Lost control of glucose level

[CraigM]

Re: curve questions

Gomey is 22lbs and she is up to 6 units every 12 hours but we are trying not to go to 7 units. .

Why are you trying not to raise the dose? They need what they need.

Yes, every dog / situation is different, but just as an example my Annie (18 pounds) is basically on 9 unites of Novolin-N.

Craig

[Raysaint]

Re: curve questions

You shouldn't worry about increasing the insulin dose, as Craig said, they need what they need. My dog is 25 lbs. and he's up to 7.5 units of NPH and still not totally regulated, but we're close. 8 units will probably be next.
And if you change insulins, it may not work the same, so you'll be starting over.

[Gomeysmom]

Re: curve questions

We went to the vet today. Doc didn't want to raise the dose until we have seen the results (at 6 units) for a 1 week period. As of Saturday Gomey will go up to (7) units if numbers are remaining high. Doc had also been saying that (7) is on the higher side of dosage so wanted to be sure where "we were at" before telling me to just start adding... (We hadn't "synced" my glucose meter with the office test either) (Which my meter read 550 and they had 506..which I guess is "normal" for human readers vs. true office test)
"If" we increase the dose Saturday, I will do another home curve on Sunday. Then after a week she will go back to the office and we will see if we are getting close. I had thought vet (who has been calling me every few days to check in; SHE IS GREAT) was thinking about switching brands but after our (hour long..NICE!) visit today the vet would like to keep with Novilin N for now. She uses vetsulin as well but says there is also an insulin (Can't remember the name) that they used in vet school that she doesn't use often that lasts 24 hours. She says is it $$ and not ideal for every dog...I will follow her lead. She is hoping we can get Gomey's pain in check as that could be another reason she is not as interested in the food. Today she also prescribed amoxicillian for maybe a UTI (we have been saving money and not testing for everything (yet) and antibiotics can only help??) It would seem the last panel did not include pancreatitis and I may have that checked too depending.....it is all compounded at the moment but luckily I have an amazingly brave patient who is a real trooper! GO ME!!

[Raysaint]

Re: curve questions

Yes, it seems that minimum a week is necessary for any insulin dose change, to allow the dog's body to adjust and get true numbers. If you change the dose Saturday, a curve the next day won't have allowed the body to adjust. Or did you mean the following Sunday?

The 24 hour insulin may be Lantus, which I use. It has a flat potency to it, doesn't really have any peak or diminishing. It's generally used in humans in conjunction with fast acting insulin. The fast helps control the sugar spikes after meals, and the Lantus gives you some even potency in between. It's not the greatest for dealing with food spikes, as it has no peak or increased strength, so it would take a long time for it to bring down food spikes, which would keep your blood sugar higher for longer periods.

[Gomeysmom]

Re: curve questions

Thank you Riley's Mom...I will not do the curve on Sunday...i hadn't thought that it would be too soon! I will do some spot checks instead! Made my own version of Ruby's Stewbie and Gomey seemed to enjoy her first portion this evening! (it is not that different from the food I have always cooked for her this "stew" just includes the beans and spinach.) I look forward to a simple morning where the food gets eaten instead of stared at for a half an hour! Appreciate everyone's help and will post again as things improve..because they WILL!!

[Daisydog10]

Re: curve questions

Daisy loves Ruby's Stewbie, but she also eats worms and lizards so it's hard to tell. Frank tried some and he said it tastes pretty good.

[Mom of Bruno]

treats

Bruno is my 9YO Lab with diabetes. I have two other Labs. I have always given each of them a large Milk Bone before bedtime. Now the other two get the Milk Bone but Bruno gets a few pieces of dehydrated liver. I feel so sorry for him. It's like a human eating spinach as everyone around is eating pizza and donuts.
Is there anything out there I can get for B that is of similar texture and taste as a dog biscuit?

[Raysaint]

Re: treats

To my knowledge, most biscuit type treats are made from wheat or flour of some kind as the main ingredient, so that will be a carb intake and likely increase blood sugar. I have a bag of Royal Canin treats that are small and crunchy, and I give him one or two once in a while.

[jesse girl]

Re: treats

yes a dog biscuit is a carby treat . my jesse gets a small one everyday

technically yes it has the potential to raise sugar but for jesse it helps to stabilize her sugar with the added glucose to help with the punch of injected insulin as it appears to be strong action for jesse

now we have no idea how bruno reacts to it . some dogs spike after meat type treats which seems illogical maybe how they affect the bodies digestive system but who knows for sure

in the end the only way to know is to test blood sugar at home see if the treat works if it does you can continue if not you maybe able to give half or something else . but the key to this disease is consistency same time same amount everyday for just about everything including walks

[MomofGus]

Re: treats

I used to feel the same way since I have 3 dogs. I have found that the tiny mini-milkbone, which are 5 calories each, do not raise my Gus's sugar. One is okay, sometimes 2 is okay since they are small, but 3 will raise his sugar as much as 100 pts! You wont know how Bruno's sugar will react unless you give him one and test an hour later or so. Or, you could switch all your dogs treats to be what Bruno gets. In reality, it's the humans who have a problem. LOL, I have found that as long as everybody is getting something, they are happy.

