problem with home testing

[tomswife29]

Hi, i am new here. i just found out last week my 10 year old 25 lb poodle terrier Tali has diabetes. she was DKA and had to be hospitilized for two nights. We have had her home for a few days, and she is a lot better than before (I had never seen her so sick before in my life before we brought her in). she is still a bit lethargic (its also 105 degrees here in cali), and she's refuses to eat her prescription w/d canned diet. i saw some posts that said the prescription diet isnt necessary, and was wondering what should i feed her? right now im giving her boiled chicken breast. my vet put her on one dose/day of 7 units of humulin nph, an antibiotic (amoxi) for a week, and half a tab of pepcid twice a day.she also told us we dont need to home test her, which i read in posts that we should home test her...i really dont know much about diabetes and am trying to learn everything so quickly i feel so overwhelmed and worried i dont want to do the wrong thing. if someone could offer me advice especially on what to feed her i would really appreciate it. i never completly trust the vets because ive had animals a long time and been through nearly everything so i know its always best to get advice from other pet owners experiencing the same things.

[BestBuddy]

Re: New here, PLEASE HELP!

Hi and welcome.

Nearly every dog needs two injections of insulin a day 12 hours apart with a meal. As for food most are feeding different things. You need to get something that works with your dog and the insulin and of course something they will eat.

BG testing is a valuable tool to help regulate and keep an eye on things at home so it may be something you can look at doing soon. Urine testing with ketodiastix will be some help especially to check for ketones.

It is all a bit overwhelming in the beginning but it does get much easier as time goes on.

Jenny

[Patty]

Re: New here, PLEASE HELP!

Hi and welcome to you! I do understand the feeling of being overwhelmed in the beginning. It's a steep learning curve, but just take it one step at a time.

First, I'd work on getting her to eat. We have dogs that are on all kinds of diets here. Lower fat (as diabetic dogs are more prone to pancreatitis) and higher fiber seem to match best. You could add a little bit of grated parmesan cheese to entice her, very small pieces of boiled chicken, or a small bit of low fat cottage cheese. Other owners have found Blue Buffalo healthy weight dog food to match insulin fairly well. What was she eating prior to diagnosis?

High blood sugar can contribute to a dog not wanting to eat as well. It's a vicious cycle. They feel crummy from high blood sugar and don't want to eat so they can't get their full dose of insulin which continues the cycle of higher blood sugar.

Next, I would talk to your vet about starting her on 2 shots a day. Meals and injections should be 12 hours apart. Often starting doses are around 1/4 unit per pound of dog twice a day. I've only heard of 2 dogs that were able to be managed on 1 shot a day thus far.

Has your vet told you how much insulin you can safely give if your dog doesn't eat to meet the body's basal needs?

Antibiotics can also raise blood sugar in some dogs, just to be aware of while she's on it. Do you know why she's on the antibiotic?

I would definitely look into home testing. It has been piece of mind for us and has literally saved my dog's life before. It's also less stressful for the dog to have curves done at home rather than at the vet's office. I'm a fan of the OneTouch Ultra meters. You can find some tips in the free meter thread here: http://www.k9diabetes.com/forum/showthread.php?t=1195

There's also a page of videos demonstrating various places you can test your dog here http://www.k9diabetes.com/bgtestvideos.html.

In the meantime, you might pick up some KetoDiastix at your local pharmacy (they can order them for you and have them in the next day often if they don't typically stock them). This will allow you to test how much glucose is spilling into the urine and whether or not your dog has ketones if she's running high.

I know it's a lot of information, but feel free to ask any questions. There are a lot of people here that can help. Welcome to you and Tali!
Patty

[CarolW]

Re: New here, PLEASE HELP!

I'm so glad you found this forum, and I agree that often, people who have companion animals can be helpful when our vets might lack some confidence, perhaps in our abilities to learn, or maybe even in how much dedication we have to keeping our companions happy and comfortable! (Sometimes the vets are right about a kind of missing dedication, but you'll find here, the members are very dedicated - and also, very helpful to each other! - always under the excellent guidance of the site-owner, Natalie, and the moderators, Patty and Peggy - I thank these people and the other members to the bottom of my heart!)

First, I suggest, as Patty mentioned, work on what Tali will eat that would be suitable. You'd want restricted fat, and something fairly high in fiber. That Blue Buffalo Healthy Weight food seems to suit an awful lot of diabetic dogs, so if it were me, I'd probably start with that. When changing food, you need to do it gradually, mixing a bit of the new in with the old, taking about a week of increasing amounts of the new, till the dog has adjusted. Dog tummies are quite sensitive to change.

