the food is taking too long to enter the bloodstream? What is the cure? Does she need a longer lasting insulin, or more often injections? Does she need less food?

The above article you referred to was what started me asking these questions. That graph is almost identical to our dogs, yet I don't know what the solution is. I did read the 'case study' Natalie refers to, however I ended up with more questions after reading.

I think we may need to increase to 3 shots per day, or possibly switch to a longer lasting insulin. Does anyone know what insulin would be considered longer lasting than Canininsulin / (Vetsulin)?

Thanks again

[jesse girl]

Re: BG Curve help

the problem that many make with this disease including me is assumptions

we dont know if those big spikes in blood sugar are exclusively related to food and or insulin running out

from what i have seem with jesse and her unique routine only getting one meal a day i have seen the lack of foods intervention with insulin and show the stored bodies blood sugar relation to insulin

i always found it quite strange that members would say the exclusively meat based protein spiked sugar quite quickly . as we know this type of food doesnt digested that quickly and show up in blood sugar

I notice the spike occurred with jesses no meal cycle with no influence of food early after insulin as it would appear with a spike after food . so the only explanation i come up with is this is the bodies response using its own stored sugar

so why is the body doing this well what i have seen with jesse is her fasting number is important . the lower her fasting the bigger the spike after insulin .the higher the sugar the lower the spike and sometimes no spike depending how high she was at fasting

Now realizing this is probably not exclusively food related i could try some things to prevent or diminish this bodies response especially at the lower range which she could spike as much as 200 points in a couple hours . So my thought was to actually give her a quick boost of sugar through food to hopefully curb the bodies response to the lower levels . tried many different types and ended up with a type of milk bone . now this was done with the cycle without the meal and i targeted the snack at a time when insulin was most active and it worked and sugar was leveled out better and more stable

over time i decided to just give the snack with insulin , not as ideal as targeted but i felt that had some inherent risk where for some reason we may forget to give her that snack later in the day when she needed it

another factor is jesse appears to only accept a certain amount of insulin at one time and thats about 3 units . this is with her only evening meal but she needs more than 3 units with that meal so what i ended up is splitting that dose , 3 at meal and 3, 2 hours later . now i adjust that dose depending on her level at fasting because 3 units is still to much if she tested at a 100

It a very fine balance with her and sometimes she will spike no matter what i do and sometimes we will see an unexpected drops . It may sound quite complicated but the routine is consistent and repeatable for what the fasting number is

This is my own opinion and what i have seen with jesse and convinced with my own hypothesis which has appeared to have some success where before we struggled . Many others have there own opinion and science still doesnt completely understand the process which is quite understandable as mike explained with replacing such a complex natural process where sugar and insulin works on the bodies demand for it and with injected insulin its more time released something quite different from the natural process

[MikeMurphy]

Re: BG Curve help

It's hard to say what the final answer is to her insulin not lasting long enough, but I wouldn't give up on Caninsulin/Vetsulin just yet. There are several things that you can try, one at a time, before switching foods or going to a longer duration insulin like Levemir.

There is plenty of room to up her insulin in .5 unit increments and then evaluate with a curve after 5-7 days. Make sure she is getting the recommended amount of food for her weight. Like you said earlier, and what jesse girl suggested, you might want to introduce a snack or two while the insulin is still active.

Also... Caninsulin/Vetsulin has a fast acting component to it that's supposed to compensate for a rise in BG shortly after eating. It sounds like your girl's BG does not rise after eating.

I'm sure others will chime in with their thoughts.

Mike

[ScottW]

Re: BG Curve help

We tried giving Georgie a treat and measured her BG level for any effect.
Her BG level was really high before her next injection. Today we measured her at 11 hours after her injection and she was 724. We gave her a treat 4 hours after her meal and injection this morning. We just gave her a little bit of her dry diabetic food.
2 days ago we gave her some diabetic food about 5 hours after injection and meal, and she tested off the Alphatrak chart (over 750)

So I don't think adding a treat is helping, unless I'm timing in incorrectly.

We are waiting for our vet to get back with advice.

thanks again to all of you for your help

[AugtheDog]

Re: BG Curve help

We tried giving Georgie a treat and measured her BG level for any effect.
Her BG level was really high before her next injection. Today we measured her at 11 hours after her injection and she was 724. We gave her a treat 4 hours after her meal and injection this morning. We just gave her a little bit of her dry diabetic food.
2 days ago we gave her some diabetic food about 5 hours after injection and meal, and she tested off the Alphatrak chart (over 750)

So I don't think adding a treat is helping, unless I'm timing in incorrectly.

We are waiting for our vet to get back with advice.

thanks again to all of you for your help

Scott-

How long has Georgie been on the diabetic food now? I was trying to find if you made a dose adjustment up or down when you started the food?
Since we started the diabetic food Auggie is very symptomatic with sugars in the 400s. But we also thought his dose was causing the symogyi effect so we made some adjustments down. I am also waiting to hear from our vet for advice. I will check back.

