Up date on Sugar

[Sugar]

I and thanks for the add...I have a 10 year old Maltese that was diagnosed with sugar 2 weeks ago...started with 3 of the pet insulin..went back high...uped it to 4...went back still high...uped it to 5....was suppose to go back today but my mom had surgery and I couldn't remember if I done 4 or 5 so now have to wait till Monday..if not down they are going to keep her and do blood curves...this was a total shock for us...we are doing all we can but I feel we are making a mess of it all...I was so glad to find you all on here...I feel like sitting down and having a good long cry...at least I have people who is going through the same thing....I was wondering if I should try and check this myself but can't find a dog meter and have read human meters don't give good readings...I hope how soon we get this regulated and try to get back to some normal..I have so much going on anyway I feel so overwhelmed...well they ever get her sugar regulated????...thanks

[k9diabetes]

Re: New to all this

Hi and welcome to you!

I would definitely try to learn to home test her blood sugar. Blood glucose curves are the best way to get a handle on how she's doing with her food and insulin - and depending on how much she weighs, 5 units given twice a day could be a rather large dose.

Single readings don't tell you much. While the blood sugar might have been 400 when tested at a particular time at the vet, it could have been much much higher or much much lower at other times of the day.

Testing at home is also great because the test is done in her normal environment. Our dog's blood sugar always tended to lower at the vet than at home.

So for the animal meter, there is the AlphaTrak, which you can order online. I also have one, I think, that I could sell you for less than the cost of a new one.

If you'd like, instead, to use a human meter, I always recommend starting with one of the OneTouch Ultras. They have the best track record used on dogs for readings that are pretty close to actual.

And all meters are really an estimate. Even the one for pets uses an algorithm to calculate blood sugar from the sample. So human meters work well as long as you use one that's good with dogs. We used a OneTouch Ultra the entire time our dog was diabetic.

Dogs are all unique in how they process food and insulin and don't necessarily do what the book says! So though the average low blood sugar time is about 6 hours after injection, it can actually be pretty much any time - within an hour or two or very late in the 12-hour cycle. That's why single blood sugar tests don't tell you much.

Please take some time to read through the main website - www.k9diabetes.com - if you haven't already. There is a lot of general information about diabetes in dogs plus videos and picture tutorials demonstrating obtaining a blood sample from various places in dogs at www.k9diabetes.com//bgtestvideos.html.

The site talks about insulin, meters, testing, goals...

You are giving insulin twice a day I hope.

If not, she should be switched to two injections a day 12 hours apart and the dose reduced from the once-a-day level.

[Sugar]

Re: New to all this

Thanks..for answering my post...I will call the vet in the morning to make sure he want 5 for the shot..yes it is twice a day..she is 11 lbs...

[k9diabetes]

Re: New to all this

That’s very likely too high a dose and should not be given so soon after diagnosis. A curve is critical as soon as possibly blue to see what’s happening with the blood sugar throughout the day.

[Sugar]

Re: New to all this

The vet has been testing each dosage every 3 days..he said if this didn't help Monday he was going to keep her on Tuesday..I will call today to make sure what dosage ..to do till Monday but I am sure it will be 5 to check..he has tried 3, 4, still high

[amydunn19]

Re: New to all this

Curves are essential to regulating blood sugar. One reading won’t tell much.

You can save yourself some money and stress by checking sugar at a home. We can help you if you are interested.

[Raysaint]

Re: New to all this

If the vet is trying 3 then 4 then 5 or whatever, that's not going to correct the high sugar right away. Dogs need a week for the body to adjust to. Start with a low dose, wait a week, then increase it a half unit, then do another curve in a week, repeat.

One thing you need is patience. It'll take weeks and months to regulate the blood sugar. It's not like human diabetes, in terms of bringing sugar into a good range.

If your vet is looking to get good blood sugar right away by increasing every day, that's dangerous because it doesn't work like that. The higher doses will probably make the dog go hypoglycemic and rebound.
Your dog is 11 lbs. so he should start at about 2.5 units of NPH, twice a day, right after eating.

Regulating your dog is a very methodical process. I hope your vet has some experience.

[Sugar]

Re: New to all this

Curves are essential to regulating blood sugar. One reading won’t tell much.

You can save yourself some money and stress by checking sugar at a home. We can help you if you are interested.

Yes I am very interested..even when he does the curves I still want to check at home..thanks so much

[Sugar]

Re: New to all this

If the vet is trying 3 then 4 then 5 or whatever, that's not going to correct the high sugar right away. Dogs need a week for the body to adjust to. Start with a low dose, wait a week, then increase it a half unit, then do another curve in a week, repeat.

One thing you need is patience. It'll take weeks and months to regulate the blood sugar. It's not like human diabetes, in terms of bringing sugar into a good range.

If your vet is looking to get good blood sugar right away by increasing every day, that's dangerous because it doesn't work like that. The higher doses will probably make the dog go hypoglycemic and rebound.
Your dog is 11 lbs. so he should start at about 2.5 units of NPH, twice a day, right after eating.

Regulating your dog is a very methodical process. I hope your vet has some experience.

