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-   -   Cataract surgery? Romeo update (http://k9diabetes.com/forum/showthread.php?t=8130)

DebEsco 05-10-2019 10:53 AM

Help for Romeo
Romeo, my toy poodle, was diagnosed diabetic on Feb 1. We have been through a lot. In the beginning, he was put on Humulin N which did not control his diabetes well. He would reach nadir about 2 or 3 hours after the shot, shoot up high immediately after. Vet raised the dose, the nadir got lower but highs remained the same but we started having hypoglycemic issues. Vet changed him to Vetsulin. Still very high most of day. Increased the dose, again hypoglycemic issues about once or twice a week low 50s. His blood curve looked like two very steep mountains and a deep valley inbetween. I took him to an internist who was one and a half hours away, told me he was on too high a dose and to back down from 2 units to 1.5 every 12 hours.

He is still having highs in the 450ish area. As you can see below from the results of his latest blood curve (I do it once a week every two hours) he is still getting to a nadir about 2 or 3 hours after the dose, and then creeping back up so he's spending a lot of the day in high 300s or 400s, sometimes up to 500s. His eyes have definitely worsened over the past three weeks so I have an appointment with an ophthalmologist week after next. He is losing weight (about 3/4 pound off his little 8 pound body, I can feel his ribs). He has thirst and peeing issues in the mornings. Internist told me to try to get him to eat more (he's on a high protein low carb food by Natures Balance), I try everything but he won't increase the amount of food he eats. He will eat snacks so I try to give him freeze dried meats so that it does not affect his sugar.

I don't know what to do. I'm making an appointment with a second internist but would like to go in with as much knowledge as possible. My gut tells me he is metabolizing the insulin too quickly but I can't guess what the fix for that would be. Was hoping someone here would have a clue? This is all very overwhelming and stressful. Thanks. Deb

6:45 AM 466 1.5 Units at 7:15 AM (after eating)
8:45 AM 308
11 AM 205
1 PM 328
2:45 PM 466
4:45 PM 518
6:45 PM 517 1.5 Units at 7:10 PM (after eating)
8:45 PM 344
10:45 PM 242

MikeMurphy 05-11-2019 03:48 AM

Re: Help for Romeo
Hi and welcome to the forum to you and Romeo.

The internist was right in reducing his insulin dose. A conservative starting dose for an 8lb dog would be 1.5 units every 12 hours. So now you are at a safe dose. Regulating tiny dogís like Romeo can be tricky because of how their body reacts to even very small changes in insulin.

From our experience here, high protein, low carb diets are usually not the best for diabetic dogs. Because they are type 1 diabetics, they do better on moderate protein, low fat diets. They need carbs and fiber to help balance the absorption of insulin. When my Lily was first diagnosed with diabetes, I had her on a high protein diet and it was causing big swings in BG. Switching to moderate protein, low fat diet helped smooth things out.

Raysaint 05-11-2019 05:09 AM

Re: Help for Romeo
I agree, the food may be part of the problem. More carbohydrate content may help. Low carb is usually not best for diabetics, human or dog. Without carbs, the insulin uses all the blood sugar up quickly, sugar goes low, then the liver can start releasing sugar to balance and protect the body.

The Humulin may not have been the problem. Itís a common insulin. The Vetsulin has a faster acting component, which may cause the early nadir and then allow the bigger climb.
If you change food, see how the insulin does but know that you may change back to the nph. Youíll have to give it some time.
And with more carbs, dosage will probably increase but your curves will determine that.

jesse girl 05-11-2019 07:14 AM

Re: Help for Romeo
This curve is pretty consistent from am to pm which is good because its nice to be predictable

As the others have said food can play a big part to stability . You are seeing a big drop early which maybe cause the big rise when it bottoms out . So that big drop has to be slowed down and flatten the curve

Its possible raising the dose in this situation may have made the body out of whack combating to much insulin and may take time to settle

Also the hunger and struggling to gain weight maybe another medical condition outside of diabetes like thyroid problem and something worth looking into

The other possibility is even 1.5 units maybe to much . My jesse ended up on less than a normal starting dose for her

You have to look at whats problematic within a curve ( hopefully consistent ) and figure on how to solve that which for your dog is that big drop in the first few hours after insulin

The other good thing insulin is working maybe to good early and would like to see that drop slowed down and flatten

DebEsco 05-11-2019 07:29 AM

Re: Help for Romeo
Thanks for the clue about the food. I had a problem with finding a good diabetic friendly food for him. Doc wanted him on Hills w/d. I quickly found out that just about all the diabetic formulas had chicken in them. He is violently allergic and gets diarrhea from chicken. Which is why I turned to the Natural Balance High Protein. Maybe it would be better to go back to his regular Natural balance food? He was always on the L.I.D. for his allergies, sweet potato and bison, grain free.