It's easiest to work with diabetes if you feed your dog twice a day, 12 hours apart, and give insulin 15 to 30 minutes after the meal. Also, if you feed the same thing, same amounts, at each meal - yes; day after day! Dogs tend not to get bored with the same foods, as humans would, so once you find what Tali will eat well, you should have things coming well under control.

As Patty suggested, I'd talk to your vet about giving two injections of insulin daily, rather than one. There was a recommendation on a web site of a major insulin manufacturer that people be asked to give one injection a day rather than two, and the implication was, because it might be hard for a human to learn to give injections, and two a day might be too overwhelming.

But - really, almost all dogs need two injections a day, and once we learn how, two is very manageable; after all, we're there to FEED the dog twice a day, too!

How are you doing with the injections? Is that coming along all right?

Does Tali weigh 25 pounds now? I'm just thinking about what the insulin dose might be if you go to two injections per day. Typically, a dog's body has to learn to use the insulin, and the principle is, to start with a low dose, and go slowly, just to make sure we don't drive the glucose levels down too far, to the point of hypoglycemia (too-low glucose levels).

Typically, the insulin dose gets raised gradually, say, once a week or once every two weeks, till the right dose for the dog is found.

And the dose is determined by measuring glucose levels in the bloodstream. I guess your vet is expecting to do this testing, and that's fine, and the vet is right that it's not necessary for you to learn. However, it's just great for your dog if you do learn how to do it yourself, for two reasons.

First, it's easier on the dog to have you do it at home than have to go to the vet's office and be there all day so the vet can test every couple of hours. But best of all, if you learn, you can run your own curves (tests every couple of hours, to check the varying glucose levels through the day), and ALSO, you can do spot checks at any time, if you're not sure just what is going on, and you think some kind of adjustment might be needed.

I think most people find it takes a bit of guts to begin learning to test, but once they get that first useful blood sample and a reading, they're on their way! And that's how it worked for us, too.

Please ask any question that occurs to you, any time, and somebody will surely jump in to give you a helping hand.

All the best to you and Tali! And please report back, so we know how you and Tali are doing!

Sun, 18 Jul 2010 17:03:39 (PDT)

[peggy0]

Re: New here, PLEASE HELP!

Hi and welcome! you've gotten alot of good advise> I'd just like to add that heat can affect blood glucose. Most find that it lowers their level. i know your vet said you don't have to monitor but its really peace of mind for you. It does seem overwhelming at first, but the more you learn, the more comfortable you will be. We are all here to help you and you can ask as many questions as often as you'd like. We have people from all over the world here, and so typically there is always someone on line to help.

[claire81]

Re: New here, PLEASE HELP!

Hi and welcome

I'm a couple of months into living with a dog with diabeties, and i'm still learning. It never ends, but as long as they can be normalised and their quality of life isn't affected, it's very very manageable.

I agree with the others, food is important. I learned that altering the diet the vet gave us by removing half a cup of the dry perscription food and adding fresh chicken and stick instead brought her levels down a couple of points. It's much safer, in my opinion, to make small changes to food than to make changes to insulin doses.

We're here for you... I hope you find the support you need here.

[tomswife29]

Re: New here, PLEASE HELP!

is the blue buffalo dry food only? she ate mostly wet food before, and dry science diet. shes pretty picky with her food and im worried she wont like anything prescription. what foods are okay for her to eat for today until i get the blue buffalo? is the boiled chicken okay or should she not have too much?

[CraigM]

Re: New here, PLEASE HELP!

Hi, and welcome from Annie and me,

It's imperative that she eats if you give insulin. For now any food that she'll eat will do. NO FOOD = NO INSULIN (Ok, there are exceptions, but this is still a pretty good rule) If she will eat what you had been feeding that will be fine.

I agree with the others that insulin 2X / day is really the norm. Annie is currently 18 pounds and is getting 6iu of Novolin-N which is pretty much the same as Humulin-N, so the 7iu you are planning is probably OK to start.

Got to go, dinner (mine) is on the table, but will come back and see how you are doing.

Remember to breath!

[BestBuddy]

Re: New here, PLEASE HELP!

There are a lot of great foods out there but they are only good if you can get your dog to eat them.

Science Diet is something a lot would not feed but it was what I used with Buddy for over 6 years. It was something he would eat and it was easy to get. I used the Science Diet Light not because Buddy was overweight but because it had lower fat. I used this for about 4 years and then changed to the Science Diet Mature for the last two years. I did try other things but he either would not eat them or they didn't seem to match the insulin so I stuck with it.

Buddy ate mostly wet with just a little dry.

