Relion/Walmart insulin and much more- HELP needed

[Charlie's mom]

Re: Relion/Walmart insulin and much more- HELP needed

Bahahaha😂🤣

[k9diabetes]

Re: Relion/Walmart insulin and much more- HELP needed

Hi Lauren!

As others have noted, Willie is nowhere near insulin resistant. He's currently on a small to normal dose for his weight.

Plus, since his urination and drinking have decreased and he's no longer having accidents, I'm sure his blood sugar is significantly lower than the 500s for large parts of the day.

He could be having quite large swings in his blood sugar - going from mid-500s to as low as 100s and then back up again. That kind of swing won't show in urine tests, which collect urine over hours and would read high from when the blood sugar was 400s and 500s even though the current blood sugar could be much much lower.

Consequently, as others noted, I would not raise his insulin dose until you get some blood sugar tests done during the day and evening at various times to see how LOW his blood sugar is going.

The insulin dose should always be based on the LOWEST blood sugar between injections. Precisely because there can be big differences between the highest and the lowest reading.

Let's say, just as an example, his blood sugar is 550 at breakfast and then falls to 100 at about noon (I have seen dogs have such large swings in blood sugar).

If, under that case, you increase the dose of insulin, you will drive down the 550 at breakfast but you will ALSO drive down the 100 at noon - potentially into hypoglycemia, which can be fatal.

So it's really important to find out what the lowest blood sugar is and base the insulin dose on that.

Then, if there are big swings in blood sugar, there are ways to flatten out the curve - such as when you feed and inject, snacks, different kind of food that better matches the action of the insulin.

So if you can get going on testing as soon as possible and keep him at 4 units twice a day for now, you want to work up to a serial blood sugar curve using your meter at home and taking readings at least every two hours starting with breakfast and going as late into the evening as you can.

Post the numbers and we will help you interpret them.

Natalie

Willie has been to the vet weekly for retesting with BGs of 500-600 consistently. Each time we raised his insulin dose some. He is now on 4 units/twice daily.
Last glucose at vet was yesterday morning = 567.

We're not seeing significant drinking/peeing, accidents in house have disappeared. No ketones in urine but tons of glucose in urine of course.

[Lauren]

Re: Relion/Walmart insulin and much more- HELP needed

I finally got the test results for Willie yesterday. His thyroid panel was normal and his low dose dex testing was hugely abnormal....but at least the (new) vet read all the stuff I printed out about insulin resistance and Cushings and believes as I do from the Dr Petersen post on Rex, that it is way too soon to talk about Cushings.
His glucose was I think nearly 500 as it has been for just over a month. That is from the testing that was done over a week ago...and his alk phos was almost normal!

Anyway his in-office glucose on their Alphatrak yesterday morning was 277!!
That is the lowest number we have seen yet.
And on 6 units/twice daily. (On my Relion meter it was 200.)

Also he has gained 1/2 pound and is now 17.5 lbs.

The vet wants me to put him on Science Diet w/d and reduce his insulin to 3 units/twice daily.
That would be cutting his insulin in half and I am pretty sure would mean a return to urine ketones.

So please respond at will.

Thanks so much

[MomofGus]

Re: Relion/Walmart insulin and much more- HELP needed

The change to w/d (which is the food my dog is on), may make the sugar levels level out, in that the w/d has more fiber and takes longer to digest. You won't know until you switch the food and test him to see his curve from the change. Lowering the insulin by 2 units seems a bit much, but that's just my opinion. If anything, I might try the food change and see what his levels look like in a curve after a couple days. If too low, then lower the insulin a unit or half unit, and be sure to test throughout the day to see the effects - too high or too low of sugar. When changing the insulin amount, they say to allow a week to 10 days for the body to settle into the new dose.

Again, just my opinion. I'm sure others will chime in. My dog was in the 400-500 range for months and took 9 months to get him where he's at now. We were lucky to not have ketones.

[Lauren]

Re: Relion/Walmart insulin and much more- HELP needed

The change to w/d (which is the food my dog is on), may make the sugar levels level out, in that the w/d has more fiber and takes longer to digest. You won't know until you switch the food and test him to see his curve from the change. Lowering the insulin by 2 units seems a bit much, but that's just my opinion. If anything, I might try the food change and see what his levels look like in a curve after a couple days. If too low, then lower the insulin a unit or half unit, and be sure to test throughout the day to see the effects - too high or too low of sugar. When changing the insulin amount, they say to allow a week to 10 days for the body to settle into the new dose.

