I'm New and need guidance

[Pappy's Mom]

Hello. I have a 12 yr old Coton. 18 lbs. Diagnosed April16, 2021. Started on 3 units Vetsulin twice daily, but quickly switched to Novolin N. He is up to 10.5 units now of Novolin N which seems like a lot to me for an 18 lb dog. I have been careful to go slowly always running a curve before increasing no more than .5 units at a time. It seems every time we increase he seems to do better for just a few days and then ends up back where we were. His morning and evening fastings run between about 250 to 350. Mornings are the lowest. But his mid day numbers are almost always high - upper 300's to low 400's. For instance, this morning at 7:00 am he was 268 which made me happy, but by 11:00 he was 455. He will usually gradually come down over the afternoon. Maybe to 350 or so by 2:30 and then finally down to around 300 by evening fasting. Honestly his morning and evening fastings are not much different now than they were when we were on 7 units. He eats 100 grams of Royal Canin GI lowfat canned food plus 37 grams of NB Venison and Sweet Potato and a few green beans twice daily. I've actually been wondering if we should go back to Vetsulin because it has the fast acting component to it. It just seems like his food gets out ahead of the insulin and then the insulin never quite catches up. I give the insulin within 10 minutes after eating.
Any and all suggestions would be welcome. Thank you

[Riliey and Mo]

Re: I'm New and need guidance

hi and welcome

first clue is what your last sentence said

"food gets ahead of the insulin" and waiting 10 minutes to inject insulin.

first thing to try is inject right after food inject after hes over 200. the insulin should meet up better with the food.

secondly might just need a food change. looks like your feeding two different kinds.

select one only and feed the manufactures recommended amount according to his weight 18 lbs .

test frequently watch for the blood sugar drop. if it does drop low reduce insulin by 1. keep testing

[jesse girl]

Re: I'm New and need guidance

Yes that is a higher dose than normal but some dogs need more insulin

Now it is possible the dose could be to much as you said levels are better for a brief period after doing a dose adjustment higher and then levels go back to where they were . Another factor is your at similar levels at 7 units . Which to me you are showing some resistence to insulin. . Now what would cause that ? Maybe diet with to much protein and not balanced with carbs could be problematic . There could be an underlying illness like a thyroid problem . Aonter theory I have is a dogs body struggles in accepting injected insulin . I could only give my Jesse a certain amount of insulin and it was lower than normal and any more than that would drive her higher after a few days after a dose adjustment higher

I understand you were methodical and conservative with dose adjustment but even than you can go past a dose that was needed as there can be some resistence to injected insulin early in the diagnosis pushing you to raise the dose .

How low have you tested blood sugar ? The levels your dog is at is not terrible and many dogs have done just fine at those levels as long as you are not seeing diabetic symptoms . You also may want to get a thyroid test to rule that out

[Pappy's Mom]

Re: I'm New and need guidance

Yes that is a higher dose than normal but some dogs need more insulin

Now it is possible the dose could be to much as you said levels are better for a brief period after doing a dose adjustment higher and then levels go back to where they were . Another factor is your at similar levels at 7 units . Which to me you are showing some resistence to insulin. . Now what would cause that ? Maybe diet with to much protein and not balanced with carbs could be problematic . There could be an underlying illness like a thyroid problem . Aonter theory I have is a dogs body struggles in accepting injected insulin . I could only give my Jesse a certain amount of insulin and it was lower than normal and any more than that would drive her higher after a few days after a dose adjustment higher

I understand you were methodical and conservative with dose adjustment but even than you can go past a dose that was needed as there can be some resistence to injected insulin early in the diagnosis pushing you to raise the dose .

How low have you tested blood sugar ? The levels your dog is at is not terrible and many dogs have done just fine at those levels as long as you are not seeing diabetic symptoms . You also may want to get a thyroid test to rule that out

Thank you so much for your reply. Its very frustrating when there are so many different factors that could be contributing. I don't know what to do first. He has an appointment a week from Friday for blood work and check up. I will ask her about checking his thyroid. I don't think his food has excessive protein but I don't know. Is there a food expert on this forum who could advise me about that? I have just had this feeling for a long time that we are spinning our wheels. One factor right now though is his allergies have kicked up and that could be the reason for this recent increase.
When you say many dogs do fine at this level - you mean even if he goes above 400 for a few hours every afternoon before coming down to around 300 at evening fasting - that is not unreasonable. I check for ketones and he is always negative there. He has good energy for his walks everyday but beyond that he mostly sleeps during the day. Of course he is 12 1/2. Oh and the lowest reading i have had is 199 and that was once. I have had a few in the low 200s but more in upper 200s in the mornings and low 300s at night with the 400s mid day. I have been testing him since April.

[Pappy's Mom]

Re: I'm New and need guidance

hi and welcome

first clue is what your last sentence said

"food gets ahead of the insulin" and waiting 10 minutes to inject insulin.

first thing to try is inject right after food inject after hes over 200. the insulin should meet up better with the food.

secondly might just need a food change. looks like your feeding two different kinds.

select one only and feed the manufactures recommended amount according to his weight 18 lbs .

test frequently watch for the blood sugar drop. if it does drop low reduce insulin by 1. keep testing

Thank you so much for your reply. I have even considered giving his shot just before I feed him. He always eats his dry food and if he gives me trouble with the canned I just force feed it and then he starts eating. So I'm not really worried that I would give the shot and then he wouldn't eat.