Jenny

[tomswife29]

Re: New here, PLEASE HELP!

im also confused as to how much i should be feeding her. she is about 25 lbs and the vet said to give her 2 cans of the wet wd a day. since she wont touch it, we are giving her boiled chicken breast and were going to try adding veggies to it tonight. i dont know how much i am supposed to feed her though...

[CraigM]

Re: New here, PLEASE HELP!

Do you think she might eat her can food if you mix in some of the chicken pieces, or a little caned tuna fish (type that is packed in water, not oil)?

[Jaye]

Re: New here, PLEASE HELP!

I never thought it would be possible to home-test my dog. I do it with my diabetic cat several times a day but Robbie, my dog, is a "worrier" and screams as if you're killing him at the merest provocation.

We were forced, because of his weird levels, to do a 24 hour blood glucose curve and opted to do it at home (ended up being more of a 36 hour one...we're still in it).

I was SHOCKED at how easily he accepted it! Really shocked... We opted for the inside of the lip (where he usually would never let me touch him). I kept very calm and matter of fact, stroked his face a few times, turned the lip over and did it. Then, because we're comparing meters, often did it again (if I didn't get enough blood for two the first time). My vet reminded me that, even in humans, the inside of the mouth is a relatively quick healing part of the body, so I don't feel guilty about it at all.

My vet is thrilled because she says that it's giving her so much more information to help manage the disease and make him feel better which, after all, is what we all want. I'm feeling more confident...there's not that nagging worry that he's too high or low. I no longer plan on using the urine test strips.

I encourage giving testing a try. I'm still shaking my head that we did it successfully.

[tomswife29]

Re: New here, PLEASE HELP!

ive tried both, she'll only eat the chicken and maybe a thimble size of the wet food. we gave her tuna and she didnt eat it. since i know she'll eat the chicken im going with that for now. someone informed me of what they are feeding their dog who weighs about the same as mine so im going to try that for now and hope she likes it. :-)

[peggy0]

Re: New here, PLEASE HELP!

a 25 pound dog should be eating about 700 calories a day. That would be alot of chicken. You might try adding some rice or sweet potato or oatmeal to it to get some more calories in her. Yes Blue buffalo comes in canned as well as dry and my dogs love it. They have a smaller can for small breeds. its chicken and brown rice with veggies. Its 207 calories a can. You might try it and see if she likes it. The can is pink Hope this helps.

[k9diabetes]

Re: New here, PLEASE HELP!

Hi, i am new here. i just found out last week my 10 year old 25 lb poodle terrier Tali has diabetes. she was DKA and had to be hospitilized for two nights. We have had her home for a few days, and she is a lot better than before (I had never seen her so sick before in my life before we brought her in). she is still a bit lethargic (its also 105 degrees here in cali), and she's refuses to eat her prescription w/d canned diet. i saw some posts that said the prescription diet isnt necessary, and was wondering what should i feed her? right now im giving her boiled chicken breast. my vet put her on one dose/day of 7 units of humulin nph, an antibiotic (amoxi) for a week, and half a tab of pepcid twice a day.she also told us we dont need to home test her, which i read in posts that we should home test her...i really dont know much about diabetes and am trying to learn everything so quickly i feel so overwhelmed and worried i dont want to do the wrong thing. if someone could offer me advice especially on what to feed her i would really appreciate it. i never completly trust the vets because ive had animals a long time and been through nearly everything so i know its always best to get advice from other pet owners experiencing the same things.

Did you happen to measure her food before she had diabetes?

If not, even if you have a rough idea of how much she ate, you can try to feed her about the same number of calories. And then a little more or a little less if she needs to gain or lose weight.

Pretty much all of the food manufacturers provide calorie information on their websites. And you can look up the number of calories in people food. A calorie is identified as Kcal on many of the dog food websites.

She will almost certainly need two shots a day and I'm hoping the vet started her on one just to get you used to it and plans to increase to 2 injections a day shortly.

You do not have to test but I suspect that you will like having it as a tool. Knowledge is power and knowing what the blood sugar is instead of trying to guess is a very powerful tool indeed. If you wind up choosing to change diets, it will also help you determine how the new food and her insulin are working.

Is the vet willing to work with you on things like diet and number of injections?

These first few weeks are the worst part. You will eventually get settled into a routine and won't have to think about it much.

Is the vet having you continue to test her urine for ketones?

Especially with only one shot a day, I'd want to watch for ketones and also just see whether her blood sugar is going very high in the evening.

I'm also a little concerned about the size of the insulin dose. Vets sometimes try to "stretch" the duration of the insulin by giving a lot of it but insulin doesn't really work that way. It gets absorbed when it gets absorbed. So 7 units at once could be sending the blood sugar quite low in the first 6 hours or so.

Another reason home testing would be very helpful.

Natalie