Remy Newly diagnosed Diabetes

[RemysMom]

First low glucose alarm in quite a while. They send my anxiety soaring! The past few days have been a totally different pattern. Just in case his cortisol has gone low again we will add that to the blood work, urinalysis, ultrasound that will be upcoming soon. Even though he has been off storyline since Feb 17 it could have gone low again if his adrenals aren’t functioning properly. I can live with the higher numbers but when he drops below 80 I get very nervous. Unfortunately I can’t check cortisol levels at home. Since low cortisol can be life threatening we do need to make sure that isn’t part of the problem. Then we can deal with the insulin again. We also don’t know how much the meloxicam is affecting the situation, or the cancer. It’s a lot to deal with. Keeping him comfortable is the most important thing.Hopefully no low glucose alarm tonight!

[jesse girl]

Yes that is a challenging situation but you appear up to for it and have done incredibly well with the task at hand .

Interesting for Jesse her sugar was stable all the way to her passing . A testament to how healthy her body was but of course her mind not so much .

Now a 80 maybe more like a 100 in reality but I understand why you use that as a low benchmark I was more at 60 for Jesse . I think she registered in the 30s which did not see any low sugar symptoms . Of course we did not have the technology you have so she may have had more low events .

Hard to say the direction things will go . Dogs have periods where they rally and things are good for a bit . People do also see this latter in life . It's the old adage we have some good days and not so good days .

[RemysMom]

Remy is nothing if not a challenge. But overall, he has done well despite everything. His doctors told me to use 80 as a ‘low’ for him because he is inconsistent. When he gets down to 80 or a bit lower we always test with the AlphaTrak to see where he actually is. Libre can be lower or higher. Usually it’s a little lower. When I am away from home I have the alarm set a bit higher to give us time to dash home if we need to get some food or sugar into him. I also have the treat throwing device for emergencies. Nothing like having three devices all screaming at me that Remy’s glucose is going low. LOL! I have no idea what has caused the change from almost zero response to insulin to this. The only change has been the meloxicam and I did read that sometimes NSAIDS can cause hypoglycemia. So for now I am backing off on his insulin a little bit and we will see if that keeps him in the safe range. I couldn’t do this without the Libre sensor! They aren’t perfect and sometimes it’s too much information but it has enabled us to keep Remy going without any clinical signs of hypoglycemia. Never a dull moment!!

[jesse girl]

Amazing what you have accomplished . The libre has been a asset to your bag of tricks . Me and Jesse had a few of them

[RemysMom]

You kept Jesse going for a long time and did an amazing job. It’s such a precious gift you gave her with years of love and care and devotion to her!

[labblab]

Hey Claire, just popping in to say that I’d be really surprised if Remy’s cortisol has started dropping again since you’ve not resumed the Vetoryl since his previous testing. However, it can never hurt to recheck it along with his other labwork. I’m guessing just a baseline cortisol would suffice in this situation, though, as opposed to needing a full ACTH. But, of course, whatever your vet thinks is best.

Marianne

[RemysMom]

Thanks Marianne. I don’t know why Remy’s cortisol would drop either without Vetoryl unless his adrenals have stopped functioning. I’m going to do a baseline along with his other bloodwork just to see where he’s at. It may well be the NSAID he’s taking for the cancer. Seems like the timing is about right.

[Riliey and Mo]

hey Claire how's Remy
are you dropping back more
good to update his weight next vet visit

[RemysMom]

His weight is still 14#. He’s been very consistent on his weight for the past several years. I weighed him this past week. I had dropped him to 5 U but now he’s going back into the old pattern where it isn’t lasting very long. He will have blood work/chem etc. this week and will do a baseline cortisol. This is pretty much how it always goes with him but with the cancer and some different meds I don’t want to change things too much all at once. He has never been regulated but he feels pretty good, looks good, stable weight, etc. He will be 15 in ten days. My main concern right now is if his bladder mass has changed and what effect the Meloxicam is having on his kidneys and liver. I am praying for at least everything is stable for the time being.

[Riliey and Mo]

thinking of you . did you get blood results back Claire?
heres a few charts to help you
thanks to Diabetic Dog Owners facebook group

[RemysMom]

Crazy busy week!! Cortisol 7.1, liver enzymes elevated, urinalysis great. Remy has been responding pretty well to insulin so we will stick to Vetsulin and continue the 5.5 twice a day. Had a couple of low glucose (down in the 60s) but overall he’s done well. A little more curve rather than the up and down and up and down stuff. Remy’s birthday is Tuesday. He will be 15 years old. After learning that the BRAF mutation test for bladder cancer is not as infallible as once thought (it DOES have false positives) and after another ultrasound that did not show any changes we decided to discontinue meloxicam for the time being. We will see his internist this week and have him evaluate and give his opinion. It’s possible the bladder mass is a polyp. His primary care felt this is a reasonable plan. We don’t want to do any harm by giving NSAID if he doesn’t need it and risk injury to his kidneys and liver. If there are no issues with urination etc. in one month we will repeat blood work, urinalysis and ultrasound and see where we’re at. The only definitive way to know for sure regarding the bladder mass would be a cystoscopy which he is too small for. Needle aspiration is risky. If the tumor is malignant it could result in seeding. We’re just happy he is doing well and seems to feel good. I hope and pray the tumor is benign but we’ll have to wait and see how it goes. I think since he’s off Vetoryl and his cortisol is fairly stable his glucose is responding better to the insulin. At least for the moment. Thanks for checking in with us! We are just thankful for each day with him and where he feels good!

[k9diabetes]

Aw.... popped in this evening and am happy to see so much good news!

[RemysMom]

For the moment he’s doing well and at his age that’s all we can ask for. I do think no longer being on Vetoryl and still having stable cortisol has helped with his diabetes. He was diagnosed with Cushings a year before the diabetes so he was on Vetoryl a long, long time. At least for now he doesn’t need it and we seem to have somewhat better glucose control now. He’s happy and we are so thankful to still have him with us and doing pretty well!! Thanks for checking on us!!