Annie & Craig - Getting too smart!

[CraigM]

Re: Annie - Getting too smart!

Looks like I'll back off the NPH about ˝iu to 8iu with the BB Healthy Weight.

4PM = 102
6PM = 63, gave a small snack and will see at 8PM feeding

So, the BB Healthy Weight looks to require less NPH than the Royal Canin Diabetic Formula. The Royal Canin has much more fiber (a good thing), so I'm thinking about mixing the two.

8PM = 413

So I either gave too much of a snack at 6PM (large rounded tablespoon of canned dog food), or there is that "rebound" thing (maybe both). For the heck of it I mixed equal parts of BB Healthy Weight and Royal Canin for dinner, and reduced the NPH by ˝iu. I have to be up at 3:30AM, so will test at 4AM.

[Noodle]

Re: Annie - Getting too smart!

I think those numbers strongly suggest rebound. If you see numbers in the 60's again, you want to treat those with a fast acting carb, like syrup, to stop the drop. Then you follow that up with a snack so that she has some more carbs kicking in by the time the immediate sugar from the syrup starts to wear off. The food you gave her has to have some time to metabolize, so she more than likely continued to drop after that 63 reading.

With Noodle, I usually use bread for the snack. It metabolizes faster than his food or biscuits. I generally give 1/2 to 1 full slice, but he weights 51lbs. Annie so tiny, probably a quarter slice would have an impact.

After giving the quick sugar and a carby snack, it's a good idea to test more frequently until you see the drop start to reverse. That way, if you test half an hour later and she is still sitting at 63 (or perhaps even lower) you know she needs more syrup and/or carbs to stabilize the BG.

I think lowering the insulin dose is a very good idea at this point. Looks like Annie might be another one around here who gets excellent results with the BB. You're going to want to step up the frequency of her BG testing during this food transition - she may need her insulin reduced even further.

With food changes, I think most of us go a lot slower with the switch - starting with 25% of the new food with 75% of the old food, waiting a few days, then moving on to a 50/50 mix. In Noodle's case, he has digestive issues if I don't go really slow. But it also gives you a peek into how the insulin may react to the new food addition.

Let us know how Annie is doing.

[CraigM]

Re: Annie - Getting too smart!

I just can't leave things alone! I think someone mentioned giving cranberry powder as a supplement to possibly prevent UTIs. Went to a local grocery and didn't find cranberry powder, but found dried cranberry in bulk sales. I bought several scoops. I did a little googling last night and discovered there is both sweetened and unsweetened dry cranberry. Wasn't sure what I bought, but feared it was the sweetened type.

Gave her 6 little cranberries mixed with her breakfast this morning. How bad could that be? PRETTY BAD

Fasting = 200 fed and added the 6 pieces of cranberry and normal injection
+4 hours = 340
+7 hours = 402
+10 hours = 323
+12 hours = 193 fasting, fed FOOD ONLY, NO CRANBERRIES, normal injection

Looks like I bought sweetened dry cranberries. At least I can put a few in my breakfast cereal! No more for Annie.

[Chase14]

Re: Annie - Getting too smart!

Hi CraigM,
Sorry to hear Annie had a rough day, Chase had high numbers too today. I got the testing down, now I need to learn what to do when they have those high numbers, I felt so helpless as I saw the numbers increase more and more! I am determined to learn, I am prayerful Chase will be regulated soon.

[Patty]

Re: Annie - Getting too smart!

Looks like I bought sweetened dry cranberries. At least I can put a few in my breakfast cereal! No more for Annie.

LOL, hope your cereal tastes good Craig . Glad you were tracking the effects of the dried cranberries.

I do use cranberry powder with Ali. This is the one I use in the 2.5oz jar: http://www.smartpakequine.com/Produc...eCategory=true
and can often find coupons for free shipping here: http://www.retailmenot.com/view/smartpakequine.com

It's not cheap but was worth it for us after the 3 month UTI battle we had early on. I use this and D-Mannose powder together.

I did stick my finger in the powder once to taste it and it is definitely NOT sweet, but Ali seems to like it mixed in her food.

Patty

[CraigM]

Re: Annie - Getting too smart!

Just wondering if anyone uses home UTI test strips, such as AZO Test Strips:
http://www.azoproducts.com/products/azo_test_strips

[Patty]

Re: Annie - Getting too smart!

Craig,
I know the nitrites and the leukocytes on the multisticks aren't always reliable. Those are the 2 things this strip tests for.

Others have had better experiences with the urine strips than I have though so I'll let them weigh in.
Patty

[CraigM]

Re: Annie - Getting too smart!