Again, just my opinion. I'm sure others will chime in. My dog was in the 400-500 range for months and took 9 months to get him where he's at now. We were lucky to not have ketones.

Willie has ketones so we are going back up in insulin. It is very difficult for me to pay such an outrageous amount of money for a dogfood with wheat and corn as the first ingredients.
I am still considering ordering it.

My single largest concern at the beginning of this adventure was whether or not Willie had insulin resistance via hypothyroidism or Cushings.
Now that I have those two questions answered I am just dealing with diabetes...

I would love to read more about your "diabetes adventure" with your dog.

I have a 19 yo blind chi who has been insulin dependent for 6-7 months and a son age 26 who was insulin dependent at age 2.

Thank you for your opinion.

[Lauren]

Re: Relion/Walmart insulin and much more- HELP needed

Hi Lauren!

As others have noted, Willie is nowhere near insulin resistant. He's currently on a small to normal dose for his weight.

Plus, since his urination and drinking have decreased and he's no longer having accidents, I'm sure his blood sugar is significantly lower than the 500s for large parts of the day.

He could be having quite large swings in his blood sugar - going from mid-500s to as low as 100s and then back up again. That kind of swing won't show in urine tests, which collect urine over hours and would read high from when the blood sugar was 400s and 500s even though the current blood sugar could be much much lower.

Consequently, as others noted, I would not raise his insulin dose until you get some blood sugar tests done during the day and evening at various times to see how LOW his blood sugar is going.

The insulin dose should always be based on the LOWEST blood sugar between injections. Precisely because there can be big differences between the highest and the lowest reading.

Let's say, just as an example, his blood sugar is 550 at breakfast and then falls to 100 at about noon (I have seen dogs have such large swings in blood sugar).

If, under that case, you increase the dose of insulin, you will drive down the 550 at breakfast but you will ALSO drive down the 100 at noon - potentially into hypoglycemia, which can be fatal.

So it's really important to find out what the lowest blood sugar is and base the insulin dose on that.

Then, if there are big swings in blood sugar, there are ways to flatten out the curve - such as when you feed and inject, snacks, different kind of food that better matches the action of the insulin.

So if you can get going on testing as soon as possible and keep him at 4 units twice a day for now, you want to work up to a serial blood sugar curve using your meter at home and taking readings at least every two hours starting with breakfast and going as late into the evening as you can.

Post the numbers and we will help you interpret them.

Natalie

His urine testing all day long has been extremely consistent. The 500 -600 glucoses were taken 3-6 hours post prandial.
And all over the map, a very few were after breakfast.
It didn't really matter when he was tested. He was always over 500.

That was why the thyroid panel and low dose dex testing were done and sent downstate. That was why the first vet labeled him with insulin resistance.

Cut your dog back to 1 unit twice daily and I bet you, too, can have this kind of fun experience.
We don't even get out of urine ketones until he is at 4 units twice daily. That is the dose the first vet told us was over the top for a 17 lb dog.

[MomofGus]

Re: Relion/Walmart insulin and much more- HELP needed

Hi,Lauren. Getting the ketones under control is critical and most important. As for the insulin amount. A dog is not totally considered insulin resistant until the insulin amount per injection equals 1 unit per pound. 17 lb dog - 17 units. My schnauzer is 20.3# and his regulation did not start until we reached 19 units. And, that was at the 9 month mark of his diagnosis, and increasing his dose every 3-4 weeks and doing home curves and know his response. For those first 9 months, his sugar levels were in the 400-500 range most of the time. I was thrilled to get any reading below 400 on a regular basis. At 19 units, he just started responding his levels stay within the normal <200 range. If you want to ready more, search for the "Gus the minischnauzer" thread. We were fortunate to only have trace ketones in the beginning and got those cleared up. We have been at this level of insulin since July.

As for the ingredients in the w/d food, several owners immediately do not like the ingredients listed. However, the food is formulated for the diabetic dog and those ingredients do help to achieve the regulation in providing the fiber, lowfat content, and carb amount needed. You can find several discussions here with agreements and disagreements. For my dog, it works. He eats a combination of canned & dry of the w/d. I even count out the number of dry kibbles for each meal.