Nutrition info: Sweet Potatoes, Bison, Potato Protein, Pea Protein, Canola Oil (Preserved with Mixed Tocopherols), Dicalcium Phosphate, Natural Flavor, Salmon Oil (Preserved with Mixed Tocopherols), Potato Fiber, Salt, Calcium Carbonate, Flaxseed, DL-Methionine, Minerals (Zinc Amino Acid Chelate, Zinc Sulfate, Ferrous Sulfate, Iron Amino Acid Chelate, Copper Sulfate, Copper Amino Acid Chelate, Sodium Selenite, Manganese Sulfate, Manganese Amino Acid Chelate, Calcium Iodate), Vitamins (Vitamin E Supplement, Niacin, d-Calcium Pantothenate, Vitamin A Supplement, Riboflavin Supplement, Thiamine Mononitrate, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Vitamin D3 Supplement, Folic Acid), Choline Chloride, Taurine, Citric Acid (preservative), Mixed Tocopherols (preservative), Rosemary Extract.

Caloric Content
3460 kcal/kg, 375 kcal/cup

MikeMurphy 05-11-2019 01:02 PM

Re: Help for Romeo
His old food has about 22% protein and 11% fat on a dry matter basis, so that wood be good. Iíd go back to that and see what happens.

If you do go back to the Natural Balance L.I.D., donít change insulin for a week. In the meantime, You could spot check at fasting and around his nadir as the days go by.


DebEsco 05-13-2019 06:31 AM

Re: Help for Romeo
I thought I had posted last night but evidently did not save it. Iím giving him half his old L.I.D. dog food (sweet potato and bison) and half high protein food to ease him back into the old food. I already see the nadir is not hitting in two hours like it has been, though havenít really figured out when it is hitting. I know one day isnít enough to tell anything so will stay the course this week and see how it goes. Yesterday he was still in high 400s low 500 afternoon and evening. We shall see. But thank you so much for the support. Iím exasperated to say the least. One positive: he does seem more playful and energetic, which means to me he is feeling better. Thanks to you! Really ticked off that none of the two vets and vet internist could have given me a clue about the high protein food. I showed all of them the bag, nary a word. Losing weight? Just feed him more...but he wonít eat ďmore,Ē and obviously more of the same was not what he needed at all.

jesse girl 05-13-2019 07:28 AM

Re: Help for Romeo
force feeding more food for weight gain usually never works for newly diabetic dogs . Blood sugar needs to be under control to be able for the body to process food to metabolize it into the body . Other problems is you could trigger pancreatitis which can be a complication and a cause of the disease and life threatening

My jesse was thin for sometime before she got to a normal weight . As long as she was maintaining and not loosing we stuck with the plan with slowly working the process . Most cases there is no quick results with this disease . It takes patience and discipline

Most find a path for there dogs to live happy , healthy dogs lives with some limitations

DebEsco 05-14-2019 06:24 AM

Re: Help for Romeo
Hi, Found our yesterday Romeo has a bladder infection. Vet thinks that could explain the 500s. Itís a vicious cycle. High sugar causes infection, infection causes higher sugar. Sheís culturing it to make sure heís on the right antibiotic but started him on clavamax. How much are bladder infections going to be a thing now? Never had a dog with this before. He was peeing in the house and drinking a lot over the last couple weeks but I attributed it to the diabetes. Aaarrrggghhh

jesse girl 05-14-2019 07:37 AM

Re: Help for Romeo
Infection will pop up from time to time for many diabetic dogs and does have a big impact on blood sugar from what we have seen on the forum

Actually in humans its not unusual to see this for non diabetics but maybe with a compromised immune system

If you test sugar at home and your dog is regulated higher sugar can point to a problem as what you maybe seeing here with higher sugar for your dog

some have given a form of cranberry supplement for UTIs and said it helped

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