[jesse girl]

Re: BG Curve help

all you can do is try something be patient give it a bit of time and if it doesnt work move onto something else

the problem with this disease we cant test for where sugar is coming from . is there other medical conditions causing the instability

It was quite brutal to get jesse to a better place it took vast amounts of attention and testing to come up with a plan that worked for her but its not perfect but much improved from those early days

what it taught me there are options if the one size program doesnt fit jesse and she has a bag of tricks if things get wonky and for jesse they will its just the nature of the disease for her

the key is to follow the protocols doing curves . looking for what is problematic in them and addressing those problems with possible solutions . If you see sustained resistance across the board in a curve it may point to a dose adjustment upward

now if you have seen better regulation on a dose and that appears to have ended there may have been a honeymoon period of still producing some of there own insulin . Its doubtful that dogs just wake up one day and do not produce insulin . more than likely its a process and your pup could be seeing this . another factor is a medical condition . infection is always on the list of for resistance

Its a process and sometimes very frustrating. With higher numbers testing for ketones is prudent and that maybe a reason to be more proactive with dosing and getting sugar down

[ScottW]

Re: BG Curve help

Georgie has been on diabetic food for about 1 month now.
Our vet called today, suggested we up her 1/2 unit to 5 units twice daily. There doesn't seem to be a somogyi effect as her nadir doesn't get too low (just under 200 with 4.5 units)

We are going to try 5 units twice daily and then do another curve in a week or so. I will be sure to spot test her with 5 units as she did get down to as low as 60 when she was in the vet's office for her curve - however she was on raw food at the time and her curve has changed dramatically since switching her to raw.

[jesse girl]

Re: BG Curve help

that would be expected with a change in diet to a diabetic prescription food that the dose would be more

Its maybe difficult to even use the previous curves with the raw diet to judge any future dosing or comparing

[cotrone2005]

Re: BG Curve help

Georgie has been on diabetic food for about 1 month now.
Our vet called today, suggested we up her 1/2 unit to 5 units twice daily. There doesn't seem to be a somogyi effect as her nadir doesn't get too low (just under 200 with 4.5 units)

We are going to try 5 units twice daily and then do another curve in a week or so. I will be sure to spot test her with 5 units as she did get down to as low as 60 when she was in the vet's office for her curve - however she was on raw food at the time and her curve has changed dramatically since switching her to raw.

Have you found good results from raw? Are you administering Curve yourselves?

[ScottW]

Re: BG Curve help

We stopped feeding her raw. From what I know now, I think her body was breaking down the food down to quickly. I'm not an expert, but with raw food her nadir (lowest Blood glucose level) of the day would be 4 hours after injection. She wouldn't stay there long, and before you know it her sugar levels were rising rapidly.

Controne2005: Since switching to dry diabetic she takes longer to reach her nadir, and stays there longer. She starts rising rapidly still, however this occurs later in the day, closer to her next injection time. I'm not knocking raw food. I think its great for dogs, just not so much for diabetic dogs. As Jessegirl explained, the insulin regimen is really set up with diabetic dog food in mind. The raw food doesn't supply enough fiber, or complex carbs. My advice would be to do a curve with raw, and if you notice the nadir comes on too early, switch to diabetic food. The diabetic food immediately raised her nadir also, which allowed us to give more insulin and bring down her highs.

We do our own curves at home. Some time just spot checking, other times full curves. Once you do a few curves and ensure everything remains exactly the same (time and size of feeding, time and dosage of insulin) you get to know when the key times to test are.

Just an update:
We upped her to 5 units last night and this morning. We did a quick BG test 5 hours post injection/meal, and she was 287. I did another test 6 hours post injection, she is a 90! Perfect! I'll test a few more times today since it is the first time she's getting 5 units.

[AugtheDog]

Re: BG Curve help

We stopped feeding her raw. From what I know now, I think her body was breaking down the food down to quickly. I'm not an expert, but with raw food her nadir (lowest Blood glucose level) of the day would be 4 hours after injection. She wouldn't stay there long, and before you know it her sugar levels were rising rapidly.

Controne2005: Since switching to dry diabetic she takes longer to reach her nadir, and stays there longer. She starts rising rapidly still, however this occurs later in the day, closer to her next injection time. I'm not knocking raw food. I think its great for dogs, just not so much for diabetic dogs. As Jessegirl explained, the insulin regimen is really set up with diabetic dog food in mind. The raw food doesn't supply enough fiber, or complex carbs. My advice would be to do a curve with raw, and if you notice the nadir comes on too early, switch to diabetic food. The diabetic food immediately raised her nadir also, which allowed us to give more insulin and bring down her highs.

We do our own curves at home. Some time just spot checking, other times full curves. Once you do a few curves and ensure everything remains exactly the same (time and size of feeding, time and dosage of insulin) you get to know when the key times to test are.

Just an update:
We upped her to 5 units last night and this morning. We did a quick BG test 5 hours post injection/meal, and she was 287. I did another test 6 hours post injection, she is a 90! Perfect! I'll test a few more times today since it is the first time she's getting 5 units.

That's great. Glad your having success on 5. We switched Auggie to the Hills w/d and immediately started getting numbers within normal range. It's encouraging to get some good glucose readings!

[Auddog]

Hi Scott,
Sorry I've been offline for a couple days. Too bad the treats idea didn't work out, but that's how it goes sometimes. It's hard to tell how an individual dog's body will react to changes, so all we can do is try it out and see what happens.
Congratulations on the success your seeing with 5 units! I hope things continue to go well!
Good job!! Keep it up!!