[Riliey and Mo]

Re: I'm New and need guidance

its really dangerous to inject 10 units before eating. if he gets sick and vomits you cant hand feed him.

i.m just saying maybe too much food. worth a check.

test before feeding then test half hour after food. if the bg rises then theres usually too much food. looking like a bowel in a glucose curve

[Pappy's Mom]

Re: I'm New and need guidance

its really dangerous to inject 10 units before eating. if he gets sick and vomits you cant hand feed him.

i.m just saying maybe too much food. worth a check.

test before feeding then test half hour after food. if the bg rises then theres usually too much food. looking like a bowel in a glucose curve

So do you mean test then feed and don't inject until after i test again? Meani g wait 30 minutes after food to inject. I can pretty much guarantee he will be higher. He is always hibher after food even WITH the insulin.

[jesse girl]

Re: I'm New and need guidance

The food seems decent that you are feeding and probably is not a problem. unless the allergies are tied to it . Allergies may have an affect more so on the medication taken as steriods can elevate sugar and can be a cause for k9 diabetes . Apoquel worked for a member and did not affect blood sugar control

Yes those levels seem to be fine for dogs that I have seen on the forum . The thing with dogs is there life spans are allot shorter than humans and moderately elevated blood sugar is usually not a problem and energy levels are good and thats very positive

It appears you have some resistance and it can be challanging figuring what that is

[Pappy's Mom]

Re: I'm New and need guidance

The food seems decent that you are feeding and probably is not a problem. unless the allergies are tied to it . Allergies may have an affect more so on the medication taken as steriods can elevate sugar and can be a cause for k9 diabetes . Apoquel worked for a member and did not affect blood sugar control

Yes those levels seem to be fine for dogs that I have seen on the forum . The thing with dogs is there life spans are allot shorter than humans and moderately elevated blood sugar is usually not a problem and energy levels are good and thats very positive

It appears you have some resistance and it can be challanging figuring what that is

His allergies are environmental. I think my biggest concern is his eyes. He already has cataracts and i was afeaid the higher readings would cause them to get worse faster.

[Riliey and Mo]

Re: I'm New and need guidance

you know for sure his blood sugar goes higher after feeding

too much food and different foods could be the problem so the blood sugar isnt consistent not regulated.

the one thing i see is giving just one brand of dog food and feed according to 18 lbs on their feed chart.

when you change the food test for the drop in blood sugar and reduce the insulin

[jesse girl]

Re: I'm New and need guidance

Cataracts are fairly common in diabetic dogs

You can throw the kitchen sink at it which is what i did some 11 years ago . I was Jesses pancreas . I was getting maybe 4 hours sleep doing mostly reactionary tools to control sugar until I could figure something that would be less obtrusive It had risk to it

I did figure out what would work just feeding her one meal a day which is still considered well out in left field but worked very well for her

[Riliey and Mo]

Re: I'm New and need guidance

another alternative which alot of people do is get a food weigh tray at walmart or coscos. start cooking home made meals. theres a food calculator online. put in his ideal weightt, weigh each individual ingredient. heres a calculator fyi.

https://www.dognutrition.com/dog-food-calculator/

[k9diabetes]

Re: I'm New and need guidance

Have you done some curves to get a detailed, hour by hour view of his BG?

"Mountain" curves are fairly common. And there are ways to flatten them out by varying the diet and the timing of the insulin injection.

Mountain curves suggest the food is being digested rather slowly. Replacing some of it with something carby and quickly digestible can help by providing blood sugar early on when the insulin is starting to work and less sugar later in the day.

10 units for 18 pounds is pretty normal. I'd say the average dose is 0.25 to 0.50 units per pound and you're just about 0.50. I've seen some terriers who weighed 20-25 pounds and needed 21-23 units of insulin. No idea why - they just needed more than average. They lived long healthy happy lives with good regulation.

Dogs aren't considered insulin resistant until they are getting 1.0 units per pound and still have high blood sugar (too high, 300s, 400s).

Allergies tend to raise blood sugar and thus require relatively larger doses of insulin. They can also create a fair amount of variability in blood sugar because they have such a direct effect on it.

When you think about it, it's amazing how much regulation we manage to achieve with a couple of insulin injections and meals a day. The blood sugar regulation system is affected by just about everything - food content, digestion, absorption of insulin, allergies, inflammation, exercise, even temperature. Fortunately, dogs don't have to have perfect blood sugar to live long healthy happy lives. They are much more tolerant of high blood sugar than humans.

Natalie

Hello. I have a 12 yr old Coton. 18 lbs. Diagnosed April16, 2021. Started on 3 units Vetsulin twice daily, but quickly switched to Novolin N. He is up to 10.5 units now of Novolin N which seems like a lot to me for an 18 lb dog. I have been careful to go slowly always running a curve before increasing no more than .5 units at a time. It seems every time we increase he seems to do better for just a few days and then ends up back where we were. His morning and evening fastings run between about 250 to 350. Mornings are the lowest. But his mid day numbers are almost always high - upper 300's to low 400's. For instance, this morning at 7:00 am he was 268 which made me happy, but by 11:00 he was 455. He will usually gradually come down over the afternoon. Maybe to 350 or so by 2:30 and then finally down to around 300 by evening fasting. Honestly his morning and evening fastings are not much different now than they were when we were on 7 units. He eats 100 grams of Royal Canin GI lowfat canned food plus 37 grams of NB Venison and Sweet Potato and a few green beans twice daily. I've actually been wondering if we should go back to Vetsulin because it has the fast acting component to it. It just seems like his food gets out ahead of the insulin and then the insulin never quite catches up. I give the insulin within 10 minutes after eating.
Any and all suggestions would be welcome. Thank you