The vet we go to is suppose to be one of the best..people come from different states to see them....has been in business for along time

[Sugar]

Re: New to all this

If the vet is trying 3 then 4 then 5 or whatever, that's not going to correct the high sugar right away. Dogs need a week for the body to adjust to. Start with a low dose, wait a week, then increase it a half unit, then do another curve in a week, repeat.

One thing you need is patience. It'll take weeks and months to regulate the blood sugar. It's not like human diabetes, in terms of bringing sugar into a good range.

If your vet is looking to get good blood sugar right away by increasing every day, that's dangerous because it doesn't work like that. The higher doses will probably make the dog go hypoglycemic and rebound.
Your dog is 11 lbs. so he should start at about 2.5 units of NPH, twice a day, right after eating.

Regulating your dog is a very methodical process. I hope your vet has some experience.

I am afraid not to do what the vet says for now because this is very new to us...I will take all the advice I can..thanks

[jesse girl]

Re: New to all this

the problem with this disease is the philosophy on how to treat is kind of all over the place

the only true way to reduce risk for an individual dog is to test blood sugar at home especially during the regulation process

i ran into problems with jesses original vet on treating and it did not work out for jesse but another dog i know they treated did great . it just shows how individualistic it can be

[k9diabetes]

Re: New to all this

This forum exists basically because so many veterinarians do not have great skills with diabetes.

When our dog was diagnosed way back in 2003, we took him to the man who literally wrote the book on canine diabetes - he's the co-author of the Canine and Feline Endocrinology used to teach veterinary students and guide veterinarians!... and he did a terrible job with our dog.

We eventually regulated him ourselves.

So here's my concerns...

The recommended starting dose is about 1/4 of a unit per pound, and I personally prefer a starting dose that's a bit more conservative at 1/5 of a unit per pound because some dogs need a lot less insulin than others.

That dose should be allowed to "settle in" for at least five days and more like a week before any change in the dose is made. And the change in the dose should be based on a curve - not on a single blood sugar reading or on a fructosamine test.

Because dogs are all unique and they have their highest and lowest blood sugars at various times. If the vet tests when the blood sugar is highest, s/he may not realize that the blood sugar is much much lower at other parts of the day and can overdose the insulin.

And it takes the body a while to adjust to having insulin again so a dose that's too low this week can be too high next week. While unregulated, their bodies become somewhat resistant to the effects of the insulin and it takes having insulin for a while to break that resistance.

Very few dogs require half a unit per pound. I would say the average dose is around 1/4 unit per pound, which for your dog is 2-3 units. And it's just too soon to tell whether your dog needs more than that.

So... first, I encourage you to learn to test your dog's blood sugar at home.

That way, you can do curves as needed to get a complete picture of how the insulin is working on her blood sugar.

Unfortunately, the reality is that your dog will need to be her advocate.

I personally would not be comfortable giving more than 3 units per injection until a full blood glucose curve is done.

And it should be done after she's been on no more than 3 units per injection for at least five days.

Then post the results of the curve and we can help you interpret it.

I will provide some links to material for you to use when talking to your vet. You have every right to raise concerns about how high the insulin dose is and the lack of a curve to determine when the blood sugar is lowest and highest.

Natalie





Two weeks in, the dose should NOT have been raised multiple times.

[k9diabetes]

Re: New to all this

Are you using NPH (N) or Vetsulin insulin?

[k9diabetes]

Re: New to all this

Per the makers of Vetsulin,
"In dogs, the initial recommended Vetsulin dose is 0.5 IU insulin/kg of body weight. . . once a day and reduced by 25% for twice a day dosing."
[http://www.vetsulin.com/vet/DosingOverview.aspx]

At 11 pounds, your dog weighs 5 kilograms so the starting dose would be at most 2.5 units, preferably 2.0 units since given twice a day.

Per the Merck Veterinary Manual,
"Most dogs require two doses of insulin a day. In general, NPH or lente is the initial insulin of choice at a dose of 0.5 U/kg, bid (twice a day). . . . Clinical signs and serial blood glucose determinations are used to monitor therapy after initial stabilization at home for 5–7 days."
[http://www.merckvetmanual.com/endocr...abetes&alt=sh]

Again, from the Vetsulin site,
"The glucose curve is an ideal tool for differentiating the problem of short duration of insulin activity versus Somogyi effect. It helps to determine insulin effectiveness, and the maximum and minimum levels of glycemia, which should ideally be between 100–250 mg/dL (5.6–13.9 mmol/L) for the majority of the day."
[http://www.vetsulin.com/vet/Monitoring_About.aspx]

Please see the main site for this and additional information and stories.
www.k9diabetes.com

[bichons9]

Re: New to all this

K-9, Mike, Amy, Raysaint, Jesse girl and all...May I pick your brain due to your abundance of expert knowledge? Is there a point at which you decide to beak protocol and increase the insulin during a trial as with Suzie? We are following your (and Mike's) instructions for the most part but wonder how long is it okay in general and/or for kidneys to overwork to pump out glucose if BG remains at a constant high.,i.e. over 3-400 with no low nadirs. I see consistency and no significant ups/downs today but what if the BG is always high? I suspect that you anticipate that the BG will slowly decline over the next few days???