We would like some thoughts on Annie's curve. This is pretty typical.

8AM BG 123 Fed & 6.5 units of Novolin N
10AM BG 275
12N BG 440
2PM BG 450
4PM BG 387
6PM BG 285
8PM BG 164 Fed & 7.0 units

8AM BG 137 Fed & 7.0 units
11AM BG 276

You can see there is a post meal spike that takes several hours to peak, and then a slow decline. She acts normal: no excessive drinking or urination.

She has been on mixed Blue Buffalo Weight Control (2 oz) and a very small amount of Royal Canin Diabetic (.5 oz) twice per day. The reason for the Royal Canin is that I have a full 16 pound bag that I don't want to throw away (cheapskate)

Her eye drops are:
diclofenac sodium ophthalmic
ofloxacin
dorzolamide
tacrolimus ointment

also mixed with her food:
1200mg fish oil
"cranberry relief" powder, per label

Had her checked for any UTIs - negative

I'm probably going to take her back to her Vet for an in house curve just to verify my curves and validate my meter.

QUESTION: I'm thinking about adding a bit of Regular (Novolin-R) to knock down the post meal spike. Any thoughts?

[peggy0]

Re: Annie - Getting too smart!

Hi Craig,

when do you give her the eye drops?

Just an fyi:

Diabetes mellitus—Ofloxacin may cause changes in blood sugar, which could lead to problems in controlling blood sugar

[CraigM]

Re: Annie - Getting too smart!

Hi Craig,

when do you give her the eye drops?

Just an fyi:

Diabetes mellitus—Ofloxacin may cause changes in blood sugar, which could lead to problems in controlling blood sugar

Usually give the drops one to two hours after meals. That could be the cause. I thought the eye vet told me none of these would bother her, but that's why I listed them here for comments.

Who in the group uses both "R" and "N"? I still wonder if that would make things better? Of course with my luck as soon as I figured out the correct dose the eye vet will change the drops!

I'll talk with Annie's regular vet, as well as eye vet about this.

[Patty]

Re: Annie - Getting too smart!

Craig,
You could always replace some of the dry food calories with a protein like Margaret and Peggy did using cottage cheese to lower the food spike.

If you decide to try the R, you'd want to back off on the N at the same time and start in small increments. Natalie might be able to give you some more guidance on that.

Patty

[k9diabetes]

Re: Annie - Getting too smart!

That's quite a mountain curve!

I'd work on determining the effect of the eye drops first.

Because your major food spike is quite a bit later in the day than a post-prandial sort of spike, which makes me think the drops could be part of it.

If you move the eye drop time and still have essentially this same mountain curve...

Replacing some of the NPH with Regular probably would help flatten things out. Regular generally lasts about 6-7 hours. Chris got it every 6 hours. You would replace some of the NPH with Regular, starting with a very small amount to see how her blood sugar responds.

Some dogs are very sensitive to faster acting insulin and put it to work very quickly, causing a sudden almost immediate drop in blood sugar. So you would need to supervise her closely when starting this.

So maybe just 1.0 units of Regular at first and I might even reduce the overall dose. 1.0 of R and 4.5 or 5.5 of NPH, which you can mix into one syringe.

Video on how to mix: http://www.youtube.com/watch?v=gizYDn2_0Io

I would tend to try Regular first rather than Humalog/Novolog, which are shorter duration and even faster acting as a 6 hour duration seems like it would work well with this curve.

Natalie

[CraigM]

Re: Annie - Getting too smart!

Thanks everyone. Here's my plan. Instead of giving the Ofloxacin drops around 10AM as I have, I'll give it before bed time for a few days (she gets it once per day).

Of course I could just run a night time curve, but I REALLY need my beauty sleep and we try to get to bed around 10PM.

Todays numbers were a little better after increasing the 8AM injection to 7.0 units:

8AM BG 137 fed & 7.0 units
11AM BG 276
2PM BG 248
4PM BG 186
6PM BG 156
8PM BG 130 fed & 7.0 units

[CraigM]

Re: Annie - Getting too smart!

I just came up with another thought / question. Getting eye drops is not one of Annie's favorite times. I usually hold her on my lap, and my wife applies the drops. Annie is suppose to get one drop of each of her solutions, but there have been times when two, or even three, drops sneak into the eye. We never made note of which drop, but I now can see where this could be critical if it was the Ofloxacin. It is possible to "over dose" on eye drops?

[peggy0]

Re: Annie - Getting too smart!

much better!!!