[Raysaint]

Re: treats

Natures Variety makes 3 flavours of biscuit treats, and are free of wheat and flour. First ingredients are meat and vegetables mainly.

http://www.instinctpetfood.com/insti...reats-for-dogs

[amydunn19]

Re: treats

From a taste perspective, the liver is probably a more preferable treat. Depending on the type of liver, it might spike blood sugar. I only found one liver based treat that didn't spike her sugar. It is a fatty organ and kind of rich by comparison. Some dogs get upset stomachs on liver.

I don't think they care what the treat is as long as they all get one.

[Mom of Bruno]

Bruno is on three a day now

Bruno had been on two feedings of one and a half cups of kibble (Precise Holistic Lamb Meal, Turkey Meal with garbanzo beans)twice a day (5 AM and PM)followed by 21 units of insulin. He gets a 30 min walk at sunrise and sunset.His curve on June 1 (One touch) was:
5 338
7 278
9 169
11 334
2 416
5 398
At the vet office on Friday at 9 AM it was 124. But since it goes up rapidly after the first four hours, the vet suggested B may be metabolizing the insulin too fast. He suggested that we can try another insulin (I would have to start over plus a higher cost) or go to a three a day cycle.So I started feeding one cup followed by 17 units three times a day 8 hours apart (5, 1, and 9) I know he should be on this regimen for a while before drawing conclusions but here's what happened yesterday:
5 332 17 units after breakfast
7 145 30 min walk
9 213
11 272
1 275 i7 units after lunch
3 239
5 256
7 202 30 min walk
9 139 dinner

Since it was so low before his final meal, I was afraid to give insulin before bedtime in case it dropped too far while I was asleep.

Did I do the wrong thing by not giving insulin after dinner or should I have given a reduced amount? For some reason, It started down after 5 even before exercise.

Any suggestions?

[jesse girl]

Re: Bruno is on three a day now

the walk at 7 maybe a problem as with jesse insulin starts working at about 1.5 hours so that walk could be at a very active time at the 2 hour mark as you may have seen with the drop to 139

now from what i have seen with jesse she will spike up at a lower range and may drop at a higher range at fasting whether bruno would have done the same you just dont know that so responding to that lower number maybe appropriate in your situation with the information given . i would have done the same thing

to this day i reduce her dose at a lower level . the funny thing its not do to going lower but spiking higher as a higher dose at a lower level for jesse spikes her sugar so lowering it seems to help . the problem with that method it may change the overall pattern at another time in the day

a spike maybe necessary for the body to have some wiggle room to work with injected insulin

how your dog responds to a lower level is an important time to figure on how to move forward but its a bit scary . actually at higher levels it was easier with so much wiggle room

the 3 shots does look pretty good at first glance but its going to take a bit of time to know if this is something that will work for the long haul . my jesse gets 3 shots but its not spaced in thirds like you but 1 shot is split in 2 at dinner time

now the walk can be risky and you should keep that in mind especially with a big dog walking away from home so definitely take some liquid sugar and snacks with you . testing before walk and after can be helpful to see how Bruno does . jesse goes on 2 walks a day and it took some time to figure and adjust to where sugar was fairly stable during . in the beginning i had to give her a spoonful of honey before we went but not anymore as her body adjusted .

i walk jesse before her shot and when she gets home she gets her shot and meal

[amydunn19]

Re: Bruno is on three a day now

I would have probably given a reduced dosage if he ate well. The problem with giving no insulin and a full meal is that the blood sugar did probably spike. But, spiking is preferable to going low. You just have to be comfortable with the adjustments you make and the more you test and observe, you will know what adjustments were too much or not enough.

I would want to do overnight testing - the shot at 9 may or may not be a problem. I would worry about giving the shot so late. Maggie always used insulin differently overnight than during the day. Because there is no activity at night, you will just have to test to see how he is using this night dosage. I would want to know that he is not going too low because with you sleeping, it will be harder to wake up if he is in trouble. It is unusual to do three shots of NPH a day but we have seen dogs that do better on that schedule so it is not unheard of. It is very important to test a great deal and not draw too many conclusions too early. Just chart your numbers and be wary of lows. It is possible that any problems can be solved by tweaking your timing.

My question or I guess, suggestion (if three a day isn't working) would be why not use a combination of R type insulin and NPH? In Maggie's last couple of years, I would keep a vial of Novolin R which is fast acting and has a shorter duration, to mix with her two doses of Novolin N as needed. The advantage of R is that it can help knock the level down without staying in the system for 8 - 10 hours. Keep in mind that this could be an option for you before switching to another insulin. Some vets aren't comfortable using R and N but I think it is because they just don't have much experience using it and testing.